Sample records for cranial irradiation pci

  1. Prophylactic cranial irradiation in limited disease small-cell lung cancer in complete remission : a retrospective analysis

    NARCIS (Netherlands)

    van der Linden, YM; van Kempen, ML; van der Tweel, [No Value; Vanderschueren, RGJRA; Schlosser, JJ; Lammers, JWJ; Struikmans, H


    Recently a meta-analysis showed an improved survival probability of prophylactic cranial irradiation (PCI) in limited disease small-cell lung cancer (LD SCLC) in complete remission after chemotherapy. We evaluated treatment results of PCI+ and PCI- in these patients. Whether PCI (n = 65) or no PCI (

  2. Should patients with extrapulmonary small-cell carcinoma receive prophylactic cranial irradiation?

    LENUS (Irish Health Repository)

    Naidoo, Jarushka


    Extrapulmonary small-cell carcinoma (EPSCC) is a rare disease. Management is based on small-cell lung carcinoma. Prophylactic cranial irradiation (PCI) is not routinely administered in EPSCC. This study investigates the role of PCI in EPSCC, by analyzing the incidence, treatment, and survival of patients with brain metastases in a national cohort. Disease biology and epidemiology are also investigated.

  3. Patient preferences regarding prophylactic cranial irradiation: A discrete choice experiment. (United States)

    Lehman, Margot; Gorayski, Peter; Watson, Susanne; Edeling, Desiree; Jackson, James; Whitty, Jennifer


    In patients with non-small cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT), prophylactic cranial irradiation (PCI) is not standard practice. This study determined patient preferences for PCI with respect to survival benefit, reduction in brain metastases (BM) and acceptable toxicity. A Discrete Choice Experiment was completed pre- and post-treatment. Patients made 15 hypothetical choices between two alternative PCI treatments described by four attributes: amount of life gained, chance of BM, ability to care for oneself, and loss of memory. Participants also chose between PCI and no PCI. 54 and 46 surveys were completed pre- and post-treatment. The most important attributes pre-treatment were: a survival benefit >6months, of 3-6months, avoiding severe problems with memory and self-care, avoiding quite a bit of difficulty with memory and maximally reducing BM recurrence. Post-treatment, BM reduction became more important. 90% of patients would accept PCI for a survival benefit >6months, with a maximal reduction in BM even if severe memory/self-care problems occurred. With a 10% reduction in BM and mild problems with memory and self-care 70% of patients pre- (90% post-treatment) would accept PCI for a survival benefit of 1-3months, and 52% pre- (78% post-treatment) for no survival benefit. Improvement in survival is the most important attribute of PCI with patients willing to accept significant toxicity for maximum survival and less toxicity for less survival benefit. BM reduction became more important after treatment. The majority of patients would accept PCI for no survival benefit and a reduction in BM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Neurochemical Evidence of Potential Neurotoxicity After Prophylactic Cranial Irradiation

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    Kalm, Marie, E-mail: [Department of Clinical Neuroscience and Rehabilitation, Insitute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Abel, Edvard [Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Wasling, Pontus [Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Nyman, Jan [Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Hietala, Max Albert [Department of Neurology, Karolinska University Hospital, Stockholm (Sweden); Bremell, Daniel; Hagberg, Lars [Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Elam, Mikael [Department of Clinical Neuroscience and Rehabilitation, Insitute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Blennow, Kaj [Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal (Sweden); Björk-Eriksson, Thomas [Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Zetterberg, Henrik [Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal (Sweden); UCL Institute of Neurology, London (United Kingdom)


    Purpose: To examine whether cerebrospinal fluid biomarkers for neuroaxonal damage, neuroglial activation, and amyloid β–related processes could characterize the neurochemical response to cranial radiation. Methods and Materials: Before prophylactic cranial irradiation (PCI) of patients with small cell lung cancer, each patient underwent magnetic resonance imaging of the brain, lumbar puncture, and Mini-Mental State Examination of cognitive function. These examinations were repeated at approximately 3 and 12 months after radiation. Results: The major findings were as follows. (1) Cerebrospinal fluid markers for neuronal and neuroglial injury were elevated during the subacute phase after PCI. Neurofilament and T-tau increased 120% and 50%, respectively, after PCI (P<.05). The same was seen for the neuroglial markers YKL-40 and glial fibrillary acidic protein, which increased 144% and 106%, respectively, after PCI (P<.05). (2) The levels of secreted amyloid precursor protein-α and -β were reduced 44% and 46%, respectively, 3 months after PCI, and the levels continued to decrease as long as 1 year after treatment (P<.05). (3) Mini-Mental State Examination did not reveal any cognitive decline, indicating that a more sensitive test should be used in future studies. Conclusion: In conclusion, we were able to detect radiation therapy–induced changes in several markers reflecting neuronal injury, inflammatory/astroglial activation, and altered amyloid precursor protein/amyloid β metabolism, despite the low number of patients and quite moderate radiation doses (20-30 Gy). These changes are hypothesis generating and could potentially be used to assess the individual risk of developing long-term symptoms of chronic encephalopathy after PCI. This has to be evaluated in large studies with extended clinical follow-up and more detailed neurocognitive assessments.

  5. Late adverse effects of whole cranial irradiation in childhood hematological disorders

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    Someya, Masanori; Nakata, Kensei; Nagakura, Hisayasu; Oouchi, Atsushi; Sakata, Kohichi; Hareyama, Masato [Sapporo Medical Coll. (Japan)


    The purpose of this study was to examine the late adverse effects of childhood hematological disorders treated with chemotherapy and radiotherapy including whole cranial irradiation at Sapporo Medical University Hospital. Twenty-eight patients were treated with chemotherapy and 18-24 Gy of prophylactic cranial irradiation (PCI) for acute lymphoblastic leukemia (ALL), and 14 patients were treated with 3-12.8 Gy of total body irradiation (TBI) and bone marrow transplantation (BMT) for ALL, acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), myelodysplastic syndrome (MDS), malignant lymphoma, and aplastic anemia (AA). Age at diagnosis ranged from 2 to 15 years old, and 28 were males and 14 were females. All patients were disease-free more than 2 years after diagnosis. Of 42 patients, 4 patients had decreased height (less than -2 S.D.), 3 patients required hormone replacement therapy, 2 patients had mental retardation, 3 patients had leukoencephalopathy, and 1 patient had a second malignancy. Except for the cases of decreased height, 3 of 7 late adverse effects were occurred in patients who had relapse of disease, and the risk of the adverse effects seemed to be higher for those patients whose doses of PCI were 22 Gy or more, or who received an additional craniospinal irradiation due to relapse of disease, and 18 Gy of PCI did not increase the risk of adverse effects. (author)

  6. Prophylactic cranial irradiation in patients with small cell lung cancer

    DEFF Research Database (Denmark)

    Ramlov, Anne; Tietze, Anna; Khalil, Azza Ahmed


    BACKGROUND: Prophylactic cerebral irradiation (PCI) is a standard treatment for all small cell lung cancer (SCLC) patients with response to chemotherapy. The aims of this study were: to evaluate patients undergoing PCI with regard to cerebral recurrence rate, site of recurrence, and overall...... retrospectively with regard to disease stage, treatment, date of PCI, steroid dose during PCI, toxicity, time to recurrence, site of recurrence and time of death. The median follow up time was 16.6months (range 3-54months). RESULTS: Of the 118 patients undergoing PCI, 74 had limited disease (LD-SCLC) and 44 had.......8%) were diagnosed with cerebral recurrence. Five of these presented with metastatic disease within the limbic system. Of these five patients, four had miliary cerebral disease and one had non-oligometastatic disease. The time from PCI to cerebral recurrence ranged from 4 to 27months. Prednisolone...

  7. Damage Effects of Rat Thymus After Cranial Irradiation

    Institute of Scientific and Technical Information of China (English)

    YU; Ying-qi; WANG; Xiao; SUI; Li; KONG; Fu-quan; MA; Nan-ru


    <正>To study the damage effects of the thymus and investigate the interaction of hypothalamic- pituitary-adrenal axis (HPA axis) in neuroimmunological signaling pathway, the rat model of cranial irradiated by carbon ions was establish. By means of enzyme-linked immunoassay (Elisa), one day of post-irradiation with carbon ions, for the group of control, irradiated or drug (Longxuejie) treated,

  8. Is phenytoin contraindicated in patients receiving cranial irradiation?

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    Borg, M.F. [Royal Adelaide Hospital, SA (Australia); Probert, J.C. [Auckland Hospital, Auckland (New Zealand). Dept. of Radiation Oncology; Zwi, L.J. [Auckland Univ. (New Zealand). Dept. of Medicine and Surgery


    Three recent publications have reported the development of erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and sodium phenytoin. Some authors have recommended that patients receiving whole brain radiation therapy and who have had seizures should not be prescribed phenytoin but an alternative anticonvulsant. This article reviews the current literature pertaining to the development of this potentially lethal complication in patients receiving whole brain radiation and phenytoin, with reference to the single recorded case of Stevens-Johnson syndrome in a patient receiving cranial irradiation and phenytoin in Auckland, New Zealand. While the clinical picture in the 16 patients reported in the literature and the current case report differed from the classical form of erythema multiforme, a similar pattern of presentation and outcome appeared in all patients reviewed, suggesting that the combination of phenytoin, cranial irradiation and the gradual reduction of concomitant steroids seem to lead to the development of erythema multiforme and/or Stevens-Johnson syndrome. The data presented, although sparse, suggest that phenytoin should not be prescribed in patients receiving cranial irradiation. 21 refs., 2 tabs., 3 figs.

  9. Prophylactic cranial irradiation in small cell lung cancer: a systematic review of the literature with meta-analysis

    Directory of Open Access Journals (Sweden)

    Vallot Frédéric


    Full Text Available Abstract Purpose A systematic review of the literature was carried out to determine the role of prophylactic cranial irradiation (PCI in small cell lung cancer (SCLC . Methods To be eligible, full published trials needed to deal with SCLC and to have randomly assigned patients to receive PCI or not. Trials quality was assessed by two scores (Chalmers and ELCWP. Results Twelve randomised trials (1547 patients were found to be eligible. Five evaluated the role of PCI in SCLC patients who had complete response (CR after chemotherapy. Brain CT scan was done in the work-up in five studies and brain scintigraphy in six. Chalmers and ELCWP scores are well correlated (p Conclusions PCI decreases brain metastases incidence and improves survival in CR SCLC patients but these effects were obtained in patients who had no systematic neuropsychological and brain imagery assessments. The long-term toxicity has not been prospectively evaluated. If PCI can be recommended in patients with SCLC and CR documented by a work-up including brain CT scan, data are lacking to generalise its use to any CR situations.

  10. SU-E-T-664: Radiobiological Modeling of Prophylactic Cranial Irradiation in Mice

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    Smith, D; Debeb, B; Woodward, W [MD Anderson Cancer Center, Houston, TX (United States)


    Purpose: Prophylactic cranial irradiation (PCI) is a clinical technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with ALL and SCLC, and we have shown the potential of PCI in select breast cancer patients through a mouse model (manuscript in preparation). We developed a computational model using our experimental results to demonstrate the advantage of treating brain micro-metastases early. Methods: MATLAB was used to develop the computational model of brain metastasis and PCI in mice. The number of metastases per mouse and the volume of metastases from four- and eight-week endpoints were fit to normal and log-normal distributions, respectively. Model input parameters were optimized so that model output would match the experimental number of metastases per mouse. A limiting dilution assay was performed to validate the model. The effect of radiation at different time points was computationally evaluated through the endpoints of incidence, number of metastases, and tumor burden. Results: The correlation between experimental number of metastases per mouse and the Gaussian fit was 87% and 66% at the two endpoints. The experimental volumes and the log-normal fit had correlations of 99% and 97%. In the optimized model, the correlation between number of metastases per mouse and the Gaussian fit was 96% and 98%. The log-normal volume fit and the model agree 100%. The model was validated by a limiting dilution assay, where the correlation was 100%. The model demonstrates that cells are very sensitive to radiation at early time points, and delaying treatment introduces a threshold dose at which point the incidence and number of metastases decline. Conclusion: We have developed a computational model of brain metastasis and PCI in mice that is highly correlated to our experimental data. The model shows that early treatment of subclinical disease is highly advantageous.

  11. WE-EF-BRA-10: Prophylactic Cranial Irradiation Reduces the Incidence of Brain Metastasis in a Mouse Model of Metastatic Breast Cancerr

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    Smith, D; Debeb, B; Larson, R; Diagaradjane, P; Woodward, W [MD Anderson Cancer Center, Houston, TX (United States)


    Purpose: Prophylactic cranial irradiation (PCI) is a clinical technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with acute lymphoblastic leukemia and small-cell lung cancer. We examined whether PCI could benefit breast cancer patients at high risk of developing brain metastases. Methods: We utilized our mouse model in which 500k green fluorescent protein (GFP)-labeled breast cancer cells injected into the tail vein of SCID/Beige mice resulted in brain metastases in approximately two-thirds of untreated mice. To test the efficacy of PCI, one set of mice was irradiated five days after cell injection with a single fraction of 4-Gy (two 2-Gy opposing fields) whole-brain irradiation on the XRAD 225Cx small-animal irradiator. Four controls were included: a non-irradiated group, a group irradiated two days prior to cell injection, and two groups irradiated 3 or 6 weeks after cell injection. Mice were sacrificed four and eight weeks post-injection and were evaluated for the presence of brain metastases on a fluorescent stereomicroscope. Results: The incidence of brain metastasis in the non-irradiated group was 77% and 90% at four and eight weeks, respectively. The PCI group had a significantly lower incidence, 20% and 30%, whereas the other three control groups had incidence rates similar to the non-treated control (70% to 100%). Further, the number of metastases and the metastatic burden were also significantly lower in the PCI group compared to all other groups. Conclusion: The timing of irradiation to treat subclinical disease is critical, as a small dose of whole-brain irradiation given five days after cell injection abrogated tumor burden by greater than 90%, but had no effect when administered twenty-one days after cell injection. PCI is likely to benefit breast cancer patients at high risk of developing brain metastases and should be strongly considered in the clinic.

  12. Prophylactic cranial irradiation could improve overall survival in patients with extensive small cell lung cancer. A retrospective study

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    Chen, Yi [Tsinghua University, Medical Center Tsinghua University, Beijing (China); Li, Jinyu; Hu, Yi; Lin, Zhi; Jiao, Shunchang [Chinese PLA General Hospital, Department of Medical Oncology, Beijing (China); Zhang, Yibao [Peking University Cancer Hospital and Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiotherapy, Beijing (China); Zhao, Zhifei [Chinese PLA General Hospital, Department of Radiation Oncology, Beijing (China)


    To evaluate the effect of prophylactic cranial irradiation (PCI) on overall survival (OS) in patients with extensive small cell lung cancer (ESCLC). Between April 2005 and May 2014, 204 patients with ESCLC who had any response (according to RECIST 1.1) to initial chemotherapy were reviewed. All patients had undergone appropriate imaging tests to exclude brain metastases before initial chemotherapy. PCI was performed on 45 patients (22.1 %) and the remaining patients (77.9 %) received no such treatment (control group). Primary endpoint was OS. The incidence of brain metastases, brain metastases-free survival (BMFS), and adverse effects were also evaluated. Survival data of the 204 patients were analyzed statistically. PCI significantly prolonged median OS from 12.6 to 16.5 months as compared to the control group (hazard ratio, HR, 0.63; 95 % confidence interval, CI, 0.41 to 0.96; p = 0.033). PCI significantly lowered the risk of brain metastases (HR 0.48; 95 % CI 0.30 to 0.76; p = 0.001). The 1-year incidence of brain metastases was 17.1 and 55.9 % in the PCI and control group, respectively. PCI significantly correlated with the increased median BMFS (p = 0.002). Additionally, multivariate analyses demonstrated that PCI was a favorable independent predictor of OS, BMFS, and the incidence of brain metastases. Acute and chronic adverse effects were generally low grade and well tolerated in patients receiving PCI. PCI after any response to initial chemotherapy significantly improved OS of ESCLC patients analyzed in this study. (orig.) [German] Beurteilung des Effekts der prophylaktischen kranialen Bestrahlung (PCI) auf das Gesamtueberleben (OS) bei Patienten mit ausgedehntem kleinzelligem Lungenkarzinom (ESCLC). Zwischen April 2005 und Mai 2014 wurden 204 Patienten mit ESCLC nach Ansprechen auf eine initiale Chemotherapie (gemaess RECIST 1.1) untersucht. Vor der Chemotherapie wurden bei allen Patienten Untersuchungen mit entsprechenden Bildgebungsverfahren

  13. Extrapulmonary small cell carcinoma. An indication for prophylactic cranial irradiation? A single center experience

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    Frueh, Martin; Cerny, Thomas [Kantonsspital St. Gallen (Switzerland). Dept. of Oncology/Hematology; Kacsir, Bela; Plasswilm, Ludwig [Kantonsspital St. Gallen (Switzerland). Dept. of Radiation Oncology; Ess, Silvia [Cancer Registry, Canton of St. Gallen, Appenzell (Switzerland); Rodriguez, Regulo [Kantonsspital St. Gallen (Switzerland). Dept. of Pathology


    Information about extrapulmonary small cell carcinoma (EPSCC) is limited and the role of prophylactic cranial irradiation (PCI) is unknown. Disease presentation and outcome of all EPSCC at our hospital between 1990 and 2009 were retrospectively analyzed. Of 30 EPSCC, the male:female ratio was 58%:42%; 83% had a performance status of 0-2. Median age was 71 years (32-80). Seventeen (57%) had limited stage (LS), 13 (43%) extensive stage (ES). The location of the primary tumor was gastrointestinal (n = 8), unknown (6), gynecological (6), urogenital (5), and ear nose throat (5). Four (13%) developed brain metastases (2 ES, 2 LS). In ES, first line chemotherapy (CT) was given in 85%, mostly platinum-etoposide (64%). Response rate was 90%. In LS, CT and radiotherapy (RT) {+-} resection resulted in persistent remissions in 67% of patients. Median survival was 16 months (1-107 months), 18 months (1-107 months), and 9 months (0.4-25 months) for LS + ES, LS, and ES, respectively. Weight loss {>=}5 % and ECOG performance status 3 + 4 were associated with poorer survival (p < 0.001 and p < 0.01, respectively). The incidence of brain metastases was relatively low (13%). More studies are necessary, before routinely offering PCI to patients with EPSCC. Best survival outcomes in LS were achieved with multimodality treatment including CT and RT. Prognosis was poor in patients with ES. (orig.)

  14. Evolution of cerebral microbleeds after cranial irradiation in medulloblastoma patients. (United States)

    Roongpiboonsopit, Duangnapa; Kuijf, Hugo J; Charidimou, Andreas; Xiong, Li; Vashkevich, Anastasia; Martinez-Ramirez, Sergi; Shih, Helen A; Gill, Corey M; Viswanathan, Anand; Dietrich, Jorg


    To characterize the temporal and spatial pattern of cerebral microbleeds (CMBs) after cranial irradiation in patients with medulloblastoma. We retrospectively identified patients with medulloblastoma treated with craniospinal irradiation at the Massachusetts General Hospital between 1999 and 2015. Longitudinal MRI including T2*-weighted gradient-recalled echo (GRE) sequences were reviewed, and the prevalence, spatial pattern, and risk factors associated with CMBs were characterized. We identified a total of 27 patients; 5 patients were children (median age 6.3 years) and 22 patients were adults (median age 28.8 years). CMBs were found in 67% (18/27) of patients, who were followed for a median of 4.1 years. Patients with CMBs had longer GRE follow-up time compared to those without CMBs (4.9 vs 1.7 years, p = 0.035). The median latency of the appearance of CMBs was 2.79 years (interquartile range 1.76-4.26). The prevalence of CMBs increased with each year from time of radiation therapy, and the cumulative prevalence was highest in patients age CMBs were mostly found in lobar distribution and predominately in bilateral occipital lobes. Patients using antithrombotic medications developed CMBs at a significantly higher rate (p = 0.041). Our data demonstrate a high prevalence of CMBs following cranial irradiation, progressively increasing with each year from time of radiation therapy. © 2017 American Academy of Neurology.

  15. Treatment of Childhood Acute Lymphoblastic Leukemia Without Prophylactic Cranial Irradiation (United States)

    Pui, Ching-Hon; Campana, Dario; Pei, Deqing; Bowman, W. Paul; Sandlund, John T.; Kaste, Sue C.; Ribeiro, Raul C.; Rubnitz, Jeffrey E.; Raimondi, Susana C.; Onciu, Mihaela; Coustan-Smith, Elaine; Kun, Larry E.; Jeha, Sima; Cheng, Cheng; Howard, Scott C.; Simmons, Vickey; Bayles, Amy; Metzger, Monika L.; Boyett, James M.; Leung, Wing; Handgretinger, Rupert; Downing, James R.; Evans, William E.; Relling, Mary V.


    Background We conducted a clinical trial to test whether prophylactic cranial irradiation could be omitted in all children with newly diagnosed acute lymphoblastic leukemia. Methods A total of 498 evaluable patients were enrolled. Treatment intensity was based on presenting features and the level of minimal residual disease after remission induction treatment. Continuous complete remission was compared between the 71 patients who previously would have received prophylactic cranial irradiation and the 56 historical controls who received it. Results The 5-year event-free and overall survival probabilities (95% confidence interval) for all 498 patients were 85.6% (79.9% to 91.3%) and 93.5% (89.8% to 97.2%), respectively. The 5-year cumulative risk of isolated central-nervous-system (CNS) relapse was 2.7% (1.1% to 4.2%), and that of any CNS relapse (isolated plus combined) was 3.9% (1.9% to 5.9%). The 71 patients had significantly better continuous complete remission than the 56 historical controls (P=0.04). All 11 patients with isolated CNS relapse remain in second remission for 0.4 to 5.5 years. CNS leukemia (CNS-3 status) or a traumatic lumbar puncture with blasts at diagnosis and a high level of minimal residual disease (≥ 1%) after 6 weeks of remission induction were significantly associated with poorer event-free survival. Risk factors for CNS relapse included the presence of the t(1;19)[TCF3-PBX1], any CNS involvement at diagnosis, and T-cell immunophenotype. Common adverse effects included allergic reactions to L-asparaginase, osteonecrosis, thrombosis, and disseminated fungal infection. Conclusions With effective risk-adjusted chemotherapy, prophylactic cranial irradiation can be safely omitted in the treatment of childhood acute lymphoblastic leukemia. PMID:19553647

  16. Early effects of cranial irradiation on hypothalamic-pituitary function

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    Lam, K.S.; Tse, V.K.; Wang, C.; Yeung, R.T.; Ma, J.T.; Ho, J.H.


    Hypothalamic-pituitary function was studied in 31 patients before and after cranial irradiation for nasopharyngeal carcinoma. The estimated radiotherapy (RT) doses to the hypothalamus and pituitary were 3979 +/- 78 (+/- SD) and 6167 +/- 122 centiGrays, respectively. All patients had normal pituitary function before RT. One year after RT, there was a significant decrease in the integrated serum GH response to insulin-induced hypoglycemia. In the male patients, basal serum FSH significantly increased, while basal serum LH and testosterone did not change. Moreover, in response to LHRH, the integrated FSH response was increased while that of LH was decreased. Such discordant changes in FSH and LH may be explained by a defect in LHRH pulsatile release involving predominantly a decrease in pulse frequency. The peak serum TSH response to TRH became delayed in 28 patients, suggesting a defect in TRH release. Twenty-one patients were reassessed 2 yr after RT. Their mean basal serum T4 and plasma cortisol levels had significantly decreased. Hyperprolactinemia associated with oligomenorrhoea was found in 3 women. Further impairment in the secretion of GH, FSH, LH, TSH, and ACTH had occurred, and 4 patients had hypopituitarism. Thus, progressive impairment in hypothalamic-pituitary function occurs after cranial irradiation and can be demonstrated as early as 1 yr after RT.

  17. Cisplatin and cranial irradiation-related hearing loss in children. (United States)

    Warrier, Rajasekharan; Chauhan, Aman; Davluri, Murali; Tedesco, Sonya L; Nadell, Joseph; Craver, Randall


    High doses of cisplatin and cranial radiotherapy (CRT) have been reported to cause irreversible hearing loss. The objective of this study was to examine the influence of cranial irradiation on cisplatin-associated ototoxicity in children with pediatric malignancies. Serial audiograms were obtained for 33 children, age <16 years, treated with cisplatin-based chemotherapy (90-120 mg/m(2) per cycle) with or without CRT. Eligible patients included those with normal baseline audiometric evaluations and without significant exposure to other ototoxic drugs. We defined significant hearing loss as a hearing threshold ≥30 dB at 2,000-8,000 Hz frequencies. The median age of our study population was 4.9 years (range 6 weeks to 16 years), and the male to female ratio was 0.8:1. The study population consisted of 15 Caucasians, 17 African-Americans, and 1 Hispanic. Fourteen patients had brain tumors, and 19 had other solid tumors. Thirteen patients were exposed to CRT, and 20 were not. Bilateral hearing loss was observed in 24/33 (73%) patients, with severe/profound (≥70 dB) impairment in 10/33 (30%) of all patients. Young age (<5 years), CRT, and brain tumors were independent prognostic factors predicting hearing loss. The study demonstrated a high incidence of hearing loss in children treated with cisplatin and CRT. Consequently, we recommend monitoring these children for the early detection of hearing loss.

  18. Hypothalmic hypopituitarism following cranial irradiation for nasopharyngeal carcinoma

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    Lam, K.S.L.; Wang, C.; Yeung, R.T.T.; Ma, J.T.C.; Ho, J.H.C.; Tse, V.K.C.; Ling, N.


    Eight patients, one male and seven females, with no pre-existing hypothalamic-pituitary disease, who developed symptoms of hypopituitarism following cranial irradiation for nasopharyngeal carcinoma were studied 5 years or more after radiotherapy. All were GH deficient. Four of the patients with no GH response during insulin tolerance tests (ITT) showed increased GH in response to synthetic human growth hormone releasing factor (GRF-44). Four patients had impaired cortisol responses to ITT, and gradual but diminished cortisol responses to ovine corticotrophin releasing factor (CRF-41). There was no significant difference between mean peak increments in response to ITT and those in response to CRF-41. TSH responses to TRH were delayed in five and absent in two patients; four of these had low free T4 index. Prolactin was raised in all seven women and increased further in response to TRH. Two patients had impaired gonadotrophin responses to LHRH. None of the patients had clinical or biochemical evidence of diabetes insipidus. These data suggest that post-irradiation hypopituitarism in these patients results from radiation damage to the hypothalamus leading to varying degrees of deficiency of the hypothalamic releasing or inhibitory factors.

  19. Prophylactic cranial irradiation may impose a detrimental effect on overall survival of patients with nonsmall cell lung cancer: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Shuan-shuan Xie

    Full Text Available To determine the role of brain metastases (BM and overall survival (OS in patients with non-small cell lung cancer (NSCLC by performing a meta-analysis of the RCTs (randomized controlled clinical trials and non-RCTs (non-randomized controlled clinical trials published in the literature.A meta-analysis was performed using trials identified through PubMed, EMBASE and Cochrane databases. Two investigators independently assessed the quality of the trials and extracted data. The outcomes included BM, OS, median survival (MS, response rate (RR, Hazard ratios (HRs and odds ratios (ORs, and their 95% confidence intervals (CIs were pooled using ReMan software.Twelve trials (6 RCTs and 6 non-RCTs involving 1,718 NSCLC patients met the inclusion criteria. They were grouped on the basis of study design for separate Meta-analyses. The results showed that prophylactic cranial irradiation (PCI reduced the risk of BM as compared with non-PCI in NSCLC patients (OR = 0.30, 95% [CI]: 0.21-0.43, p<0.00001. However, HRs for OS favored non-PCI (HR = 1.19, 95% [CI]: 1.06-1.33, p = 0.004, without evidence of heterogeneity between the studies.Our results suggest that although PCI decreased the risk of BM, it may impose a detrimental effect on OS of NSCLC patients.

  20. Reduction of adult height in childhood acute lymphoblastic leukemia survivors after prophylactic cranial irradiation

    NARCIS (Netherlands)

    Bongers, MEJ; Francken, AB; Rouwe, C; Kamps, WA; Postma, A


    Background. Impaired linear growth is a well-recognized complication in long-term childhood ALL survivors who received cranial irradiation. However, as many patients achieve a final height between the 5th and the 95th centile, the true incidence of linear growth impairment might be underestimated. M

  1. Decline in Tested and Self-Reported Cognitive Functioning After Prophylactic Cranial Irradiation for Lung Cancer: Pooled Secondary Analysis of Radiation Therapy Oncology Group Randomized Trials 0212 and 0214

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    Gondi, Vinai, E-mail: [Central Dupage Hospital Cancer Center, Warrenville, Illinois (United States); University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin (United States); Paulus, Rebecca [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Bruner, Deborah W. [Nell Hodgson Woodfull School of Nursing, Emory University, Atlanta, Georgia (United States); Meyers, Christina A. [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gore, Elizabeth M. [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Wolfson, Aaron [University of Miami School of Medicine, Miami, Florida (United States); Werner-Wasik, Maria [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Sun, Alexander Y. [Princess Margaret Hospital, Toronto, ON (Canada); Choy, Hak [University of Texas Southwestern Moncreif Cancer Center, Fort Worth, Texas (United States); Movsas, Benjamin [Henry Ford Health System, Detroit, Michigan (United States)


    Purpose: To assess the impact of prophylactic cranial irradiation (PCI) on self-reported cognitive functioning (SRCF), a functional scale on the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0214 randomized patients with locally advanced non-small cell lung cancer to PCI or observation; RTOG 0212 randomized patients with limited-disease small cell lung cancer to high- or standard-dose PCI. In both trials, Hopkins Verbal Learning Test (HVLT)-Recall and -Delayed Recall and SRCF were assessed at baseline (after locoregional therapy but before PCI or observation) and at 6 and 12 months. Patients developing brain relapse before follow-up evaluation were excluded. Decline was defined using the reliable change index method and correlated with receipt of PCI versus observation using logistic regression modeling. Fisher's exact test correlated decline in SRCF with HVLT decline. Results: Of the eligible patients pooled from RTOG 0212 and RTOG 0214, 410 (93%) receiving PCI and 173 (96%) undergoing observation completed baseline HVLT or EORTC QLQ-C30 testing and were included in this analysis. Prophylactic cranial irradiation was associated with a higher risk of decline in SRCF at 6 months (odds ratio 3.60, 95% confidence interval 2.34-6.37, P<.0001) and 12 months (odds ratio 3.44, 95% confidence interval 1.84-6.44, P<.0001). Decline on HVLT-Recall at 6 and 12 months was also associated with PCI (P=.002 and P=.002, respectively) but was not closely correlated with decline in SRCF at the same time points (P=.05 and P=.86, respectively). Conclusions: In lung cancer patients who do not develop brain relapse, PCI is associated with decline in HVLT-tested and self-reported cognitive functioning. Decline in HVLT and decline in SRCF are not closely correlated, suggesting that they may represent distinct elements of the cognitive spectrum.

  2. Enhanced cis-platinum ototoxicity in children with brain tumours who have received simultaneous or prior cranial irradiation

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    Walker, D.A.; Pillow, J.; Waters, K.D.; Keir, E.


    We report on four children who received cis-platinum simultaneously with, or in one case 10 months after, cranial irradiation and experienced exaggerated ototoxicity affecting all audible frequencies. The hearing loss was severe, affecting the critical areas for speech perception, and necessitated the provision of bilateral hearing aids. The audiograms of these patients are shown and compared to those of four children who had received cis-platinum as part of their treatment for neuroblastoma but without cranial irradiation. The precipitation of the exaggerated hearing loss with the administration of cis-platinum in one patient 10 months after finishing cranial irradiation suggests that care should be taken in the timing of cis-platinum administration in relation to concurrent or previous cranial irradiation.

  3. Cranial irradiation induces bone marrow-derived microglia in adult mouse brain tissue. (United States)

    Okonogi, Noriyuki; Nakamura, Kazuhiro; Suzuki, Yoshiyuki; Suto, Nana; Suzue, Kazutomo; Kaminuma, Takuya; Nakano, Takashi; Hirai, Hirokazu


    Postnatal hematopoietic progenitor cells do not contribute to microglial homeostasis in adult mice under normal conditions. However, previous studies using whole-body irradiation and bone marrow (BM) transplantation models have shown that adult BM cells migrate into the brain tissue and differentiate into microglia (BM-derived microglia; BMDM). Here, we investigated whether cranial irradiation alone was sufficient to induce the generation of BMDM in the adult mouse brain. Transgenic mice that express green fluorescent protein (GFP) under the control of a murine stem cell virus (MSCV) promoter (MSCV-GFP mice) were used. MSCV-GFP mice express GFP in BM cells but not in the resident microglia in the brain. Therefore, these mice allowed us to detect BM-derived cells in the brain without BM reconstitution. MSCV-GFP mice, aged 8-12 weeks, received 13.0 Gy irradiation only to the cranium, and BM-derived cells in the brain were quantified at 3 and 8 weeks after irradiation. No BM-derived cells were detected in control non-irradiated MSCV-GFP mouse brains, but numerous GFP-labeled BM-derived cells were present in the brain stem, basal ganglia and cerebral cortex of the irradiated MSCV-GFP mice. These BM-derived cells were positive for Iba1, a marker for microglia, indicating that GFP-positive BM-derived cells were microglial in nature. The population of BMDM was significantly greater at 8 weeks post-irradiation than at 3 weeks post-irradiation in all brain regions examined. Our results clearly show that cranial irradiation alone is sufficient to induce the generation of BMDM in the adult mouse.

  4. Impact of Prophylactic Cranial Irradiation Timing on Brain Relapse Rates in Patients With Stage IIIB Non-Small-Cell Lung Carcinoma Treated With Two Different Chemoradiotherapy Regimens

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    Topkan, Erkan, E-mail: [Baskent University Adana Medical Faculty, Department of Radiation Oncology, Kisla Saglik Yerleskesi, Adana (Turkey); Parlak, Cem; Kotek, Ayse; Yuksel, Oznur [Baskent University Adana Medical Faculty, Department of Radiation Oncology, Kisla Saglik Yerleskesi, Adana (Turkey); Cengiz, Mustafa [Hacettepe University Medical Faculty, Oncology Hospital, Department of Radiation Oncology, Sihhiye, Ankara (Turkey); Ozsahin, Mahmut [University of Lausanne, University Hospital, Department of Radiation Oncology, Lausanne (Switzerland); Pehlivan, Berrin [Akdeniz University Medical Faculty, Department of Radiation Oncology, Antalya (Turkey)


    Purpose: To retrospectively assess the influence of prophylactic cranial irradiation (PCI) timing on brain relapse rates in patients treated with two different chemoradiotherapy (CRT) regimens for Stage IIIB non-small-cell lung cancer (NSCLC). Methods and Materials: A cohort of 134 patients, with Stage IIIB NSCLC in recursive partitioning analysis Group 1, was treated with PCI (30 Gy at 2 Gy/fr) following one of two CRT regimens. Regimen 1 (n = 58) consisted of three cycles of induction chemotherapy (ICT) followed by concurrent CRT (C-CRT). Regimen 2 (n = 76) consisted of immediate C-CRT during thoracic radiotherapy. Results: At a median follow-up of 27.6 months (range, 7.2-40.4), 65 patients were alive. Median, progression-free, and brain metastasis-free survival (BMFS) times for the whole study cohort were 23.4, 15.4, and 23.0 months, respectively. Median survival time and the 3-year survival rate for regimens 1 and 2 were 19.3 vs. 26.1 months (p = 0.001) and 14.4% vs. 34.4% (p < .001), respectively. Median time from the initiation of primary treatment to PCI was 123.2 (range, 97-161) and 63.4 (range, 55-74) days for regimens 1 and 2, respectively (p < 0.001). Overall, 11 (8.2%) patients developed brain metastasis (BM) during the follow-up period: 8 (13.8%) in regimen 1 and 3 (3.9%) in regimen 2 (p = 0.03). Only 3 (2.2%) patients developed BM at the site of first failure, and for 2 of them, it was also the sole site of recurrence. Median BMFS for regimens 1 and 2 were 17.4 (13.5-21.3) vs. 26.0 (22.9-29.1 months), respectively (p < 0.001). Conclusion: These results suggest that in Stage IIIB NSCLC patients treated with PCI, lower BM incidence and longer survival rates result from immediate C-CRT rather than ITC-first regimens. This indicates the benefit of earlier PCI use without delay because of induction protocols.

  5. Cognitive effects of chemotherapy and/or cranial irradiation in adults

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    Welzel, G.; Wenz, F. [Dept. of Radiation Oncology, Mannheim Medical Center, Univ. of Heidelberg, Mannheim (Germany); Steinvorth, S. [Dept. of Brain and Cognitive Sciences, MIT and Dept. of Radiology, Harvard Univ., Cambridge, MA (United States)


    Background: cognitive effects after cranial radiotherapy are widely discussed, but there is growing evidence that chemotherapy may also induce changes in neuropsychological functioning. This review summarizes the published literature regarding cognitive functioning after cancer therapy in adult patients. Material and methods: 63 reports from January 1980 to July 2003 assessing objective cognitive effects of irradiation and/or chemotherapy by neuropsychologic evaluation were analyzed. 57 studies with 3,424 patients were included for evaluation. Results: the results of this review confirm that both chemotherapy and irradiation can result in cognitive deficits. No clinically relevant differences are found for cognitive deficits, cognitive impairment rate, and single cognitive domains, when chemotherapy, cranial irradiation and combined radio- and chemotherapy were compared. Only 28 trials with 1,000 patients report quantitative data on patients with cognitive deficits after therapy. There are 44.1% (range 18-75%) of 451 patients in the chemotherapy group, 44.0% (range 29-83%) of 320 patients in the radiotherapy group, and 64.5% (range 30-100%) of 229 patients in the combined irradiation and chemotherapy group with cognitive deficits. Furthermore, cognitive functioning below average before chemo- or radiotherapy is found in subgroups of cancer patients. Conclusion: there is evidence of cognitive impairment in adult tumor patients after chemotherapy similar to effects after cranial irradiation. Cognitive functioning below average before therapy may be due to paraneoplastic effects. More prospective studies with a long-term follow-up using standardized neuropsychometric testing, assessment of premorbid intelligence, and suited control groups are needed. (orig.)

  6. Factors Affecting the Risk of Brain Metastasis in Small Cell Lung Cancer With Surgery: Is Prophylactic Cranial Irradiation Necessary for Stage I-III Disease?

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    Gong Linlin; Wang, Q.I.; Zhao Lujun; Yuan Zhiyong; Li Ruijian [Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, and Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin (China); Wang Ping, E-mail: [Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, and Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin (China)


    Purpose: The use of prophylactic cranial irradiation (PCI) in small cell lung cancer (SCLC) with surgical resection has not been fully identified. This study undertook to assess the factors affecting the risk of brain metastases in patients with stage I-III SCLC after surgical resection. The implications of PCI treatment for these patients are discussed. Methods and Materials: One hundred twenty-six patients treated with surgical resection for stage I-III SCLC from January 1998-December 2009 were retrospectively analyzed to elucidate the risk factors of brain metastases. Log-rank test and Cox regression model were used to determine the risk factors of brain metastases. Results: The median survival time for this patient population was 34 months, and the 5-year overall survival rate was 34.9%. For the whole group, 23.0% (29/126) of the patients had evidence of metastases to brain. Pathologic stage not only correlated with overall survival but also significantly affected the risk of brain metastases. The 5-year survival rates for patients with pathologic stages I, II, and III were 54.8%, 35.6%, and 14.1%, respectively (P=.001). The frequency of brain metastases in patients with pathologic stages I, II, and III were 6.25% (2/32), 28.2% (11/39), and 29.1% (16/55) (P=.026), respectively. A significant difference in brain metastases between patients with complete resection and incomplete resection was also observed (20.5% vs 42.9%, P=.028). The frequency of brain metastases was not found to be correlated with age, sex, pathologic type, induction chemotherapy, adjuvant chemotherapy, or adjuvant radiation therapy. Conclusions: Stage I SCLC patients with complete resection had a low incidence of brain metastases and a favorable survival rate. Stage II-III disease had a higher incidence of brain metastases. Thus, PCI might have a role for stage II-III disease but not for stage I disease.

  7. Cranial irradiation alters dendritic spine density and morphology in the hippocampus.

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    Ayanabha Chakraborti

    Full Text Available Therapeutic irradiation of the brain is a common treatment modality for brain tumors, but can lead to impairment of cognitive function. Dendritic spines are sites of excitatory synaptic transmission and changes in spine structure and number are thought to represent a morphological correlate of altered brain functions associated with hippocampal dependent learning and memory. To gain some insight into the temporal and sub region specific cellular changes in the hippocampus following brain irradiation, we investigated the effects of 10 Gy cranial irradiation on dendritic spines in young adult mice. One week or 1 month post irradiation, changes in spine density and morphology in dentate gyrus (DG granule and CA1 pyramidal neurons were quantified using Golgi staining. Our results showed that in the DG, there were significant reductions in spine density at both 1 week (11.9% and 1 month (26.9% after irradiation. In contrast, in the basal dendrites of CA1 pyramidal neurons, irradiation resulted in a significant reduction (18.7% in spine density only at 1 week post irradiation. Analysis of spine morphology showed that irradiation led to significant decreases in the proportion of mushroom spines at both time points in the DG as well as CA1 basal dendrites. The proportions of stubby spines were significantly increased in both the areas at 1 month post irradiation. Irradiation did not alter spine density in the CA1 apical dendrites, but there were significant changes in the proportion of thin and mushroom spines at both time points post irradiation. Although the mechanisms involved are not clear, these findings are the first to show that brain irradiation of young adult animals leads to alterations in dendritic spine density and morphology in the hippocampus in a time dependent and region specific manner.

  8. Organ and effective dose coefficients for cranial and caudal irradiation geometries: photons. (United States)

    Veinot, K G; Eckerman, K F; Hertel, N E


    With the introduction of new recommendations of the International Commission on Radiological Protection (ICRP) in Publication 103, the methodology for determining the protection quantity, effective dose, has been modified. The modifications include changes to the defined organs and tissues, the associated tissue weighting factors, radiation weighting factors and the introduction of reference sex-specific computational phantoms. Computations of equivalent doses in organs and tissues are now performed in both the male and female phantoms and the sex-averaged values used to determine the effective dose. Dose coefficients based on the ICRP 103 recommendations were reported in ICRP Publication 116, the revision of ICRP Publication 74 and ICRU Publication 57. The coefficients were determined for the following irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right and left lateral (RLAT and LLAT), rotational (ROT) and isotropic (ISO). In this work, the methodology of ICRP Publication 116 was used to compute dose coefficients for photon irradiation of the body with parallel beams directed upward from below the feet (caudal) and directed downward from above the head (cranial). These geometries may be encountered in the workplace from personnel standing on contaminated surfaces or volumes and from overhead sources. Calculations of organ and tissue kerma and absorbed doses for caudal and cranial exposures to photons ranging in energy from 10 keV to 10 GeV have been performed using the MCNP6.1 radiation transport code and the adult reference phantoms of ICRP Publication 110. As with calculations reported in ICRP 116, the effects of charged-particle transport are evident when compared with values obtained by using the kerma approximation. At lower energies the effective dose per particle fluence for cranial and caudal exposures is less than AP orientations while above ∼30 MeV the cranial and caudal values are greater.

  9. Organ and Effective Dose Coefficients for Cranial and Caudal Irradiation Geometries: Neutrons (United States)

    Veinot, K. G.; Eckerman, K. F.; Hertel, N. E.; Hiller, M. M.


    With the introduction of new recommendations by ICRP Publication 103, the methodology for determining the protection quantity, effective dose, has been modified. The modifications include changes to the defined organs and tissues, the associated tissue weighting factors, radiation weighting factors, and the introduction of reference sex-specific computational phantoms (ICRP Publication 110). Computations of equivalent doses in organs and tissues are now performed in both the male and female phantoms and the sex-averaged values used to determine the effective dose. Dose coefficients based on the ICRP 103 recommendations were reported in ICRP Publication 116, the revision of ICRP Publication 74 and ICRU Publication 57. The coefficients were determined for the following irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right and left lateral (RLAT and LLAT), rotational (ROT), and isotropic (ISO). In this work, the methodology of ICRP Publication 116 was used to compute dose coefficients for neutron irradiation of the body with parallel beams directed upward from below the feet (caudal) and directed downward from above the head (cranial). These geometries may be encountered in the workplace from personnel standing on contaminated surfaces or volumes and from overhead sources. Calculations of organ and tissue absorbed doses for caudal and cranial exposures to neutrons ranging in energy from 10-9 MeV to 10 GeV have been performed using the MCNP6 radiation transport code and the adult reference voxel phantoms of ICRP Publication 110. At lower energies the effective dose per particle fluence for cranial and caudal exposures is less than AP orientations while above about 30 MeV the cranial and caudal values are greater.

  10. Weekly Cisplatin during cranial irradiation for malignant melanoma metastatic to brain

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    Stewart, D.J.; Feun, L.G.; Maor, M.; Leavens, M.; Burgess, M.A.; Benjamin, R.S.; Bodey, G.P. Sr.


    Because Cisplatin potentiates the effect of radiotherapy in animal tumor systems and because Cisplatin is capable of causing regressions of human malignant melanomas, a study was initiated in patients with malignant melanoma metastatic to brain to investigate the feasibility of administering Cisplatin once a week during cranial irradiation. Cisplatin 40 mg/m2/week (three doses) was given I.V. to 18 patients during whole brain irradiation, 3 000 rads in 12 fractions over 21/2 weeks. Eleven patients also received Cisplatin 120 mg/m2 every three weeks, starting three weeks after cranial irradiation. Median survival was ten weeks, and only one of 13 patients whose brain metastases had not been resected experienced neurological and CT scan improvement. Thirteen patients have died, and brain metastases were a major cause. No regression of extracerebral tumor was seen in 15 patients with evaluable extracerebral lesions. During weekly low-dose Cisplatin administration, nausea and vomiting were moderate to severe. No granulocytopenia was noted, although three courses were associated with mild thrombocytopenia. Mucositis, peri orbital swelling, vertigo, and headache were each noted in two of 51 courses of treatment and seizures, ototoxicity, pancreatitis, and hiccups were each noted in one course. Renal toxicity and ototoxicity each developed in three of the 11 patients receiving Cisplatin 120 mg/m2, and nausea and vomiting were severe.

  11. Scattered dose to thyroid from prophylactic cranial irradiation during childhood: a Monte Carlo study. (United States)

    Mazonakis, Michalis; Tzedakis, Antonis; Damilakis, John; Varveris, Haris; Kachris, Stefanos; Gourtsoyiannis, Nicholas


    The purpose of this study was to estimate the scattered dose to thyroid from prophylactic cranial irradiation during childhood. The MCNP transport code and mathematical phantoms representing the average individual at ages 3, 5, 10, 15 and 18 years old were employed to simulate cranial radiotherapy using two lateral opposed fields. The mean radiation dose received by the thyroid gland was calculated. A 10 cm thick lead block placed on the patient's couch to shield the thyroid was simulated by MCNP code. The Monte Carlo model was validated by measuring the scattered dose to the unshielded and shielded thyroid using three different humanoid phantoms and thermoluminescense dosimetry. For a cranial dose of 18 Gy, the thyroid dose obtained by Monte Carlo calculations varied from 47 to 79 cGy depending upon the age of the child. Appropriate placement of the couch block resulted in a thyroid dose reduction by 39 to 54%. Thyroid dose values at all possible positions of the radiosensitive gland with respect to the inferior field edge at five different patient ages were found. The mean difference between Monte Carlo results and thyroid dose measurements was 9.6%.

  12. NOTE: Scattered dose to thyroid from prophylactic cranial irradiation during childhood: a Monte Carlo study (United States)

    Mazonakis, Michalis; Tzedakis, Antonis; Damilakis, John; Varveris, Haris; Kachris, Stefanos; Gourtsoyiannis, Nicholas


    The purpose of this study was to estimate the scattered dose to thyroid from prophylactic cranial irradiation during childhood. The MCNP transport code and mathematical phantoms representing the average individual at ages 3, 5, 10, 15 and 18 years old were employed to simulate cranial radiotherapy using two lateral opposed fields. The mean radiation dose received by the thyroid gland was calculated. A 10 cm thick lead block placed on the patient's couch to shield the thyroid was simulated by MCNP code. The Monte Carlo model was validated by measuring the scattered dose to the unshielded and shielded thyroid using three different humanoid phantoms and thermoluminescense dosimetry. For a cranial dose of 18 Gy, the thyroid dose obtained by Monte Carlo calculations varied from 47 to 79 cGy depending upon the age of the child. Appropriate placement of the couch block resulted in a thyroid dose reduction by 39 to 54%. Thyroid dose values at all possible positions of the radiosensitive gland with respect to the inferior field edge at five different patient ages were found. The mean difference between Monte Carlo results and thyroid dose measurements was 9.6%.

  13. Evolution of growth hormone neurosecretory disturbance after cranial irradiation for childhood brain tumours: a prospective study

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    Spoudeas, H.A.; Hindmarsh, P.C.; Brook, C.G.D. [Middlesex Hospital, London (United Kingdom); Matthews, D.R. [Radcliffe Infirmary, Oxford (United Kingdom)


    To determine the aetiopathology of post-irradiation growth hormone (GH) deficiency, we performed a mixed longitudinal analysis of 56 24 h serum GH concentration profiles and 45 paired insulin-induced hypoglycaemia tests (ITT) in 35 prepubertal children, aged 1.5-11.8 years, with brain tumours in the posterior foss (n = 25) or cerebral hemispheres (n 10). Assessments were made before (n = 16), 1 year (n = 25) and 2 to 5 years (n = 15) after a cranial irradiation (DXR) dose of at least 30 Gy. Fourier transforms, occupancy percentage, first-order derivatives (FOD) and mean concentrations were determined from the GH profiles taken after neurosurgery but before radiotherapy (n = 16) and in three treatment groups: Group 1: neurosurgery only without DXR (9n 9); Group 2: {>=} 30 Gy DXR only (n = 22); Group 3: {>=} 30 Gy DXR with additional chemotherapy (n = 9). Results were compared with those from 26 short normally growing (SN) children. (author).

  14. Intracerebral cavernous hemangioma after cranial irradiation in childhood. Incidence and risk factors

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    Strenger, V.; Sovinz, P.; Lackner, H.; Dornbusch, H.J.; Moser, A.; Urban, C. [Graz Medical Univ. (Austria). Div. of Pediatric Hematology and Oncology; Lingitz, H. [Graz Medical Univ. (Austria). Dept. of Therapeutic Radiology and Oncology; Eder, H.G. [Graz Medical Univ. (Austria). Dept. of Neurosurgery


    Background and Purpose: Radiotherapy is an integral part of various therapeutic regimens in pediatric and adult oncology. Endocrine dysfunction, neurologic and psychiatric deficits, secondary malignancies and radiation-induced necrosis are well-known possible late effects of cranial irradiation. However, only sporadic cases of radiation-induced cavernous hemangiomas (RICH) have been reported so far. Patients and Methods: Pediatric patients who underwent cranial radiation therapy for malignant diseases between January 1980 and December 2003 were retrospectively analyzed. After the end of therapy they entered a detailed follow-up program. Results: Of 171 patients, eight (three patients with medulloblastoma, three patients with acute lymphoblastic leukemia, and one patient each with ependymoma and craniopharyngioma) developed intracerebral cavernoma 2.9-18.4 years after irradiation representing a cumulative incidence (according to the Kaplan-Meier method) of 2.24%, 3.86%, 4.95%, and 6.74% within 5, 10, 15, and 20 years following radiation therapy, respectively. In patients treated in the first 10 years of life, RICH occurred with shorter latency and significantly more often (p = 0.044) resulting in an even higher cumulative incidence. Conclusion: These findings and previously published cases show that cavernous hemangiomas may occur after irradiation of the brain several years after the end of therapy irrespective of the radiation dose and type of malignancy. Particularly children < 10 years of age at the time of irradiation are at higher risk. Since patients with RICH frequently do not show symptoms but hemorrhage is a possible severe complication, imaging of the central nervous system should be performed routinely for longer follow- ups, particularly in patients who were treated as young children. (orig.)

  15. Mediastinal radiotherapy after multidrug chemotherapy and prophylactic cranial irradiation in patients with SCLC - treatment results after long-term follow-up and literature overview; Radiotherapie mediastinale apres chimiotherapie et irradiation prophylactique de l'encephale chez des patients atteints d'un carcinome bronchique a petites cellules - Resultats et revue de la litterature

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    Herrmann, M.K.A.; Bloch, E.; Overbeck, T.; Wolff, H.A.; Hille, A.; Hess, C.F.; Christiansen, H. [Department of Radiotherapy, University Hospital Goettingen, Robert-Koch-Str. 40, 37075 Goettingen (Germany); Koerber, W. [Department of Pneumology, Weende Hospital, Section Lenglern, Pappelweg 5, 37120 Bovenden-Lenglern (Germany); Vorwerk, H. [Department of Hematology and Oncology, University Hospital Goettingen, Robert-Koch-Str. 40, 37075 Goettingen (Germany); Muller, M.; Pradier, O. [Department de cancerologie, CHU Morvan, 5, avenue Foch, 29200 Brest cedex (France)


    Introduction. - Curative therapy for patients with small-cell lung cancer (SCLC) is based on multidrug chemotherapy combinations and radiotherapy. After a long time follow-up, the aim of the study was to evaluate the efficacy and toxicity of sequential chemo-radiotherapy and the effect of prophylactic cranial irradiation (PCI). Methods. - From 1995-2005, 96 patients with SCLC (64 limited-disease [LD], 32 extensive-disease [ED]; median age 61 years [range 39-79]) were treated at our department with varying chemotherapy regimens and sequential mediastinal radiotherapy (50 Gy + 10 Gy boost in case of residual disease after chemotherapy). Afterwards, 15 patients with LD, good general condition and at least partial response after local treatment received PCI (30 Gy). Results. - After a median follow-up of 78.6 months, 20 patients remained alive (20.8%, median survival time 18.2 months). The 2-/5-year overall survival rates were 33.8% and 12.6%, the 2-/5-year loco-regional control rates were 30.3% and 24.5%, respectively. Distant metastases occurred in 43 patients (24 cerebral). Cerebral metastasis occurred in 6.7% and 27.2% of the patients with PCI and without PCI respectively. Only tumor stage showed a statistically significant impact on overall survival and loco-regional control in multivariate analysis. Radiotherapy was well tolerated. Grade 3/4 toxicity occurred in seven patients. Prognosis of patients with SCLC remains poor. Administration of PCI in selected patients bears a decrease in the incidence of cerebral metastases. Alternative chemotherapy schemes as well as irradiation schemes and techniques should be the substance of future randomized trials. (authors)

  16. The Role of DNA Methylation Changes in Radiation-Induced Bystander Effects in cranial irradiated Mice (United States)

    Zhang, Meng; Sun, Yeqing; Xue, Bei; Wang, Xinwen; Wang, Jiawen


    Heavy-ion radiation could lead to bystander effect in neighboring non-hit cells by signals released from directly-irradiated cells. The exact mechanisms of radiation-induced bystander effect in distant organ remain obscure, yet accumulating evidence points to the role of DNA methylation changes in bystander effect. To identify the molecular mechanism that underlies bystander effects of heavy-ion radiation, the male Balb/c and C57BL mice were cranial exposed to 40, 200, 2000mGy dose of carbon heavy-ion radiation, while the rest of the animal body was shielded. The γH2AX foci as the DNA damage biomarker in directly irradiation organ ear and the distant organ liver were detected on 0, 1, 2, 6, 12 and 24h after radiation, respectively. Methylation-sensitive amplifcation polymorphism (MSAP) was used to monitor the level of polymorphic genomic DNA methylation changed with dose and time effects. The results show that cranial irradiated mice could induce the γH2AX foci and genomic DNA methylation changes significantly in both the directly irradiation organ ear and the distant organ liver. The percent of DNA methylation changes were time-dependent and tissue-specific. Demethylation polymorphism rate were highest separately at 1 h in 200 mGy and 6 h in 2000 mGy after irradiation in ear. The global DNA methylation changes tended to occur in the CG sites. We also found that the numbers of γH2AX foci and the genomic methylation changes of heavy-ion radiation-induced bystander effect in liver could be obvious 1 h after radiation and achieved the maximum at 6 h, while the changes could recover gradually at 12 h. The results suggest that mice head exposed to heavy-ion radiation can induce damage and methylation pattern changed in both directly radiation organ ear and distant organ liver. Moreover, our findings are important to understand the molecular mechanism of radiation induced bystander effects in vivo. Keywords: Heavy-ion radiation; Bystander effect; DNA methylation; γH2

  17. The role of prophylactic cranial irradiation in regionally advanced non-small cell lung cancer. A Southwest Oncology Group Study

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    Rusch, V.W.; Griffin, B.R.; Livingston, R.B. (Univ. of Washington, Seattle (USA))


    Lung cancer is the most common malignant disease in the United States. Only the few tumors detected very early are curable, but there has been some progress in the management of more advanced non-small cell lung cancer, particularly in regionally inoperable disease. Prevention of central nervous system relapse is an important issue in this group of patients because brain metastases ultimately develop in 20% to 25% of them. Seventy-three patients with regionally advanced non-small cell lung cancer were entered into a Phase II trial of neutron chest radiotherapy sandwiched between four cycles of chemotherapy including cisplatin, vinblastine, and mitomycin C. Prophylactic cranial irradiation was administered concurrently with chest radiotherapy (3000 cGy in 10 fractions in 15 patients; 3600 cGy in 18 fractions in the remaining 50 patients). Patients underwent computed tomographic scan of the brain before treatment and every 3 months after treatment. The initial overall response rate was 79%, but 65 of the 73 patients have subsequently died of recurrent disease. Median follow-up is 9 months for all 73 patients and 26 months for eight long-term survivors. No patient who completed the prophylactic cranial irradiation program had clinical or radiologic brain metastases. Toxic reactions to prophylactic cranial irradiation included reversible alopecia in all patients, progressive dementia in one patient, and possible optic neuritis in one patient. Both of these patients received 300 cGy per fraction of irradiation. The use of prophylactic cranial irradiation has been controversial, but its safety and efficacy in this trial supports its application in a group of patients at high risk for central nervous system relapse. Further evaluation of prophylactic cranial irradiation in clinical trials for regionally advanced non-small cell lung cancer is warranted.

  18. Cranial grafting of stem cell-derived microvesicles improves cognition and reduces neuropathology in the irradiated brain. (United States)

    Baulch, Janet E; Acharya, Munjal M; Allen, Barrett D; Ru, Ning; Chmielewski, Nicole N; Martirosian, Vahan; Giedzinski, Erich; Syage, Amber; Park, Audrey L; Benke, Sarah N; Parihar, Vipan K; Limoli, Charles L


    Cancer survivors face a variety of challenges as they cope with disease recurrence and a myriad of normal tissue complications brought on by radio- and chemotherapeutic treatment regimens. For patients subjected to cranial irradiation for the control of CNS malignancy, progressive and debilitating cognitive dysfunction remains a pressing unmet medical need. Although this problem has been recognized for decades, few if any satisfactory long-term solutions exist to resolve this serious unintended side effect of radiotherapy. Past work from our laboratory has demonstrated the neurocognitive benefits of human neural stem cell (hNSC) grafting in the irradiated brain, where intrahippocampal transplantation of hNSC ameliorated radiation-induced cognitive deficits. Using a similar strategy, we now provide, to our knowledge, the first evidence that cranial grafting of microvesicles secreted from hNSC affords similar neuroprotective phenotypes after head-only irradiation. Cortical- and hippocampal-based deficits found 1 mo after irradiation were completely resolved in animals cranially grafted with microvesicles. Microvesicle treatment was found to attenuate neuroinflammation and preserve host neuronal morphology in distinct regions of the brain. These data suggest that the neuroprotective properties of microvesicles act through a trophic support mechanism that reduces inflammation and preserves the structural integrity of the irradiated microenvironment.

  19. Hippocampal-dependent neurocognitive impairment following cranial irradiation observed in pre-clinical models: current knowledge and possible future directions. (United States)

    Tomé, Wolfgang A; Gökhan, Şölen; Gulinello, Maria E; Brodin, N Patrik; Heard, John; Mehler, Mark F; Guha, Chandan


    We reviewed the literature for studies pertaining to impaired adult neurogenesis leading to neurocognitive impairment following cranial irradiation in rodent models. This compendium was compared with respect to radiation dose, converted to equivalent dose in 2 Gy fractions (EQD2) to allow for direct comparison between studies. The effects of differences between animal species and the dependence on animal age as well as for time after irradiation were also considered. One of the major sites of de novo adult neurogenesis is the hippocampus, and as such, this review also focuses on assessing evidence related to the expression and potential effects of inflammatory cytokines on neural stem cells in the subgranular zone of the dentate gyrus and whether this correlates with neurocognitive impairment. This review also discusses potential strategies to mitigate the detrimental effects on neurogenesis and neurocognition resulting from cranial irradiation, and how the rationale for these strategies compares with the current outcome of pre-clinical studies.

  20. Cranial irradiation modulates hypothalamic-pituitary-adrenal axis activity and corticosteroid receptor expression in the hippocampus of juvenile rat. (United States)

    Velickovic, Natasa; Djordjevic, Ana; Drakulic, Dunja; Stanojevic, Ivana; Secerov, Bojana; Horvat, Anica


    Glucocorticoids, essential for normal hypothalamic-pituitary-adrenal (HPA) axis activity, exert their action on the hippocampus through two types of corticosteroid receptors: the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR). Recent studies report that exposure of juvenile rats to cranial irradiation adversely affects HPA axis stability leading to its activation along with radiation- induced inflammation. This study was aimed to examine the acute effects of radiation on HPA axis activity and hippocampal corticosteroid receptor expression in 18-day-old rats. Since immobilization was part of irradiation procedure, both irradiated and sham-irradiated animals were exposed to this unavoidable stress. Our results demonstrate that the irradiated rats exhibited different pattern of corticosteroid receptor expression and hormone levels compared to respective controls. These differences included upregulation of GR protein in the hippocampus with a concomitant elevation of GR mRNA and an increase in circulating level of corticosterone. In addition, the expression of MR, both at the level of protein and gene expression, was not altered. Taken together, this study demonstrates that cranial irradiation in juvenile rats leads to enhanced HPA axis activity and increased relative GR/MR ratio in hippocampus. The present paper intends to show that neuroendocrine response of normal brain tissue to localized irradiation comprise both activation of HPA axis and altered corticosteroid receptor balance, probably as consequence of innate immune activation.

  1. Prognosis of non-small cell lung cancer with brain metastases and the clinical role of cranial irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Tsuyoshi; Katakami, Nobuyuki; Tomioka, Hiromi; Okazaki, Miki; Sakamoto, Hiroko; Ishihara, Kyosuke; Iwasaki, Hironobu; Umeda, Fumikazu; Nakai, Hitoshi (Kobe City General Hospital, Hyogo (Japan))


    Prognosis of 95 consecutive patients with non-small cell lung cancer with brain metastases were evaluated. Three factors, therapy for brain metastases, general performance status (PS) and distant metastases to other organs had significant impact on survival. Among these 3 factors, PS was independent from the other 2 factors. Significant correlation was present, however, between therapy and other organ metastases, and few patients with brain and other distant metastases received aggressive treatment for brain metastases. Cranial irradiation had significant impact on survival even in those patients with brain and other distant metastases. Cranial irradiation also reduced death from brain metastases in responders. Our results indicate that there are several subgroups with different prognosis in patients with non-small cell lung cancer with brain metastases, therefore the most beneficial treatment modality should be selected for each group of patients. (author).

  2. Prospective study of the development of growth hormone deficiency in children given cranial irradiation, and its relation to statural growth

    Energy Technology Data Exchange (ETDEWEB)

    Brauner, R.; Rappaport, R.; Prevot, C.; Czernichow, P.; Zucker, J.M.; Bataini, P.; Lemerle, J.; Sarrazin, D.; Guyda, H.J.


    Although GH deficiency (GHD) is the most frequent hormonal abnormality that occurs after cranial radiation, the natural course of this complication and its relationship to growth in children are not known. Therefore, we undertook a 2-yr prospective study of 16 children, aged 1.7-15 yr at the time of treatment, who received cranial (31-42 Gy (1 Gy = 100 rads)) and spinal radiation for medulloblastoma or ependymoma (group I). Their growth was compared to that of 11 children given similar doses of cranial radiation only (group II). The mean plasma GH response to arginine-insulin test (AITT) was 9.1 +/- 1.5 (+/- SE) micrograms/L in group I and 8.5 +/- 1.8 micrograms/L in group II (P = NS). After 2 yr, 16 of the 27 children had a peak plasma GH value below 8 micrograms/L after AITT, and 10 children had a peak response less than 5 micrograms/L. In addition, in group I, AITT and sleep-related GH secretion were compared; at the 2 yr follow-up only 3 of 13 children had discrepant results. At the 2 yr follow-up children treated by cranial and spinal radiation had a mean height of -1.46 +/- 0.40 SD below the normal mean. In contrast, the children given only cranial radiation had a mean height of -0.15 +/- 0.18 SD; P less than 0.02. Therefore, most of the growth retardation appeared to be due to lack of spinal growth. GHD is thus an early complication of cranial radiation in these children, and no significant growth retardation can be attributed to GHD during the first 2 yr. These data contribute to the organization of follow-up in irradiated children in order to decide when human GH treatment is necessary.

  3. Prophylactic cranial irradiation for non-small cell lung cancer: a systematic review%非小细胞肺癌预防性全脑照射系统评价

    Institute of Scientific and Technical Information of China (English)

    白鸽; 古丽比也·沙比尔; 张建清; 杨媚; 包永星; 张莉


    Objective To determine whether prophylactic cranial irradiation (PCI) has a role in the management of patients with non-small cell lung carcinoma (NSCLC) treated with radical intent.Methods We searched The Cochrane Library,MEDLINE,EMbase,CBM,CNKI and VIP.The quality of the included studies was critically evaluated.Data analyses were performed using the Cochrane Collaboration's RevMan 5.1 software.Results Four randomized controlled trials involving 905 patients met the inclusion criteria.The results meta-analyses showed the incidence of brain metastases was lower in PCI group compared with the observation group ( x2 =1.98,P =0.000 ) ; but there is no evidence of 1-year overall survival (OS) benefit ( x2 =1.12,P =0.880).Only RTOG 2009 provides prospective data:There were no significant differences in global cognitive function (P =0.600) or ADL ( P =0.880) after PCI,but there was a significant decline in immediate recall (P=0.030) and delayed recall (P =0.008 ) at 1 year,At 1 year,there was no significant differences in QOL after PCI ( P =0.050).Conclusions This systematic review show significantly decreases the risk of BM without improving 1-year OS in NSCLC patient receiving prophylactic cranial irradiation.There is insufficient evidence to support the use of PCI in clinical practice.Where possible,patients should be offered entry into a clinical trial.%目的 系统评价预防性全脑照射(PCI)对非小细胞肺癌(NSCLC)的有效性和安全性.方法 计算机检索Cochrane图书馆、MEDLINE、EMbase、中国生物医学文献数据库、中国期刊全文数据库和万方数据库,收集PCI治疗NSCLC的随机对照试验,由2名评价员按照纳入与排除标准选择文献、评价质量和提取资料,对符合纳入标准的研究用RevMan 5.1软件进行荟萃分析.结果 共纳入4个随机对照试验共905例患者.与对照组(467例)相比,PCI组(438例)能减低脑转移率(x2=1.98,P =0.000),但不延长1年总生存率(x2=1.12,P=0.880).

  4. Alternative causes of hypopituitarism: traumatic brain injury, cranial irradiation, and infections. (United States)

    Pekic, Sandra; Popovic, Vera


    Hypopituitarism often remains unrecognized due to subtle clinical manifestations. Anterior pituitary hormone deficiencies may present as isolated or multiple and may be transient or permanent. Traumatic brain injury (TBI) is recognized as a risk factor for hypopituitarism, most frequently presenting with isolated growth hormone deficiency (GHD). Data analysis shows that about 15% of patients with TBI have some degree of hypopituitarism which if not recognized may be mistakenly ascribed to persistent neurologic injury and cognitive impairment. Identification of predictors for hypopituitarism after TBI is important, one of them being the severity of TBI. The mechanisms involve lesions in the hypothalamic-pituitary axis and inflammatory changes in the central nervous system (CNS). With time, hypopituitarism after TBI may progress or reverse. Cranial irradiation is another important risk factor for hypopituitarism. Deficiencies in anterior pituitary hormone secretion (partial or complete) occur following radiation damage to the hypothalamic-pituitary region, the severity and frequency of which correlate with the total radiation dose delivered to the region and the length of follow-up. These radiation-induced hormone deficiencies are irreversible and progressive. Despite numerous case reports, the incidence of hypothalamic-pituitary dysfunction following infectious diseases of the CNS has been underestimated. Hypopituitarism usually relates to the severity of the disease, type of causative agent (bacterial, TBC, fungal, or viral) and primary localization of the infection. Unrecognized hypopituitarism may be misdiagnosed as postencephalitic syndrome, while the presence of a sellar mass with suprasellar extension may be misdiagnosed as pituitary macroadenoma in a patient with pituitary abscess which is potentially a life-threatening disease.

  5. Effects of ACNU and cranial irradiation on the mouse immune system

    Energy Technology Data Exchange (ETDEWEB)

    Yamanaka, Ryuya; Tanaka, Ryuichi; Yoshida, Seiichi; Mori, Hiroshi; Takeda, Norio; Satoh, Mitsuya (Niigata Univ. (Japan). Brain Research Inst.)


    The effects of 1-(4-amino-2-methyl-5-pyrimidinyl)-methyl- 3-(2-chloroethyl)-3-nitrosourea (ACNU) and cranial irradiation on the immune system were studied in three groups of 90 mice: Group A, intraperitoneal injection of ACNU (30 mg/kg); Group B, single exposure of 10 Gy to the head; and Group C, intraperitoneal injection of ACNU (30 mg/kg) and single exposure of 10 Gy to the head. Peripheral white blood cell counts, spleen cell subsets, natural killer (NK) cell activity, lymphocyte blastogenesis, and production of interferon (IFN)-[gamma] were analyzed once a week for 6 weeks after treatment. In Group A, NK cell activity decreased between weeks 4-5, concanavalin A blastogenesis decreased during weeks 1-5, and the levels of L3T4 (CD4) and Lyt2 cells (CD8) and IFN-[gamma] production decreased during weeks 2-5. However, all tested parameters returned to the normal range at 6 weeks. In Group B, all parameters except for the L3T4 cell level and the IFN-[gamma] production decreased during week 1, and returned to the normal range thereafter. The concentration of L3T4 cells decreased during week 2 and between weeks 5-6. The IFN-[gamma] production increased during week 1, decreased during week 2, and returned to the normal range thereafter. In Group C, the suppressive effects were severe and continued for a longer period than in either Group A or B. Concanavalin A blastogenesis, L3T4 cell concentration, and IFN-[gamma] production were still suppressed after 6 weeks. Therefore, intensive radiochemotherapy for brain tumor may suppress the immunological function. (author).

  6. CTO PCI Procedural Planning. (United States)

    Lembo, Nicholas J; Karmpaliotis, Dimitri; Kandzari, David E


    Chronic total occlusion percutaneous coronary intervention (CTO PCI) procedural planning involves much thought and deliberation before one actually attempts to cross the CTO lesion in the cardiac catheterization laboratory. Careful preprocedural angiographic assessment is a key to successful CTO PCI. CTO PCI represents the most complex PCI one can perform, and thus operator and staff training as well as the concept of CTO days are all essential for a successful CTO PCI program. Copyright © 2012. Published by Elsevier Inc.

  7. Neurologic, neuropsychologic, and computed cranial tomography scan abnormalities in 2- to 10-year survivors of small-cell lung cancer. (United States)

    Johnson, B E; Becker, B; Goff, W B; Petronas, N; Krehbiel, M A; Makuch, R W; McKenna, G; Glatstein, E; Ihde, D C


    In order to evaluate the relationship between neurologic function and cranial irradiation, 20 patients treated on National Cancer Institute (NCI) small-cell lung cancer (SCLC) trials who were alive and free of cancer 2.4 to 10.6 years (median, 6.2) from the start of therapy were studied. All were tested with a neurologic history and examination, mental status examination, neuropsychologic testing, and review of serial computed cranial tomography (CCT) scans. Fifteen patients had been treated with prophylactic cranial irradiation (PCI), two patients with therapeutic cranial irradiation, and three received no cranial irradiation. All patients but one were ambulatory and none were institutionalized. Fifteen patients (75%) had neurologic complaints, 13 (65%) had abnormal neurologic examinations, 12 (60%) had abnormal mental status examinations, 13 (65%) had abnormal neuropsychologic testing, and 15 (75%) had abnormal CCT scans. Compared with those given low-dose maintenance chemotherapy during PCI using 200 to 300 rad per fraction, patients who were given high-dose induction chemotherapy during the time of cranial irradiation or large radiotherapy fractions (400 rad) were more likely to have abnormal mental status examinations (6/6 v 4/9) and abnormal neuropsychologic tests (6/6 v 4/9), but no major difference in CCT findings was present. CCT scans in the majority of cases (11/18) showed progressive ventricular dilatation or cerebral atrophy up to 8 years after stopping therapy. We conclude neurologic abnormalities are common in long-term survivors of SCLC, and may be more prominent in patients given high-dose chemotherapy during cranial irradiation or treated with large radiotherapy fractions. The CCT scan abnormalities are common and progressive years after prophylactic cranial irradiation and chemotherapy are stopped.

  8. PCI bus demystified

    CERN Document Server

    Abbott, Doug


    The peripheral component interconnect (PCI) bus is the dominant bus system used to connect the different elements making up today''s high-performance computer systems. Different PCI implementations have also been developed for such applications as telecommunications and embedded computing. If an application calls for high speed, high reliability, flexible configuration, and bus mastering, then PCI is the only logical bus choice. This book is an applications-oriented introduction to the PCI bus, with an emphasis on implementing PCI in a variety of computer architectures. Special attention is given to industrial and mission-critical applications of PCI bus.·Fully describes PCI electrical specifications, mechanical requirements, and signal types·Covers advanced topics through numerous design examples to increase the readers understanding of the subject ·Includes updated coverage of PCI-X 2.0

  9. ApoE isoform modulates effects of cranial ⁵⁶Fe irradiation on spatial learning and memory in the water maze. (United States)

    Yeiser, Lauren A; Villasana, Laura E; Raber, Jacob


    Apolipoprotein E, which plays an important role in lipid transport and metabolism and neuronal repair, might modulate the CNS risk following (56)Fe irradiation exposure during space missions. In this study, we investigated this risk by behavioral and cognitive testing male E2, E3, and E4 mice 3 months following cranial (56)Fe irradiation. In the open field, mice irradiated with 2 Gy showed higher activity levels than sham-irradiated mice or mice irradiated with 1 Gy. In addition, E2 mice showed higher activity and lower measures of anxiety than E3 and E4 mice in the open field and elevated zero maze. During hidden platform training, sham-irradiated mice showed most robust learning, 1 Gy irradiated mice reduced learning, and 2 Gy irradiated mice no improvement over the four sessions. In the water maze probe trials, sham-irradiated E2, E3, and E4 mice and E2 and E4 mice irradiated with 1 Gy showed spatial memory retention, but E3 mice irradiated with 1 Gy, and E2, E3, and E4 mice irradiated with 2 Gy did not. Thus, cranial (56)Fe irradiation increases activity levels in the open field and impairs spatial learning and memory in the water maze. E3 mice are more susceptible than E2 or E4 mice to impairments in spatial memory retention in the water maze, indicating that apoE isoform modulates the CNS risk following space missions.

  10. Survival and Neurocognitive Outcomes After Cranial or Craniospinal Irradiation Plus Total-Body Irradiation Before Stem Cell Transplantation in Pediatric Leukemia Patients With Central Nervous System Involvement

    Energy Technology Data Exchange (ETDEWEB)

    Hiniker, Susan M. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Agarwal, Rajni [Section of Stem Cell Transplantation, Department of Pediatrics, Stanford University, Stanford, California (United States); Modlin, Leslie A. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Gray, Christine C. [Division of Child and Adolescent Psychiatry, Department of Psychiatry, Stanford University, Stanford, California (United States); Harris, Jeremy P.; Million, Lynn [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Kiamanesh, Eileen F. [Cancer Clinical Trials Office, Stanford Cancer Institute, Stanford University, Stanford, California (United States); Donaldson, Sarah S., E-mail: [Department of Radiation Oncology, Stanford University, Stanford, California (United States)


    Purpose: To evaluate survival and neurocognitive outcomes in pediatric acute lymphoblastic leukemia (ALL) patients with central nervous system (CNS) involvement treated according to an institutional protocol with stem cell transplantation (SCT) and a component of craniospinal irradiation (CSI) in addition to total-body irradiation (TBI) as preparative regimen. Methods and Materials: Forty-one pediatric ALL patients underwent SCT with TBI and received additional cranial irradiation or CSI because of CNS leukemic involvement. Prospective neurocognitive testing was performed before and after SCT in a subset of patients. Cox regression models were used to determine associations of patient and disease characteristics and treatment methods with outcomes. Results: All patients received a cranial radiation boost; median total cranial dose was 24 Gy. Eighteen patients (44%) received a spinal boost; median total spinal dose for these patients was 18 Gy. Five-year disease-free survival (DFS) for all patients was 67%. Those receiving CSI had a trend toward superior DFS compared with those receiving a cranial boost alone (hazard ratio 3.23, P=.14). Patients with isolated CNS disease before SCT had a trend toward superior DFS (hazard ratio 3.64, P=.11, 5-year DFS 74%) compared with those with combined CNS and bone marrow disease (5-year DFS 59%). Neurocognitive testing revealed a mean post-SCT overall intelligence quotient of 103.7 at 4.4 years. Relative deficiencies in processing speed and/or working memory were noted in 6 of 16 tested patients (38%). Pre- and post-SCT neurocognitive testing revealed no significant change in intelligence quotient (mean increase +4.7 points). At a mean of 12.5 years after transplant, 11 of 13 long-term survivors (85%) had completed at least some coursework at a 2- or 4-year college. Conclusion: The addition of CSI to TBI before SCT in pediatric ALL with CNS involvement is effective and well-tolerated. Craniospinal irradiation plus TBI is worthy

  11. Patterns of failure in limited-stage small cell lung cancer: Implications of TNM stage for prophylactic cranial irradiation. (United States)

    Wu, Abraham J; Gillis, Andrea; Foster, Amanda; Woo, Kaitlin; Zhang, Zhigang; Gelblum, Daphna Y; Downey, Robert J; Rosenzweig, Kenneth E; Ong, Leonard; Perez, Carmen A; Pietanza, M Catherine; Krug, Lee; Rudin, Charles M; Rimner, Andreas


    The relationship between tumor-node-metastasis (TNM) stage and patterns of failure in limited-stage small cell lung cancer (LS-SCLC) remains unclear. We hypothesized that TNM stage predicts brain metastasis risk, and could inform the use of prophylactic cranial irradiation. We reviewed 283 patients with stage I-IIIB SCLC. Competing-risks regression was used to analyze local, distant, and brain failure. Multivariate analysis was used to evaluate the effect of treatment and clinical factors on failure and OS. Patients with stage I or II SCLC (35% of cohort) had significantly better survival and lower risk of distant and brain metastasis, compared with stage III patients. The 5-year cumulative incidence of brain metastasis for stage I/II and III were 12% and 26%, respectively. Stage had no correlation with local failure. On multivariate analysis, stage was independently prognostic for survival, distant metastasis risk, and brain metastasis risk. TNM staging predicts likelihood of distant metastasis, brain metastasis, and survival in LS-SCLC. This supports the routine use of TNM staging in clinical practice. The lower risk of brain metastasis in stage I and II SCLC suggests that prophylactic cranial irradiation could play a more limited role in treatment of early-stage disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. The Role of DNA Methylation Changes in Radiation-Induced Transgenerational Genomic Instability and Bystander Effects in cranial irradiated Mice (United States)

    Zhang, Meng; Sun, Yeqing; Gao, Yinglong; Zhang, Baodong

    Heavy-ion radiation could lead to genome instability in the germline, and therefore to transgenerational genome and epigenome instability in offspring of exposed males. The exact mechanisms of radiation-induced genome instability in directly exposed and in bystander organ remain obscure, yet accumulating evidence points to the role of DNA methylation changes in genome instability development. The potential of localized body-part exposures to affect the germline and thus induce genome and epigenome changes in the progeny has not been studied. To investigate whether or not the paternal cranial irradiation can exert deleterious changes in the protected germline and the offsprings, we studied the alteration of DNA methylation in the shielded testes tissue. Here we report that the localized paternal cranial irradiation results in a significant altered DNA methylation in sperm cells and leads to a profound epigenetic dysregulation in the unexposed progeny conceived 3 months after paternal exposure. The possible molecular mechanisms and biological consequences of the observed changes are discussed. Keywords: Heavy-ion radiation; Transgenerational effect; Genomic Instability Bystander Effects; DNA methylation.

  13. Circulating tumor cells correlate with recurrence in stage III small-cell lung cancer after systemic chemoradiotherapy and prophylactic cranial irradiation. (United States)

    Fu, Lei; Liu, Fang; Fu, Hui; Liu, Liqing; Yuan, Shuanghu; Gao, Yongsheng; Fu, Zheng; Yu, Jinming


    We investigated the correlation between circulating tumor cells and the incidence of brain metastases as a first site of recurrence among patients with small-cell lung cancer after systemic chemoradiotherapy and prophylactic cranial irradiation. In addition, we assessed the contribution of circulating tumor cells for planning the appropriate total dose of prophylactic cranial irradiation for small-cell lung cancer. Patients (n = 112) with diagnosed Stage III small-cell lung cancer were treated with four cycles of platinum-based regimen and concurrent chest irradiation, and then prophylactic cranial irradiation. Blood samples for circulating tumor cell analysis were obtained before the initiation of chemotherapy and after the first and fourth cycle of chemotherapy. Circulating tumor cells after the first cycle of chemotherapy correlated with tumor response after completion of chemotherapy (P = 0.012). Patients with brain as the first site suffered a higher rate of further metastases to other organs, and local recurrence, compared with those whose first site was the other organs (P lung cancer. For patients with circulating tumor cells >218, prophylactic cranial irradiation at a total dose of 30 Gy in 15 fractions is insufficient. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  14. Evaluation of growth hormone release and human growth hormone treatment in children with cranial irradiation-associated short stature

    Energy Technology Data Exchange (ETDEWEB)

    Romshe, C.A.; Zipf, W.B.; Miser, A.; Miser, J.; Sotos, J.F.; Newton, W.A.


    We studied nine children who had received cranial irradiation for various malignancies and subsequently experienced decreased growth velocity. Their response to standard growth hormone stimulation and release tests were compared with that in seven children with classic GH deficiency and in 24 short normal control subjects. With arginine and L-dopa stimulation, six of nine patients who received radiation had a normal GH response (greater than 7 ng/ml), whereas by design none of the GH deficient and all of the normal children had a positive response. Only two of nine patients had a normal response to insulin hypoglycemia, with no significant differences in the mean maximal response of the radiation and the GH-deficient groups. Pulsatile secretion was not significantly different in the radiation and GH-deficient groups, but was different in the radiation and normal groups. All subjects in the GH-deficient and radiation groups were given human growth hormone for 1 year. Growth velocity increased in all, with no significant difference in the response of the two groups when comparing the z scores for growth velocity of each subject's bone age. We recommend a 6-month trial of hGH in children who have had cranial radiation and are in prolonged remission with a decreased growth velocity, as there is no completely reliable combination of GH stimulation or release tests to determine their response.

  15. Dietary essential fatty acids and gender-specific behavioral responses in cranially irradiated rats. (United States)

    Elkin, T David; Wollan, Michael O; Anderson, Stacy L; Gaston, Robert; Meyer, William; Fuemmeler, Bernard F; Holloway, Frank A; Martin, Rex E


    Specific memory deficits, reduced intellectual processing speed, and a variety of social and behavioral problems have been implicated as long-term effects of cranial radiation therapy (CRT). These deficits are thought to be related to changes in brain cytology and structure associated with microvascular aberrations. N-3 fatty acids may serve as protectants in pediatric patients who receive CRT for brain tumors. Timed-pregnant rat dams were fed one of four diets that were identical in all respects, except for their essential fatty acid content. The dams were placed on these diets at the beginning of the third trimester of gestation and their pups remained on them throughout the study. The rats' behavioral response as judged by acoustic startle response (ASR) and neurocognitive response (performance in a radial maze, RM) were evaluated in relation to diet, gender, and CRT. The following hypotheses were tested: (1) female rats will show greater CRT-induced neurocognitive and behavioral deficits; (2) dietary n-3 fatty acids will diminish CRT-induced neurocognitive and behavioral deficits; (3) gender-specific differences would be dampened by n-3 fatty acids in the diet. All three hypotheses were partially supported. These findings are discussed in light of the potential neuroprotective effects of n-3 fatty acids.

  16. Feasibility of small animal cranial irradiation with the microRT system

    Energy Technology Data Exchange (ETDEWEB)

    Kiehl, Erich L.; Stojadinovic, Strahinja; Malinowski, Kathleen T.; Limbrick, David; Jost, Sarah C.; Garbow, Joel R.; Rubin, Joshua B.; Deasy, Joseph O.; Khullar, Divya; Izaguirre, Enrique W.; Parikh, Parag J.; Low, Daniel A.; Hope, Andrew J. [Washington University School of Medicine, St. Louis, Missouri 63110 (United States); Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298 (United States); Washington University School of Medicine, St. Louis, Missouri 63110 (United States); Princess Margaret Hospital, Toronto, Ontario M5G 2M9 (Canada)


    Purpose: To develop and validate methods for small-animal CNS radiotherapy using the microRT system. Materials and Methods: A custom head immobilizer was designed and built to integrate with a pre-existing microRT animal couch. The Delrin couch-immobilizer assembly, compatible with multiple imaging modalities (CT, microCT, microMR, microPET, microSPECT, optical), was first imaged via CT in order to verify the safety and reproducibility of the immobilization method. Once verified, the subject animals were CT-scanned while positioned within the couch-immobilizer assembly for treatment planning purposes. The resultant images were then imported into CERR, an in-house-developed research treatment planning system, and registered to the microRTP treatment planning space using rigid registration. The targeted brain was then contoured and conformal radiotherapy plans were constructed for two separate studies: (1) a whole-brain irradiation comprised of two lateral beams at the 90 degree sign and 270 degree sign microRT treatment positions and (2) a hemispheric (left-brain) irradiation comprised of a single A-P vertex beam at the 0 degree sign microRT treatment position. During treatment, subject animals (n=48) were positioned to the CERR-generated treatment coordinates using the three-axis microRT motor positioning system and were irradiated using a clinical Ir-192 high-dose-rate remote after-loading system. The radiation treatment course consisted of 5 Gy fractions, 3 days per week. 90% of the subjects received a total dose of 30 Gy and 10% received a dose of 60 Gy. Results: Image analysis verified the safety and reproducibility of the immobilizer. CT scans generated from repeated reloading and repositioning of the same subject animal in the couch-immobilizer assembly were fused to a baseline CT. The resultant analysis revealed a 0.09 mm average, center-of-mass translocation and negligible volumetric error in the contoured, murine brain. The experimental use of the head

  17. Differential effects of 18- and 24-Gy cranial irradiation on growth rate and growth hormone release in children with prolonged survival after acute lymphocytic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Cicognani, A.; Cacciari, E.; Vecchi, V.; Cau, M.; Balsamo, A.; Pirazzoli, P.; Tosi, M.T.; Rosito, P.; Paolucci, G.


    To evaluate the effects of two different doses of cranial irradiation on growth and growth hormone (GH) release, we studied 61 children with acute lymphocytic leukemia who had survived at least five years in continuous complete remission. Forty-three children received 24 Gy (group 1) and 18 children received 18 Gy (group 2). Height was evaluated at diagnosis, at the end of treatment, and 6, 12, and 24 months later. Growth hormone release was evaluated by arginine and levodopa tests after the end of treatment. After diagnosis, the height SD score decreased significantly in both groups; two years after the end of treatment, only group 1 showed an SD score for height that was still significantly lower than at diagnosis. Group 1 showed impaired GH responses to the tests and, compared with controls, group 1 in fact included a percentage of subjects with a normal response to levodopa (ie, greater than 8 micrograms/L) that was significantly lower (56.4% vs 83.3%) and a percentage of nonresponders to both tests that was significantly higher (21.6% vs 0%). These data indicate that only patients treated with lower cranial irradiation dosage (18 Gy) had complete growth recovery and normal GH responses to pharmacologic tests.

  18. Ramping up PCI production

    Energy Technology Data Exchange (ETDEWEB)

    Bergsma, D.; Kieftenbeld, B.; Bol, L. [Corus Strip Products IJmuiden (Netherlands). Blast Furnace Dept.


    This paper described the improvements at the Corus Strip Products IJmuiden coal preparation plant and injection facilities that have resulted in ultra high productivities and very low coke rates of the blast furnaces. Pulverized coal injection (PCI) began at the steelmaking plant 25 years ago. Since then, an increased coal preparation output has been realized each year. The capacity of the mills and the injection systems were increased from about 70 tons/h to over 200 tons/h, thereby allowing a steady decrease in coke rate per ton of hot metal with a considerable increase in hot metal production from the blast furnaces. Many modifications were in hardware, but much of the increase in productivity was due to increasing the aimed pulverized coal (PC) particle size, selecting different coals and improving process control in both milling and injection facilities. Depending on the coal variety, the specific PCI-rates could reach over 250 kg/thm. The excellent performance was made possible by improving key factors such as burden quality, burdening, cast house performance and installation reliability. The modifications also solved constraints in working pressure; uptake pulverized coal moisture content; inlet and outlet air temperature; and injection rate stability. Coal selection was based on handlability, chemical composition and economics. 1 tab., 9 figs.

  19. 根治性治疗后非小细胞肺癌的预防性脑照射%Prophylactic Cranial Irradiation for Preventing Brain Metastases in Patients Undergoing Radical Treatment for Non-Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    李伟雄; 黄玉娟


    @@ 1 文献来源 Lester JF,Coles B,Macbeth FR.Prophylactic cranial irradiation for preventing brain metastases in patients undergoing radical treatment for non-small cell lung cancer[DB/CD].The Cochrane Library 2007,Issue 3.

  20. PCI-SIG推出PCI Express新规范

    Institute of Scientific and Technical Information of China (English)


    负责PCI Express业界标准I/O技术的特别兴趣小组PCI—SIG日前官布,推出PCI Express ExpressModule规范。这个PCI Express规范定义了可热插拔的I/O扩展模块标准,能够大幅度提高企业级服务器和工作站平台的可靠性及设计灵活性。符合ExpressModule规范的产品有望于2005年底面市。在PCI—SIG规范中,

  1. Actuarial risk of isolated CNS involvement in Ewing's sarcoma following prophylactic cranial irradiation and intrathecal methotrexate

    Energy Technology Data Exchange (ETDEWEB)

    Trigg, M.E.; Makuch, R.; Glaubiger, D.


    Records of 154 patients with Ewing's sarcoma treated at the National Cancer Institute were reviewed to assess the incidence and risk of developing isolated central nervous system (CNS) Ewing's sarcoma. Sixty-two of the 154 patients had received CNS irradiation and intrathecal (i.t.) methotrexate as part of their initial therapy to prevent the occurrence of isolated CNS Ewing's sarcoma. The risk of developing isolate CNS Ewing's sarcoma was greatest within the first two years after diagnosis and was approximately 10%. The overall risk of CNS recurrence in the group of patients receiving DNS treatment was similar to the group receiving no therapy directed to the CNS. The occurrence of isolated CNS involvement was not prevented by the use of CNS irradiation and i.t. methotrexate. Because of a lack of efficacy to the CNS irradiation regimen, current treatment regimens do not include therapy directed to CNS.

  2. Application of probabilistic fiber-tracking method of MR imaging to measure impact of cranial irradiation on structural brain connectivity in children treated for medulloblastoma (United States)

    Duncan, Elizabeth C.; Reddick, Wilburn E.; Glass, John O.; Hyun, Jung Won; Ji, Qing; Li, Yimei; Gajjar, Amar


    We applied a modified probabilistic fiber-tracking method for the extraction of fiber pathways to quantify decreased white matter integrity as a surrogate of structural loss in connectivity due to cranial radiation therapy (CRT) as treatment for pediatric medulloblastoma. Thirty subjects were examined (n=8 average-risk, n=22 high-risk) and the groups did not differ significantly in age at examination. The pathway analysis created a structural connectome focused on sub-networks within the central executive network (CEN) for comparison between baseline and post-CRT scans and for comparison between standard and high dose CRT. A paired-wise comparison of the connectivity between baseline and post-CRT scans showed the irradiation did have a significant detrimental impact on white matter integrity (decreased fractional anisotropy (FA) and decreased axial diffusivity (AX)) in most of the CEN sub-networks. Group comparisons of the change in the connectivity revealed that patients receiving high dose CRT experienced significant AX decreases in all sub-networks while the patients receiving standard dose CRT had relatively stable AX measures across time. This study on pediatric patients with medulloblastoma demonstrated the utility of this method to identify specific sub-networks within the developing brain affected by CRT.

  3. 肝素钠外涂联合紫外线照射治疗冠状动脉介入术后局部淤斑的效果观察%Therapeutic Effects of Ultraviolet Irradiation plus Heparin Sodium on Post-PCI Subcutaneous Ecchymosis

    Institute of Scientific and Technical Information of China (English)

    徐佳; 涂国红; 殷容光


    Objective To observe the effects of ultraviolet irradiation plus heparin sodium on subcutaneous ecchymosis in post-PCI patients. Methods A total of 60 post-PCI patients were randomly divided into control group, in which patients were treated with heparin sodium cream and experiment group, in which patients were provided with heparin sodium and ultraviolet irradiation. The diameter decrease of subcutaneous ecchymosis and its complete absorption time in both groups were compared. Results Compared with that of control group, the diameter of subcutaneous ecchymosis of experiment group decreased more quickly and its complete absorption time shortened(P<0.001). Conclusion Ultraviolet irradiation plus heparin sodium can significantly promote the absorption of the subcutaneous ecchymosis in PCI patients, and improve the local outcome in the puncture site.%目的 观察紫外线照射联合外用肝素钠软膏治疗冠状动脉介入治疗术后患者穿刺点皮下淤斑的效果.方法 选取冠状动脉介入治疗术后发生穿刺点淤斑的患者,随机分为观察组和对照组各30例,观察组采用局部紫外线照射联合外用肝素钠软膏,对照组仅使用肝素钠软膏,比较两组术后7 d 时的皮下淤斑直径缩小值和淤斑完全吸收时间的差异.结果 观察组术后7 d皮下淤斑直径缩小值为(7.7±0.8)cm,对照组为(6.3±1.1)cm,两组差异有统计学意义(P<0.001);观察组淤斑完全吸收时间(10.1±1.4)d,比对照组(12.5±1.2)d 缩短(P<0.001).结论 紫外线照射联合外用肝素钠软膏治疗可以明显促进冠状动脉介入治疗术后患者皮下淤斑的吸收,改善局部预后.

  4. Future of the PCI Readmission Metric. (United States)

    Wasfy, Jason H; Yeh, Robert W


    Between 2013 and 2014, the Centers for Medicare and Medicaid Services and the National Cardiovascular Data Registry publically reported risk-adjusted 30-day readmission rates after percutaneous coronary intervention (PCI) as a pilot project. A key strength of this public reporting effort included risk adjustment with clinical rather than administrative data. Furthermore, because readmission after PCI is common, expensive, and preventable, this metric has substantial potential to improve quality and value in American cardiology care. Despite this, concerns about the metric exist. For example, few PCI readmissions are caused by procedural complications, limiting the extent to which improved procedural technique can reduce readmissions. Also, similar to other readmission measures, PCI readmission is associated with socioeconomic status and race. Accordingly, the metric may unfairly penalize hospitals that care for underserved patients. Perhaps in the context of these limitations, Centers for Medicare and Medicaid Services has not yet included PCI readmission among metrics that determine Medicare financial penalties. Nevertheless, provider organizations may still wish to focus on this metric to improve value for cardiology patients. PCI readmission is associated with low-risk chest discomfort and patient anxiety. Therefore, patient education, improved triage mechanisms, and improved care coordination offer opportunities to minimize PCI readmissions. Because PCI readmission is common and costly, reducing PCI readmission offers provider organizations a compelling target to improve the quality of care, and also performance in contracts involve shared financial risk.

  5. Extended intrathecal methotrexate may replace cranial irradiation for prevention of CNS relapse in children with intermediate-risk acute lymphoblastic leukemia treated with Berlin-Frankfurt-Münster-based intensive chemotherapy. The Associazione Italiana di Ematologia ed Oncologia Pediatrica. (United States)

    Conter, V; Aricò, M; Valsecchi, M G; Rizzari, C; Testi, A M; Messina, C; Mori, P G; Miniero, R; Colella, R; Basso, G


    To assess the effect of treatment intensification and that of extended intrathecal methotrexate substitution for cranial irradiation in intermediate-risk acute lymphoblastic leukemia (ALL) children treated with a Berlin-Frankfurt-Münster (BFM)-based intensive chemotherapy. Three hundred ninety-six children with non-B-ALL were enrolled onto the Associazione Italiana di Ematologia ed Oncologic Pediatrica (AIEOP) ALL 88 study. Standard risk (SR) included patients with low tumor burden (BFM risk index [RI], or = 0.8 but less than 1.2; and high risk (HR) were those with an RI > or = 1.2 or CNS involvement at diagnosis. The treatment schedule was a modified version of the ALL-BFM 86 study. CNS-directed treatment consisted of high-dose methotrexate (HD-MTX; 5 g/m2 for four courses) plus intrathecal methotrexate (IT-MTX; nine doses); IR patients additionally received extended IT-MTX (nine doses during continuation therapy); cranial irradiation was given only to HR patients. Of the 375 (94.7%) children who achieved remission, 1.3% had an adverse event other than relapse. The estimated event-free survival (EFS) at 6 years was 66.6% (SE 2.4) overall; 80.7% (4.5) in the SR patients, 77.5% (3.9) in the IR patients, and 54.5% (3.7) in the HR patients. Relapse occurred in 107 children (27.0%). Isolated CNS relapse occurred in 20 children (5.0%): 5 (6.3%) in the SR group, 1 (0.8%) in the IR group, and 14 (7.1%) in the HR group. The estimated 6-year CNS leukemia-free survival was 94.6% (1.2) overall: 93.5% (2.8) in the SR group, 99.1% (0.9) in the IR group, and 92.3% (2.0) in the HR group. Cranial irradiation may be omitted safely in IR ALL patients treated with BFM-based intensive chemotherapy when extended intrathecal chemotherapy is given. Because the CNS disease control was less complete in the SR group, these data challenge the effectiveness of HD-MTX for protection from CNS disease and support the protective role of extended intrathecal chemotherapy.

  6. Prophylactic Cranial Irradiation in Local Advanced Non Small-Cell Lung Cancer: Result from A Multi Center Clinical Trial from German%局部晚期非小细胞肺癌患者的预防性脑照射——来自德国的多中心临床试验结果

    Institute of Scientific and Technical Information of China (English)

    樊旼; 徐崇锐


    @@ 1 文献来源 ①Stuschke BM,Eberhardt W,P(o)ttgen C,et al.Prophylactic cranial irradiation in locally advanced non-small-cell lung cancer after muhimodality treatment:Long-term follow-up and investigations of late neuropsychologic effects[J].J Clin Oncol,1999,17:2700-2709.

  7. Immediate treatment effects of high-dose methotrexate and cranial irradiation on neuropsychological functions of children treated for acute lymphoblastic leukemia at a regional cancer center

    Directory of Open Access Journals (Sweden)

    Sundaramoorthy Chidambaram


    Full Text Available Context: Overall cure rates for pediatric acute lymphoblastic leukemia (ALL have improved; however, the neuropsychological sequelae of ALL treatment have not been adequately documented in India. Aims: The present study assesses the immediate effects of ALL treatment on neuropsychological functioning, at the Regional Cancer Center in Chennai, South India. Materials and Methods: Newly diagnosed with ALL patients (n = 24 (aged 6-15 years; 13M:11F registered between March 2008 and February 2009 were included. Patients who had received high-dose methotrexate (HD-MTX and cranial radiotherapy (CRT as part of their treatment were enrolled for the study. Neurocognitive assessments were done to assess various functions such as performance intelligence, visuo-perception, visuo-spatial, perceptual organization, processing speed, planning, working memory, and immediate verbal memory (IVM (Malin′s intelligence scale; verbal fluency (ideation fluency test and verbal attention (vigilance test. Three assessments were done during induction (baseline, after re-induction phase (second and during the maintenance phase (third. Results: The patients performed significantly worse in the third assessment (mean duration from diagnosis 17.48 months on performance intelligence quotient (PIQ, visuo-perception, visuo-spatial, processing speed, planning, IVM, verbal attention, and verbal fluency (P 0.05. Significant difference was observed between age groups 6 and 10 (41.7% and 11-15 years (58.3% in perceptual organization, verbal fluency, and verbal attention (P 0.05. Conclusions: Combining HD MTX and CRT had an immediate effect on neuropsychological sequelae among the children with ALL, however, long-term evaluation is recommended to study the long-term effects.

  8. PCI compliance understand and implement effective PCI data security standard compliance

    CERN Document Server

    Williams, Branden R


    The credit card industry established the PCI Data Security Standards to provide a minimum standard for how vendors should protect data to ensure it is not stolen by fraudsters. PCI Compliance, 3e, provides the information readers need to understand the current PCI Data Security standards, which have recently been updated to version 2.0, and how to effectively implement security within your company to be compliant with the credit card industry guidelines and protect sensitive and personally identifiable information. Security breaches continue to occur on a regular basis, affecting millions of

  9. PCI Opens Tile Adhesives Plant in Foshan

    Institute of Scientific and Technical Information of China (English)

    Jenny Du


    @@ On October 22nd, 2007 BASF celebrated the inauguration of Asia's first PCI tilead hesives plant in Foshan, Guangdong Province. The plant is designed to provide a platform for the transfer of cutting-edge tiling systems technologies and solutions from Germany to China to benefit local construction chemicals sector.

  10. Head and neck region consolidation radiotherapy and prophylactic cranial irradiation with hippocampal avoidance delivered with helical tomotherapy after induction chemotherapy for non-sinonasal neuroendocrine carcinoma of the upper airways

    Directory of Open Access Journals (Sweden)

    Franco Pierfrancesco


    Full Text Available Abstract Background Non-sinonasal neuroendocrine carcinomas (NSNECs of the head and neck are considered an unfrequent clinico-pathological entity. Combined modality treatment represents an established therapeutic option for undifferentiated forms where distant metastasis is a common pattern of failure. Methods We report on a case of NSNEC treated with sequential chemo-radiation consisting of 6 cycles of cisplatin and etoposide followed by loco-regional radiation to the head and neck and simultaneous prophylactic cranial irradiation to prevent from intracranial spread, delivered with helical tomotherapy with the 'hippocampal avoidance' technique in order to reduce neuro-cognitive late effects. Results One year after the end of the whole combined modality approach, the patient achieved complete remission, with no treatment-related sub-acute and late effects. Conclusions The present report highlights the importance of multidisciplinary management for NSNECs of the head and neck, as the possibility to achieve substantial cure rates with mild side effects with modern radiotherapy techniques.

  11. PCI DSS a practical guide to implementing and maintaining compliance

    CERN Document Server

    Wright, Steve


    This newly revised, practical guide, gives you a step by step guide to achieving Payment Card Industry Data Security Standard (PCI DSS) compliance - showing you how to create, design and build a PCI compliance framework.

  12. Prognostic significance of the initial cerebro-spinal fluid (CSF) involvement of children with acute lymphoblastic leukaemia (ALL) treated without cranial irradiation: results of European Organization for Research and Treatment of Cancer (EORTC) Children Leukemia Group study 58881. (United States)

    Sirvent, Nicolas; Suciu, Stefan; Rialland, Xavier; Millot, Frédéric; Benoit, Yves; Plantaz, Dominique; Ferster, Alice; Robert, Alain; Lutz, Patrick; Nelken, Brigitte; Plouvier, Emmanuel; Norton, Lucilia; Bertrand, Yves; Otten, Jacques


    To evaluate the prognostic significance of the initial cerebro-spinal fluid (CSF) involvement of children with ALL enrolled from 1989 to 1996 in the EORTC 58881 trial. Patients (2025) were categorised according to initial central nervous system (CNS) status: CNS-1 (CNS negative, n=1866), CNS-2 (<5 leucocytes/mm(3), CSF with blasts, n=50), CNS-3 (CNS positive, n=49), TLP+ (TLP with blasts, n=60). CNS-directed therapy consisted in intravenous (i.v.) methotrexate (5 g/sqm) in 4-10 courses, and intrathecal methotrexate injections (10-20), according to CNS status. Cranial irradiation was omitted in all patients. In the CNS1, TLP+, CNS2 and CNS3 group the 8-year EFS rate (SE%) was 69.7% (1.1%), 68.8% (6.2%), 71.3% (6.5%) and 68.3% (6.2%), respectively. The 8-year incidence of isolated CNS relapse (SE%) was 3.4% (0.4%), 1.7% (1.7%), 6.1% (3.5%) and 9.4% (4.5%), respectively, whereas the 8-year isolated or combined CNS relapse incidence was 7.6% (0.6%), 3.5% (2.4%), 10.2% (4.4%) and 11.7% (5.0%), respectively. Patients with CSF blasts had a higher rate of initial bad risk features. Multivariate analysis indicated that presence of blasts in the CSF had no prognostic value: (i) for EFS and OS; (ii) for isolated and isolated or combined CNS relapse; WBC count<25 × 10(9)/L and Medac E-coli asparaginase treatment were each related to a lower CNS relapse risk. The presence of initial CNS involvement has no prognostic significance in EORTC 58881. Intensification of CNS-directed chemotherapy, without CNS radiation, is an effective treatment of initial meningeal leukaemic involvement. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. PCI Compliance Understand and Implement Effective PCI Data Security Standard Compliance

    CERN Document Server

    Chuvakin, Anton


    Identity theft and other confidential information theft have now topped the charts as the #1 cybercrime. In particular, credit card data is preferred by cybercriminals. Is your payment processing secure and compliant?. Now in its second edition, PCI Compliance has been revised to follow the new PCI DSS standard 1.2.1. Also new to this edition: Each chapter has how-to guidance to walk you through implementing concepts, and real-world scenarios to help you relate to the information and better grasp how it impacts your data. This book provides the information that you need to understand the curre

  14. Overview of the Cranial Nerves (United States)

    ... they were damaged. Cranial nerve disorders can affect smell, taste, vision, sensation in the face, facial expression, ... Cranial Nerve Number Name Function Test 1st Olfactory Smell The ability to smell is tested by asking ...

  15. Long-term consequences of growth hormone replacement and cranial radiation on pituitary function

    NARCIS (Netherlands)

    Appelman-Dijkstra, Natasha Mireille


    This thesis covers the consequences of cranial irradiation of non-pituitary tumors, eg nasopharyngeal carcinoma, on pituitary function. In chapter 2 we have performed a meta-analysis of available data reported in literature on pituitary function after cranial radiotherapy for head and neck and non-p

  16. Development of 8-lane PCI-Express protocol using VHDL

    Directory of Open Access Journals (Sweden)

    K. Harish


    Full Text Available Flosolver Mk 8 is the latest family member of the Flosolver series of parallel computers in CSIR-NAL that is currently being developed, to have a performance of 10 TFLOPS with 1024 processors in it. It is based on distributed memory concept, using quad core xeon processors[11]. Each cluster consists of 8 processors, a FPGA based Floswitch, and 4 PCI cards. The inter Cluster communication is carried out through optical transceivers to provide high speed communication. PCI is used for interface between the server and the FloSwitch. Unlike any other switch, the Floswitch has the capability of performing information processing operation which is a unique feature, along with message passing[12]. To this existing system the project intends to replace the PCI card with 8- lane PCI-Express add-on card. The PCI-Express defines a line rate of 2.5Gbps per lane. The basic goal of this project entitled “Development of PCI Express protocol using VHDL” is to Design and Develop a PCI-Express protocol for a 8x PCI-e card, with an optical transceiver and DPM (Dual Port Memory as an external interfaces. The development includes the generation of 8 x PCI-e cores and interfacing the core for optical transaction and also for the DPM transaction. The PCI-Express add-on card contains a FPGA (Virtex V– XC5VLX110T and the card supports 8X lane. FPGA provides an interface between the PCI-Express signals, the DPM and the optical transceiver module. The protocol has to be developed using VHDL and simulated using model sim 6.1f

  17. PCI Embedded Computer Systems公司CPU板

    Institute of Scientific and Technical Information of China (English)


    PCI Embedded Computer Systems推出面向低功耗嵌入式系统的传导冷却XMC CPU板。AMD Geode LX 800处理器系列以基于x86的嵌入式处理器提供了所需的性能和功耗适应性,工作频率为500MHz时,最大功耗3.9W,典型功耗1.8W。Geode LX处理器提供了毫无折损地设计创新产品所需的低功耗x86性能。在AMD Geode CS5536伴随器件的配合下,

  18. [Current strategy in PCI for CTO]. (United States)

    Asakura, Yasushi


    Recently, CTO PCI has come into wide use all over the world and it has been standardized. The 1st step is an antegrade approach using single wire. The 2nd strategy would be parallel wire technique. And the next would be a retrograde approach. In this method, retrograde wiring with Corsair is done at first. If it is successful, externalization is established using 300 cm wire, and this system is able to provide strong back-up support. If it fails, reverse CART technique is the next step. IVUS guided wiring is a last resort. The 2nd wire is manipulated with IVUS guidance. Now, initial success rate is more than 90% with these methods.

  19. Coordinated CSN-UNESA research plan (PCI); Plan coordinado de investigacion CSN-UNESA (PCI)

    Energy Technology Data Exchange (ETDEWEB)

    Incinillas, J.


    This article contains a description of the essence and current status of the Coordinated Research Plan (PCI), beginning with details on the general specifications of the Framework Agreement signed by CSN and UNESA in September 1997, with an initial duration of four years and extendable on a yearly basis. The section on PCI Management describes the governing bodies, the mechanisms for including a project, tracking of projects underway, and the mechanisms for concluding projects. The Plan's generic goals are to acquire and increase technological skills and tools to guarantee operation of the nuclear park, take advantage of the synergies of the plants as a whole, and optimize the regulatory framework from the standpoint of safety and efficiency. In addition, strategic targets concerning efficiency, technological development and environment are defined. The current project status, overall budget and project completed to data are described. (Author)

  20. The inherent catastrophic traps in retrograde CTO PCI. (United States)

    Wu, Eugene B; Tsuchikane, Etsuo


    When we learn to drive, our driving instructor tells us how to check the side mirror and turn your head to check the blind spot before changing lanes. He tells us how to stop at stop signs, how to drive in slippery conditions, the safe stopping distances, and these all make our driving safe. Similarly, when we learn PCI, our mentors teach us to seat the guiding catheter co-axially, to wire the vessel safely, to deliver balloon and stents over the wire, to watch the pressure of the guiding, in order that we perform PCI safely and evade complications. In retrograde CTO PCI, there is no such published teaching. Also many individual mentors have not had the wide experience to see all the possible complications of retrograde CTO PCI and, therefore, may not be able to warn their apprentice. As the number of retrograde procedures increase worldwide, there is a corresponding increase in catastrophic complications, many of which, we as experts, can see are easily avoidable. To breach this gap in knowledge, this article describes 12 commonly met inherent traps in retrograde CTO PCI. They are inherent because by arranging our equipment in the manner to perform retrograde CTO PCI, these complications are either induced directly or happen easily. We hope this work will enhance safety of retrograde CTO PCI and avoid many catastrophic complications for our readers and operators. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  1. Neuromuscular ultrasound of cranial nerves. (United States)

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S


    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  2. Bivalirudin started during emergency transport for primary PCI

    DEFF Research Database (Denmark)

    Steg, Philippe Gabriel; van 't Hof, Arnoud; Hamm, Christian W;


    Bivalirudin, as compared with heparin and glycoprotein IIb/IIIa inhibitors, has been shown to reduce rates of bleeding and death in patients undergoing primary percutaneous coronary intervention (PCI). Whether these benefits persist in contemporary practice characterized by prehospital initiation...

  3. Evolution und Zukunftsperspektiven der perkutanen Koronarintervention (PCI

    Directory of Open Access Journals (Sweden)

    Meier B


    Full Text Available Die kathetergestützte Behandlung der Koronaren Herzkrankheit (PCI hat aus der vorwiegend diagnostischen Disziplin Kardiologie eine halbchirurgische gemacht. Als Geburtsstunde dieser sogenannten interventionellen Kardiologie gilt der 16. September 1977, als in Zürich durch Grüntzig zum ersten Mal ein Herzkranzgefäß aufgeweitet wurde. Dem damals 38-jährigen Patienten geht es auch heute, 33 Jahre später, ausgezeichnet. Zwischenzeitlich ist dieser Eingriff zum wesentlichsten medizinischen Eingriff schlechthin geworden. Man schätzt seine Frequenz global auf 2–3 Millionen pro Jahr. In Österreich werden jährlich über 20.000 solche Eingriffe durchgeführt. Etwa 34 österreichische Zentren bieten diesen Eingriff an. Heute werden solche Eingriffe etwa 2- bis 4- mal mehr durchgeführt als klassische herzchirurgische Bypass-Operationen, welche es seit den 1960er-Jahren gibt. Die zunehmende Frühabklärung der Koronaren Herzkrankheit führt dazu, dass sie meistens im noch wenig fortgeschrittenen Stadium entdeckt wird, welches durch kathetergestützte Behandlung ausreichend therapiert werden kann. Späte Stadien benötigen nach wie vor die offene Herzoperation. In den gut 3 Jahrzehnten ihres Bestehens hat die Koronardilatation mit dem Einsatz des Koronarstents ab 1986 eine wesentliche Verbesserung erfahren. Seit ca. 7 Jahren geben diese Metallgitterchen ein Medikament ab, welches eine überschießende Narbenbildung verhindert und damit die Notwendigkeit für erneute Eingriffe vermindert. Andere Verfahren, mit der Absicht den Ballon zu ersetzen (Laser, Bohrgeräte etc. haben sich nicht durchgesetzt. Die Koronardilatation bleibt im Sandwich zwischen einer rein medikamentösen Therapie bei leichter Koronarer Herzkrankheit und der chirurgischen Therapie bei fortgeschrittener Koronarer Herzkrankheit. Die jeweiligen Grenzen sind Grauzonen, die nicht von allen Fachleuten gleich gehandhabt werden.

  4. Effects of primary PCI and facilitated PCI on myocardial viability and ventricular systolic synchrony in acute myocardial infarction patients

    Institute of Scientific and Technical Information of China (English)

    谷新顺; 傅向华; 马宁


    Effects of primary PCI and facilitated PCI on myocardial viability and ventricular systolic synchrony in acute myocardial infarction patients!石家庄050000$河北医科大学第二医院@谷新顺 !石家庄050000$河北医科大学第二医院@傅向华 !石家庄050000$河北医科大学第二医院@马宁

  5. [Babies with cranial deformity]. (United States)

    Feijen, Michelle M W; Claessens, Edith A W M Habets; Dovens, Anke J Leenders; Vles, Johannes S; van der Hulst, Rene R W J


    Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet therapy. During the last two decades the incidence of positional plagiocephaly has increased in the Netherlands. This increase is due to the recommendation that babies be laid on their backs in order to reduce the risk of sudden infant death syndrome. We suggest the following: in cases of positional preference of the infant, referral to a physiotherapist is indicated. In cases of unacceptable deformity of the cranium at the age 5 months, moulding helmet therapy is a possible treatment option.

  6. Vincristine induced cranial polyneuropathy. (United States)

    Bay, Ali; Yilmaz, Cahide; Yilmaz, Nebi; Oner, Ahmet Faik


    We describe a 5-year-old girl showed recovery of vincristine induced cranial polyneuropathy with pyridoxine and pyridostigmine treatment. A 5-year-old girl was diagnosed preB cell Acute Lymphoblastic Leukemia (ALL). She received chemotherapy according to the previously described modified St. Jude total therapy studies XIII. Five days after the fourth dose of vincristine, she presented with bilateral ptosis. Neurological examination revealed bilateral ptosis, and complete external opthalmoplegia with normal pupillary and corneal reflexes. She received 3.8 mg cumulative dose of vincristin before development of ptosis. A neuroprotective and neuroregenerative treatment attempt with pyridoxine and pyridostigmine was initiated. The bilateral ptosis markedly improved after 7 days of pyridoxine and pyridostigmine treatment and completely resolved after two weeks. The both agents were given for 3 weeks and were well tolerated without any side effects. During the follow up period we did not observe residue or recurrence of the ptosis.

  7. [Military assistance in transportation of patients for an emergency PCI intervention]. (United States)

    Rothmann, Susani; Terkelsen, Christian Juhl; Lassen, Jens Flensted; Eriksen, Jon Lindskov


    Patients with ST-elevation myocardial infarction (STEMI) are treated with primary percutaneous coronary intervention (pPCI) or fibrinolysis. pPCI is superior to fibrinolysis when initiated timely. However, geography and weather sometimes become obstacles for transporting the patient to a PCI centre. In this case story teamwork between hospital instances and the military enabled transport to a PCI centre for a PCI intervention even though the weather conditions were unfavourable.

  8. PCI-SS: MISO dynamic nonlinear protein secondary structure prediction

    Directory of Open Access Journals (Sweden)

    Aboul-Magd Mohammed O


    Full Text Available Abstract Background Since the function of a protein is largely dictated by its three dimensional configuration, determining a protein's structure is of fundamental importance to biology. Here we report on a novel approach to determining the one dimensional secondary structure of proteins (distinguishing α-helices, β-strands, and non-regular structures from primary sequence data which makes use of Parallel Cascade Identification (PCI, a powerful technique from the field of nonlinear system identification. Results Using PSI-BLAST divergent evolutionary profiles as input data, dynamic nonlinear systems are built through a black-box approach to model the process of protein folding. Genetic algorithms (GAs are applied in order to optimize the architectural parameters of the PCI models. The three-state prediction problem is broken down into a combination of three binary sub-problems and protein structure classifiers are built using 2 layers of PCI classifiers. Careful construction of the optimization, training, and test datasets ensures that no homology exists between any training and testing data. A detailed comparison between PCI and 9 contemporary methods is provided over a set of 125 new protein chains guaranteed to be dissimilar to all training data. Unlike other secondary structure prediction methods, here a web service is developed to provide both human- and machine-readable interfaces to PCI-based protein secondary structure prediction. This server, called PCI-SS, is available at In addition to a dynamic PHP-generated web interface for humans, a Simple Object Access Protocol (SOAP interface is added to permit invocation of the PCI-SS service remotely. This machine-readable interface facilitates incorporation of PCI-SS into multi-faceted systems biology analysis pipelines requiring protein secondary structure information, and greatly simplifies high-throughput analyses. XML is used to represent the input

  9. Soap operas and social marketing: the PCI strategy. (United States)

    Fox, I

    This article presents the impact of soap operas and social marketing efforts, developed by Population Communications International (PCI), on changing the attitude and behavior of individuals toward family planning, health, women empowerment, and pro-social issues. The objective of the program is to motivate individuals and communities to make reproductive health and development choices which will contribute significantly in slowing population growth. In addition, these were designed to complement the efforts of those providing health services in several countries. PCI is responsible in training creative talent, research in determining the issues and arrangements necessary for a program to be aired. After following the methods promoted by the PCI, reports on the Tanzania and Kenya programs further confirm that the mass media education programs for changing behavior are effective. During the two conferences organized by PCI, three American production organizations initiated new storylines based on the issues discussed. Moreover, several countries expressed their desire to develop similar conferences in their countries. To end, PCI is designing additional soaps in other countries; wherein, the problem lies not on contraceptive availability, but on deeply held fears, superstitions, and culture equating having children with man's virility and dominance.

  10. Cranial Autonomic Symptoms in Migraine

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Cranial autonomic symptoms (CAS in patients with migraine and cluster headaches (CH were characterized and compared in a prospective study of consecutive patients attending a headache clinic at Taipei Veterans General Hospital, Taiwan.

  11. The computed cranial focal point

    NARCIS (Netherlands)

    Jong, G.A. de; Maal, T.J.J.; Delye, H.


    INTRODUCTION: Stereophotogrammetry is a radiation-free method for monitoring skull development after craniosynostosis repair. Lack of clear fixed reference points complicate longitudinal comparison of 3D photographs. Therefore we developed the 'computed cranial focal point' (CCFP). METHODS: The CCFP

  12. An extended multi-zone combustion model for PCI simulation (United States)

    Kodavasal, Janardhan; Keum, SeungHwan; Babajimopoulos, Aristotelis


    Novel combustion modes are becoming an important area of research with emission regulations more stringent than ever before, and with fuel economy being assigned greater importance every day. Homogeneous Charge Compression Ignition (HCCI) and Premixed Compression Ignition (PCI) modes in particular promise better fuel economy and lower emissions in internal combustion engines. Multi-zone combustion models have been popular in modelling HCCI combustion. In this work, an improved multi-zone model is suggested for PCI combustion modelling. A new zoning scheme is suggested based on incorporating the internal energy of formation into an earlier conventional HCCI multi-zone approach, which considers a two-dimensional reaction space defined by equivalence ratio and temperature. It is shown that the added dimension improves zoning by creating more representative zones, and thus reducing errors compared to the conventional zoning approach, when applied to PCI simulation.

  13. Optimal catchment area and primary PCI centre volume revisited

    DEFF Research Database (Denmark)

    Schoos, Mikkel Malby; Pedersen, Frants; Holmvang, Lene


    AIMS: The currently stated optimal catchment population for a pPCI centre is 300,000-1,100,000, resulting in 200-800 procedures/year. pPCI centres are increasing in number even within small geographic areas. We describe the organisation and quality of care after merging two high-volume centres....... The quality of a centre reflects governance, training, resources and pre-hospital triage, rather than catchment population and STEMI incidence, as long as a minimum volume is guaranteed. Resources can be utilised better by merging neighbouring centres, without negative effects on quality of care....

  14. Invasive cranial mycosis our experiences

    Directory of Open Access Journals (Sweden)

    Tapas Kumbhkar


    Full Text Available Fungi can cause serious cranial infections in immunocompromised and diabetic patients. Common pathogens mainly include Aspergillus and Mucor. These organisms cause tissue invasion and destruction of adjacent structures (e.g. orbit, ethmoid, sphenoid, maxillary & cavernous sinuses. Mortality and morbidity rate is high despite combined surgical, antifungal and antidiabetic treatment. We present our experience of six cases with such infection.

  15. MRI findings in cranial eumycetoma

    Directory of Open Access Journals (Sweden)

    Munawwar Ahmed


    Full Text Available Cranial eumycetoma (CE due to direct inoculation of Madurella grisea into the scalp is extremely rare. We describe a case of CE caused by direct inoculation of M. grisea with the characteristic MRI findings of the "dot-in-circle" sign and a conglomeration of multiple, extremely hypointense "dots."

  16. Predictors of Interventional Success of Antegrade PCI for CTO. (United States)

    Luo, Chun; Huang, Meiping; Li, Jinglei; Liang, Changhong; Zhang, Qun; Liu, Hui; Liu, Zaiyi; Qu, Yanji; Jiang, Jun; Zhuang, Jian


    This study aimed to identify significant lesion features of chronic total occlusions (CTOs) that predict failure of antegrade (A) percutaneous coronary intervention (PCI) using pre-procedure coronary computed tomography angiography (CTA) combined with conventional coronary angiography (CCA). The current predictors of successful A-PCI in the setting of CTOs are uncertain. Such knowledge might prompt early performance of a retrograde (R)-PCI approach if predictors of A-PCI failure are present. Consecutive patients confirmed to have at least 1 CTO of native coronary arteries underwent coronary CTA- and CCA-guided PCI in which computed tomography and fluoroscopic images were placed side by side before or during PCI. The study included 103 patients with 108 CTOs; 80 lesions were successfully treated with A-PCI and 28 lesions failed this approach, for an A-PCI success rate of 74%. A total of 15 of 28 failed cases underwent attempted R-PCI. Only 1 case also failed R-PCI; thus, the total PCI success rate was 87%. By multivariable analysis, the factors significantly predictive of failed A-PCI included negative remodeling (odds ratio [OR]: 137.82) and lesion length >31.89 mm on coronary CTA (OR: 7.04), and ostial or bifurcation lesions on CCA (OR: 8.02). R-PCI was successful in 14 of 15 patients (93.3%), in whom good appearance of the occluded distal segment and well-developed collateral vessels were present. Morphologic predictors of failed A-PCI on the basis of pre-procedure coronary CTA and CCA imaging may be identified, which may assist in determining which patients with CTO lesions would benefit from an early R-PCI strategy. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. Assessment of VME-PCI Interfaces with Linux Drivers

    CERN Document Server

    Schossmater, K; CERN. Geneva


    Abstract This report summarises the performance measurements and experiences recorded by testing three commercial VME-PCI interfaces with their Linux drivers. These interfaces are manufactured by Wiener, National Instruments and SBS Bit 3. The developed C programs are reading/writing a VME memory in different transfer modes via these interfaces. A dual processor HP Kayak XA-s workstation was used with the CERN certified Red Hat Linux 6.1 running on it.

  18. Application of PCI9052 in CPU Unit%PCI9052在CPU单元中的应用

    Institute of Scientific and Technical Information of China (English)




  19. The controversy of cranial bone motion. (United States)

    Rogers, J S; Witt, P L


    Cranial bone motion continues to stimulate controversy. This controversy affects the general acceptance of some intervention methods used by physical therapists, namely, cranial osteopathic and craniosacral therapy techniques. Core to these intervention techniques is the belief that cranial bone mobility provides a compliant system where somatic dysfunction can occur and therapeutic techniques can be applied. Diversity of opinion over the truth of this concept characterizes differing viewpoints on the anatomy and physiology of the cranial complex. Literature on cranial bone motion was reviewed for the purpose of better understanding this topic. Published research overall was scant and inconclusive. Animal and human studies demonstrate a potential for small magnitude motion. Physical therapists should carefully scrutinize the literature presented as evidence for cranial bone motion. Further research is needed to resolve this controversy. Outcomes research, however, is needed to validate cranial bone mobilization as an effective treatment.

  20. Epidemiological approach to emergent cranial surgery of cranial traumas

    Directory of Open Access Journals (Sweden)

    Hülagü Kaptan


    Full Text Available

    Objective: In this study, we aim to define the emergent cranial surgery of cranial trauma cases in terms of the reason of occurance, diagnosis, prognostic factors and results. Methods: 153 cases hospitalized in our clinic during a four year period were statistically analysed in accordance with trauma etiology, age, gender, application GCS (Glascow Coma Score mortality rate, location and established patology.

    Results: 76% (116 of the 153 cases were male. The most frequent etiological reasons were, in descending order, traffic accident 52% (n = 80, fall 34% (n = 53, direct trauma to the head 14(n =20. 45% (n = 69 were diagnosed epidural haematomas, 26% (n = 40 were diagnosed depression fractures and 3% (n = 5 were diagnosed intracerebral haematomas. A meaningful statistical difference was found in the comparison of the diagnosis regarding gender (p=0,012 age group (p=0,0282 and GCS (p=0,0001.

    Conclusions: In order to prevent cranial traumas, studies aimed at minimizing traffic accidents should be undertaken. The most essential action after the accident has occured is triage, and this is of great importance in order to establish communication among the health institutions.

  1. Posttraumatic Cranial Cystic Fibrous Dysplasia

    Directory of Open Access Journals (Sweden)

    Arata Tomiyama


    Full Text Available A 14-year-old was girl admitted to our hospital with a subcutaneous mass of the occipital head. The mass had grown for 6 years, after she had sustained a head injury at the age of 6, and was located directly under a previous wound. Skull X-ray Photograph (xp, computed tomography (CT, and magnetic resonance imaging (MRI showed a bony defect and cystic changes in the skull corresponding to a subcutaneous mass. Bone scintigraphy revealed partial accumulation. The patient underwent total removal of the skull mass, and the diagnosis from the pathological findings of the cyst wall was fibrous dysplasia (FD. The radiographic findings for cystic cranial FD can be various. Progressive skull disease has been reported to be associated with head trauma, but the relationship between cranial FD and head trauma has not been previously reported. Previous studies have suggested that c-fos gene expression is a key mechanism in injury-induced FD.

  2. Cranial kinesis in palaeognathous birds. (United States)

    Gussekloo, Sander W S; Bout, Ron G


    Cranial kinesis in birds is induced by muscles located caudal on the cranium. These forces are transferred onto the moveable parts of the skull via the Pterygoid-Palatinum Complex (PPC). This bony structure therefore plays an essential role in cranial kinesis. In palaeognathous birds the morphology of the PPC is remarkably different from that of neognathous birds and is thought to be related to the specific type of cranial kinesis in palaeognaths known as central rhynchokinesis. We determined whether clear bending zones as found in neognaths are present in the upper bill of paleognaths, and measured bending forces opposing elevation of the upper bill. A static force model was used to calculate the opening forces that can be produced by some of the palaeognathous species. We found that no clear bending zones are present in the upper bill, and bending is expected to occur over the whole length of the upper bill. Muscle forces are more than sufficient to overcome bending forces and to elevate the upper bill. The resistance against bending by the bony elements alone is very low, which might indicate that bending of bony elements can occur during food handling when muscles are not used to stabilise the upper bill. Model calculations suggest that the large processi basipterygoidei play a role in stabilizing the skull elements, when birds have to resist external opening forces on the upper bill as might occur during tearing leafs from plants. We conclude that the specific morphology of the palaeognathous upper bill and PPC are not designed for active cranial kinesis, but are adapted to resist external forces that might cause unwanted elevation of the upper bill during feeding.

  3. Cranial computed tomography in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Boltshauser, E. (Zuerich Univ. (Switzerland). Kinderklinik)


    This paper deals mainly with methodical aspects (such as sedation, intravenous and intrathecal application of contrast media) and with common difficulties in interpretation of computed tomography images. The indications for cranial CT are discussed in respect to probable therapeutic consequences and expected diagnostic yield. In the view of the author CT is, as a rule, not required in assessing chronic headache, generalised epileptic convulsions, non-specific mental retardation and cerebral palsy.

  4. Cranial imaging in child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P.; Wilms, G. [Department of Radiology, University Hospitals, Leuven (Belgium); Casteels, I. [Department of Ophthalmology, University Hospitals, Leuven (Belgium)


    Serious head injury in children less than 2 years old is often the result of child abuse. The role of the different neuroimaging modalities in child abuse is reviewed. Skull X-ray and cranial CT are mandatory. Repeat or serial imaging may be necessary and brain MR imaging may contribute to the diagnostic work-up, particularly in the absence of characteristic CT findings. The radiologist plays an important role in accurately identifying non-accidental cranial trauma. The clinical presentation can be non-specific or misleading. The possibility should be considered of a combined mechanism, i.e., an underlying condition with superimposed trauma. In this context, the radiologist is in the front line to suggest the possibility of child abuse. It is therefore important to know the spectrum of, sometimes subtle, imaging findings one may encounter. Opthalmological examination is of the greatest importance and is discussed here, because the combination of retinal hemorrhages and subdural hematoma is very suggestive of non-accidental cranial trauma. (orig.)

  5. Irradiation tests of texture controlled cladding for pressurized water reactor in foreign reactor

    Energy Technology Data Exchange (ETDEWEB)

    Ukawa, Kazunori [Hokkaido Electric Power Co., Inc., Sapporo (Japan); Abeta, Sadaaki


    PWR electric power companies and makers are promoting a high burn-up program for nuclear fuel aiming at reducing spent fuel. PCI tolerance performance of fuel clad is desirable to promote a high burnup program. It is clear that when we change the direction of a Zircaloy crystal structure by improving a manufacture process (texture control), PCI tolerance performance greatly improved. In this study, an improved clad was burnt in a R2 reactor to 61.5 GWd/t and a power ramp test was carried out in Sweden. Based on irradiation data, power ramp test data and post irradiation examination data, improvement of PCI tolerance performance was confirmed. (author)

  6. Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease (FAME)

    DEFF Research Database (Denmark)

    van Nunen, Lokien X; Zimmermann, Frederik M; Tonino, Pim A L


    BACKGROUND: In the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (FAME) study, fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) improved outcome compared with angiography-guided PCI for up to 2 years of follow-up. The aim in this study...... artery disease were randomly assigned to undergo angiography-guided PCI or FFR-guided PCI. Before randomisation, stenoses requiring PCI were identified on the angiogram. Patients allocated to angiography-guided PCI had revascularisation of all identified stenoses. Patients allocated to FFR-guided PCI had...

  7. 100 Gbps PCI-Express Readout for the LHCb Upgrade

    CERN Document Server

    Durante, Paolo; Schwemmer, Rainer; Marconi, Umberto; Balbi, Gabriele; Lax, Ignazio


    We present a new data acquisition system under development for the next upgrade of the LHCb experiment at CERN. We focus in particular on the design of a new common readout board, the PCIe40, and on the viability of PCI-Express as an interconnect technology for high speed readout. We describe a new high-performance DMA controller for data acquisition, implemented on an FPGA, coupled with a custom software module for the Linux kernel. Lastly, we describe how these components can be leveraged to achieve a throughput of 100 Gbit/s per readout board.

  8. Validation and incremental value of the hybrid algorithm for CTO PCI. (United States)

    Pershad, Ashish; Eddin, Moneer; Girotra, Sudhakar; Cotugno, Richard; Daniels, David; Lombardi, William


    To evaluate the outcomes and benefits of using the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The hybrid algorithm harmonizes antegrade and retrograde techniques for performing CTO PCI. It has the potential to increase success rates and improve efficiency for CTO PCI. No previous data have analyzed the impact of this algorithm on CTO PCI success rates and procedural efficiency. Retrospective analysis of contemporary CTO PCI performed at two high-volume centers with adoption of the hybrid technique was compared to previously published CTO outcomes in a well matched group of patients and lesion subsets. After adoption of the hybrid algorithm, technical success was significantly higher in the post hybrid algorithm group 189/198 (95.4%) vs the pre-algorithm group 367/462 (79.4%) (P CTO PCI. © 2014 Wiley Periodicals, Inc.

  9. Cranial kinesis in the amphibia: a review. (United States)

    Iordanskiĭ, N N


    All extant orders of amphibians are characterized by kinetic skulls. Main type of intracranial movability in amphibians is pleurokinetism, that is supplemented in different amphibian groups by various types of rhyncho- and prokinetism. The most primitive pattern of cranial kinesis is revealed in the stegocrotaphic gymnophions. More paedomorphic species retain general cranial flexibility that is characteristic of larval skull. That is unfavourable for evolution of well-regulated (adult) cranial kinesis and related feeding adaptations. Kinetism is also reduced in the species with heavily ossified skulls. Adaptive role and evolution of cranial kinesis in amphibians are discussed.

  10. PCI coals: quality parameters for an efficient usage; Carvoes para PCI: parametros de qualidade para uma utilizacao eficiente

    Energy Technology Data Exchange (ETDEWEB)

    Holcombe, D.; Coin, C.D.A. [Australian Coal Industry Research Labs., Riverview, QLD (Australia); Caldeira Filho, J.G [P.D.C.A. Consultoria Empresarial, Volta Redonda, RJ (Brazil)


    The technology of chemical reduction in blast furnaces has been presenting an increase in coke injection rates during the last five years. Even though the blast furnaces have been achieving excellent production rates, there is still a discussion in the community concerning which types of coke are more appropriate to the operation as well as the limits of coke injection through the blasts. This work discusses the role of PCI in metallurgy as well as its limitations giving special emphasis to the several quality parameters in the process 16 refs., 2 tabs.

  11. Macrophage mediated PCI enhanced gene-directed enzyme prodrug therapy (United States)

    Christie, Catherine E.; Zamora, Genesis; Kwon, Young J.; Berg, Kristian; Madsen, Steen J.; Hirschberg, Henry


    Photochemical internalization (PCI) is a photodynamic therapy-based approach for improving the delivery of macromolecules and genes into the cell cytosol. Prodrug activating gene therapy (suicide gene therapy) employing the transduction of the E. coli cytosine deaminase (CD) gene into tumor cells, is a promising method. Expression of this gene within the target cell produces an enzyme that converts the nontoxic prodrug, 5-FC, to the toxic metabolite, 5-fluorouracil (5-FU). 5-FC may be particularly suitable for brain tumors, because it can readily cross the bloodbrain barrier (BBB). In addition the bystander effect, where activated drug is exported from the transfected cancer cells into the tumor microenvironment, plays an important role by inhibiting growth of adjacent tumor cells. Tumor-associated macrophages (TAMs) are frequently found in and around glioblastomas. Monocytes or macrophages (Ma) loaded with drugs, nanoparticles or photosensitizers could therefore be used to target tumors by local synthesis of chemo attractive factors. The basic concept is to combine PCI, to enhance the ex vivo transfection of a suicide gene into Ma, employing specially designed core/shell NP as gene carrier.

  12. Cranial birth trauma; Kraniales Geburtstrauma

    Energy Technology Data Exchange (ETDEWEB)

    Papanagiotou, P.; Roth, C.; Politi, M.; Zimmer, A.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Rohrer, T. [Universitaetsklinikum des Saarlandes, Klinik fuer Allgemeine Paediatrie und Neonatologie, Homburg/Saar (Germany)


    Injuries to an infant that result during the birth process are categorized as birth trauma. Cranial injuries due to mechanical forces such as compression or traction include caput succedaneum, cephalhematoma, subgaleal hematoma and intracranial hemorrhaging. Hypoxic ischemic encephalopathy is the consequence of systemic asphyxia occurring during birth. (orig.) [German] Als Geburtstrauma werden die Verletzungen des Saeuglings bezeichnet, die waehrend der Geburt stattfinden. Zu den Verletzungen, die am Schaedel auftreten koennen und hauptsaechlich durch mechanische Kraefte wie Kompression oder Traktion verursacht werden, gehoeren das Caput succedaneum, das Zephalhaematom, das subgaleale Haematom und die intrakranielle Blutung. Die hypoxisch-ischaemische Enzephalopathie ist die Folge einer systemischen Asphyxie waehrend der Geburt. (orig.)

  13. The Cranial Nerve Skywalk: A 3D Tutorial of Cranial Nerves in a Virtual Platform (United States)

    Richardson-Hatcher, April; Hazzard, Matthew; Ramirez-Yanez, German


    Visualization of the complex courses of the cranial nerves by students in the health-related professions is challenging through either diagrams in books or plastic models in the gross laboratory. Furthermore, dissection of the cranial nerves in the gross laboratory is an extremely meticulous task. Teaching and learning the cranial nerve pathways…

  14. 基于DMI校验的PCI ROM保护算法%A PCI ROM protection algorithm based on DMI verify

    Institute of Scientific and Technical Information of China (English)



    PCI ROM广泛存在于显卡、网卡、RAID卡、硬盘保护卡等PCI设备中.通过对PCI、SMBIOS、DMI规范和相关算法的研究,介绍了DMI的功用,探讨了DMI在BIOS中的位置及通过SMBIOS访问DMI的方式,说明了POST代码处理ROM的流程.针对PCI ROM保护的问题,提出了一种通过校验DMI来决定是否执行PCI ROM的方法.

  15. Vincristine-Induced Cranial Neuropathy

    Directory of Open Access Journals (Sweden)

    Ahmad TALEBIAN*


    Full Text Available How to Cite This Article: Talebian A, Goudarzi RM, Mohammadzadeh M , Mirzadeh AS. Vincristine-Induced Cranial Neuropathy. Iran J Child Neurol. 2014 Winter; 8(1:66-68. Abstract Vincristine (VCR is a vinca alkaloid that is used for treatment of many malignancies. The vinca alkaloids are neurotoxic, usually causing a peripheral neuropathy, but cranial neuropathies are rare as side effects. Described here is the case of a 2.5-year-old boy, a known case of Wilms’ tumor, treated by vincristine (0/067 mg/kg/day and dactinomycin (0/045 mg/kg/day after surgery. Three weeks after treatment, he presented with bilateral ptosis. Neurological examination revealed bilateral ptosis with normal pupillary reflex and eye movement. He received 3.015 mg cumulative dose of vincristine before development of ptosis. Treatment with pyridoxine (150 mg/m2 p.o. BID and pyridostigmine (3 mg/kg p.o. BID started as neuroprotective agents, and after 7 days the problem disappeared. The treatment continued for 6 weeks and there were no signs of ptosis or a recurrence in follow up 2 months later.

  16. Vincristine-Induced Cranial Neuropathy

    Directory of Open Access Journals (Sweden)

    Ahmad TALEBIAN*


    Full Text Available How to Cite This Article: Talebian A, Goudarzi RM, Mohammadzadeh M , Mirzadeh AS. Vincristine-Induced Cranial Neuropathy. Iran J Child Neurol. 2014 Winter; 8(1:66-68. AbstractVincristine (VCR is a vinca alkaloid that is used for treatment of many malignancies.The vinca alkaloids are neurotoxic, usually causing a peripheral neuropathy, but cranial neuropathies are rare as side effects. Described here is the case of a 2.5-year-old boy, a known case of Wilms’ tumor, treated by vincristine (0/067 mg/kg/day and dactinomycin (0/045 mg/kg/day after surgery. Three weeks after treatment, he presented with bilateral ptosis.Neurological examination revealed bilateral ptosis with normal pupillary reflex and eye movement. He received 3.015 mg cumulative dose of vincristine before development of ptosis.Treatment with pyridoxine (150 mg/m2 p.o. BID and pyridostigmine (3 mg/kg p.o. BID started as neuroprotective agents, and after 7 days the problem disappeared.The treatment continued for 6 weeks and there were no signs of ptosis or a recurrence in follow up 2 months later. References:Toopchizade V, Hosseini M, et al. Electrophysiological signs of neuropathy caused by vincristine. Medical Journal of Tabriz University of Medical Sciences. 2010 Autumn;31(3; 19-25.Gursel E.S. Vincristine-Induced Unilateral Ptosis in a Child. Pediatr Neurol 2009; 41:461-463.Ngamphaiboon N, Sweeney R, Wetzler M, Wang ES. Pyridoxine treatment of vincristine-induced cranial polyneuropathy in an adult patient with acute lymphocytic leukemia: Case report and review of the literature. Leuk Res. 2010 Aug;34(8:e194-6.Lash SC, Williams CP, Marsh CS, Crithchley C, Hodgkins PR, Mackie EJ. Acute Sixth-Nerve Palsy After Vincristine Therapy. Journal of AAPOS 2004 Feb;8(1: 67-8.Bay A, Yilmaz C, Yilmaz N, Oner AF. Vincristine induced cranial polyneuropathy. Indian J Pediatr. 2006 Jun;73(6:531-3.Tuxen M K, Hansen SW. Complication of treatment, Neurotoxicity secondary to antineoplastic

  17. Cranial osteology in Momotidae (Aves: Coraciiformes). (United States)

    Pascotto, Márcia C; Donatelli, Reginaldo J


    Momotidae (motmots) is found throughout Latin America between Mexico and northern Argentina. Given the absence of detailed studies of cranial osteology of Momotidae in the literature, this article presents a comprehensive description of the variation of the cranial osteology in all nine species of Momotidae and compares the results with published studies of other families of Coraciiformes and families in other orders. In addition, the cranial structures described are related to ecological and behavioral aspects of Momotidae. The cranial osteology of Baryphthengus ruficapillus is described in detail and compared with other species of Momotidae. The results indicate the presence in Momotidae of modified cranial structures, among which the most conspicuous are the frontal, lacrimal, squamosal, orbital, and laterosphenoid regions, as well as the palatine, upper jaw, pterygoid, and mandible.

  18. Pci e migrazioni interne nella Torino del “miracolo”

    Directory of Open Access Journals (Sweden)

    Michelangela Di Giacomo


    Full Text Available This paper aims at discussing the evolution of the Communist Italian Party’s theoretical and political approach with the reference to the internal migrations occurred in Italy during the ’60s. The point of view is Turin, the capital of the automotive industry, where politicians had to manage the social, economic and urban transformations brought by a significant flood of people moving from the South. Our thesis is the following: firstly interested in internal immigration for electoral reasons, afterwards the PCI increased its interest, and it started considering immigrants as a specific part of society with its own needs. The consequence was a double approach: in the factory identifying immigrants with the working class through the same struggle against owners; in the city, enhancing immigrants’ unrest and protecting their claims.

  19. Robotic PCI – Has It Come of Age?

    Directory of Open Access Journals (Sweden)

    Johnson Francis


    Full Text Available Last issue of the Journal contained an article on the benefits of robotic telesurgery. Now we would like to examine another aspect of robotics in medicine - Robotic enhanced percutaneous coronary intervention (PCI. The first-in-humans pilot clinical trial involving 18 patients was published in 2006. In this study angioplasty guidewire, balloon and stents were navigated by a computerized system. The guidewire could cross the lesion successfully in 17 cases and 15 of these cases could be successfully completed by remote navigation. The remaining 3 cases were completed manually. The proposed advantages of the system was a significantly lower radiation exposure to the operator and possibly more precise positioning of the coronary stent. There was no increase in fluoroscopy time.

  20. 7,528 patients treated with PCI - a Scandinavian real-life scenario

    DEFF Research Database (Denmark)

    Pedersen, S.; Galatius, S.; Bech, J.


    AIM: Analyze clinical, temporal and procedural characteristics from 7,528 consecutive percutaneous coronary intervention (PCI) patients in one of the largest published contemporary European PCI-database during a 6-year period. METHOD: Retrospective study design. Period: 1998-2004. Temporal...

  1. 47 CFR 61.45 - Adjustments to the PCI for Local Exchange Carriers. (United States)


    ... the time the PCI was updated to PCIt−1 * base period demand) + Z, all divided by R. PCIt = The new PCI... the CMT basket will equal 6.5%, and all End User Common Line charges, rates and nominal caps, will be... change in base period demand and inclusion of new services for that annual filing, the absolute level...

  2. Surgical treatment of cranial neuralgias. (United States)

    Franzini, Angelo; Ferroli, Paolo; Messina, Giuseppe; Broggi, Giovanni


    The most common types of cranial neuralgias amenable to surgical therapeutic options are trigeminal neuralgia and glossopharyngeal neuralgia, the former having an approximate incidence of 5/100000 cases per year and the latter of 0.05/100000 cases per year. Surgical therapy of these pathological conditions encompasses several strategies, going from ablative procedures to neurovascular decompression, to radiosurgery. The choice of the most appropriate surgical option (which must be taken into account when all conservative treatments have proven to be unsuccessful) has to take into account many factors, the most important ones being neuroradiological evidence of a neurovascular conflict, severity of symptoms, the age and clinical history of the patient, and the patient's overall medical condition. In this chapter we report our experience with the treatment of trigeminal and glossopharyngeal neuralgia, describing the surgical procedures performed and reviewing the most recent aspects on this subject in the past literature.

  3. Tumors Presenting as Multiple Cranial Nerve Palsies

    Directory of Open Access Journals (Sweden)

    Kishore Kumar


    Full Text Available Cranial nerve palsy could be one of the presenting features of underlying benign or malignant tumors of the head and neck. The tumor can involve the cranial nerves by local compression, direct infiltration or by paraneoplastic process. Cranial nerve involvement depends on the anatomical course of the cranial nerve and the site of the tumor. Patients may present with single or multiple cranial nerve palsies. Multiple cranial nerve involvement could be sequential or discrete, unilateral or bilateral, painless or painful. The presentation could be acute, subacute or recurrent. Anatomic localization is the first step in the evaluation of these patients. The lesion could be in the brain stem, meninges, base of skull, extracranial or systemic disease itself. We present 3 cases of underlying neoplasms presenting as cranial nerve palsies: a case of glomus tumor presenting as cochlear, glossopharyngeal, vagus and hypoglossal nerve palsies, clivus tumor presenting as abducens nerve palsy, and diffuse large B-cell lymphoma presenting as oculomotor, trochlear, trigeminal and abducens nerve palsies due to paraneoplastic involvement. History and physical examination, imaging, autoantibodies and biopsy if feasible are useful for the diagnosis. Management outcomes depend on the treatment of the underlying tumor.

  4. Moyamoya syndrome precipitated by cranial irradiation for craniopharyngioma in children. (United States)

    Lee, Hyun Seok; Seol, Ho Jun; Kong, Doo-Sik; Shin, Hyung Jin


    Recently, combination of surgery and radiation therapy (RT) has been recommended in the treatment of craniopharyngioma. RT could be associated with late complications, including vasculopathy. We report two cases of the moyamoya syndrome seen in children with craniopharyngioma who received RT after surgical resection. Thirty-five patients in pediatric age with craniopharyngioma were surgically treated. Fifteen out of 35 patients underwent surgical resection followed by RT or gamma knife surgery. Two of the 15 were found to have symptoms of transient ischemic attack and were diagnosed as moyamoya syndrome through the cerebral angiography. Age at RT was 4 and 13 years, respectively. The latent period for development of the moyamoya syndrome was 27 months and 3 years, respectively, after RT. The RT dose of both patients was 54 Gy. These two patients received bilateral encephaloduroarteriosynangiosis procedures. We report here these two cases of radiation-induced moyamoya syndrome in pediatric craniopharyngioma. Pediatric patients with craniopharyngioma who received RT should be reminded, during follow-up, about the risk of development of the moyamoya syndrome.

  5. Toxic Epidermal Necrolysis Associated with Antiepileptic Drugs and Cranial Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Shereen Elazzazy


    Full Text Available Case reports on the development of toxic epidermal necrolysis (TEN associated with concurrent administration of phenytoin with cranial radiation therapy (Ahmed (2004, Criton et al. (1997, and Rzany et al. (1996, but reports about erythema multiforme, which can develop in patients treated with levetiracetam and cranial irradiation, are very limited. This paper presents evidence that TEN may be induced by concurrent use of radiation with both phenytoin and levetiracetam. Our case is a 42-year-old male patient, a case of gliosarcoma who developed purpuric dermatitis associated with phenytoin when combined with cranial radiation therapy; although phenytoin was discontinued and switched to levetiracetam, the patient had more severe symptoms of toxic epidermal necrolysis (TEN on levetiracetam; the patient improved with aggressive symptom management, discontinuation of antiepileptic drugs (AEDs, and holding radiotherapy. Although TEN is a rare toxicity, physicians should pay a special attention to the monitoring of brain tumor patients on antiepileptic prophylaxis during cranial irradiation; furthermore, patients should be counselled to notify their physicians if they develop any new or unusual symptoms.

  6. Cranial Autonomic Symptoms in Pediatric Migraine

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Investigators at the University of California, San Francisco, examined the frequency of cranial autonomic symptoms in all pediatric and adolescent patients with migraine seen in 4 different clinical settings during July 2010 to June 2012.

  7. Shared decision making in patients with stable coronary artery disease: PCI choice.

    Directory of Open Access Journals (Sweden)

    Megan Coylewright

    Full Text Available BACKGROUND: Percutaneous coronary intervention (PCI and optimal medical therapy (OMT are comparable, alternative therapies for many patients with stable angina; however, patients may have misconceptions regarding the impact of PCI on risk of death and myocardial infarction (MI in stable coronary artery disease (CAD. METHODS AND RESULTS: We designed and developed a patient-centered decision aid (PCI Choice to promote shared decision making for patients with stable CAD. The estimated benefits and risks of PCI+OMT as compared to OMT were displayed in a decision aid using pictographs with natural frequencies and text. We engaged patients, clinicians, health service researchers, and designers with over 20 successive iterations of the decision aid, which were field tested during real-world clinical encounters involving clinicians and patients. The decision aid is intended to facilitate knowledge transfer, deliberation based on patient values and preferences, and shared decision making. CONCLUSIONS: We describe the methods and outcomes of the design and development of a decision aid (PCI Choice to promote shared decision making between clinicians and patients regarding the choice of PCI+OMT vs. OMT for treatment of stable CAD. We will evaluate the impact of PCI Choice on patient knowledge, decisional conflict, participation in decision-making, and treatment choice in an upcoming randomized trial.

  8. Intra cranial complications of tuberculous otitis media

    Directory of Open Access Journals (Sweden)

    M Prakash


    Full Text Available Tuberculosis is one of the most common infections in the world. It is seen that tuberculous otitis media (TOM is almost secondary to pulmonary tuberculosis. In this review we have tried to deal with all the aspects of the intra cranial complications of TOM such as tuberculoma, otitic hydrocephalus, brain abscess and tuberculous meningitis. The aspects covered in this review are the pathology, clinical features, and investigations of the intra cranial manifestations.

  9. Feasibility and safety of 7-Fr radial approach for complex PCI. (United States)

    Egred, Mohaned


    Although the transradial approach is well established for percutaneous coronary intervention (PCI), it is perceived as being not suitable for 7-Fr complex PCI, which is traditionally performed from the femoral approach. To evaluate the procedural success and outcome of 7-Fr transradial complex PCI. Retrospective review and analysis of all patients undergoing 7-Fr transradial complex PCI from August 2008 until October 2010 in a tertiary cardiac center setting. Transradial 7-Fr complex PCI was performed in 77 patients after manual assessment of the radial pulse and size. The radial access was obtained successfully in all 77 patients. The age range was 39-88 years with 16 patients (23.4%) over 80 years of age and 14 females (18.1%). There were 30 left main stem PCI (39%), 31 (40.2%) chronic total occlusion (CTO), and 13 (16.8%) rotational atherectomy. Intravascular ultrasound (IVUS) was used in 17 (22%) cases, cutting balloons in 16 (20.7%), and LASER PCI in 2 (2.6%) cases. Procedural success was achieved in 76 of 77 (98.7%) with 1 failure to canalize a CTO. There was 1 patient with type I coronary perforation managed conservatively. There was no in-hospital mortality. All radial pulses were present 6 hours after the procedure and only 23 patients were seen for follow-up, and all had patent radial artery 4-6 months following the procedure. A 7-Fr transradial complex PCI is feasible and can be carried out safely and successfully with excellent results. In suitable patients, male or female, complex PCI need not always be performed from the femoral approach.  ©2011, Wiley Periodicals, Inc.

  10. Cranial trepanation in The Egyptian. (United States)

    Collado-Vázquez, S; Carrillo, J M


    Medicine and literature have been linked from ancient times; proof of this shown by the many doctors who have made contributions to literature and the many writers who have described medical activities and illnesses in their works. An example is The Egyptian, the book by Mika Waltari that provides a masterly narration of the protagonist's medical activity and describes the trepanation technique. The present work begins with the analysis of trepanations since prehistory and illustrates the practice of the trepanation in The Egyptian. The book mentions trepanation frequently and illustrates how to practice it and which instruments are required to perform it. Trepanation is one of the oldest surgical interventions carried out as treatment for cranial trauma and neurological diseases, but it also had the magical and religious purpose of expelling the evil spirits which caused the mental illness, epilepsy, or migraine symptoms. Trepanation is a surgical practice that has been carried out since prehistory to treat post-traumatic epilepsy, migraine, and psychiatric illness. The Egyptian is a book that illustrates the trepan, the trepanation technique, and the required set of instruments in full detail. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  11. [Computed tomography and cranial paleoanthropology]. (United States)

    Cabanis, Emmanuel Alain; Badawi-Fayad, Jackie; Iba-Zizen, Marie-Thérèse; Istoc, Adrian; de Lumley, Henry; de Lumley, Marie-Antoinette; Coppens, Yves


    Since its invention in 1972, computed tomography (C.T.) has significantly evolved. With the advent of multi-slice detectors (500 times more sensitive than conventional radiography) and high-powered computer programs, medical applications have also improved. CT is now contributing to paleoanthropological research. Its non-destructive nature is the biggest advantage for studying fossil skulls. The second advantage is the possibility of image analysis, storage, and transmission. Potential disadvantages include the possible loss of files and the need to keep up with rapid technological advances. Our experience since the late 1970s, and a recent PhD thesis, led us to describe routine applications of this method. The main contributions of CT to cranial paleoanthropology are five-fold: --Numerical anatomy with rapid acquisition and high spatial resolution (helicoidal and multidetector CT) offering digital storage and stereolithography (3D printing). --Numerical biometry (2D and 3D) can be used to create "normograms" such as the 3D craniofacial reference model used in maxillofacial surgery. --Numerical analysis offers thorough characterization of the specimen and its state of conservation and/or restoration. --From "surrealism" to virtual imaging, anatomical structures can be reconstructed, providing access to hidden or dangerous zones. --The time dimension (4D imaging) confers movement and the possibility for endoscopic simulation and internal navigation (see Iconography). New technical developments will focus on data processing and networking. It remains our duty to deal respectfully with human fossils.

  12. Cranial kinesis in gekkonid lizards (United States)

    Herrel; De Vree F; Delheusy; Gans


    Cranial kinesis was studied in two species of gekkonid lizard, Gekko gecko and Phelsuma madagascariensis, using cineradiography and electromyography. The skull of these geckoes showed the three types of kinesis described by Versluys at the beginning of this century: streptostyly, mesokinesis and metakinesis. In accordance with the later model of Frazzetta, the skull of these animals can be modelled by a quadratic crank system: when the mouth opens during feeding, the quadrate rotates forward, the palato-maxillary unit is lifted and the occipital unit swings forward. During jaw closing, the inverse movements are observed; during crushing, the system is retracted beyond its resting position. The data gathered here indicate that the coupled kinesis (streptostyly + mesokinesis) is most prominently present during the capture and crushing cycles of feeding and is largely absent during late intraoral transport, swallowing, drinking and breathing. The electromyographic data indicate a consistent pattern of muscular activation, with the jaw opener and pterygoid protractor always active during the fast opening phase, and the jaw closers active during closing and crushing. Our data generally support the model of Frazzetta. Although the data gathered here do not allow speculation on the functional significance of the kinesis, they clearly provide some key elements required for a further investigation of the functional and adaptive basis of the system.

  13. Osteopathia striata with cranial sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Gay, B.B. [Emory Univ., Atlanta, GA (United States). Dept. of Radiology; Elsas, L.J. [Emory Univ., Atlanta, GA (United States). Dept. of Pediatrics; Wyly, J.B. [Emory Univ., Atlanta, GA (United States). Dept. of Radiology; Pasquali, M. [Emory Univ., Atlanta, GA (United States). Dept. of Pediatrics


    Osteopathia striata with cranial sclerosis (OS-CS) is a specific bone dysplasia manifested by hypertelorism, flat nasal bridge, frontal bossing, large head, hypoplastic maxilla, palate anomalies, chronic otitis media, hearing deficits, nasal obstruction, and neurological changes of deafness, facial palsy, ophthalmoplegia, and mental retardation. We will review the clinical and radiologic findings in a new patient from birth to 20 years; this is believed to be the thirty-fifth patient reported. OS-CS is 2.5 times more common in females and occurs as an autosomal dominant condition or a sporadic dominant mutation with patients presenting for evaluation from the newborn period to the fifth decade. Skeletal abnormalities are distinctive including sclerosis of the skull base and calvarium, linear striated densities in the long bones and pelvis, and poor development of the mastoid and sinus air cells. Radionuclide bone scans with SPECT indicated in our patient increased bone turnover which was supported by biochemical findings of increased pyridinoline excretion. The major complications are due to constriction of essential foramina at the skull base. The condition is not life-threatening but can produce disability. (orig.)

  14. Vincristine-induced cranial neuropathy. (United States)

    Talebian, Ahmad; Goudarzi, Razieh Moazam; Mohammadzadeh, Mahdi; Mirzadeh, Azadeh Sadat


    Vincristine (VCR) is a vinca alkaloid that is used for treatment of many malignancies. The vinca alkaloids are neurotoxic, usually causing a peripheral neuropathy, but cranial neuropathies are rare as side effects. Described here is the case of a 2.5-year-old boy, a known case of Wilms' tumor, treated by vincristine (0.067 mg/kg/day) and dactinomycin (0.045 mg/kg/day) after surgery. Three weeks after treatment, he presented with bilateral ptosis. Neurological examination revealed bilateral ptosis with normal pupillary reflex and eye movement. He received 3.015 mg cumulative dose of vincristine before development of ptosis. Treatment with pyridoxine (150 mg/m2 p.o. BID) and pyridostigmine (3 mg/kg p.o. BID) was started as neuroprotective agents, and after 7 days the problem disappeared. The treatment continued for 6 weeks and there were no signs of ptosis or a recurrence in follow up 2 months later.

  15. Late Double-Barrel Lumen Following Successful CTO-PCI Using the Crossboss Stingray System. (United States)

    Roy, James; Rees, David; Ramsay, David; Weaver, James


    There remains limited randomized controlled trials on long-term clinical outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI). New techniques involving dissection of the subintimal space and reentry into the true lumen increase success rates in CTO-PCI. However, their longer-term safety and efficacy remain unknown and poorly studied. We present a case of double-lumen formation seen at 1 year post CTO-PCI using subintimal dissection reentry with late restoration of major side branches.

  16. Predictors of subjective health status 10 years post-PCI

    Directory of Open Access Journals (Sweden)

    Jan C. van den Berge


    Conclusions: SF-36 scores at baseline, age, and previous PCI were significant predictors of subjective health status 10 years post-PCI. Specifically, the SF-36 score at baseline was an important predictor. Thus assessment of subjective health status at baseline is useful as an indicator to predict long-term subjective health status. Subjective health status becomes better by optimal medical treatment, cardiac rehabilitation and psychosocial support. This is the first study determining predictors of subjective health status 10 years post-PCI.

  17. Dehydrocoupling of dimethylamine borane catalyzed by Rh(PCy3)2H2Cl. (United States)

    Sewell, Laura J; Huertos, Miguel A; Dickinson, Molly E; Weller, Andrew S; Lloyd-Jones, Guy C


    The Rh(III) species Rh(PCy3)2H2Cl is an effective catalyst (2 mol %, 298 K) for the dehydrogenation of H3B·NMe2H (0.072 M in 1,2-F2C6H4 solvent) to ultimately afford the dimeric aminoborane [H2BNMe2]2. Mechanistic studies on the early stages in the consumption of H3B·NMe2H, using initial rate and H/D exchange experiments, indicate possible dehydrogenation mechanisms that invoke turnover-limiting N-H activation, which either precedes or follows B-H activation, to form H2B═NMe2, which then dimerizes to give [H2BNMe2]2. An additional detail is that the active catalyst Rh(PCy3)2H2Cl is in rapid equilibrium with an inactive dimeric species, [Rh(PCy3)H2Cl]2. The reaction of Rh(PCy3)2H2Cl with [Rh(PCy3)H2(H2)2][BAr(F)4] forms the halide-bridged adduct [Rh(PCy3)2H2(μ-Cl)H2(PCy3)2Rh][BAr(F)4] (Ar(F) = 3,5-(CF3)2C6H3), which has been crystallographically characterized. This dinuclear cation dissociates on addition of H3B·NMe2H to re-form Rh(PCy3)2H2Cl and generate [Rh(PCy3)2H2(η(2)-H3B·NMe2H)][BAr(F)4]. The fate of the catalyst at low catalyst loadings (0.5 mol %) is also addressed, with the formation of an inactive borohydride species, Rh(PCy3)2H2(η(2)-H2BH2), observed. On addition of H3B·NMe2H to Ir(PCy3)2H2Cl, the Ir congener Ir(PCy3)2H2(η(2)-H2BH2) is formed, with concomitant generation of the salt [H2B(NMe2H)2]Cl.

  18. Patient Selection for Diagnostic Coronary Angiography and Hospital-Level PCI Appropriateness: Insights from the NCDR® (United States)

    Bradley, Steven M.; Spertus, John A.; Kennedy, Kevin F.; Nallamothu, Brahmajee K.; Chan, Paul S.; Patel, Manesh R.; Bryson, Chris L.; Malenka, David J.; Rumsfeld, John S.


    Importance Diagnostic coronary angiography in asymptomatic patients may lead to inappropriate percutaneous coronary intervention (PCI) due to a diagnostic to therapeutic cascade. Understanding the relationship between patient selection for coronary angiography and PCI appropriateness may inform strategies to minimize inappropriate procedures. Objective To determine if hospitals that frequently perform coronary angiography in asymptomatic patients, a clinical scenario wherein the benefit of angiography is less clear, are more likely to perform inappropriate PCI. Design, Setting and Participants Multicenter observational study of 544 hospitals participating in the CathPCI Registry® between July 2009 and September 2013. Measures Hospital proportion of asymptomatic patients at diagnostic coronary angiography and a hospital's rate of inappropriate PCI, as defined by 2012 Appropriate Use Criteria for coronary revascularization. Results Of 1,225,562 patients who underwent elective coronary angiography, 308,083 (25.1%) were asymptomatic. The hospital proportion of angiograms in asymptomatic patients ranged from 1.0% to 73.6% (median 24.7%, interquartile range 15.9% to 35.9%). By hospital quartiles of asymptomatic patients at angiography, hospitals with higher rates of asymptomatic patients at angiography had higher median rates of inappropriate PCI (14.8% vs. 20.2% vs. 24.0 vs. 29.4% from lowest to highest quartile, P<.001 for trend). This was attributable to more frequent use of PCI in asymptomatic patients at hospitals with higher rates of angiography in asymptomatic patients (inappropriate and asymptomatic PCI; 5.4% vs. 9.9% vs. 14.7% vs. 21.6% from lowest to highest quartile, P<.001 for trend). Hospitals with higher rates of asymptomatic patients at angiography also had lower rates of appropriate PCI (38.6% vs. 33.0% vs. 32.3% vs. 32.9%% from lowest to highest quartile, P<.001 for trend). Conclusions and Relevance In a national sample of hospitals, performing coronary

  19. Cranial electrotherapy stimulation and fibromyalgia. (United States)

    Gilula, Marshall F


    Cranial electrotherapy stimulation (CES) is a well-documented neuroelectrical modality that has been proven effective in some good studies of fibromyalgia (FM) patients. CES is no panacea but, for some FM patients, the modality can be valuable. This article discusses aspects of both CES and FM and how they relate to the individual with the condition. FM frequently has many comorbidities such as anxiety, depression, insomnia and a great variety of different rheumatologic and neurological symptoms that often resemble multiple sclerosis, dysautonomias, chronic fatigue syndrome and others. However, despite long-standing criteria from the American College of Rheumatology for FM, some physicians believe there is probably no single homogeneous condition that can be labeled as FM. Whether it is a disease, a syndrome or something else, sufferers feel like they are living one disaster after another. Active self-involvement in care usually enhances the therapeutic results of various treatments and also improves the patient's sense of being in control of the condition. D-ribose supplementation may prove to significantly enhance energy, sleep, mental clarity, pain control and well-being in FM patients. A form of evoked potential biofeedback, the EPFX, is a powerful stress reduction technique which assesses the chief stressors and risk factors for illness that can impede the FM patient's built-in healing abilities. Future healthcare will likely expand the diagnostic criteria of FM and/or illuminate a group of related conditions and the ways in which the conditions relate to each other. Future medicine for FM and related conditions may increasingly involve multimodality treatment that features CES as one significant part of the therapeutic regimen. Future medicine may also include CES as an invaluable, cost-effective add-on to many facets of clinical pharmacology and medical therapeutics.

  20. Seismic new PCI system for C.N. Almaraz. Design, installation and testing; Nuevo sistema de PCI Sismico para C. N. Almaraz. diseno, montaje y pruebas

    Energy Technology Data Exchange (ETDEWEB)

    Eugenio Poza, J. M. de; Arguello Tara, A.; Galan Herranz, D.


    Through an important design modification has been installed in the Almaraz nuclear power plant a new system capable of meeting PCI the requirements of paragraph 3.6.4. the NFPA-805. This new system is capable of covering all areas of fire of the station with equipment necessary for the safe stop with a water supply of functional fire protection after an earthquake of stop secure (SSE). In addition, this new seismic PCI system is capable of replacing the volume lost by evaporation of pools of storage of spent fuel to events beyond the design basis. (Author)

  1. Incidence, predictors and prognostic importance of bleeding after primary PCI for ST-elevation myocardial infarction.

    NARCIS (Netherlands)

    Hermanides, R.S.; Ottervanger, J.P.; Dambrink, J.H.; Boer, M.J. de; Hoorntje, J.C.A.; Gosselink, A.T.M.; Suryapranata, H.; Hof, A.W. van 't


    AIMS: To investigate incidence, predictors and prognosis of bleeding in ST elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: A large scale, prospective, observational study was performed between 1991 and 2004 in a

  2. Computational Fluid Dynamics (CFD) Modeling for High Rate Pulverized Coal Injection (PCI) into the Blast Furnace

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Chenn Zhou


    Pulverized coal injection (PCI) into the blast furnace (BF) has been recognized as an effective way to decrease the coke and total energy consumption along with minimization of environmental impacts. However, increasing the amount of coal injected into the BF is currently limited by the lack of knowledge of some issues related to the process. It is therefore important to understand the complex physical and chemical phenomena in the PCI process. Due to the difficulty in attaining trus BF measurements, Computational fluid dynamics (CFD) modeling has been identified as a useful technology to provide such knowledge. CFD simulation is powerful for providing detailed information on flow properties and performing parametric studies for process design and optimization. In this project, comprehensive 3-D CFD models have been developed to simulate the PCI process under actual furnace conditions. These models provide raceway size and flow property distributions. The results have provided guidance for optimizing the PCI process.

  3. CompactPCI/Linux Platform in FTU Slow Control System

    Institute of Scientific and Technical Information of China (English)

    F.Iannone; L.Wang; C.Centioli; M.Panella; G.Mazza; V.Vitale


    In large fusion experiments, such as tokamak devices, there is a common trend for slow control systems. Because of complexity of the plants, the so-called 'Standard Model' (SM) in slow control has been adopted on several tokamak machines. This model is based on a three-level hierarchical control: 1) High-Level Control (HLC) with a supervisory function; 2) Medium-Level Control (MLC) to interface and concentrate I/O field equipments; 3) Low-Level Control (LLC)with hard real-time I/O function, often managed by PLCs.FTU control system designed with SM concepts has underwent several stages of developments in its fifteen years duration of runs. The latest evolution was inevitable, due to the obsolescence of the MLC CPUs, based on VME-MOTOROLA 68030 with OS9 operating system. A large amount of C code was developed for that platform to route the data flow from LLC, which is constituted by 24 Westinghouse Numalogic PC-700 PLCs with about 8000 field-points, to HLC, based on a commercial Object-Oriented Real-Time database on Alpha/CompaqTru64 platform.Therefore, we have to look for cost-effective solutions and finally a CompactPCI-Intel x86platform with Linux operating system was chosen. A software porting has been done, taking into account the differences between OS9 and Linux operating system in terms of Inter/Network Processes Communications and I/O multi-ports serial driver.This paper describes the hardware/software architecture of the new MLC system, emphasizing the reliability and the low costs of the open source solutions. Moreover, a huge amount of software packages available in open source environment will assure a less painful maintenance, and will open the way to further improvements of the system itself.

  4. PCI for Unstable Angina in Elderly Patients%PCI 治疗高龄不稳定性心绞痛的疗效

    Institute of Scientific and Technical Information of China (English)

    涂晓文; 苏涛; 黄国明; 王洪如; 乔怀宇


    目的:探讨经皮冠状动脉介入(PCI)治疗高龄不稳定性心绞痛的临床疗效。方法将118例不稳定性心绞痛患者按是否行 PCI 治疗分为2组:PCI 组(65例)和 ODT 组(53例)。PCI 组患者采用 PCI 治疗,术后采用阿司匹林肠溶片、硫酸氢氯吡格雷治疗。ODT 组患者采用阿司匹林肠溶片、硫酸氢氯吡格雷治疗,同时采用单纯优化药物治疗。观察2组患者治疗6个月后血清肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、去甲肾上腺素(NE)、肾上腺素(E)、肌酐(Cr)及左心室舒张内径(LVDD)、左心室射血分数(LVEF)差值,胸痛缓解率、生存率、再次住院率和主要不良心血管事件(非致死性心肌梗死、脑卒中)。结果PCI 组患者治疗6个月后血清 PRA、Ang Ⅱ、ALD、NE、E 及 LVEF 差值、再次住院率均明显低于 ODT 组,LVDD 差值、胸痛症状缓解率均明显高于 ODT 组(均P <0.05)。结论PCI 较 ODT 能够显著降低高龄不稳定性心绞痛患者心脏相关神经内分泌因子的水平,PCI 的治疗疗效明显优于单纯优化药物治疗。%ABSTRACT:Objective To investigate the clinical efficacy of percutaneous coronary intervention (PCI)for unstable angina in elderly patients.Methods A total of 118 elderly patients with unsta-ble angina were divided into two groups.Patients in PCI group(n=65)were given PCI and post-operative treatment with enteric-coated aspirin tablets and clopidogrel bisulfate.Patients in ODT group(n=53)were treated with enteric-coated aspirin tablets,clopidogrel bisulfate and optimal drug therapy(ODT).Serum renin activity,angiotensin Ⅱ (AngⅡ),aldosterone(ALD),norepi-nephrine(NE),epinephrine(E),creatinine(Cr),left ventricular diastolic inner diameter(LVDD) difference,left ventricular ejection fraction(LVEF)difference,chest pain remission rate,survival rate,readmission rate,and incidence of adverse

  5. Adenosine kinase inhibition protects against cranial radiation-induced cognitive dysfunction

    Directory of Open Access Journals (Sweden)

    Munjal M Acharya


    Full Text Available Clinical radiation therapy for the treatment of CNS cancers leads to unintended and debilitating impairments in cognition. Radiation-induced cognitive dysfunction is long lasting, however, the underlying molecular and cellular mechanisms are still not well established. Since ionizing radiation causes microglial and astroglial activation, we hypothesized that maladaptive changes in astrocyte function might be implicated in radiation-induced cognitive dysfunction. Among other gliotransmitters, astrocytes control the availability of adenosine, an endogenous neuroprotectant and modulator of cognition, via metabolic clearance through adenosine kinase (ADK. Adult rats exposed to cranial irradiation (10 Gy showed significant declines in performance of hippocampal-dependent cognitive function tasks (novel place recognition, novel object recognition, and contextual fear conditioning 1 month after exposure to ionizing radiation using a clinically relevant regimen. Irradiated rats spent less time exploring a novel place or object. Cranial irradiation also led to reduction in freezing behavior compared to controls in the fear conditioning task. Importantly, immunohistochemical analyses of irradiated brains showed significant elevation of ADK immunoreactivity in the hippocampus that was related to astrogliosis and increased expression of glial fibrillary acidic protein (GFAP. Conversely, rats treated with the ADK inhibitor 5-iodotubercidin (5-ITU, 3.1 mg/kg, i.p., for 6 days prior to cranial irradiation showed significantly improved behavioral performance in all cognitive tasks 1 month post exposure. Treatment with 5-ITU attenuated radiation-induced astrogliosis and elevated ADK immunoreactivity in the hippocampus. These results confirm an astrocyte-mediated mechanism where preservation of extracellular adenosine can exert neuroprotection also against radiation-induced pathology. These innovative findings link radiation-induced changes in cognition and CNS

  6. Adenosine Kinase Inhibition Protects against Cranial Radiation-Induced Cognitive Dysfunction. (United States)

    Acharya, Munjal M; Baulch, Janet E; Lusardi, Theresa A; Allen, Barrett D; Chmielewski, Nicole N; Baddour, Al Anoud D; Limoli, Charles L; Boison, Detlev


    Clinical radiation therapy for the treatment of CNS cancers leads to unintended and debilitating impairments in cognition. Radiation-induced cognitive dysfunction is long lasting; however, the underlying molecular and cellular mechanisms are still not well established. Since ionizing radiation causes microglial and astroglial activation, we hypothesized that maladaptive changes in astrocyte function might be implicated in radiation-induced cognitive dysfunction. Among other gliotransmitters, astrocytes control the availability of adenosine, an endogenous neuroprotectant and modulator of cognition, via metabolic clearance through adenosine kinase (ADK). Adult rats exposed to cranial irradiation (10 Gy) showed significant declines in performance of hippocampal-dependent cognitive function tasks [novel place recognition, novel object recognition (NOR), and contextual fear conditioning (FC)] 1 month after exposure to ionizing radiation using a clinically relevant regimen. Irradiated rats spent less time exploring a novel place or object. Cranial irradiation also led to reduction in freezing behavior compared to controls in the FC task. Importantly, immunohistochemical analyses of irradiated brains showed significant elevation of ADK immunoreactivity in the hippocampus that was related to astrogliosis and increased expression of glial fibrillary acidic protein (GFAP). Conversely, rats treated with the ADK inhibitor 5-iodotubercidin (5-ITU, 3.1 mg/kg, i.p., for 6 days) prior to cranial irradiation showed significantly improved behavioral performance in all cognitive tasks 1 month post exposure. Treatment with 5-ITU attenuated radiation-induced astrogliosis and elevated ADK immunoreactivity in the hippocampus. These results confirm an astrocyte-mediated mechanism where preservation of extracellular adenosine can exert neuroprotection against radiation-induced pathology. These innovative findings link radiation-induced changes in cognition and CNS functionality to altered

  7. Pediatric neuroradiology: Cerebral and cranial diseases

    Energy Technology Data Exchange (ETDEWEB)

    Diebler, C.; Dulac, O.


    In this book, a neuroradiologist and a neuropediatrician have combined forces to provide the widest possible knowledge in investigating cranial and cerebral disorders in infancy and childhood. Based on more than 20,000 pediatric CT examinations, with a follow-up time often exceeding ten years, the book aims to bridge interdisciplinary gaps and help radiologists, pediatricians and neurosurgeons solve the various problems of pediatric neuroradiology that frequently confront them. For each disease, the etiology, clinical manifestation, pathological lesions and radiological presentations are discussed, supported by extensive illustrations. Malformative, vascular, traumatic, tumoral, infectious and metabolic diseases are reviewed. Miscellaneous conditions presenting particular symptoms or syndromes are also studied, such as hydrocephalus and neurological complications of leukemia. Contents: Cerebral and cranial malformations; neurocutaneous syndromes; inherited metabolic diseases; infectious diseases - vascular disorders; intracranial tumors; cranial trauma - miscellaneous and subject index.

  8. Cranial osteopathy: its fate seems clear

    Directory of Open Access Journals (Sweden)

    Hartman Steve E


    Full Text Available Abstract Background According to the original model of cranial osteopathy, intrinsic rhythmic movements of the human brain cause rhythmic fluctuations of cerebrospinal fluid and specific relational changes among dural membranes, cranial bones, and the sacrum. Practitioners believe they can palpably modify parameters of this mechanism to a patient's health advantage. Discussion This treatment regime lacks a biologically plausible mechanism, shows no diagnostic reliability, and offers little hope that any direct clinical effect will ever be shown. In spite of almost uniformly negative research findings, "cranial" methods remain popular with many practitioners and patients. Summary Until outcome studies show that these techniques produce a direct and positive clinical effect, they should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.

  9. Mosaicism in osteopathia striata with cranial sclerosis. (United States)

    Joseph, Dennis J; Ichikawa, Shoji; Econs, Michael J


    Osteopathia striata with cranial sclerosis is an X-linked dominant condition caused by mutations in the WTX gene, resulting in linear striations in long bones in combination with cranial sclerosis. This condition is usually lethal in males. OBJECTIVE/PATIENT: Our aim was to determine the underlying genetic cause in a 37-yr-old male with this condition. DNA sequencing of peripheral blood and hair was performed to identify mutations in WTX. Quantitative PCR was performed to determine gene copy number variation. DNA sequenced from peripheral blood revealed the presence of two alleles at the 1108th position of the WTX gene. Subsequent DNA sequencing of hair follicles and quantitative PCR confirmed the presence of mosaicism. A novel mutation (c.1108G>T) found in our patient results in a truncated protein (E370X). Our patient represents the first confirmed case of mosaicism in osteopathia striata with cranial sclerosis.

  10. Independent predictors of retrograde failure in CTO-PCI after successful collateral channel crossing. (United States)

    Suzuki, Yoriyasu; Muto, Makoto; Yamane, Masahisa; Muramatsu, Toshiya; Okamura, Atsunori; Igarashi, Yasumi; Fujita, Tsutomu; Nakamura, Shigeru; Oida, Akitsugu; Tsuchikane, Etsuo


    To evaluate factors for predicting retrograde CTO-PCI failure after successful collateral channel crossing. Successful guidewire/catheter collateral channel crossing is important for the retrograde approach in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). A total of 5984 CTO-PCI procedures performed in 45 centers in Japan from 2009 to 2012 were studied. The retrograde approach was used in 1656 CTO-PCIs (27.7%). We investigated these retrograde procedures to evaluate factors for predicting retrograde CTO-PCI failure even after successful collateral channel crossing. Successful guidewire/catheter collateral crossing was achieved in 77.1% (n = 1,276) of 1656 retrograde CTO-PCI procedures. Retrograde procedural success after successful collateral crossing was achieved in 89.4% (n = 1,141). Univariate analysis showed that the predictors for retrograde CTO-PCI failure were in-stent occlusion (OR = 1.9829, 95%CI = 1.1783 - 3.3370 P = 0.0088), calcified lesions (OR = 1.9233, 95%CI = 1.2463 - 2.9679, P = 0.0027), and lesion tortuosity (OR = 1.5244, 95%CI = 1.0618 - 2.1883, P = 0.0216). On multivariate analysis, lesion calcification was an independent predictor of retrograde CTO-PCI failure after successful collateral channel crossing (OR = 1.3472, 95%CI = 1.0614 - 1.7169, P = 0.0141). The success rate of retrograde CTO-PCI following successful guidewire/catheter collateral channel crossing was high in this registry. Lesion calcification was an independent predictor of retrograde CTO-PCI failure after successful collateral channel crossing. Devices and techniques to overcome complex CTO lesion morphology, such as lesion calcification, are required to further improve the retrograde CTO-PCI success rate. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Cranial symmetry in baleen whales (Cetacea, Mysticeti) and the occurrence of cranial asymmetry throughout cetacean evolution (United States)

    Fahlke, Julia M.; Hampe, Oliver


    Odontoceti and Mysticeti (toothed and baleen whales) originated from Eocene archaeocetes that had evolved from terrestrial artiodactyls. Cranial asymmetry is known in odontocetes that can hear ultrasound (>20,000 Hz) and has been linked to the split function of the nasal passage in breathing and vocalization. Recent results indicate that archaeocetes also had asymmetric crania. Their asymmetry has been linked to directional hearing in water, although hearing frequencies are still under debate. Mysticetes capable of low-frequency and infrasonic hearing (<20 Hz) are assumed to have symmetric crania. This study aims to resolve whether mysticete crania are indeed symmetric and whether mysticete cranial symmetry is plesiomorphic or secondary. Cranial shape was analyzed applying geometric morphometrics to three-dimensional (3D) cranial models of fossil and modern mysticetes, Eocene archaeocetes, modern artiodactyls, and modern odontocetes. Statistical tests include analysis of variance, principal components analysis, and discriminant function analysis. Results suggest that symmetric shape difference reflects general trends in cetacean evolution. Asymmetry includes significant fluctuating and directional asymmetry, the latter being very small. Mysticete crania are as symmetric as those of terrestrial artiodactyls and archaeocetes, without significant differences within Mysticeti. Odontocete crania are more asymmetric. These results indicate that (1) all mysticetes have symmetric crania, (2) archaeocete cranial asymmetry is not conspicuous in most of the skull but may yet be conspicuous in the rostrum, (3) directional cranial asymmetry is an odontocete specialization, and (4) directional cranial asymmetry is more likely related to echolocation than hearing.

  12. Protein C inhibitor (PCI) binds to phosphatidylserine exposing cells with implications in the phagocytosis of apoptotic cells and activated platelets. (United States)

    Rieger, Daniela; Assinger, Alice; Einfinger, Katrin; Sokolikova, Barbora; Geiger, Margarethe


    Protein C Inhibitor (PCI) is a secreted serine protease inhibitor, belonging to the family of serpins. In addition to activated protein C PCI inactivates several other proteases of the coagulation and fibrinolytic systems, suggesting a regulatory role in hemostasis. Glycosaminoglycans and certain negatively charged phospholipids, like phosphatidylserine, bind to PCI and modulate its activity. Phosphatidylerine (PS) is exposed on the surface of apoptotic cells and known as a phagocytosis marker. We hypothesized that PCI might bind to PS exposed on apoptotic cells and thereby influence their removal by phagocytosis. Using Jurkat T-lymphocytes and U937 myeloid cells, we show here that PCI binds to apoptotic cells to a similar extent at the same sites as Annexin V, but in a different manner as compared to live cells (defined spots on ∼10-30% of cells). PCI dose dependently decreased phagocytosis of apoptotic Jurkat cells by U937 macrophages. Moreover, the phagocytosis of PS exposing, activated platelets by human blood derived monocytes declined in the presence of PCI. In U937 cells the expression of PCI as well as the surface binding of PCI increased with time of phorbol ester treatment/macrophage differentiation. The results of this study suggest a role of PCI not only for the function and/or maturation of macrophages, but also as a negative regulator of apoptotic cell and activated platelets removal.

  13. Protein C inhibitor (PCI binds to phosphatidylserine exposing cells with implications in the phagocytosis of apoptotic cells and activated platelets.

    Directory of Open Access Journals (Sweden)

    Daniela Rieger

    Full Text Available Protein C Inhibitor (PCI is a secreted serine protease inhibitor, belonging to the family of serpins. In addition to activated protein C PCI inactivates several other proteases of the coagulation and fibrinolytic systems, suggesting a regulatory role in hemostasis. Glycosaminoglycans and certain negatively charged phospholipids, like phosphatidylserine, bind to PCI and modulate its activity. Phosphatidylerine (PS is exposed on the surface of apoptotic cells and known as a phagocytosis marker. We hypothesized that PCI might bind to PS exposed on apoptotic cells and thereby influence their removal by phagocytosis. Using Jurkat T-lymphocytes and U937 myeloid cells, we show here that PCI binds to apoptotic cells to a similar extent at the same sites as Annexin V, but in a different manner as compared to live cells (defined spots on ∼10-30% of cells. PCI dose dependently decreased phagocytosis of apoptotic Jurkat cells by U937 macrophages. Moreover, the phagocytosis of PS exposing, activated platelets by human blood derived monocytes declined in the presence of PCI. In U937 cells the expression of PCI as well as the surface binding of PCI increased with time of phorbol ester treatment/macrophage differentiation. The results of this study suggest a role of PCI not only for the function and/or maturation of macrophages, but also as a negative regulator of apoptotic cell and activated platelets removal.

  14. Multivessel percutaneous coronary intervention in patients with stable angina: a common approach? Lessons learned from the EHS PCI registry. (United States)

    Bauer, Timm; Möllmann, Helge; Zeymer, Uwe; Hochadel, Matthias; Nef, Holger; Weidinger, Franz; Zahn, Ralf; Hamm, Christian W; Marco, Jean; Gitt, Anselm K


    The aim of this study was to evaluate clinical characteristics, procedural details, and outcomes of patients undergoing elective multivessel percutaneous coronary intervention (MV-PCI) in Europe. A total of 7113 patients with stable coronary artery disease and at least two major epicardial vessels with ≥ 70% stenosis were included in this analysis of the contemporary Euro Heart Survey PCI registry. Patients undergoing MV-PCI (n = 3376, 47.5%) were compared with those with single-vessel PCI (SV-PCI) (n = 3737, 52.5%). Patients with MV-PCI were more likely to have congestive heart failure, whereas those with SV-PCI more often suffered from noncardiac comorbidities. Hospital mortality (0.1% vs 0.3%) and the incidence of nonfatal postprocedural myocardial infarction (1.0% vs 0.7%) were low in patients with MV-PCI and SV-PCI. In the multivariate analysis, no significant difference in the incidence of hospital death (odds ratio (OR) 0.44, 95% confidence interval (CI) 0.15-1.27) could be observed between the two groups. However, the risk for postprocedural myocardial infarction (OR 1.57, 95% CI 0.93-2.67) tended to be higher among patients undergoing MV-PCI. Independent determinants for performing MV-PCI were age, comorbidities, and coronary anatomy. In Europe almost half of all patients with multivessel disease were treated with MV-PCI. Hospital complications were low, but a trend toward a higher rate of postprocedural myocardial infarctions was seen in patients with MV-PCI.

  15. Use and outcome of thrombus aspiration in patients with primary PCI for acute ST-elevation myocardial infarction: results from the multinational Euro Heart Survey PCI Registry. (United States)

    Weipert, Kay F; Bauer, Timm; Nef, Holger M; Möllmann, Helge; Hochadel, Matthias; Marco, Jean; Weidinger, Franz; Zeymer, Uwe; Gitt, Anselm K; Hamm, Christian W


    The clinical benefit of thrombus aspiration (TA) in patients presenting with acute ST-elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PCI) is not well defined. Furthermore, there is a large variation in the use of TA in real-world registries. Between 2005 and 2008, a total of 7146 consecutive patients with acute STEMI undergoing primary PCI were prospectively enrolled into the PCI Registry of the Euro Heart Survey Programme. For the present analysis, patients treated additionally with TA (n = 897, 12.6 %) were compared with those without TA (n = 6249, 87.4 %). Patients with hemodynamic instability at initial presentation (15.1 vs. 11.0 %; p < 0.001) and resuscitation prior to PCI (10.4 vs. 7.4 %; p = 0.002) were more frequently treated with TA. TIMI flow grade 0/1 before PCI was more often found among those with TA (73.5 vs. 58.6 %; p < 0.001). After adjustment for confounding factors in the propensity score analysis, TA was not associated with improved in-hospital survival (risk difference -1.1 %, 95 % confidence interval -2.7 to 0.6 %). In this European real-world registry, the rate of TA use was low. Hemodynamically unstable patients were more likely to be treated with TA. Consistent with the results of the TASTE study and the TOTAL trial, TA was not associated with a significant reduction in short-term mortality.

  16. Isovaleric acidaemia: cranial CT and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Sogut, Ayhan; Acun, Ceyda; Tomsac, Nazan; Demirel, Fatma [Department of Paediatrics, Karaelmas University, Zonguldak (Turkey); Aydin, Kubilay [Department of Radiology, Istanbul Medical School, Istanbul University, Camlikyolu, B. mehmetpasa sokak yavuz apt. No:10/10, Etiler, Istanbul (Turkey); Aktuglu, Cigdem [Department of Paediatrics, Cerrahpasa Medical School, Istanbul University, Istanbul (Turkey)


    Isovaleric acidaemia is an inborn error of leucine metabolism due to deficiency of isovaleryl-CoA dehydrogenase, which results in accumulation of isovaleric acid in body fluids. There are acute and chronic-intermittent forms of the disease. We present the cranial CT and MRI findings of a 19-month-old girl with the chronic-intermittent form of isovaleric acidaemia. She presented with severe metabolic acidosis, hyperglycaemia, glycosuria, ketonuria and acute encephalopathy. Cranial CT revealed bilateral hypodensity of the globi pallidi. MRI showed signal changes in the globi pallidi and corticospinal tracts of the mesencephalon, which were hypointense on T1-weighted and hyperintense on T2-weighted images. (orig.)

  17. Depression and Anxiety after Acute Myocardial Infarction Treated by Primary PCI (United States)

    Kala, Petr; Hudakova, Nela; Jurajda, Michal; Kasparek, Tomas; Ustohal, Libor; Parenica, Jiri; Sebo, Marek; Holicka, Maria


    Aims The main objective of the study was to find out prevalence of depression and anxiety symptoms in the population of patients with AMI with ST-segment elevation (STEMI), treated with primary PCI (pPCI). Secondary target indicators included the incidence of sleep disorders and loss of interest in sex. Methods and results The project enrolled 79 consecutive patients with the first AMI, aged <80 years (median 61 years, 21.5% of women) with a follow-up period of 12 months. Symptoms of depression or anxiety were measured using the Beck Depression Inventory II tests (BDI-II, cut-off value ≥14) and Self-Rating Anxiety Scale (SAS, cut-off ≥ 45) within 24 hours of pPCI, before the discharge, and in 3, 6 and 12 months). Results with the value p<0.05 were considered as statistically significant. The BDI-II positivity was highest within 24 hours after pPCI (21.5%) with a significant decline prior to the discharge (9.2%), but with a gradual increase in 3, 6 and 12 months (10.4%; 15.4%; 13.8% respectively). The incidence of anxiety showed a relatively similar trend: 8.9% after pPCI, and 4.5%, 10.8% and 6.2% in further follow-up. Conclusions Patients with STEMI treated by primary PCI have relatively low overall prevalence of symptoms of depression and anxiety. A significant decrease in mental stress was observed before discharge from the hospital, but in a period of one year after pPCI, prevalence of both symptoms was gradually increasing, which should be given medical attention. PMID:27074002

  18. 21 CFR 882.4325 - Cranial drill handpiece (brace). (United States)


    ... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill handpiece (brace). (a) Identification. A cranial drill handpiece (brace) is a hand holder, which is...

  19. Neurosyphilis Involving Cranial Nerves in Brain Stem: 2 Case Reports

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Hye [Dept. of Radiology, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Choi, Woo Suk; Kim, Eui Jong [Dept. of Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of); Yoon, Sung Sang; Heo, Sung Hyuk [Dept. of Neurology, Kyung Hee University Hospital, Seoul (Korea, Republic of)


    Neurosyphilis uncommonly presents with cranial neuropathies in acute syphilitic meningitis and meningovascular neurosyphilis. We now report two cases in which the meningeal form of neurosyphilis involved cranial nerves in the brain stem: the oculomotor and trigeminal nerve.

  20. Anatomically shaped cranial collimation (ACC) for lateral cephalometric radiography: a technical report. (United States)

    Hoogeveen, R C; van der Stelt, P F; Berkhout, W E R


    Lateral cephalograms in orthodontic practice display an area cranial of the base of the skull that is not required for diagnostic evaluation. Attempts have been made to reduce the radiation dose to the patient using collimators combining the shielding of the areas above the base of the skull and below the mandible. These so-called "wedge-shaped" collimators have not become standard equipment in orthodontic offices, possibly because these collimators were not designed for today's combination panoramic-cephalometric imaging systems. It also may be that the anatomical variability of the area below the mandible makes this area unsuitable for standardized collimation. In addition, a wedge-shaped collimator shields the cervical vertebrae; therefore, assessment of skeletal maturation, which is based on the stage of development of the cervical vertebrae, cannot be performed. In this report, we describe our investigations into constructing a collimator to be attached to the cephalostat and shield the cranial area of the skull, while allowing the visualization of diagnostically relevant structures and markedly reducing the size of the irradiated area. The shape of the area shielded by this "anatomically shaped cranial collimator" (ACC) was based on mean measurements of cephalometric landmarks of 100 orthodontic patients. It appeared that this collimator reduced the area of irradiation by almost one-third without interfering with the imaging system or affecting the quality of the image. Further research is needed to validate the clinical efficacy of the collimator.

  1. Cranial kinesis in geckoes: functional implications. (United States)

    Herrel, A; Aerts, P; De Vree, F


    Although it is generally assumed that cranial kinesis is a plesiomorphic characteristic in squamates, experimental data tend to contradict this hypothesis. In particular, coupled kinesis (i.e. streptostyly and mesokinesis) presumably arose independently in only a limited number of highly specialised groups. In this study, we investigated cranial kinesis in one of the most specialised of these groups: geckoes. On the basis of cineradiographic and electromyographic data, the fast opening and the slow closing/power stroke phases were modelled to elucidate possible functions of the observed kinesis. The results of these analyses show that the retraction of the muzzle unit during crushing is a self-reinforcing system that increases bite force and reduces the joint forces; the active protraction of the kinetic system during jaw opening, in contrast, enhances opening speed through the coupling of the intracranial units. It can be argued that cranial kinesis in geckoes is probably not an adaptive trait as such but, instead, a consequence of the 'Bauplan' of the cranial system in these animals. Presumably as a result of constructional constraints on the size of the jaw musculature and eyes, the supratemporal and postorbital bars were lost, which resulted in enormous mobility in the skull. To counteract the potential negative factors associated with this (decrease in bite force, skull damage), the kinetic system may have become coupled, and thus functional.

  2. Entrainment and the cranial rhythmic impulse. (United States)

    McPartland, J M; Mein, E A


    Entrainment is the integration or harmonization of oscillators. All organisms pulsate with myriad electrical and mechanical rhythms. Many of these rhythms emanate from synchronized pulsating cells (eg, pacemaker cells, cortical neurons). The cranial rhythmic impulse is an oscillation recognized by many bodywork practitioners, but the functional origin of this impulse remains uncertain. We propose that the cranial rhythmic impulse is the palpable perception of entrainment, a harmonic frequency that incorporates the rhythms of multiple biological oscillators. It is derived primarily from signals between the sympathetic and parasympathetic nervous systems. Entrainment also arises between organisms. The harmonizing of coupled oscillators into a single, dominant frequency is called frequency-selective entrainment. We propose that this phenomenon is the modus operandi of practitioners who use the cranial rhythmic impulse in craniosacral treatment. Dominant entrainment is enhanced by "centering," a technique practiced by many healers, for example, practitioners of Chinese, Tibetan, and Ayurvedic medicine. We explore the connections between centering, the cranial rhythmic impulse, and craniosacral treatment.

  3. 21 CFR 882.4360 - Electric cranial drill motor. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Electric cranial drill motor. 882.4360 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4360 Electric cranial drill motor. (a) Identification. An electric cranial drill motor is an electrically operated power source...

  4. 38 CFR 4.124 - Neuralgia, cranial or peripheral. (United States)


    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Neuralgia, cranial or....124 Neuralgia, cranial or peripheral. Neuralgia, cranial or peripheral, characterized usually by a... code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete...

  5. 38 CFR 4.123 - Neuritis, cranial or peripheral. (United States)


    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Neuritis, cranial or peripheral. 4.123 Section 4.123 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS....123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss...

  6. Angiographic and Clinical Impact of Successful Manual Thrombus Aspiration in Diabetic Patients Undergoing Primary PCI

    Directory of Open Access Journals (Sweden)

    Mohamed Shehata


    Full Text Available Background. Diabetes mellitus is associated with worse angiographic and clinical outcomes after percutaneous coronary intervention (PCI. Aim. To investigate the impact of manual thrombus aspiration on in-stent restenosis (ISR and clinical outcome in patients treated by bare-metal stent (BMS implantation for ST-segment elevation myocardial infarction (STEMI. Methods. 100 diabetic patients were prospectively enrolled. They were randomly assigned to undergo either standard primary PCI (group A, 50 patients or PCI with thrombus aspiration using Export catheter (group B, 50 patients. The primary endpoint was the rate of eight-month ISR. The secondary endpoint included follow-up for major adverse cardiac events (MACE. Results. Mean age of the study cohort was 59.86±8.3 years, with 64 (64% being males. Baseline characteristics did not differ between both groups. Eight-month angiogram showed that group B patients had significantly less late lumen loss (0.17±0.35 versus 0.60±0.42 mm, P<0.001, with lower incidence of ISR (4% versus 16.6%, P<0.001. There was a trend towards lower rate of MACE in the same group of patients. Conclusion. In diabetic patients undergoing primary PCI, manual thrombus aspiration (compared with standard PCI was associated with better ISR rate after BMS implantation.

  7. Cardiac rehabilitation outcomes following a 6-week program of PCI and CABG Patients

    Directory of Open Access Journals (Sweden)

    Herbert F Jelinek


    Full Text Available Coronary artery events requiring intervention are associated with depressed cardiac autonomic function. Whether a 6-week cardiac rehabilitation (CR differs in effectiveness in improving exercise capacity (6MWT, cardiorespiratory function (peakVO2 and autonomic function (HRV following either cardiac bypass surgery (CABG or percutaneous coronary revascularization (PCI is unknown. The current study therefore compared the change in 6MWT and peak VO2 to HRV variables following a 6-week cardiac rehabilitation program and with patients having either PCI or CABG. Thirty-eight patients, (PCI, n=22 and CABG, n=16 participated in the CR program and results for pre and post six minute walk test (6MWT, peakVO2 and heart rate variability (HRV were obtained. Our study has shown that a six weeks program following either PCI or CABG improves function. However the effect on post-CABG differs to that of post-PCI patients. The change in distance walked (6MWT, metres was higher in the CABG (Δ6MWT: 61, p

  8. Protection effects of Sigmart for no-reflow or myocardial reperfusion injury after undergoing PCI surgery

    Institute of Scientific and Technical Information of China (English)

    Xiao-Peng Wu; Xuan-Qi Wang; Lei-Sen Han; Chong-Zhen Wang; Yin-Juan Mao; Wei-Jie Li


    Objective:To study the protection effects of Sigmart for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery.Methods: A total of 150 patients undergoing PCI surgery were selected and divided into control group and observation group with 75 cases in each group. After undergoing the surgery, both groups were given low molecular heparin 4 100 IU for 3 d, 100 mg + aspirin + atorvastatin 20 mg + clopidogrel 75 mg. 5 mL of blood specimen were collected for detection of troponin I (TnI), myocardial enzyme spectrum (CK, CK-MB) level to evaluate myocardial myocardial reperfusion injury after undergoing PCI surgery. Also electrocardiogram (ECG) were detected. Six months after the surgery, effects of Sigmart for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery were evaluated.Results: 1, 6, 12, 24 h after the surgery, TnI, Mb, CK-Mb levels of were significant different from those before undergoing the surgery, and these levels of the observation group were significant higher than that of the control group. ST segment elevation at 2, 12, and 24 h after undergoing the surgery were significant obvious than that of the control group. According to the follow up, incidence of comprehensive end point event was significant higher than that of the control group. SAQ and SF-36 scores of the two groups were significant different. Conclusion: Sigmart shows good protection effects for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery.

  9. Myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Yu-Jun Zhao


    Objective:To study the myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction and explore the possible molecular mechanisms. Methods:A total of 84 patients with acute myocardial infarction who received emergency PCI treatment in our hospital from February 2014 to October 2015 were selected for study and randomly divided into and ticagrelor group and clopidogrel group that received different perioperative anti-platelet therapy. Degree of myocardial cell damage, cardiac pump function as well as blood perfusion and platelet aggregation function of two groups were evaluated. Results:Before as well as 10 min and 24 h after PCI, plasma CK-MB and cTnI levels as well as maximum platelet aggregation rate and P2Y12 reaction unit of ticagrelor group were significantly lower than those of clopidogrel group, and ADP-way platelet inhibition rate were higher than those of clopidogrel group; after PCI, TIMI blood flow grade, TMP myocardial perfusion grade and LVEF of ticagrelor group were significantly higher than those of clopidogrel group, LVEDD was significantly lower than that of clopidogrel group and the number of cases with no reflow/slow flow was less than that of clopidogrel group. Conclusions:The myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction is better than that of clopidogrel, and ticagrelor can enhance the anti-platelet aggregation effect to exert myocardium-protective effect.

  10. Pediatric cerebral sinovenous thrombosis following cranial surgery. (United States)

    Petrov, Dmitriy; Uohara, Michael Y; Ichord, Rebecca; Ali, Zarina; Jastrzab, Laura; Lang, Shih-Shan; Billinghurst, Lori


    Pediatric cerebral sinovenous thrombosis (CSVT) is an important, though less common subtype of pediatric stroke. It has been linked to several risk factors, including cranial procedures, with few studies highlighting this relationship. The aim of this study was to characterize the diagnosis and treatment of CSVT after cranial surgery. An institutional pediatric stroke research database was used to identify all CSVT cases diagnosed within 30 days of cranial surgery from November 2004 to December 2014. Thirteen subjects were retrospectively analyzed for clinical presentation, surgical details, radiographic characteristics, laboratory study results, treatment, and outcome. Diagnostic testing and treatment adhered to a consensus-based institutional stroke protocol. Cranial vault reconstruction, subdural empyema evacuation, and tumor resection were each observed in three subjects. Eleven (85%) subjects had sinus exposure during surgery, and eight (73%) developed thrombus in a sinus within or adjacent to the operative field. Two (15%) had documented iatrogenic sinus injury. On post-operative testing, ten (77%) subjects had prothrombotic abnormalities. Seven (54%) were treated with anti-coagulation therapy (ACT) starting on a median of post-operative day (POD) 3 (IQR 1-3) for a median of 2.9 months (IQR 2.4-5.4). Median time to imaging evidence of partial or complete recanalization was 2.4 months (IQR 0.7-5.1). No symptomatic hemorrhagic complications were encountered. Pediatric CSVT may be encountered after cranial surgery, and decisions related to anti-coagulation are challenging. The risk of CSVT should be considered in pre-surgical planning and post-operative evaluation of cases with known risk factors. In our study, judicious use of ACT was safe in the post-operative period.

  11. Stem cell transplantation strategies for the restoration of cognitive dysfunction caused by cranial radiotherapy. (United States)

    Acharya, Munjal M; Roa, Dante E; Bosch, Omar; Lan, Mary L; Limoli, Charles L


    Radiotherapy often provides the only clinical recourse for those afflicted with primary or metastatic brain tumors. While beneficial, cranial irradiation can induce a progressive and debilitating decline in cognition that may, in part, be caused by the depletion of neural stem cells. Given the increased survival of patients diagnosed with brain cancer, quality of life in terms of cognitive health has become an increasing concern, especially in the absence of any satisfactory long-term treatments. To address this serious health concern we have used stem cell replacement as a strategy to combat radiation-induced cognitive decline. Our model utilizes athymic nude rats subjected to cranial irradiation. The ionizing radiation is delivered as either whole brain or as a highly focused beam to the hippocampus via linear accelerator (LINAC) based stereotaxic radiosurgery. Two days following irradiation, human neural stem cells (hNSCs) were stereotaxically transplanted into the hippocampus. Rats were then assessed for changes in cognition, grafted cell survival and for the expression of differentiation-specific markers 1 and 4-months after irradiation. Our cognitive testing paradigms have demonstrated that animals engrafted with hNSCs exhibit significant improvements in cognitive function. Unbiased stereology reveals significant survival (10-40%) of the engrafted cells at 1 and 4-months after transplantation, dependent on the amount and type of cells grafted. Engrafted cells migrate extensively, differentiate along glial and neuronal lineages, and express a range of immature and mature phenotypic markers. Our data demonstrate direct cognitive benefits derived from engrafted human stem cells, suggesting that this procedure may one day afford a promising strategy for the long-term functional restoration of cognition in individuals subjected to cranial radiotherapy. To promote the dissemination of the critical procedures necessary to replicate and extend our studies, we have

  12. Effect of intracoronary injection of tirofiban combined with anisodamine on myocardial perfusion in patients with STEMI after PCI

    Institute of Scientific and Technical Information of China (English)

    Xiao-Gang Zhu; Li-Yue Wang; Hao-Jin Ren; Jin-Hua Liu


    Objective:To analyze the effect of intracoronary injection of tirofiban combined with anisodamine on myocardial perfusion in patients with STEMI after PCI.Methods:A total of 78 patients with acute ST segment elevation myocardial infarction (STEMI) who received PCI therapy in our hospital were randomly divided into control group and observation group, control group accepted routine PCI treatment, observation group received intracoronary injection of tirofiban and anisodamine in PCI, and myocardial perfusion of two groups was compared.Results: QRS duration values of observation group the instant after PCI and 4h after PCI were less than those of control group (P<0.05);99mTc-MIBI and18F-FDG intake of observation group after PCI were more than those of control group (P<0.05); serum MCP-1, sFas, Copeptin, OPN and vWF levels of observation group 4 h after PCI were lower than those of control group (P<0.05).Conclusions:Intracoronary injection of tirofiban combined with anisodamine can optimize myocardial perfusion in patients with STEMI after PCI, and has positive clinical significance.

  13. Controversies in the treatment of patients with STEMI and multivessel disease: is it time for PCI of all lesions? (United States)

    Ong, Peter; Sechtem, Udo


    Several randomized trials have suggested a benefit for multivessel PCI in patients with STEMI and multivessel disease. However, none of the studies compared multivessel PCI with a staged PCI-approach which is the current guideline recommended approach. The results of the trials may overestimate the beneficial effect of the multivessel PCI approach because the control group did not receive any ischaemia testing for evaluation of the significance of remaining lesions. Thus, unfavourable aspects of the multivessel PCI approach such as overestimation of non-culprit lesions at the time of acute coronary angiography, complications associated with PCI of the non-culprit lesion (i.e. dissection, no-reflow, acute stent thrombosis) or increased risk for contrast induced nephropathy may have gone unnoticed as the comparative management pathway was unusual and likely inferior to the guideline recommended approach. We believe that culprit lesion only PCI and staged evaluation of remaining areas of myocardial ischaemia with subsequent PCI is still preferable in patients with STEMI and multivessel disease but a randomized study comparing this approach with multivessel PCI is needed.

  14. 微型计算机PCI总线浅析%On Microcomputer PCI Bus

    Institute of Scientific and Technical Information of China (English)

    张宝菊; 孙景瑞; 刘艳


    较系统地分析了PCI总线的定义、分类及特点,论述了PCI总线的读写时序及总线仲裁问题,并将PCI总线应用在图象处理等方面,解决了数据通量的瓶颈问题.%This article analyses the definition,classification andpeculiarity of PCI bus systematically. And it expounds the problem of reading and writing proc ession and arbiitration of PCI bus. Further more, the PCI bus has been used in the im age treatment and any other fields,solving the difficult problem of data flux.

  15. Short- and Long-Term Cause of Death in Patients Treated With Primary PCI for STEMI

    DEFF Research Database (Denmark)

    Pedersen, Frants; Butrymovich, Vitalij; Kelbæk, Henning


    ,804 consecutive patients with STEMI (age 63 ± 13 years, 72% males) treated with primary PCI. RESULTS: Patients were followed up for a median of 4.7 years. During a total of 13,447 patient-years, 717 patients died. Main causes of death within the first 30 days were cardiogenic shock and anoxic brain injury after......BACKGROUND: Short-term mortality has been studied thoroughly in patients undergoing primary percutaneous coronary intervention (PCI), whereas long-term cause of death in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. OBJECTIVES: The goal of this study...... was to describe the association between time and cause of death in patients with STEMI undergoing primary PCI. METHODS: A centralized civil registration system, patient files, and public disease and death cause registries with an accurate record linkage were used to trace time and cause of death in 2...

  16. Risk prediction models for major adverse cardiac event (MACE) following percutaneous coronary intervention (PCI): A review (United States)

    Manan, Norhafizah A.; Abidin, Basir


    Five percent of patients who went through Percutaneous Coronary Intervention (PCI) experienced Major Adverse Cardiac Events (MACE) after PCI procedure. Risk prediction of MACE following a PCI procedure therefore is helpful. This work describes a review of such prediction models currently in use. Literature search was done on PubMed and SCOPUS database. Thirty literatures were found but only 4 studies were chosen based on the data used, design, and outcome of the study. Particular emphasis was given and commented on the study design, population, sample size, modeling method, predictors, outcomes, discrimination and calibration of the model. All the models had acceptable discrimination ability (C-statistics >0.7) and good calibration (Hosmer-Lameshow P-value >0.05). Most common model used was multivariate logistic regression and most popular predictor was age.

  17. Charcoal injection in blast furnaces (Bio-PCI: CO2 reduction potential and economic prospects

    Directory of Open Access Journals (Sweden)

    Cristobal Feliciano-Bruzual


    Full Text Available The steel industry is under pressure to reduce its CO2 emissions, which arise from the use of coal. In the long-term, the injection of pulverized particles of charcoal from biomass through blast furnace tuyeres, in this case called Bio-PCI, is an attractive method from both an environmental and metallurgical viewpoint. The potential of Bio-PCI has been assessed in terms of its CO2 abatement potential and economic viewpoint. A cost objective function has been used to measure the impact of biochar substitution in highly fuel-efficient BF among the top nine hot metal producers; estimations are based on the relevant cost determinants of ironmaking. This contribution aims to shed light on two strategic questions: Under what conditions is the implementation of Bio-PCI economically attractive? Additionally, where is such a techno-economic innovation likely to be taken up the earliest? The results indicate the potential for an 18–40% mitigation of CO2. Findings from the economic assessment show that biochar cannot compete with fossil coal on price alone; therefore, a lower cost of biochar or the introduction of carbon taxes will be necessary to increase the competitiveness of Bio-PCI. Based on the current prices of raw materials, electricity and carbon taxes, biochar should be between 130.1 and 236.4 USD/t and carbon taxes should be between 47.1 and 198.7 USD/t CO2 to facilitate the substitution of Bio-PCI in the examined countries. In regard to implementation, Brazil, followed by India, China and the USA appeared to be in a better position to deploy Bio-PCI.

  18. FFR result post PCI is suboptimal in long diffuse coronary artery disease. (United States)

    Baranauskas, Arvydas; Peace, Aaron; Kibarskis, Aleksandras; Shannon, Joanne; Abraitis, Vytautas; Bajoras, Vilhelmas; Bilkis, Valdas; Aidietis, Audrius; Laucevicius, Aleksandras; Davidavicius, Giedrius


    The aim of this study was to evaluate the functional result immediately post PCI and at nine-month follow-up, and to ascertain how often a functionally optimal result of >0.95 can be achieved in long coronary lesions treated with long second- or newer-generation DES. Patients receiving DES measuring ≥30 mm with FFR value ≤0.8 were included in the study. Stent length was defined as long (30 to 49 mm; L-DES) and ultra-long (≥50 mm; UL-DES). Angiographic and FFR evaluation was performed before and after PCI and at nine-month follow-up. A total of 74 patients each received a mean stent length of 50.72±14.6 mm. Mean FFR post PCI was 0.88±0.06. An optimal post PCI FFR value of >0.95 was achieved in only 9/74 patients (12.2%), and was not achieved in any UL-DES patients. Only 12/74 (16.2%) had FFR post PCI of 0.91 to 0.95; 8/74 (10.8%) patients remained ischaemic (≤0.8). FFR gradient across the stent was higher in UL-DES patients compared to L-DES patients (0.07±0.03 vs. 0.04±0.03; p=0.001). At follow-up, the angiographic restenosis rate was 4.7%, and the functional restenosis rate was 15.1%. The FFR result post PCI was suboptimal in the majority of patients treated with long DES and was particularly poor when the total stent length exceeded 50 mm.

  19. Design and Verification for PCS Layer of PCI Express Using VHDL

    Directory of Open Access Journals (Sweden)

    Hemant Kumar Soni Mr. Vikas Gupta Mrs. Deepti Agrawal


    Full Text Available The aim of this paper is to design and verify the physical layer implementation by using ISE 8.1 from Xilinx and Spartan 3 FPGA to reduce the cost and hardware as well without affecting the performance and reliability of PCI Express. PCI is the third generation high performance I/O bus used to interconnect peripheral devices in applications such as computing and communicating platform. PCI Express is an all in compassing I/O device interconnect bus that has application in the Mobile, Desktop, Workstation, Server, Embedded computing and communication platform. PCS is the sub layer of the physical layer of PCI Express 1.0. The major constituents of this layer are transmitter and receiver. Transmitter comprises of 8b/10b encoder. The Primary purpose of this scheme is to embed a clock into the serial bit stream of transmitter lanes with advancement in the design by reducing the utilized hardware resources within FPGA. No clock is transmitted along with the serial data bit stream. This eliminates EMI noise and provides DC balance. Receiver comprises of special symbol detector, elastic buffer and 8b/10b decoder. . 8b/10b decoder gives 8bit character and data/control signals. Disparity error and Decode error can be known though this module. If any error is present in the received data then loopback signal is generated. This work uses VHDL to model different blocks of the PCS of physical layer of PCI Express. The RTL code is simulated, synthesized and implemented using the ISE 8.1 from Xilinx and the Spartan 3 FPGA was targeted for implementation. In this paper we have reduced the hardware as well as cost of total system without affecting the speed of the PCI Express.

  20. Chronic Total Occlusion - Percutaneous Coronary Intervention (CTO-PCI) Experience in a Single, Multi-operator Australian Centre: Need for dedicated CTO-PCI programs. (United States)

    BoganaShanmugam, Vimalraj; Psaltis, Peter J; Wong, Dennis T; Seneviratne, Sujith; Cameron, James; Meredith, Ian T; Malaiapan, Yuvaraj


    Chronic total occlusions (CTOs) represent a unique set of lesions for percutaneous coronary intervention (PCI) because of the complexity of techniques required to treat them. We retrospectively reviewed the CTO-PCI experience between January 2010 and December 2012, in a multi-operator single centre, which is one of the largest volume PCI centres in Australia. Eighty-two patients (62.6±11.3 years, 85% males) who had CTO-PCIs were included. The most common site of CTO was the right coronary artery (44%), followed by the left circumflex (30%) and left anterior descending (26%) arteries. Using the Japanese CTO scoring system, 34% of lesions were classified as easy, 37% intermediate, 23% difficult and 6% very difficult. All PCIs were performed by antegrade approach. Selected procedural characteristics included: re-attempt procedure 10%; multiple access sites 21%; more than one guidewire 77%; additional support modality 60%; drug-eluting stents 97%; stent number 1.6±0.8; total stent length 40.1±24.5mm; fluoroscopy time 33±17min; contrast volume 257.2±110.8mL. Overall CTO success rate was 60%. In-hospital adverse outcomes included 1.2% mortality, 9.8% peri-procedural myocardial infarction, 4.9% emergency bypass surgery, 3% cardiac tamponade and 4.9% contrast induced nephropathy. We report modest success rates in a single Australian centre experience in a relatively conservative cohort of CTO-PCI prior to the initiation of a dedicated CTO revascularisation program. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  1. LabVIEW and PCI DAQ Card Based HTS Test and Control Platforms

    Institute of Scientific and Technical Information of China (English)

    Hui-Bin Zhao; Jian-Xun Jin; Pu-Chun Jiang; Wen-Hui Gao; Zi-Lu Liang


    This paper introduces the relevant parameters and related characteristics of the LabVIEW and PCI6221 data acquisition (DAQ) card, describes in detail the approach of building the measure and control platform of virtual instrument (VI) using LabVIEW and PCI6221, specifically discusses the system's application in high temperature superconductor (HTS) research including the test of HTS volt-ampere characteristics and the HTS magnetic energy storage. The experiments prove that the VI test and control system is easy to build and convenient to use.

  2. The association between type D personality, and depression and anxiety ten years after PCI


    AL-Qezweny, M.N.A.; Utens, E.M.W.J.; Dulfer, K.; Hazemeijer, B.A.F.; van Geuns, R-J.; Daemen, J.; van Domburg, R.


    Objective There are indications that type D personality and depression are associated in patients treated with percutaneous coronary intervention (PCI). However, at present it is unclear whether this relationship holds in the long term. This study’s aim was to investigate the association between type D personality at 6 months post-PCI (baseline), and depression at 10-year follow-up. A secondary aim was to test the association between type D personality at baseline and anxiety at 10-year follo...

  3. Hospital PCI Appropriateness and In-Hospital Procedural Outcomes: Insights from the NCDR® (United States)

    Bradley, Steven M.; Chan, Paul S.; Spertus, John A.; Kennedy, Kevin F.; Douglas, Pamela S.; Patel, Manesh R.; Anderson, H. Vernon; Ting, Henry H.; Rumsfeld, John S.; Nallamothu, Brahmajee K.


    Background Measurement of hospital quality has traditionally focused on processes of care and post-procedure outcomes. Appropriateness measures for percutaneous coronary intervention (PCI) assess quality as it relates to patient selection in the context of anticipated benefits relative to potential harm. The association, if any, between patient selection for PCI and processes of care and post-procedural outcomes is unknown. Defining whether these measures are redundant or complementary can inform the optimal range of metrics for monitoring quality. Methods We included patients undergoing non-acute (elective) PCI within the NCDR CathPCI Registry® between July 2009 and April 2011. We examined the association between a hospital’s proportion of non-acute PCIs categorized as inappropriate by the 2009 Appropriate Use Criteria (AUC) for Coronary Revascularization and in-hospital mortality, bleeding complications, and use of optimal guideline-directed medical therapy at discharge (i.e. aspirin, thienopyridines, and statins). Results A total of 203,531 non-acute PCIs from 779 hospitals were classified by the AUC. Of these, 101,779 (50.0%) were classified as appropriate, 77,220 (35.5%) as uncertain, and 24,532 (12.1%) as inappropriate. When categorized as hospital tertiles, the range of inappropriate PCI was 0.0 to 8.1% in the lowest-tertile, 8.1 to 15.2% in the middle-tertile, and 15.2 to 58.6% in the highest-tertile. Compared with lowest-tertile hospitals, mortality was not significantly different at middle-tertile (adjusted odds ratio [OR] 0.93; 95% confidence interval [CI] 0.73 to 1.19) or highest-tertile hospitals (OR 1.12; 95% CI 0.88 to 1.43; p=0.35 for differences between any tertile). Similarly, risk-adjusted bleeding did not vary significantly (middle-tertile OR 1.13; 95% CI 1.02 to 1.16; highest-tertile OR 1.02; 95% CI 0.91 to 1.16; p=0.07 for differences between any tertile) nor did use of optimal therapy at discharge after PCI (85.3% vs. 85.7% vs. 85.2%; P=0

  4. Cranial neuralgias: from physiopathology to pharmacological treatment. (United States)

    De Simone, Roberto; Ranieri, Angelo; Bilo, Leonilda; Fiorillo, Chiara; Bonavita, Vincenzo


    Cranial neuralgias are paroxysmal painful disorders of the head characterised by some shared features such as unilaterality of symptoms, transience and recurrence of attacks, superficial and "shock-like" quality of pain and the presence of triggering factors. Although rare, these disorders must be promptly recognised as they harbour a relatively high risk for underlying compressive or inflammatory disease. Nevertheless, misdiagnosis is frequent. Trigeminal and glossopharyngeal neuralgias are sustained in most cases by a neurovascular conflict in the posterior fossa resulting in a hyperexcitability state of the trigeminal circuitry. If the aetiology of trigeminal neuralgia (TN) and other typical neuralgias must be brought back to the peripheral injury, their pathogenesis could involve central allodynic mechanisms, which, in patients with inter-critical pain, also engage the nociceptive neurons at the thalamic-cortical level. Currently available medical treatments for TN and other cranial neuralgias are reviewed.

  5. Cranial Imaging Findings of Hypertension in Pregnancy

    Directory of Open Access Journals (Sweden)

    Yusuf Tamam


    Full Text Available The aim of this study was to find out the cranial imaging findings of complicated hypertensive disorders of pregnancy. Forty two patients with preeclampsia, eclampsia and HELLP syndrome were admitted to the study at Obstetrics Division of Dicle University from January 2001 to December 2004. Computed Tomography was made to the forty two patients. The Computed Tomograpy findings of 20 (47.62% patients were normal whereas computed Tomograpy findings of 22 (52.28% patients were pathological. Eight patients (19% had intracranial hemorrhage, 5 (11.9 % patients had infarct, 9 (21.42% patients had specific lesions. A wide imaging spectrum from ischemic area to intracranial hemorrhages can be detected in hypertensive disorders of pregnancy. Thus it is essential to make cranial imaging in patients with symptoms and neurological deficit.

  6. Transverse sinus air after cranial trauma

    Energy Technology Data Exchange (ETDEWEB)

    Cihangiroglu, Mutlu E-mail:; Ozdemir, Huseyin; Kalender, Omer; Ozveren, Faik; Kabaalioglu, Adnan


    Air in vascular compartments has been rarely reported. We report a case in whom air within transverse sinus and sinus confluence through ruptured superior sagittal sinus (SSS) due to fractures of parietal and frontal bones was disclosed by computed tomography (CT). Although air in transverse sinus has been reported rarely this could be the first case with air in transverse sinus through the SSS after cranial trauma.

  7. Role of cranial imaging in epileptic status

    Energy Technology Data Exchange (ETDEWEB)

    Nair, Pradeep P.; Kalita, Jayantee [Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014 (India); Misra, Usha K. [Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014 (India)], E-mail:


    Introduction: There is paucity of studies evaluating the role of cranial imaging in the management of status epilepticus (SE); therefore this study evaluates the role of imaging in predicting the outcome of SE. Methods: Consecutive patients with SE were prospectively evaluated. Clinical evaluation, blood counts, serum chemistry and cerebrospinal fluid (CSF) were carried out. Cranial CT scan was performed on a spiral CT and MRI on a 1.5 T scanner. Patients were treated with IV sodium valproate, phenytoin and benzodiazepines as per fixed protocol. Outcome was defined as seizure control at 1 h and mortality. Various clinical and radiological parameters were correlated. Results: There were 99 patients with SE whose mean age was 35 (1-78) years, 40 females and 17 were below 12 years of age. Fifty six patients had central nervous system (CNS) infections, 15 strokes, 13 metabolic encephalopathy, 5 drug default and in the remaining 10 patients various acute symptomatic causes were present. Cranial imaging was abnormal in 59% patients. CT was abnormal in 21 (47.7%) out of 44 patients whereas MRI was abnormal in 26 (63.4%) out of 41 patients. Both MRI and CT were carried out in 14 patients and 12 revealed abnormalities; 2 had abnormality only on MRI. Imaging revealed cortical lesions in 10, subcortical in 19 and both cortical as well as subcortical in 30 patients. One hour seizure control was achieved in 60, seizures recurred within 24 h in 38 and 27 patients died during hospital stay. Seizure type, duration of SE, seizure control at 1 h and mortality did not correlate with radiological abnormalities. Conclusion: Cranial imaging reveals structural abnormality in 59% patients with SE and was not related to SE control and mortality.

  8. Cranial Osteology of Meiglyptini (Aves: Piciformes: Picidae

    Directory of Open Access Journals (Sweden)

    Reginaldo José Donatelli


    Full Text Available The Meiglyptini comprise eight species grouped into three genera: Meiglyptes and Mulleripicus, with three species each, and Hemicircus, with two species. The aim of the present study was to describe the cranial osteology of six species and three genera of Meiglyptini and to compare them to each other, as well as with other species of woodpeckers and other bird groups. The cranial osteology varied among the investigated species, but the most markedly distinct characteristics were: (1 a frontal overhang is only observed in the middle portion of the frontale of H. concretus; (2 the Proc. zygomaticus and suprameaticus are thick and long in species of the genus Mulleripicus, but short in other species; (3 the Pes pterygoidei is relatively larger in species of the genus Mulleripicus, while it is narrow, thin and relatively smaller in species of the genus Meiglyptes and indistinct in H. concretus; (4 the bony projection of the ectethmoidale is relatively short and thin in species of Mulleripicus and more developed in H. concretus. It appears that the greatest structural complexity of the cranial osteology is associated with the birds’ diet, with the frugivorous H. concretus being markedly different from the insectivorous species.


    Directory of Open Access Journals (Sweden)



    Full Text Available The small passerine Cyclaris gujanensis can tear into small pieces large or heavy-bodied preys that could not be swallowed whole such as frogs, snakes, bats and birds. However there are few studies on the cranial anatomy of this species. Thus, we focused on the description of the cranial osteology to contribute to the anatomical knowledge of this species and to make some assumptions about functional anatomy. The fossa temporalis is shallow but broad and the fossa of os palatinum is deepened. The os quadratum processes are long and thick. The os pterygoideum is enlarged and the upper jaw is strongly inclined ventrally (140° with reference to the skull. The rostral extremity of rhamphotheca is hooked with ventral concavity to fit the mandible (pincer form. The mandible fossae are deepened and broad and its bulky medial process probably provides mandible stability and strong support to the muscles attached on it. All these peculiar characteristics probably indicate a considerable force in the C. gujanensis jaws and partially explain its distinctive feeding habit compared with the other Vireonidae. Nevertheless, new studies with functional approaches to analysis the forces of the muscle fibers and the cranial kinesis are needed to prove the hypotheses mentioned above.

  10. Cranial osteology of meiglyptini (aves: piciformes: picidae). (United States)

    Donatelli, Reginaldo José


    THE MEIGLYPTINI COMPRISE EIGHT SPECIES GROUPED INTO THREE GENERA: Meiglyptes and Mulleripicus, with three species each, and Hemicircus, with two species. The aim of the present study was to describe the cranial osteology of six species and three genera of Meiglyptini and to compare them to each other, as well as with other species of woodpeckers and other bird groups. The cranial osteology varied among the investigated species, but the most markedly distinct characteristics were: (1) a frontal overhang is only observed in the middle portion of the frontale of H. concretus; (2) the Proc. zygomaticus and suprameaticus are thick and long in species of the genus Mulleripicus, but short in other species; (3) the Pes pterygoidei is relatively larger in species of the genus Mulleripicus, while it is narrow, thin and relatively smaller in species of the genus Meiglyptes and indistinct in H. concretus; (4) the bony projection of the ectethmoidale is relatively short and thin in species of Mulleripicus and more developed in H. concretus. It appears that the greatest structural complexity of the cranial osteology is associated with the birds' diet, with the frugivorous H. concretus being markedly different from the insectivorous species.

  11. Cranial fasciitis of childhood: a case report. (United States)

    Kumon, Y; Sakaki, S; Sakoh, M; Nakano, K; Fukui, K; Kurihara, K


    Cranial fasciitis of childhood is very rare, only 17 cases having been reported in the literature. We report an additional case of this rare disease. The patient was a 5-year-old boy who complained of left exophthalmos and double vision. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large epidural mass in the left frontal region that had invaded into the underlying anterior skull base. The tumor showed homogeneous, low density with nonhomogeneous contrast enhancement on the CT scans, and low intensity on the T1-weighted and high intensity on the T2-weighted MRI images. A whitish-pink, elastic, hard tumor was revealed in the epidural space in the left anterior cranial fossa, which was totally excised with curettage of the affected anterior skull base. The origin of the tumor was suspected to be the fibrous connective tissue of the sphenofrontal suture. The histological diagnosis was that of cranial fasciitis. There was no evidence of recurrence 1 year postoperatively.

  12. Studing cranial vault modifications in ancient Mesoamerica. (United States)

    Tiesler, Vera


    The artificial modification of infant cranial vaults through massages or by means of constriction and compression devices constitutes a readily visible, permanent body modification that has been employed cross-culturally to express identity, ethnicity, beauty, status and gender. For those ancient societies that staged head shaping, these cultural correlates may be ascertained by examining cranial shapes together with other data sets from the archaeological record. Studies of skulls modified for cultural reasons also provide important clues for understanding principles in neural growth and physiopathological variation in cranial expansion. This paper focuses on head shaping techniques in Mesoamerica, where the practice was deeply rooted and widespread before the European conquest. It provides a comprehensive review of the Mesoamericanistic research on shaping techniques, implements and taxonomies. An up-dated, interdisciplinary examination of the physiological implications and the cultural meanings of artificially produced head shapes in different times and culture areas within Mesoamerica leads to a discussion of the scope, caveats, and future directions involved in this kind of research in the region and beyond.

  13. Cranial involvement in sickle cell disease

    Energy Technology Data Exchange (ETDEWEB)

    Alkan, Ozlem, E-mail: [Department of Radiology, Faculty of Medicine, Baskent University, Ankara (Turkey); Kizilkilic, Ebru, E-mail: [Department of Hematology, Faculty of Medicine, Baskent University, Ankara (Turkey); Kizilkilic, Osman, E-mail: [Department of Radiology, Faculty of Medicine, Baskent University, Ankara (Turkey); Yildirim, Tulin, E-mail: [Department of Radiology, Faculty of Medicine, Baskent University, Ankara (Turkey); Karaca, Sibel, E-mail: [Department of Neurology, Faculty of Medicine, Baskent University, Ankara (Turkey); Yeral, Mahmut, E-mail: [Department of Hematology, Faculty of Medicine, Baskent University, Ankara (Turkey); Kasar, Mutlu, E-mail: [Department of Hematology, Faculty of Medicine, Baskent University, Ankara (Turkey); Ozdogu, Hakan, E-mail: [Department of Hematology, Faculty of Medicine, Baskent University, Ankara (Turkey)


    Purpose: To evaluate cranial findings in patients with neurologically symptomatic sickle cell disease (SCD). Materials and methods: We studied 50 consecutive patients with SCD and neurologic symptoms. All patients underwent brain MR examinations: all 50 underwent classic MR imaging; 42, diffusion-weighted MR imaging; 10, MR angiography; four, MR venography; and three patients, digital subtraction angiography. Results: Of the 50 SCD patients, 19 (38%) had normal MR findings, and 31 (62%) showed abnormalities on brain MR images. Of the 50 patients, 16 (32%) had ischemic lesions; two (4%), subarachnoid hemorrhage; one (2%), moya-moya pattern; one (2%), posterior reversible encephalopathy; one (2%), dural venous sinus thrombosis; 12 (24%), low marrow signal intensity and thickness of the diploic space; 12 (24%), cerebral atrophy; and two (4%), osteomyelitis. Twenty-seven patients (54%) presented with headache, which was the most common clinical finding. Conclusions: The cranial involvement is one of the most devastating complications of SCD. Early and accurate diagnosis is important in the management of cranial complications of SCD.

  14. Real-time fusion of coronary CT angiography with X-ray fluoroscopy during chronic total occlusion PCI

    Energy Technology Data Exchange (ETDEWEB)

    Ghoshhajra, Brian B.; Takx, Richard A.P. [Harvard Medical School, Cardiac MR PET CT Program, Massachusetts General Hospital, Department of Radiology and Division of Cardiology, Boston, MA (United States); Stone, Luke L.; Yeh, Robert W.; Jaffer, Farouc A. [Harvard Medical School, Cardiac Cathetrization Laboratory, Cardiology Division, Massachusetts General Hospital, Boston, MA (United States); Girard, Erin E. [Siemens Healthcare, Princeton, NJ (United States); Brilakis, Emmanouil S. [Cardiology Division, Dallas VA Medical Center and UT Southwestern Medical Center, Dallas, TX (United States); Lombardi, William L. [University of Washington, Cardiology Division, Seattle, WA (United States)


    The purpose of this study was to demonstrate the feasibility of real-time fusion of coronary computed tomography angiography (CTA) centreline and arterial wall calcification with X-ray fluoroscopy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Patients undergoing CTO PCI were prospectively enrolled. Pre-procedural CT scans were integrated with conventional coronary fluoroscopy using prototype software. We enrolled 24 patients who underwent CTO PCI using the prototype CT fusion software, and 24 consecutive CTO PCI patients without CT guidance served as a control group. Mean age was 66 ± 11 years, and 43/48 patients were men. Real-time CTA fusion during CTO PCI provided additional information regarding coronary arterial calcification and tortuosity that generated new insights into antegrade wiring, antegrade dissection/reentry, and retrograde wiring during CTO PCI. Overall CTO success rates and procedural outcomes remained similar between the two groups, despite a trend toward higher complexity in the fusion CTA group. This study demonstrates that real-time automated co-registration of coronary CTA centreline and calcification onto live fluoroscopic images is feasible and provides new insights into CTO PCI, and in particular, antegrade dissection reentry-based CTO PCI. (orig.)

  15. PCI Based Read-out Receiver Card in the ALICE DAQ System

    CERN Document Server

    Carena, W; Dénes, E; Divià, R; Schossmaier, K; Soós, C; Sulyán, J; Vascotto, Alessandro; Van de Vyvre, P


    The Detector Data Link (DDL) is the high-speed optical link for the ALICE experiment. This link shall transfer the data coming from the detectors at 100 MB/s rate. The main components of the link have been developed: the destination Interface Unit (DIU), the Source Interface Unit (SIU) and the Read-out Receiver Card (RORC). The first RORC version is based on the VME bus. The performance tests show that the maximum VME bandwidth could be reached. Meanwhile the PCI bus became very popular and is used in many platforms. The development of a PCI-based version has been started. The document describes the prototype version in three sections. An overview explains the main purpose of the card: to provide an interface between the DDL and the PCI bus. Acting as a 32bit/33MHz PCI master the card is able to write or read directly to or from the system memory from or to the DDL, respectively. Beside these functions the card can also be used as an autonomous data generator. The card has been designed to be well adapted to ...

  16. Answer the call: let's make 2015 the year of magical thinking in CTO PCI. (United States)

    Heuser, Richard R


    Prevalence of chronic total occlusions (CTO's) is as high as 50% in angiographic series Patients are helped with successful recanalization of CTO's In spite of current improved success rates in CTO percutaneous coronary intervention (PCI), only 10-12% of CTO's are currently attempted. © 2015 Wiley Periodicals, Inc.

  17. Molecular analysis of the replication origin of the Lactococcus lactis plasmid pCI305

    NARCIS (Netherlands)

    Foley, S; Bron, S; Venema, G; Daly, C; Fitzgerald, GF


    The replication origin region, ori, of the Lactococcus lactis subsp. lactis plasmid pCI305 contains three-and-one-half directly repeated 22-bp sequences and two inverted repeat sequences, IR1 and IR2. These inverted repeat sequences overlap the promoter of the repB gene, which encodes a protein (Rep

  18. PCI express bus design of large format array IRFPA high-speed acquisition system (United States)

    Huang, Zewu; Zheng, Xing; Zeng, Xingxin; Liu, Ziji


    In this paper, a novel solution of PCI Express Bus was designed to improve the data transfer rate for large format array infrared imaging acquisition system. In this structure, an embedded PCI Express hard intellectual property (IP) block of Stratix IV GX FPGA was used, and the protocol stack module is totally compliant with PCI Express base specification Gen 2.0 which includes PHY-MAC, Data Link, and transaction layers. In order to communicate with CPU through computer PCIe root port, a pipeline structure was established with two SSRAMs to carry out the function of real-time data process. The DMA mode was adopted for the high-speed data transmission on the PCI Express Bus. Some other control logic parts such as detector drive signal generator - display controller and PCIe configuration module were also designed and introduced in this paper. According to the evaluation, the data transmission speed was up to 5.6Gbps, which means that this system could meet the qualifications of infrared imaging data acquisition. Compared with traditional infrared imaging data acquisition systems, this solution is more integrated and faster, so it is suitable for larger format and higher frame rate of infrared focal plane image acquisition in nowadays and future.

  19. Lack of consensus in biomarker measurement to diagnose PCI-related myocardial infarction

    DEFF Research Database (Denmark)

    Al-Dakhiel, Zaid; Rune Larsen, Søren; Svenstrup Poulsen, Tina


    Objective. To evaluate if biomarker sampling in PCI has adhered to the 2 000 consensus document for the diagnosis of procedure-related myocardial infarction (MI). Design. Firstly, a review of relevant papers from 2000 to September 2007 was done. Secondly, in October 2007, a questionnaire addressing...

  20. Prehospital diagnosis in STEMI patients treated by primary PCI : the key to rapid reperfusion

    NARCIS (Netherlands)

    Vermeulen, R. P.; Jaarsma, T.; Hanenburg, F. G. A.; Nannenberg, J. W.; Jessurun, G. A. J.; Zijlstra, F.


    Background. Primary coronary intervention (PCI) for acute myocardial infarction should be performed as quickly as possible, with a door-to-balloon time of less then 90 minutes. However, in daily practice this cannot always be achieved. Prehospital diagnosis of ST-elevation myocardial infarction (STE

  1. Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery

    NARCIS (Netherlands)

    D.J. Cohen (David J.); B.A. van Hout (Ben); P.W.J.C. Serruys (Patrick); F.W. Mohr (Friedrich); C.M. Miguel (Carlos); P. den Heijer (Peter); M.M. Vrakking (M. M.); K.K. Wang (Kenneth); E.M. Mahoney (Elizabeth M.); S. Audi (Salma); K. Leadly (Katrin); K.D. Dawkins (Keith); A.P. Kappetein (Arie Pieter)


    textabstractBACKGROUND: Previous studies have shown that among patients undergoing multivessel revascularization, coronary-artery bypass grafting (CABG), as compared with percutaneous coronary intervention (PCI) either by means of balloon angioplasty or with the use of bare-metal stents, results in

  2. Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery

    NARCIS (Netherlands)

    D.J. Cohen (David J.); B.A. van Hout (Ben); P.W.J.C. Serruys (Patrick); F.W. Mohr (Friedrich); C.M. Miguel (Carlos); P. den Heijer (Peter); M.M. Vrakking (M. M.); K.K. Wang (Kenneth); E.M. Mahoney (Elizabeth M.); S. Audi (Salma); K. Leadly (Katrin); K.D. Dawkins (Keith); A.P. Kappetein (Arie Pieter)


    textabstractBACKGROUND: Previous studies have shown that among patients undergoing multivessel revascularization, coronary-artery bypass grafting (CABG), as compared with percutaneous coronary intervention (PCI) either by means of balloon angioplasty or with the use of bare-metal stents, results in

  3. Insights into the Proton Transfer Mechanism of a Bilin Reductase PcyA Following Neutron Crystallography. (United States)

    Unno, Masaki; Ishikawa-Suto, Kumiko; Kusaka, Katsuhiro; Tamada, Taro; Hagiwara, Yoshinori; Sugishima, Masakazu; Wada, Kei; Yamada, Taro; Tomoyori, Katsuaki; Hosoya, Takaaki; Tanaka, Ichiro; Niimura, Nobuo; Kuroki, Ryota; Inaka, Koji; Ishihara, Makiko; Fukuyama, Keiichi


    Phycocyanobilin, a light-harvesting and photoreceptor pigment in higher plants, algae, and cyanobacteria, is synthesized from biliverdin IXα (BV) by phycocyanobilin:ferredoxin oxidoreductase (PcyA) via two steps of two-proton-coupled two-electron reduction. We determined the neutron structure of PcyA from cyanobacteria complexed with BV, revealing the exact location of the hydrogen atoms involved in catalysis. Notably, approximately half of the BV bound to PcyA was BVH(+), a state in which all four pyrrole nitrogen atoms were protonated. The protonation states of BV complemented the protonation of adjacent Asp105. The "axial" water molecule that interacts with the neutral pyrrole nitrogen of the A-ring was identified. His88 Nδ was protonated to form a hydrogen bond with the lactam O atom of the BV A-ring. His88 and His74 were linked by hydrogen bonds via H3O(+). These results imply that Asp105, His88, and the axial water molecule contribute to proton transfer during PcyA catalysis.

  4. Invasive measurement of coronary microvascular resistance in patients with acute myocardial infarction treated by primary PCI. (United States)

    Amier, Raquel P; Teunissen, Paul F A; Marques, Koen M; Knaapen, Paul; van Royen, Niels


    Up to 40% of patients with acute myocardial infarction develop microvascular obstruction (MVO) despite successful treatment with primary percutaneous coronary intervention (PCI). The presence of MVO is linked to negative remodelling and left ventricular dysfunction, leading to decreased long-term survival, increased morbidity and reduced quality of life. The acute obstruction and dysfunction of the microvasculature can potentially be reversed by pharmacological treatment in addition to the standard PCI treatment. Identifying patients with post-PCI occurrence of MVO is essential in assessing which patients could benefit from additional treatment. However, at present there is no validated method to identify these patients. Angiographic parameters like myocardial blush grade or corrected Thrombolysis In Myocardial Infarction (TIMI) flow do not accurately predict the occurrence of MVO as visualised by MRI in the days after the acute event. Theoretically, acute MVO can be detected by intracoronary measurements of flow and resistance directly following the PCI procedure. In MVO the microvasculature is obstructed or destructed and will therefore display a higher coronary microvascular resistance (CMVR). The methods for intracoronary assessment of CMVR are based on either thermodilution or Doppler-flow measurements. The aim of this review is to present an overview of the currently available methods and parameters for assessing CMVR, with special attention given to their use in clinical practice and information provided by clinical studies performed in patients with acute myocardial infarction.

  5. Impaired health status in Type D patients following PCI in the drug-eluting stent era

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Denollet, Johan; Ong, Andrew T L


    Drug-eluting stenting reduces restenosis post-percutaneous coronary intervention (PCI), but subgroups of patients may not benefit optimally from this procedure. We examined the impact of Type D personality on health status over time and the clinical relevance of Type D as a predictor of impaired ...

  6. Cranial Radiation for Pediatric T-Lineage Acute Lymphoblastic Leukemia: A Systematic Review and Meta-analysis


    Kelly, Michael J.; Thomas A. Trikalinos; Dahabreh, Issa J.; Gianferante, Matthew; Parsons, Susan K.


    There are heterogeneous approaches to cranial irradiation therapy (CRT) for T-lineage acute lymphoblastic leukemia (T-ALL). We performed a systematic review of studies that specified a radiation strategy and reported survival for pediatric T-ALL. Our analysis included 62 publications reporting 78 treatment groups (patient n=5844). The average event-free survival (EFS) was higher by 6% per 5 years (p

  7. BIO-PCI, Charcoal injection in Blast Furnaces: State of the art and economic perspectives

    Directory of Open Access Journals (Sweden)

    Feliciano-Bruzual, C.


    Full Text Available The injection of grinded particles of charcoal through the tuyeres in Blast Furnaces, here coined Bio-PCI, presents as an attractive and plausible alternative to significantly reduce the CO2 emissions generated during hot metal production. In this contribution a summary of the technological fundaments, benefits and limitations of the incorporation of Bio-PCI is presented. Additionally the principal economic challenges of renewables fuel in ironmaking are exposed, with especial interest in the main productions costs of charcoal making. In this sense, a strategic question arises: can the residual biomass drive the emergence of Bio-PCI?, our analysis leads to conclude that the use of residual biomass (e.g. agricultural and forestry residues may significantly reduce the production cost in 120-180 USD/t in comparison to primary woods sources, this naturally increment the economical attractiveness of Bio-PCI substitution.La inyección de carbón vegetal por toberas en Altos Hornos, aqui denominada Bio-PCI, se presenta como una forma atractiva y realista de reducir significativamente las emisiones de CO2 generadas durante la producción de arrabio. En esta contribución se presenta un resumen de los fundamentos tecnológicos, los beneficios y las limitaciones de la incorporación de la tecnología del Bio-PCI. Adicionalmente se exponen los retos económicos que enfrentan los combustibles renovables a los fósiles, con especial interés en los principales costos de producción del carbón vegetal. En este sentido se plantea una pregunta estratégica: ¿puede la biomasa residual impulsar el desarrollo de la Bio-PCI?. Nuestro análisis conlleva a concluir que la utilización de biomasa residual (residuos forestales y agrícolas puede reducir sensiblemente el costo del carbón vegetal entre 120-180 USD/t en comparación con biomasa primaria, incrementando su competitividad frente al carbón mineral.

  8. Circumscribed changes in the cranial vault in extracerebral accumulations of fluid in the middle cranial fossa

    Energy Technology Data Exchange (ETDEWEB)

    Trittmacher, S.; Purmann, H.; Hunsdiek, F.; Schmid, A.; Traupe, H.


    On the basis of 26 cases with extracerebral fluid accumulation in the middle cranial fossa the bony changes occurring in this connection are described and discussed in respect of their aetiology. If there are bony accompanying reactions, two entities can be observed on principle: One group shows thinning and protrusion of the temporal squama, raising of the lesser wing of the sphenoid bone and protrusion of the greater wing of the sphenoid bone. The second group is associated with thickening of the temporal squama and of the lesser and greater wing of the sphenoid bone without showing any change in volume of the middle cranial fossa. (orig./GDG).

  9. Pictorial essay: Vascular interventions in extra cranial head and neck

    Directory of Open Access Journals (Sweden)

    Suyash S Kulkarni


    Full Text Available Medicine is an ever changing field and interventional radiology (IR procedures are becoming increasingly popular because of high efficacy and its minimally invasive nature of the procedure. Management of disease processes in the extra cranial head and neck (ECHN has always been a challenge due to the complex anatomy of the region. Cross sectional imaging of the ECHN has grown and evolved tremendously and occupies a pivotal and integral position in the clinical management of variety of head and neck pathologies. Advances in angiographic technologies including flat panel detector systems, biplane, and 3-dimensional rotational angiography have consolidated and expanded the role of IR in the management of various ECHN pathologies. The ECHN is at cross roads between the origins of great vessels and the cerebral vasculature. Thorough knowledge of functional and technical aspects of neuroangiography is essential before embarking on head and neck vascular interventions. The vessels of the head and neck can be involved by infectious and inflammatory conditions, get irradiated during radiotherapy and injured due to trauma or iatrogenic cause. The ECHN is also a common site for various hypervascular neoplasms and vascular malformations, which can be treated with endovascular and percutaneous embolization. This pictorial essay provides a review of variety of ECHN pathologies which were managed by various IR procedures using different approaches.

  10. Twelfth cranial nerve involvement in Guillian Barre syndrome

    Directory of Open Access Journals (Sweden)

    Subrat Kumar Nanda


    Full Text Available Guillian Barre Syndrome (GBS is associated with cranial nerve involvement. Commonest cranial nerves involved were the facial and bulbar (IXth and Xth. Involvement of twelfth cranial nerve is rare in GBS. We present a case of GBS in a thirteen years old boy who developed severe tongue weakness and wasting at two weeks after the onset of GBS. The wasting and weakness of tongue improved at three months of follow up. Brief review of the literature about XIIth cranial nerve involvement in GBS is discussed.

  11. Imaging of muscular denervation secondary to motor cranial nerve dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Connor, S.E.J. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom)]. E-mail:; Chaudhary, N. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom); Fareedi, S. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom); Woo, E.K. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom)


    The effects of motor cranial nerve dysfunction on the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of head and neck muscles are reviewed. Patterns of denervation changes are described and illustrated for V, VII, X, XI and XII cranial nerves. Recognition of the range of imaging manifestations, including the temporal changes in muscular appearances and associated muscular grafting or compensatory hypertrophy, will avoid misinterpretation as local disease. It will also prompt the radiologist to search for underlying cranial nerve pathology, which may be clinically occult. The relevant cranial nerve motor division anatomy will be described to enable a focussed search for such a structural abnormality.

  12. [Cranial nerves - spectrum of inflammatory and tumorous changes]. (United States)

    Nemec, S F; Kasprian, G; Nemec, U; Czerny, C


    Inflammatory processes as well as primary and secondary tumorous changes may involve cranial nerves causing neurological deficits. In addition to neurologists, ENT physicians, ophthalmologists and maxillofacial surgeons, radiologists play an important role in the investigation of patients with cranial nerve symptoms. Multidetector computed tomography (MDCT) and particularly magnetic resonance imaging (MRI) allow the depiction of the cranial nerve anatomy and pathological neural changes. This article briefly describes the imaging techniques in MDCT and MRI and is dedicated to the radiological presentation of inflammatory and tumorous cranial nerve pathologies.

  13. Cranial radiation exposure during cerebral catheter angiography. (United States)

    Chohan, Muhammad Omar; Sandoval, Daniel; Buchan, Andrew; Murray-Krezan, Cristina; Taylor, Christopher L


    Radiation exposure to patients and personnel remains a major concern in the practice of interventional radiology, with minimal literature available on exposure to the forehead and cranium. In this study, we measured cranial radiation exposure to the patient, operating interventional neuroradiologist, and circulating nurse during neuroangiographic procedures. We also report the effectiveness of wearing a 0.5 mm lead equivalent cap as protection against radiation scatter. 24 consecutive adult interventional neuroradiology procedures (six interventional, 18 diagnostic) were prospectively studied for cranial radiation exposures in the patient and personnel. Data were collected using electronic detectors and thermoluminescent dosimeters. Mean fluoroscopy time for diagnostic and interventional procedures was 8.48 (SD 2.79) min and 26.80 (SD 6.57) min, respectively. Mean radiation exposure to the operator's head was 0.08 mSv, as measured on the outside of the 0.5 mm lead equivalent protective headgear. This amounts to around 150 mSv/year, far exceeding the current deterministic threshold for the lens of the eye (ie, 20 mSv/year) in high volume centers performing up to five procedures a day. When compared with doses measured on the inside of the protective skullcap, there was a statistically significant reduction in the amount of radiation received by the operator's skull. Our study suggests that a modern neurointerventional suite is safe when equipped with proper protective shields and personal gear. However, cranial exposure is not completely eliminated with existing protective devices and the addition of a protective skullcap eliminates this exposure to both the operator and support staff. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  14. The role of cranial kinesis in birds. (United States)

    Bout, R G; Zweers, G A


    In birds, the ability to move the upper beak relative to the braincase has been the subject of many functional morphological investigations, but in many instances the adaptive significance of cranial kinesis remains unclear. Alternatively, cranial kinesis may be considered a consequence of the general design of the skull, rather than an adaptive trait as such. The present study reviews some results related to the mechanism and functional significance of cranial kinesis in birds. Quantitative three-dimensional X-ray has shown that in skulls morphologically as divers as paleognaths and neognaths the mechanism for elevation of the upper beak is very similar. One of the mechanisms proposed for avian jaw movement is a mechanical coupling of the upper and the lower jaw movement by the postorbital ligament. Such a mechanical coupling would necessitate upper beak elevation. However, independent control of upper and lower jaw has been shown to occur during beak movements in birds. Moreover, kinematic modeling and force measurements suggests that the maximum extensibility of collagen, in combination with the short distance of the insertion of the postorbital ligament to the quadrato-mandibular articulation do not constitute a block to lower jaw depression. The lower jaw ligaments serve to limit the maximal extension of the mandibula. It is suggested here that cranial kinesis in avian feeding may have evolved as a consequence of an increase in eye size. This increase in size led to a reduction of bony bars in the lateral aspect of the skull enabling the transfer of quadrate movement to the upper jaw. The selective forces favoring the development of a kinetic upper beak in birds may be subtle and act in different ecological contexts. Simultaneous movement of the upper and lower jaw not only increases the velocity of beak movements, but with elevated upper beak also less force is required to open the lower jaw. However, the penalty of increased mobility of elements in a

  15. Cranial computed tomographic abnormalities in leptomeningeal metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y.Y.; Glass, J.P.; Geoffray, A.; Wallace, S.


    Sixty-four (57.6%) of 111 cancer patients with cerebrospinal fluid cytology positive for malignant cells had cranial computed tomographic (CT) scans within 2 weeks before or after a lumbar puncture. Twenty-two (34.3%) of the 64 had abnormal CT findings indicative of leptomeningeal metastasis. Thirteen (59.6%) of these 22 patients had associated parenchymal metastases. Recognition of leptomeningeal disease may alter the management of patients with parenchymal metastases. Communicating hydrocephalus in cancer patients should be considered to be related to leptomeningeal metastasis until proven otherwise.

  16. Cranial juvenile psammomatoid ossifying fibroma: case report. (United States)

    Barrena López, Cristina; Bollar Zabala, Alicia; Úrculo Bareño, Enrique


    Juvenile psammomatoid ossifying fibroma (JPOF) is a fibroosseous tumor that arises in the craniofacial bones in young people. This lesion usually originates in the jaw, orbit, and ethmoid complex but can also be associated with the skull base and calvaria. Diagnosis must be made based on observing typical radiological and histopathological features. Although JPOF is a rare pathological entity, neurosurgeons must consider this odontogenic lesion in the differential diagnosis of skull masses given the lesion's aggressive behavior and locally invasive growth. Treatment must be gross-total resection. In the following article, the authors present a case of cranial JPOF and discuss various aspects of this entity.

  17. Continued improvement of clinical outcome and cost effectiveness following intravascular ultrasound guided PCI: insights from a prospective, randomised study (United States)

    Gaster, A L; Slothuus Skjoldborg, U; Larsen, J; Korsholm, L; von Birgelen, C; Jensen, S; Thayssen, P; Pedersen, K E; Haghfelt, T H


    Objective: To investigate in a prospective randomised study both long term clinical effects and cost effectiveness of percutaneous coronary interventions (PCI) with or without intravascular ultrasound (IVUS) guidance. Methods: 108 male patients with stable angina referred for PCI of a significant coronary lesion were randomly assigned to IVUS guided PCI or conventional PCI. Individual accumulated costs of the entire follow up period were calculated and compared in the randomisation groups. Effectiveness of treatment was measured by freedom from major adverse cardiac events. Results: Cost effectiveness of IVUS guided PCI that was noted at six months was maintained and even accentuated at long term follow up (median 2.5 years). The cumulated cost level was found to be lower for the IVUS guided group, with a cumulated cost of &163 672 in the IVUS guided group versus &313 706 in the coronary angiography group (p = 0.01). Throughout the study, mean cost per day was lower in the IVUS guided PCI group (&2.7 v &5.2; p = 0.01). In the IVUS group, 78% were free from major adverse cardiac events versus 59% in the coronary angiography group (p = 0.04) with an odds ratio of 2.5 in favour of IVUS guidance. Conclusion: IVUS guidance results in continued improvement of long term clinical outcome and cost effectiveness. The results of this study suggest that IVUS guidance may be used more liberally in PCI. PMID:12923023

  18. Cranial symmetry in baleen whales (Cetacea, Mysticeti) and the occurrence of cranial asymmetry throughout cetacean evolution. (United States)

    Fahlke, Julia M; Hampe, Oliver


    Odontoceti and Mysticeti (toothed and baleen whales) originated from Eocene archaeocetes that had evolved from terrestrial artiodactyls. Cranial asymmetry is known in odontocetes that can hear ultrasound (>20,000 Hz) and has been linked to the split function of the nasal passage in breathing and vocalization. Recent results indicate that archaeocetes also had asymmetric crania. Their asymmetry has been linked to directional hearing in water, although hearing frequencies are still under debate. Mysticetes capable of low-frequency and infrasonic hearing (evolution. Asymmetry includes significant fluctuating and directional asymmetry, the latter being very small. Mysticete crania are as symmetric as those of terrestrial artiodactyls and archaeocetes, without significant differences within Mysticeti. Odontocete crania are more asymmetric. These results indicate that (1) all mysticetes have symmetric crania, (2) archaeocete cranial asymmetry is not conspicuous in most of the skull but may yet be conspicuous in the rostrum, (3) directional cranial asymmetry is an odontocete specialization, and (4) directional cranial asymmetry is more likely related to echolocation than hearing.

  19. Design of PCI Express Interface Card Based on Nios Ⅱ%基于NiosⅡ的PCI Express接口卡的设计

    Institute of Scientific and Technical Information of China (English)

    彭晴晴; 孟令军; 尹维汉; 李鹏飞


    In this paper, a design of PCI Express interface card based on Nios H is presented. The composition theory of Nios Q soft - core processor and the process of LVDS signal processing and application PCIE bus communication arc introduced. Each functional module and the specific of the design principium are given a detailed discussion. Functional realization of the system was tested one by one. The test results show that the stable interface card can complete the data transfer effectively.%根据NiosⅡ软核处理器的组成原理,提出了一种基于 NiosⅡ的PCI- Express(简称PCIE)接口卡的设计方法,研究了系统对LVDS信号的处理和应用PCIE总线接口通信的过程;详细讨论了系统各功能模块的实现原理,并对各模块进行了实际的分析和测试,测试结果表明该接口卡性能稳定,可以有效地完成数据传输.

  20. 扩张PCI-E显卡阵容 盈通X600Pro系列显卡

    Institute of Scientific and Technical Information of China (English)


    盈通向市场提供全面的PCI-E产品.2款PCI-E显卡新品面世——镭龙RX600Pro豪华版、镭龙RX600Pro MAX。两款显卡都采用集成HSI桥接功能的RX600Pro芯片.性能跟R9600XT差距不大.最大不同在于它完整支持PCI-Ex16接口标准.使用0.11微米工艺制造。

  1. Lateral angle and cranial base sexual dimorphism

    DEFF Research Database (Denmark)

    Duquesnel Mana, Mathilde; Adalian, Pascal; Lynnerup, Niels


    SUMMARY: Previous studies have yielded very different results in sex estimation based on measurements of the lateral angle (LA) of the temporal bone. The purpose of this study was to, first, investigate if the bad results obtained by the LA method could be due to the methodology and then, second......, to examine sexual dimorphism in the relationship between the lateral angle and cranial base shape. The lateral angle method was tested using a forensic sample of 102 CT scans of the head with known sex. We measured the angle using two methods: measurements directly on the CT slide, the method usually applied...... the direct measurements. The mean angle was greater in females (48.2° ± 7.2°) than in males (45.38° ±8.06°) but the difference was not significant (t-test, p = 0.063). A statistically significant difference in cranial base shape existed between the two sexes, but the results also demonstrated a major overlap...

  2. Disorders of the lower cranial nerves

    Directory of Open Access Journals (Sweden)

    Josef Finsterer


    Full Text Available Lesions of the lower cranial nerves (LCN are due to numerous causes, which need to be differentiated to optimize management and outcome. This review aims at summarizing and discussing diseases affecting LCN. Review of publications dealing with disorders of the LCN in humans. Affection of multiple LCN is much more frequent than the affection of a single LCN. LCN may be affected solely or together with more proximal cranial nerves, with central nervous system disease, or with nonneurological disorders. LCN lesions have to be suspected if there are typical symptoms or signs attributable to a LCN. Causes of LCN lesions can be classified as genetic, vascular, traumatic, iatrogenic, infectious, immunologic, metabolic, nutritional, degenerative, or neoplastic. Treatment of LCN lesions depends on the underlying cause. An effective treatment is available in the majority of the cases, but a prerequisite for complete recovery is the prompt and correct diagnosis. LCN lesions need to be considered in case of disturbed speech, swallowing, coughing, deglutition, sensory functions, taste, or autonomic functions, neuralgic pain, dysphagia, head, pharyngeal, or neck pain, cardiac or gastrointestinal compromise, or weakness of the trapezius, sternocleidomastoid, or the tongue muscles. To correctly assess manifestations of LCN lesions, precise knowledge of the anatomy and physiology of the area is required.

  3. Study on Calibration System for Electronic Transformers Based on High-Accuracy PCI Card

    Directory of Open Access Journals (Sweden)

    Mingzhu Zhang


    Full Text Available With preliminary applying of Electronic Transformer (ET based on IEC 61850 standards in power grid, the calibrations of tested transformers have attracted extensive research attention. This study proposes a novel Calibration System of ET (CSET based on high-accuracy card. Data acquisition of ET and Standard Trans-former (ST is gotten by optic Ethernet and PCI-4462 data acquisition card, respectively. Meanwhile, the synchronized sampling between ET and ST is completed on the optic/electronic pulse signal of PCI synchronization card. The signals processing and human interface are realized by Labview software. The system proposed in the study is feasible for calibrating Electronic Voltage/Current Transformers (EVT/ECT of different voltage classes. System tests show that the precision of the system can get to 0.2°.

  4. Study on Calibration System for Electronic Transformers Based on High-Accuracy PCI Card

    Directory of Open Access Journals (Sweden)

    Mingzhu Zhang


    Full Text Available With preliminary applying of Electronic Transformer (ET based on IEC 61850 standards in power grid, the calibration of tested transformers has attracted extensive research attention. This study proposes a novel Calibration System of ET (CSET based on high-accuracy card. Data acquisition of ET and standard trans-former (ST is gotten by optic Ethernet and PCI-4462 data acquisition card, respectively. Meanwhile, the synchronized sampling between ET and ST is completed on the optic/electronic pulse signal of PCI synchronization card. The signals processing and human interface are realized by Lab view software. The system proposed in the study is feasible for calibrating Electronic Voltage/Current Transformers (EVT/ECT of different voltage classes. System tests show that the precision of the system can get to 0.2°.

  5. 掌握PCI Express电源管理机能

    Institute of Scientific and Technical Information of China (English)



    PCI Express电潦管理的终极目标,自然就是做好省电的控制,并在不使用时就进入体眠或中止模式,一旦要回复过来,也必须通过唤醒(Wake)的过程。PCI Express定义了LO.LOs、L1、L2以及L3等连接状态,也就是电源管理的具体实现方式。而所谓的。PME-power management event信息”.就是唤醒的运用之道。

  6. Prediction Study on PCI Failure of Reactor Fuel Based on a Radial Basis Function Neural Network

    Directory of Open Access Journals (Sweden)

    Xinyu Wei


    Full Text Available Pellet-clad interaction (PCI is one of the major issues in fuel rod design and reactor core operation in water cooled reactors. The prediction of fuel rod failure by PCI is studied in this paper by the method of radial basis function neural network (RBFNN. The neural network is built through the analysis of the existing experimental data. It is concluded that it is a suitable way to reduce the calculation complexity. A self-organized RBFNN is used in our study, which can vary its structure dynamically in order to maintain the prediction accuracy. For the purpose of the appropriate network complexity and overall computational efficiency, the hidden neurons in the RBFNN can be changed online based on the neuron activity and mutual information. The presented method is tested by the experimental data from the reference, and the results demonstrate its effectiveness.

  7. Single-chip correlator implementation for PCI-bus personal computers (United States)

    O'Callaghan, Michael J.; Perlmutter, Stephen H.; Wolt, Barry


    We have previously reported on the design and operation of a novel single-chip optical correlator prototype. Two ferroelectric liquid crystal SLMs and a high-speed APS camera were built into a single CMOS integrated circuit. Diffractive Fourier transform lenses were fabricated onto the surface of a window which was mounted on top of the chip. We are now working towards implementing the correlator as a business card-sized module mounted on a PCI card which can be plugged into the motherboard of industry standard PCs. We are also upgrading the SLMs to have analog optical modulation capability. The PCI card contains input and output image buffers, plus high-speed circuitry which digitizes the four analog output channels of the correlator's camera. This paper describes the system we are developing, some of the electronic and optical engineering issues involved, and the present status of our work.

  8. Comparison of the PCI distortion effects on the Auger lineshape for electron and photon impact ionization

    Energy Technology Data Exchange (ETDEWEB)

    Paripas, B. [Department of Physics, University of Miskolc, 3515 Miskolc-Egyetemvaros (Hungary)]. E-mail:; Vitez, G. [Department of Physics, University of Miskolc, 3515 Miskolc-Egyetemvaros (Hungary); Vikor, Gy. [Department of Atomic Physics, Stockholm University, 10405 (Sweden); Tokesi, K. [Institute of Nuclear Research of the Hungarian Academy of Sciences (ATOMKI), P.O. Box 51, H-4001 Debrecen (Hungary); Sankari, R. [Department of Physical Sciences, University of Oulu, P.O. Box 3000, FIN-90014 Oulu (Finland); Calo, A. [Department of Physical Sciences, University of Oulu, P.O. Box 3000, FIN-90014 Oulu (Finland)


    The distortion effects of the post-collision interaction (PCI) on the Ar LMM Auger electron lineshape for electron and photon impact ionization have been calculated. The calculations were based on the eikonal model of Kuchiev and Sheinerman [Sov. Phys. - Tech. Phys. 32 (1987) 879]. It is shown that the Auger peak asymmetry depends on the emission angle of the Auger electron relative to the primary beam (and the polarization vector of the photon beam). At a given excess energy, defined as the difference between the impact energy and the binding energy, the absolute value of the Auger peak asymmetry is always larger for electron impact ionization than for photoionization. At the same time, the angular dependence of the PCI distortion is stronger for photoionization. In both cases the Auger peak asymmetry has a maximum when the energy of the ejected electron and that of the Auger electron are nearly equal. The calculations are in good agreement with our previous experimental results.

  9. CMS Tracker Readout Prototype Front-End Driver PCI Mezzanine Card (Mk1) (connector side)

    CERN Multimedia



    The tracking system of the CMS detector at the LHC employs Front End Driver (FED) cards to digitise, buffer and sparsify analogue data arriving via optical links from on detector pipeline chips. This paper describes a prototype version of the FED based upon the popular commercial PCI bus Mezzanine Card (PMC) form factor. The FED-PMC consists of an 8 channel, 9 bit ADC, card, providing a 1 MByte data buffer and operating at the LHC design frequency of 40 MHz. The core of the card is a re-programmable FPGA which allows the functionality of the card to be conveniently modified. The card is supplied with a comprehensive library of C routines.The PMC form factor allows the card to be plugged onto a wide variety of processor carrier boards and even directly into PCI based PCs. The flexibility of the FPGA based design permits the card to be used in a variety of ADC based applications.

  10. Time-recovering PCI-AER interface for bio-inspired spiking systems (United States)

    Paz-Vicente, R.; Linares-Barranco, A.; Cascado, D.; Vicente, S.; Jimenez, G.; Civit, A.


    Address Event Representation (AER) is an emergent neuromorphic interchip communication protocol that allows for real-time virtual massive connectivity between huge number neurons located on different chips. By exploiting high speed digital communication circuits (with nano-seconds timings), synaptic neural connections can be time multiplexed, while neural activity signals (with mili-seconds timings) are sampled at low frequencies. Also, neurons generate 'events' according to their activity levels. More active neurons generate more events per unit time, and access the interchip communication channel more frequently, while neurons with low activity consume less communication bandwidth. When building multi-chip muti-layered AER systems it is absolutely necessary to have a computer interface that allows (a) to read AER interchip traffic into the computer and visualize it on screen, and (b) inject a sequence of events at some point of the AER structure. This is necessary for testing and debugging complex AER systems. This paper presents a PCI to AER interface, that dispatches a sequence of events received from the PCI bus with embedded timing information to establish when each event will be delivered. A set of specialized states machines has been introduced to recovery the possible time delays introduced by the asynchronous AER bus. On the input channel, the interface capture events assigning a timestamp and delivers them through the PCI bus to MATLAB applications. It has been implemented in real time hardware using VHDL and it has been tested in a PCI-AER board, developed by authors, that includes a Spartan II 200 FPGA. The demonstration hardware is currently capable to send and receive events at a peak rate of 8,3 Mev/sec, and a typical rate of 1 Mev/sec.

  11. Fractional flow reserve-guided PCI for stable coronary artery disease

    DEFF Research Database (Denmark)

    De Bruyne, Bernard; Fearon, William F; Pijls, Nico H J


    BACKGROUND: We hypothesized that in patients with stable coronary artery disease and stenosis, percutaneous coronary intervention (PCI) performed on the basis of the fractional flow reserve (FFR) would be superior to medical therapy. METHODS: In 1220 patients with stable coronary artery disease, we......-therapy group (8.1% vs. 19.5%; hazard ratio, 0.39; 95% confidence interval [CI], 0.26 to 0.57; Pratio, 0.23; 95% CI, 0.14 to 0.38; P

  12. Cranial muscles in amphibians: development, novelties and the role of cranial neural crest cells. (United States)

    Schmidt, Jennifer; Piekarski, Nadine; Olsson, Lennart


    Our research on the evolution of the vertebrate head focuses on understanding the developmental origins of morphological novelties. Using a broad comparative approach in amphibians, and comparisons with the well-studied quail-chicken system, we investigate how evolutionarily conserved or variable different aspects of head development are. Here we review research on the often overlooked development of cranial muscles, and on its dependence on cranial cartilage development. In general, cranial muscle cell migration and the spatiotemporal pattern of cranial muscle formation appears to be very conserved among the few species of vertebrates that have been studied. However, fate-mapping of somites in the Mexican axolotl revealed differences in the specific formation of hypobranchial muscles (tongue muscles) in comparison to the chicken. The proper development of cranial muscles has been shown to be strongly dependent on the mostly neural crest-derived cartilage elements in the larval head of amphibians. For example, a morpholino-based knock-down of the transcription factor FoxN3 in Xenopus laevis has drastic indirect effects on cranial muscle patterning, although the direct function of the gene is mostly connected to neural crest development. Furthermore, extirpation of single migratory streams of cranial neural crest cells in combination with fate-mapping in a frog shows that individual cranial muscles and their neural crest-derived connective tissue attachments originate from the same visceral arch, even when the muscles attach to skeletal components that are derived from a different arch. The same pattern has also been found in the chicken embryo, the only other species that has been thoroughly investigated, and thus might be a conserved pattern in vertebrates that reflects the fundamental nature of a mechanism that keeps the segmental order of the head in place despite drastic changes in adult anatomy. There is a need for detailed comparative fate-mapping of pre

  13. Determine Operating Reactor to Use for the 2016 PCI Level 1 Milestone

    Energy Technology Data Exchange (ETDEWEB)

    Clarno, Kevin T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)


    The Consortium for Advanced Simulation of Light Water Reactors (LWRs) (CASL) Level 1 milestone to “Assess the analysis capability for core-wide [pressurized water reactor] PWR Pellet- Clad Interaction (PCI) screening and demonstrate detailed 3-D analysis on selected sub-region” (L1:CASL.P13.03) requires a particular type of nuclear power plant for the assessment. This report documents the operating reactor and cycles chosen for this assessment in completion of the physics integration (PHI) milestone to “Determine Operating Reactor to use for PCI L1 Milestone” (L3:PHI.CMD.P12.02). Watts Bar Unit 1 experienced (at least) one fuel rod failure in each of cycles 6 and 7, and at least one was deemed to be duty related rather than being primarily related to a manufacturing defect or grid effects. This brief report documents that the data required to model cycles 1–12 of Watts Bar Unit 1 using VERA-CS contains sufficient data to model the PHI portion of the PCI challenge problem. A list of additional data needs is also provided that will be important for verification and validation of the BISON results.

  14. High PCI and low coke rate BF operation in ArcelorMittal Flat Carbon Europe

    Energy Technology Data Exchange (ETDEWEB)

    Dauwels, G.; Clairay, S.; Hess, E.; Janz, J.; Goimard, J.C.; Eymond, J.L. [ArcelorMittal (France)


    Coke production capacity within ArcelorMittal is not sufficient to provide the amount of coke needed for the total hot metal production. In order to address the challenges regarding coke availability, ArcelorMittal Flat Carbon Europe (FCE) sector has applied a low coke operation pulverized coal injection (PCI) technology to 17 of its blast furnaces across Europe. This paper described the charging pattern, blast conditions, hearth drainage and burden quality needed for high PCI rates. The coal injection rates of the different blast furnaces has been increased from 150-180 kg/thm to 180-200 kg/thm with a good replacement ratio. The lessons learned from high coal injection rate operations were discussed. The long term objective for FCE is to average a coal injection level of 200-220 kg/thm. This paper also discussed issues of coal quality, such as selection of coal; influence of coal quality on the blast furnace operation; and influence of coke quality on hearth drainage and hot metal quality. Coke quality was also discussed in terms of coke requirements and new global coke quality parameters. The difficulties in increasing PCI rate were shown to be associated with ferrous burden quality, particularly sinter. Adjustments to coke layer thickness can prevent instabilities. 8 refs., 23 figs.

  15. Event-driven timing system based on MRF cPCI hardware for HLS-II

    Institute of Scientific and Technical Information of China (English)

    李川; 王季刚; 宣科; 刘功发; 王琳; 李为民; 李京袆


    Hefei Light Source (HLS)-II is a vacuum ultraviole (VUV) synchrotron light source. A major upgrade of the light source was finished at the end of 2014. The timing system was rebuilt using compact peripheral component interconnect (cPCI) event-driven hardware to meet synchronization requirements of the machine. In the new system, the cPCI event-driven products manufactured by the micro-research finland (MRF) Oy are employed to achieve about 100 output signals with different interfaces. Device supports and drivers developed for common Experimental Physics and Industrial Control System (EPICS) records are used to access the registers on the timing modules. Five cPCI-bus input/output controllers (IOCs) distributed in different areas of the light source host timing modules for various subsystems. The delay resolution of this system is 9.8 ns for most channels and 9 ps for the channels used for triggering the electron gun and the injection kickers. The measured rms jitter of the output signal is less than 27 ps. Using the bucket chooser, this system enables the HLS-II to fill the storage ring with any designated bunch pattern. Benefitting from this upgrade, brightness and performance of the light source are significantly improved.

  16. Comparison of radial to femoral PCI in acute myocardial infarction and cardiogenic shock: a systematic review. (United States)

    Gandhi, Sumeet; Kakar, Ron; Overgaard, Christopher B


    In randomized control trials and meta-analyses in patients with acute MI undergoing PCI, the radial artery (RA) approach compared to the femoral artery (FA) approach has shown to safely reduce access site related bleeding, length of hospitalization, and major adverse cardiac event (MACE) rates. However, these studies have excluded patients with cardiogenic shock. A systematic search was conducted to retrieve studies that investigated the safety of RA to FA PCI in patients with AMI and cardiogenic shock. Primary outcomes of interest was the pooled relative risk ratio (RR) of access site related bleeding. Secondary outcomes included (i) 30-day all cause mortality, (ii) major bleeding, (iii) final TIMI 3 flow, (iv) fluoroscopy time, and (v) amount of contrast volume administered. 6 observational studies with 7,753 patients met inclusion; 5,347 (69 %) with STEMI, 2,406 (31 %) with non-STEMI. In comparison of RA to FA PCI, there was less access site related bleeding (relative risk (RR) 0.11, p = 0.001), less 30-day mortality (RR 0.65, p = 0.0 cardiogenic shock.

  17. 21 CFR 882.4370 - Pneumatic cranial drill motor. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pneumatic cranial drill motor. 882.4370 Section 882.4370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... drill motor. (a) Identification. A pneumatic cranial drill motor is a pneumatically operated...

  18. 21 CFR 882.5800 - Cranial electrotherapy stimulator. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cranial electrotherapy stimulator. 882.5800 Section 882.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... electrotherapy stimulator. (a) Identification. A cranial electrotherapy stimulator is a device that...

  19. Osteopathia Striata With Cranial Sclerosis Owing to WTX Gene Defect

    NARCIS (Netherlands)

    Perdu, Bram; de Freitas, Fenna; Frints, Suzanne G. M.; Schouten, Meyke; Schrander-Stumpel, Connie; Barbosa, Mafalda; Pinto-Basto, Jorge; Reis-Lima, Margarida; de Vernejoul, Marie-Christine; Becker, Kristin; Freckmann, Marie-Louise; Keymolen, Kathlijn; Haan, Eric; Savarirayan, Ravi; Koenig, Rainer; Zabel, Bernhard; Vanhoenacker, Filip M.; Van Hul, Wim


    Osteopathia striata with cranial sclerosis (OSCS) is an X-linked dominant condition marked by linear striations mainly affecting the metaphyseal region of the long bones and pelvis in combination with cranial sclerosis. Recently, the disease-causing gene was identified as the WTX gene (FAM123B), an

  20. The contribution of subsistence to global human cranial variation. (United States)

    Noback, Marlijn L; Harvati, Katerina


    Diet-related cranial variation in modern humans is well documented on a regional scale, with ample examples of cranial changes related to the agricultural transition. However, the influence of subsistence strategy on global cranial variation is less clear, having been confirmed only for the mandible, and dietary effects beyond agriculture are often neglected. Here we identify global patterns of subsistence-related human cranial shape variation. We analysed a worldwide sample of 15 populations (n = 255) with known subsistence strategies using 3-D landmark datasets designed to capture the shape of different units of the cranium. Results show significant correlations between global cranial shape and diet, especially for temporalis muscle shape and general cranial shape. Importantly, the differences between populations with either a plant- or an animal-based diet are more pronounced than those between agriculturalists and hunter-gatherers, suggesting that the influence of diet as driver of cranial variation is not limited to Holocene transitions to agricultural subsistence. Dental arch shape did not correlate with subsistence pattern, possibly indicating the high plasticity of this region of the face in relation to age, disease and individual use of the dentition. Our results highlight the importance of subsistence strategy as one of the factors underlying the evolution of human geographic cranial variation.

  1. Cranial joint histology in the mallard duck (Anas platyrhynchos): new insights on avian cranial kinesis. (United States)

    Bailleul, Alida M; Witmer, Lawrence M; Holliday, Casey M


    The evolution of avian cranial kinesis is a phenomenon in part responsible for the remarkable diversity of avian feeding adaptations observable today. Although osteological, developmental and behavioral features of the feeding system are frequently studied, comparatively little is known about cranial joint skeletal tissue composition and morphology from a microscopic perspective. These data are key to understanding the developmental, biomechanical and evolutionary underpinnings of kinesis. Therefore, here we investigated joint microstructure in juvenile and adult mallard ducks (Anas platyrhynchos; Anseriformes). Ducks belong to a diverse clade of galloanseriform birds, have derived adaptations for herbivory and kinesis, and are model organisms in developmental biology. Thus, new insights into their cranial functional morphology will refine our understanding of avian cranial evolution. A total of five specimens (two ducklings and three adults) were histologically sampled, and two additional specimens (a duckling and an adult) were subjected to micro-computed tomographic scanning. Five intracranial joints were sampled: the jaw joint (quadrate-articular); otic joint (quadrate-squamosal); palatobasal joint (parasphenoid-pterygoid); the mandibular symphysis (dentary-dentary); and the craniofacial hinge (a complex flexion zone involving four different pairs of skeletal elements). In both the ducklings and adults, the jaw, otic and palatobasal joints are all synovial, with a synovial cavity and articular cartilage on each surface (i.e. bichondral joints) ensheathed in a fibrous capsule. The craniofacial hinge begins as an ensemble of patent sutures in the duckling, but in the adult it becomes more complex: laterally it is synovial; whereas medially, it is synostosed by a bridge of chondroid bone. We hypothesize that it is chondroid bone that provides some of the flexible properties of this joint. The heavily innervated mandibular symphysis is already fused in the

  2. Neonatal cranial sonography: A concise review for clinicians

    Directory of Open Access Journals (Sweden)

    Pankaj Gupta


    Full Text Available Cranial sonography continues to hold an important place in neonatal care. Attributes favorable to sonography that make it almost indispensable for routine care of the newborn includes easy access, low cost, portability, lack of ionizing radiations and exemption from sedation or anaesthesia. Cranial sonography has highest impact in neonates suspected to have meningitis and its complications; perinatal ischemia particularly periventricular leukomalacia (PVL; hydrocephalus resulting from multitude of causes and hemorrhage. Not withstanding this, cranial sonography has yielded results for a repertoire of indications. Approach to cranial sonography involves knowledge of the normal developmental anatomy of brain parenchyma for correct interpretation. Correct technique, taking advantage of multiple sonographic windows and variable frequencies of the ultrasound probes allows a detailed and comprehensive examination of brain parenchyma. In this review, we discuss the technique, normal and variant anatomy as well as disease entities of neonatal cranial sonography.

  3. Analysis of Payment Card Industry Data Security Standard [PCI DSS] Compliance by Confluence of COBIT 5 Framework

    Directory of Open Access Journals (Sweden)

    Ashish Ukidve


    Full Text Available The Payment Card Industry Data Security Standard (PCI DSS aims to enhance the security of cardholder data and is required when cardholder data or authentication data are stored, processed or transmitted. The implementation of enabling processes from COBIT 5 can complement compliance to PCI DSS. COBIT 5 assists enterprises in governance and management of enterprise IT and, at the same time, supports the need to meet security requirements with supporting processes and management activities. This paper provides analysis of mapping of COBIT 5 supporting processes to PCI DSS 3.0 security requirements. It also presents domains which support the simultaneous application of COBIT 5 and PCI DSS 3.0 which would help create collaborations within the enterprise

  4. Quantitative computed tomography and cranial burr holes: a model to evaluate the quality of cranial reconstruction in humans. (United States)

    Worm, Paulo Valdeci; Ferreira, Nelson Pires; Ferreira, Marcelo Paglioli; Kraemer, Jorge Luiz; Lenhardt, Rene; Alves, Ronnie Peterson Marcondes; Wunderlich, Ricardo Castilho; Collares, Marcus Vinicius Martins


    Current methods to evaluate the biologic development of bone grafts in human beings do not quantify results accurately. Cranial burr holes are standardized critical bone defects, and the differences between bone powder and bone grafts have been determined in numerous experimental studies. This study evaluated quantitative computed tomography (QCT) as a method to objectively measure cranial bone density after cranial reconstruction with autografts. In each of 8 patients, 2 of 4 surgical burr holes were reconstructed with autogenous wet bone powder collected during skull trephination, and the other 2 holes, with a circular cortical bone fragment removed from the inner table of the cranial bone flap. After 12 months, the reconstructed areas and a sample of normal bone were studied using three-dimensional QCT; bone density was measured in Hounsfield units (HU). Mean (SD) bone density was 1535.89 (141) HU for normal bone (P < 0.0001), 964 (176) HU for bone fragments, and 453 (241) HU for bone powder (P < 0.001). As expected, the density of the bone fragment graft was consistently greater than that of bone powder. Results confirm the accuracy and reproducibility of QCT, already demonstrated for bone in other locations, and suggest that it is an adequate tool to evaluate cranial reconstructions. The combination of QCT and cranial burr holes is an excellent model to accurately measure the quality of new bone in cranial reconstructions and also seems to be an appropriate choice of experimental model to clinically test any cranial bone or bone substitute reconstruction.

  5. An unusual orbito-cranial foreign body

    Directory of Open Access Journals (Sweden)

    Misra Madhumati


    Full Text Available The rarity of orbito-cranial gun shot injury in both war and civilian practice has been reported. In a large series of 351 missile head injuries in the Vietnam war, orbital penetration was noted in 0.6% cases only. Review of literature shows that orbital injury was ipsilateral to the cerebral injury in most reported cases. We have previously reported a rare case of left parieto-occipital lobe injury due to gun shot wound of the contralateral (right orbit. The case reported here sustained a bullet injury to the left frontal bone but the missile was located below the contralateral (right optic canal. The rarity of the case prompted this report.

  6. Cyberknife radiosurgery for cranial plasma cell tumor. (United States)

    Alafaci, Cetty; Grasso, Giovanni; Conti, Alfredo; Caffo, Mariella; Salpietro, Francesco Maria; Tomasello, Francesco


    Cranial and intracranial involvement by myelomatous disease is relatively uncommon. Furthermore, systemic manifestations of multiple myeloma are present in the majority of these cases at the time of symptom onset. The authors report the case of a patient with serial appearance of multiple intracranial plasma cell tumor localizations as the first manifestations of a multiple myeloma. The patient was treated with CyberKnife radiosurgery for a lesion localized at the clivus and sella turcica with complete local control. With such a technique, based on high-dose conformality, the tumor was centered with an ablative dose of radiation and, at the same time, with a low dose spreading to the surrounding critical structures. The radiosensitivity of plasma cell tumors renders this treatment modality particularly advantageous for their localized manifestation. A technical description of this case is provided. To our knowledge, this is the first case of successful Cyberknife radiosurgery of multifocal intracranial plasmacytoma.

  7. The "Taste of Turnover" Exhibit Monitoring System Based on PCI-1751%基于PCI-1751的模拟翻车展项监控系统

    Institute of Scientific and Technical Information of China (English)

    钟汉如; 罗建华



  8. A High-Speed DMA Transmission System Based on PCI Express Bus%一种基于PCI Express总线的DMA高速传输系统

    Institute of Scientific and Technical Information of China (English)

    侯杭呈; 王忆文; 李辉


    A high speed transmission system based on PCI Express bus was described,together with the design of DMA.Two FIFOs were fitted at both ends of the transmission card to provide standard FIFO interface,which was connected with fiber channel data,CT image acquisition data,A/D sampling data,etc.Experimental results verified the reliability of transmission in DMA read/write modes,and the speed of DMA transaction was measured.It has been shown that the high speed transmission system based on lane 8 PCI express bus had a DMA transaction speed up to 1 000 MB/s for a DMA transfer size of 1 M byte,which meets the requirement of most high speed data transmission applications.%介绍了DMA高速传输系统的结构以及DMA的设计,搭建了×8通道的PCIE系统.在整个系统的板卡终端,连接了两个FIFO,提供标准的FIFO接口,能连接光纤数据、CT图像采集数据、A/D采样数据等.实验验证了DMA读和DMA写两种传输方式的可靠性,测试了DMA读写的传输速度.实验表明,在单次DMA传输大小达到1MB时,×8通道的PCIE系统DMA读和写速度均能达到1 000 MB/s,可满足大部分高速数据传输的要求.

  9. Anthropogenic environments exert variable selection on cranial capacity in mammals. (United States)

    Snell-Rood, Emilie C; Wick, Naomi


    It is thought that behaviourally flexible species will be able to cope with novel and rapidly changing environments associated with human activity. However, it is unclear whether such environments are selecting for increases in behavioural plasticity, and whether some species show more pronounced evolutionary changes in plasticity. To test whether anthropogenic environments are selecting for increased behavioural plasticity within species, we measured variation in relative cranial capacity over time and space in 10 species of mammals. We predicted that urban populations would show greater cranial capacity than rural populations and that cranial capacity would increase over time in urban populations. Based on relevant theory, we also predicted that species capable of rapid population growth would show more pronounced evolutionary responses. We found that urban populations of two small mammal species had significantly greater cranial capacity than rural populations. In addition, species with higher fecundity showed more pronounced differentiation between urban and rural populations. Contrary to expectations, we found no increases in cranial capacity over time in urban populations-indeed, two species tended to have a decrease in cranial capacity over time in urban populations. Furthermore, rural populations of all insectivorous species measured showed significant increases in relative cranial capacity over time. Our results provide partial support for the hypothesis that urban environments select for increased behavioural plasticity, although this selection may be most pronounced early during the urban colonization process. Furthermore, these data also suggest that behavioural plasticity may be simultaneously favoured in rural environments, which are also changing because of human activity.

  10. Concomitant cranial and ocular combat injuries during Operation Iraqi Freedom. (United States)

    Cho, Raymond I; Bakken, Hans E; Reynolds, Mark E; Schlifka, Brett A; Powers, David B


    Concomitant cranial and ocular injuries were frequently seen in combat casualties during Operation Iraqi Freedom. The incidence of these injuries is reported along with an interventional case series. A retrospective review was conducted of all surgical patients treated by U.S. Army neurosurgeons and ophthalmologists in Iraq from December 2005 to April 2006. Out of 104 patients with cranial trauma and 158 patients with ocular trauma, 34 had both cranial and ocular injuries (32.7 and 21.5% of patients with cranial and ocular injuries, respectively). Neurosurgical procedures included exploratory craniotomy, decompressive craniectomy, and frontal sinus surgery. Ophthalmologic surgical procedures included globe exploration, open globe repair, primary enucleation, orbital fracture repair, lateral canthotomy and cantholysis, and repair of lid and periocular lacerations. Patients with cranial trauma had a higher incidence of orbital fracture, orbital compartment syndrome, and multiple ocular injuries compared with patients without cranial trauma (odds ratio 6.4, 3.9, and 3.3, respectively). A strong association exists between cranial and ocular trauma in combat casualties treated during Operation Iraqi Freedom. Combat health support personnel should maintain a high level of suspicion for one of these injuries when the other is present. Co-locating neurosurgeons and ophthalmologists in support of combat operations facilitates the optimal treatment of patients with these combined injuries.

  11. Relationship of the distance between non-PCI hospitals and primary PCI centers, mode of transport, and reperfusion time among ground and air interhospital transfers using NCDR's ACTION Registry-GWTG: a report from the American Heart Association Mission: Lifeline Program. (United States)

    Nicholson, Benjamin D; Dhindsa, Harinder S; Roe, Matthew T; Chen, Anita Y; Jollis, James G; Kontos, Michael C


    ST-segment myocardial infarction patients frequently present to non-percutaneous coronary intervention (PCI) hospitals and require interhospital transfer for primary PCI. The effect of distance and mode of transport to the PCI center and the frequency that recommended primary PCI times are met are not clear. Data from the ACTION Registry(®)-GWTG™ were used to determine the distance between the Non-PCI and PCI center and first door time to balloon time based on transfer mode (ground and air) for patients having interhospital transfer for primary PCI. From July 1, 2008, to December 31, 2012, 17 052 ST-segment myocardial infarction patients were transferred to 413 PCI hospitals. The median distance from the non-PCI hospital to the primary PCI center was 31.9 miles (Q1, Q3: 19.1, 47.9; ground 25.2 miles; air 43.9 miles; P40 miles air transport predominanted. Median first door time to balloon time time for patients transferred for primary PCI was 118 minutes (Q1, Q3: 95 152), with time for patients transported by air significantly longer (median 124 versus 113 minutes; respectively, Ptransfer for primary PCI is associated with prolonged reperfusion times. These delays should prompt increased consideration of fibrinolytic therapy, emergency medical services hospital bypass protocols, and improved systems of care for ST-segment myocardial infarction patients requiring transfer. © 2014 American Heart Association, Inc.

  12. Botulinum toxin physiology in focal hand and cranial dystonia. (United States)

    Karp, Barbara Illowsky


    The safety and efficacy of botulinum toxin for the treatment of focal hand and cranial dystonias are well-established. Studies of these adult-onset focal dystonias reveal both shared features, such as the dystonic phenotype of muscle hyperactivity and overflow muscle contraction and divergent features, such as task specificity in focal hand dystonia which is not a common feature of cranial dystonia. The physiologic effects of botulinum toxin in these 2 disorders also show both similarities and differences. This paper compares and contrasts the physiology of focal hand and cranial dystonias and of botulinum toxin in the management of these disorders.

  13. Multiple Cranial Nerve Palsy Due to Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Esra Eruyar


    Full Text Available Cerebral venous thrombosis (CVT is a rare clinical condition between cerebrovasculer diases. The most common findings are headache, seizure and focal neurological deficit. Multiple cranial nerve palsy due to CVT is rarely seen and it is not clear pathology. A pathology that could explain the lack of cranial nerve imaging is carrying suspected diagnosis but the disease is known to provide early diagnosis and treatment. We want to emphasize with this case multipl cranial nerve palsy due to CVT is seen rarely and good response to treatment.

  14. Botulinum Toxin Physiology in Focal Hand and Cranial Dystonia

    Directory of Open Access Journals (Sweden)

    Barbara Illowsky Karp


    Full Text Available The safety and efficacy of botulinum toxin for the treatment of focal hand and cranial dystonias are well-established. Studies of these adult-onset focal dystonias reveal both shared features, such as the dystonic phenotype of muscle hyperactivity and overflow muscle contraction and divergent features, such as task specificity in focal hand dystonia which is not a common feature of cranial dystonia. The physiologic effects of botulinum toxin in these 2 disorders also show both similarities and differences. This paper compares and contrasts the physiology of focal hand and cranial dystonias and of botulinum toxin in the management of these disorders.

  15. Further validation of the hybrid algorithm for CTO PCI; difficult lesions, same success. (United States)

    Basir, Mir B; Karatasakis, Aris; Alqarqaz, Mohammad; Danek, Barbara; Rangan, Bavana V; Brilakis, Emmanouil S; Kim, Henry; O'Neill, William W; Alaswad, Khaldoon

    To evaluate the success rates and outcome of the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) by a single operator in two different clinical settings. We compared 279 consecutive CTO PCIs performed by a single, high-volume operator using the hybrid algorithm in two different clinical settings. Data were collected through the PROGRESS CTO Registry. We compared 145 interventions performed in a community program (cohort A) with 134 interventions performed in a referral center (cohort B). Patient in cohort B had more complex lesions with higher J-CTO (3.0 vs. 3.41; pCTO (1.5 vs.1.8, P=0.003) scores, more moderate to severe tortuosity (38% vs. 64%; pCTO PCI attempts (15% vs. 35%; p=0.001). Both technical (95% vs. 91%; p=0.266) and procedural (94% vs. 88%; p=0.088) success rates were similar between the two cohorts despite significantly different lesion complexity. Overall major adverse cardiovascular events were higher in cohort B (1.4% vs. 7.8%; p=0.012) without any significant difference in mortality (0.7% vs. 2.3%, p=0.351). In spite of higher lesion complexity in the setting of a quaternary-care referral center, use of the hybrid algorithm for CTO PCI enabled similarly high technical and procedural success rates as compared with those previously achieved by the same operator in a community-based program at the expense of a higher rate of MACE. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. A Specified Procedure for Distress Identification and Assessment for Urban Road Surfaces Based on PCI

    Directory of Open Access Journals (Sweden)

    Giuseppe Loprencipe


    Full Text Available In this paper, a simplified procedure for the assessment of pavement structural integrity and the level of service for urban road surfaces is presented. A sample of 109 Asphalt Concrete (AC urban pavements of an Italian road network was considered to validate the methodology. As part of this research, the most recurrent defects, those never encountered and those not defined with respect to the list collected in the ASTM D6433 have been determined by statistical analysis. The goal of this research is the improvement of the ASTM D6433 Distress Identification Catalogue to be adapted to urban road surfaces. The presented methodology includes the implementation of a Visual Basic for Application (VBA language-based program for the computerization of Pavement Condition Index (PCI calculation with interpolation by the parametric cubic spline of all of the density/deduct value curves of ASTM D6433 distress types. Also, two new distress definitions (for manholes and for tree roots and new density/deduct curve values were proposed to achieve a new distress identification manual for urban road pavements. To validate the presented methodology, for the 109 urban pavements considered, the PCI was calculated using the new distress catalogue and using the ASTM D6433 implemented on PAVERTM. The results of the linear regression between them and their statistical parameters are presented in this paper. The comparison of the results shows that the proposed method is suitable for the identification and assessment of observed distress in urban pavement surfaces at the PCI-based scale.

  17. Improvement in PCI property of PWR fuel cladding by texture control

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, S. (Kansai Electric Power Co., Inc., Osaka (Japan)); Abeta, S.; Ozawa, M.; Takahashi, T.


    Effects of texture on out-of-pile Stress Corrosion Cracking (SCC) resistance in Zircaloy fuel cladding tube and the Pellet-Clad Interaction (PCI) property of a fuel rod using texture controlled cladding tube under power ramp conditions are described. The cladding tube with radial texture, which means that the c-axis of hcp crystal of Zr is highly concentrated in the radial direction of the tube, showed excellent performance in out-of-pile SCC tests and power ramp tests. (author).

  18. Androgen action during male sex differentiation includes suppression of cranial suspensory ligament development

    NARCIS (Netherlands)

    J.M.A. Emmen (Judith); A. McLuskey; J.A. Grootegoed (Anton); A.O. Brinkmann (Albert)


    textabstractThe cranial suspensory ligament is located on the border of the cranial (mesonephric) mesentery in adult female mammals, which runs between the cranial pole of the internal genitalia and the dorsal abdominal wall. Absence of the cranial suspensory ligament i

  19. Cranial nerve injury after minor head trauma. (United States)

    Coello, Alejandro Fernández; Canals, Andreu Gabarrós; Gonzalez, Juan Martino; Martín, Juan José Acebes


    There are no specific studies about cranial nerve (CN) injury following mild head trauma (Glasgow Coma Scale Score 14-15) in the literature. The aim of this analysis was to document the incidence of CN injury after mild head trauma and to correlate the initial CT findings with the final outcome 1 year after injury. The authors studied 49 consecutive patients affected by minor head trauma and CN lesions between January 2000 and January 2006. Detailed clinical and neurological examinations as well as CT studies using brain and bone windows were performed in all patients. Based on the CT findings the authors distinguished 3 types of traumatic injury: no lesion, skull base fracture, and other CT abnormalities. Patients were followed up for 1 year after head injury. The authors distinguished 3 grades of clinical recovery from CN palsy: no recovery, partial recovery, and complete recovery. Posttraumatic single nerve palsy was observed in 38 patients (77.6%), and multiple nerve injuries were observed in 11 (22.4%). Cranial nerves were affected in 62 cases. The most affected CN was the olfactory nerve (CN I), followed by the facial nerve (CN VII) and the oculomotor nerves (CNs III, IV, and VI). When more than 1 CN was involved, the most frequent association was between CNs VII and VIII. One year after head trauma, a CN deficit was present in 26 (81.2%) of the 32 cases with a skull base fracture, 12 (60%) of 20 cases with other CT abnormalities, and 3 (30%) of 10 cases without CT abnormalities. Trivial head trauma that causes a minor head injury (Glasgow Coma Scale Score 14-15) can result in CN palsies with a similar distribution to moderate or severe head injuries. The CNs associated with the highest incidence of palsy in this study were the olfactory, facial, and oculomotor nerves. The trigeminal and lower CNs were rarely damaged. Oculomotor nerve injury can have a good prognosis, with a greater chance of recovery if no lesion is demonstrated on the initial CT scan.

  20. "Moya-moya' disease caused by cranial trauma. (United States)

    Fernandez-Alvarez, E; Pineda, M; Royo, C; Manzanares, R


    A case of "moya-moya" disease of a 12-year-old boy is reported. The clinical history started at 3 years 2 months after cranial trauma. The patient developed mental retardation, hemiparesis and seizures.

  1. Prevalence of and risk factors for cranial ultrasound abnormalities in ...

    African Journals Online (AJOL)

    in cerebral blood flow, or platelet and coagulation disorders, form the ... To assess how many very low birth weight (VLBW) infants had cranial ultrasound screening at ..... who were outborn, and there are many factors that could explain the.

  2. Clinical and cranial computed tomography scan findings in adults ...

    African Journals Online (AJOL)

    cerebral haemorrhage followed by brain oedema and raised Intra-cranial pressure (ICP). Intra-cerebral ... This was a descriptive, cross sectional study conduct- ed in Mulago .... This could partly be explained by the mechanism of impact in ...

  3. Accounting for cranial vault growth in experimental design. (United States)

    Power, Stephanie M; Matic, Damir B; Holdsworth, David W


    Earlier studies have not accounted for continued growth when using the rat calvarial defect model to evaluate bone healing in vivo. The purpose of this study was: 1) to calculate rat cranial vault growth over time; and 2) to determine the effects of accounting for growth on defect healing. Bilateral parietal defects were created in 10 adult Wistar rats. Serial microscopic computerized tomography scans were performed. Bone mineral content (BMC) measured according to standard technique and repeated accounting for cranial growth over time was compared with the use of parametric and nonparametric tests. Cranial vault growth continued through 22 weeks of age, increasing 7.5% in width and 9.1% in length, and calvarial defects expanded proportionately. BMC was greater within defects accounting for growth 2-12 weeks postoperatively (P accounting for cranial growth given advances in serial imaging techniques. Crown Copyright © 2014. Published by Mosby, Inc. All rights reserved.

  4. Functional electrical stimulation improves brain perfusion in cranial trauma patients

    National Research Council Canada - National Science Library

    Amorim, Bárbara Juarez; Santos, Allan de Oliveira; Oberg, Telma Dagmar; Romanato, Juliana; Anjos, Dalton A; Lima, Mariana da Cunha Lopes de; Ramos, Celso Darío; Honorato, Donizete Cesar; Camargo, Edwaldo Eduardo; Etchebehere, Elba Cristina de Sá Camargo


    ...: cranial trauma and major vascular insults. All SPECT images were analyzed using SPM. RESULTS: There was a significant statistical difference between the two groups related to patient's ages and extent of hypoperfusion in the SPECT...

  5. A Case of Neurosyphilis Presenting with Multiple Cranial Neuropathy

    Directory of Open Access Journals (Sweden)

    Eda Kılıç Çoban


    Full Text Available Syphilis is a sexually-transmitted disease caused by the spirochete bacterium Treponema pallidum. Central nervous system involvement can occur in every stage of the disease. It is classified into: acute syphilitic meningitis, meningovascular syphilis, and parenchymatous neurosyphilis. Acute basilar syphilitic meningitis is characterized primarily by the presence of cranial nerve involvement. As cranial nerve enhancement may be seen in a broad range of diseases, it can be the only clinical feature of neurosyphilis.

  6. A validation study of the Brazilian version of the pornography consumption inventory (PCI) in a sample of female university students. (United States)

    Baltieri, Danilo Antonio; Luísa de Souza Gatti, Ana; Henrique de Oliveira, Vitor; Junqueira Aguiar, Ana Saito; Almeida de Souza Aranha e Silva, Renata


    Although men constitute the widest consumer group of pornography, the Internet has facilitated both the production of and access to pornographic material by women as well. However, few measures are available to examine pornography-use constructs, which can compromise the reliability of statements regarding the harmful use of pornography. Our study aimed to confirm the factorial validity and internal consistency of the Pornography Consumption Inventory (PCI) in a sample of female university students in Brazil. The PCI is a four-factor, 15-item, five-point Likert-type scale. After translation and back-translation of the PCI, it was administered to 105 female medical students. Exploratory and confirmatory factor analyses were conducted to examine the construct validity. The results supported the four-factor model of the PCI. The model showed adequate internal reliability and good fit indices (comparative fit index (CFI) = 0.95, Tucker-Lewis index (TLI) = 0.94, root mean square error of approximation (RMSEA) = 0.07 (95% confidence interval (CI) = 0.04-0.09), and standardized root mean square residual (SRMR) = 0.08). Overall, the findings from this study support the use of the PCI in Portuguese-speaking women. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  7. Cranial suture morphology and its relationship to diet in Cebus. (United States)

    Byron, Craig D


    Cranial sutures are complex morphological structures. Four Cebus species (C. albifrons, C. apella, C. capucinus, C. olivaceus) are used here to test the hypothesis that sagittal suture complexity is enhanced in animals that eat materially challenging foods. These primates are ideal for such comparative studies because they are closely related and some are known to exhibit differences in the material properties of the foods they ingest and masticate. Specifically, Cebus apella is notable among members of this genus for ingesting food items of high toughness as well as consistently demonstrating a relatively robust cranial morphology. Consistent with previous studies, C. apella demonstrates significantly more robust mandibular and temporal fossa morphology. Also, C. apella possesses sagittal sutures that are more complex than congenerics. These data are used to support the hypothesis that cranial suture complexity is increased in response to consuming diets with more obdurate material properties. One interpretation of this hypothesis is that, compared to non-apelloids, total strain in the apelloid cranial suture connective tissue environment is elevated due to increased jaw muscle activity by increases in either force magnitudes or the number of chewing events. It is argued that greater masticatory function enhances the growth and modeling of cranial suture interdigitation. These data show that cranial suture complexity is one more hard tissue feature from the skull that might be used to inform hypotheses of dietary functional morphology.

  8. Three-dimensional virtual surgery models for percutaneous coronary intervention (PCI) optimization strategies (United States)

    Wang, Hujun; Liu, Jinghua; Zheng, Xu; Rong, Xiaohui; Zheng, Xuwei; Peng, Hongyu; Silber-Li, Zhanghua; Li, Mujun; Liu, Liyu


    Percutaneous coronary intervention (PCI), especially coronary stent implantation, has been shown to be an effective treatment for coronary artery disease. However, in-stent restenosis is one of the longstanding unsolvable problems following PCI. Although stents implanted inside narrowed vessels recover normal flux of blood flows, they instantaneously change the wall shear stress (WSS) distribution on the vessel surface. Improper stent implantation positions bring high possibilities of restenosis as it enlarges the low WSS regions and subsequently stimulates more epithelial cell outgrowth on vessel walls. To optimize the stent position for lowering the risk of restenosis, we successfully established a digital three-dimensional (3-D) model based on a real clinical coronary artery and analysed the optimal stenting strategies by computational simulation. Via microfabrication and 3-D printing technology, the digital model was also converted into in vitro microfluidic models with 3-D micro channels. Simultaneously, physicians placed real stents inside them; i.e., they performed “virtual surgeries”. The hydrodynamic experimental results showed that the microfluidic models highly inosculated the simulations. Therefore, our study not only demonstrated that the half-cross stenting strategy could maximally reduce restenosis risks but also indicated that 3-D printing combined with clinical image reconstruction is a promising method for future angiocardiopathy research.

  9. LabVIEW Interface for PCI-SpaceWire Interface Card (United States)

    Lux, James; Loya, Frank; Bachmann, Alex


    This software provides a LabView interface to the NT drivers for the PCISpaceWire card, which is a peripheral component interface (PCI) bus interface that conforms to the IEEE-1355/ SpaceWire standard. As SpaceWire grows in popularity, the ability to use SpaceWire links within LabVIEW will be important to electronic ground support equipment vendors. In addition, there is a need for a high-level LabVIEW interface to the low-level device- driver software supplied with the card. The LabVIEW virtual instrument (VI) provides graphical interfaces to support all (1) SpaceWire link functions, including message handling and routing; (2) monitoring as a passive tap using specialized hardware; and (3) low-level access to satellite mission-control subsystem functions. The software is supplied in a zip file that contains LabVIEW VI files, which provide various functions of the PCI-SpaceWire card, as well as higher-link-level functions. The VIs are suitably named according to the matching function names in the driver manual. A number of test programs also are provided to exercise various functions.

  10. Fabrication of a radiotherapeutic carrier for a case of fibrosarcoma invaded to the left cranial base

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Ryo [Tokyo Medical and Dental Univ. (Japan). Graduate School; Inoue, Takaaki; Mukohyama, Hitoshi [and others


    Radiotherapy has the advantage in treating the malignant tumor developed in head and neck region, especially in preserving the function and shape of the tissue. Since 1981, we have cooperated with radiotherapists in fabricating various kinds of custom-made radiotherapy prostheses such as shields, spacers, carriers and molds. The purpose of a carrier is to place the radioactive source close to the tumor so that a concentrated dose is delivered to the tumor tissue with minimum irradiation of healthy tissue. We fabricated a radiotherapy appliance (a carrier) for a fibrosarcoma that had developed in the left cranial base. Since the maxillary defect was large and connected to oral cavity, the carrier was designed to introduce Gold-198 grains to the tumor while being anchored with a plate section. A satisfactory treatment result was obtained with this design of carrier. This article describes the fabrication procedure of this carrier, which comprised an anchoring plate attached to the remaining palate and teeth, and a carrier section extending from the anchoring plate to the cranial base where the fibrosarcoma had invaded. (author)

  11. PAPP-A and IGFBP-4 fragment levels in patients with ST-elevation myocardial infarction treated with heparin and PCI

    DEFF Research Database (Denmark)

    Hjortebjerg, Rikke; Lindberg, Søren; Jensen, Jan S


    OBJECTIVES: Circulating levels of pregnancy-associated plasma protein-A (PAPP-A) predict outcome in patients with acute coronary syndrome (ACS). Unfortunately, administration of heparin to patients with ACS increases circulating PAPP-A, probably by a detachment of PAPP-A from cell surfaces......-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Prior to PCI, patients were injected with 10,000IU of unfractionated heparin (UFH). Blood samples were collected immediately before PCI, but after UFH-injection, immediately after PCI and on day 1 and day 2...

  12. The Application of PCI-1712 Data Acquisition Card in Impact Testing Machine%PCI-1712数据采集卡在冲击试验机上的应用

    Institute of Scientific and Technical Information of China (English)



    文章介绍了一款性能优异的多功能数据采集卡PCI-1712.针对RPSW摆锤示波冲击试验机计算机数据采集及处理系统存在的问题,用PCI-1712对设备数据采集系统硬件进行了改造.本文主要阐述了这款数据采集卡在Visual Basic环境下进行数据采集的一些主要方法.

  13. Subepicardial haematoma, a rare and potentially lethal complication of CTO-PCI: case of an exceptional recovery after conservative management. (United States)

    de Vos, Annemiek M J; van der Schaaf, Rene J


    We present the case of an 82-year-old woman undergoing high-risk chronic total occlusion percutaneous coronary intervention (CTO-PCI) of the right coronary artery. Hours after the procedure, a subepicardial haematoma was diagnosed as a result of coronary perforation during the procedure. This rare and potentially lethal complication evolved exceptionally benignly after conservative management; our patient fully recovered. Increasingly complex procedures in high-risk patient categories warrant awareness of procedural complications, especially those that are subtle and appear relatively late, and are therefore most hazardous. Recognition of this rare complication and choosing the optimal strategy is of the utmost importance when dealing with patients who undergo PCI. We here describe the rare case of a potential lethal complication in high-risk CTO-PCI, which evolved relatively benignly. 2014 BMJ Publishing Group Ltd.

  14. Sodium pump distribution is not reversed in the DBA/2FG-pcy, polycystic kidney disease model mouse. (United States)

    Kawa, G; Nagao, S; Yamamoto, A; Omori, K; Komatz, Y; Takahashi, H; Tashiro, Y


    Recently, it has been reported that Na,K-ATPase in the renal epithelia of human autosomal dominant polycystic kidney disease and cpk mouse, a murine model of autosomal recessive polycystic kidney disease, mislocates to apical plasma membrane and that mislocated Na,K-ATPase causes the cyst formation. Whether the DBA/2FG-pcy mice, which are presumably a suitable model for autosomal dominant polycystic kidney disease, also exhibit the reversal polarity of Na,K-ATPase localization was examined. Kidneys of newborn DBA/2FG-pcy mice, and those at early and late stages of cyst development were examined by immunohistochemical techniques. At any stage, abnormal distribution of Na,K-ATPase on the apical membranes of tubular epithelial cells could not be detected. It is suggested that cysts can be formed without reversed polarity of Na,K-ATPase distribution in pcy mice.

  15. PCI总线从接口的设计与验证%Design and Verification of PCI-slave Interface

    Institute of Scientific and Technical Information of China (English)

    闫福鑫; 许志宏; 刘佑宝


    讨论了一种包括配置空间和I/0空间的从PCI( PCI -slave)接口电路的Verilog HDL设计.重点介绍了顶层的系统架构,对其进行了功能分析和结构划分,并详细阐述了各子模块电路的设计和实现.根据PCI总线交易时序,给出使用有限状态机实现接收总线信号控制本地逻辑的方法.针对PCI时序的复杂性,提出了一种新颖实用的PCI系统验证方法,并重点讲述了组建验证平台的方法及其优点.通过编写测试激励程序完成了功能仿真,仿真和验证的结果表明,该接口电路在功能和时序上符合PCI技术规范,达到了预定的目标.%The Verilog HDL design for PCI-slave interface including configuration space and I/O space is discussed. A general overview of the top-level architecture is provided, the thought and the function of each module are also introduced in detail. The timing simulation is implemented and the method of using the state machine is put forward to ensure the proper completion of the bus operation. A new verification methodology for PCI system is discussed. In addition, the approach to test bench and it's advantage are also emphasized. The result of timing simulation and experiment shows that the design of PCI-slave interface complies with PCI local bus specification revision and achieves the expectation.

  16. Irradiation damage

    Energy Technology Data Exchange (ETDEWEB)

    Howe, L.M


    There is considerable interest in irradiation effects in intermetallic compounds from both the applied and fundamental aspects. Initially, this interest was associated mainly with nuclear reactor programs but it now extends to the fields of ion-beam modification of metals, behaviour of amorphous materials, ion-beam processing of electronic materials, and ion-beam simulations of various kinds. The field of irradiation damage in intermetallic compounds is rapidly expanding, and no attempt will be made in this chapter to cover all of the various aspects. Instead, attention will be focused on some specific areas and, hopefully, through these, some insight will be given into the physical processes involved, the present state of our knowledge, and the challenge of obtaining more comprehensive understanding in the future. The specific areas that will be covered are: point defects in intermetallic compounds; irradiation-enhanced ordering and irradiation-induced disordering of ordered alloys; irradiation-induced amorphization.

  17. Executive Dysfunction 25 Years after Treatment with Cranial Radiotherapy for Pediatric Lymphoid Malignancies. (United States)

    Schuitema, Ilse; de Sonneville, Leo; Kaspers, Gertjan; van der Pal, Helena; Uyttebroeck, Anne; van den Bos, Cor; Veerman, Anjo


    The first cohorts to survive childhood lymphoid malignancies treated with cranial irradiation are now aging into adulthood, and concerns are growing about the development of radiotherapy-induced cognitive deficits in the aging brain. These deficits are hypothesized to increase over time. Their impact on daily functioning of older survivors, and the accompanying need for interventions, should be anticipated. By describing a detailed profile of executive function deficits and their associations with age, specific targets for neuropsychological intervention can be identified. Fifty survivors of childhood lymphoid malignancies and 58 related controls were assessed with the Amsterdam Neuropsychological Tasks program. The survivors were on average 31.1 (4.9) years old, treated with 22.5 (6.8) Gy cranial irradiation, and examined on average 25.5 (3.1) years after diagnosis. The survivors showed significantly decreased response speed, irrespective of the task at hand. Furthermore, we found deficits in working memory capacity, inhibition, cognitive flexibility, executive visuomotor control, attentional fluctuations, and sustained attention. Older age was associated with poorer performance on executive visuomotor control and inhibition. On executive visuomotor control, 50% of female survivors performed more than 1.5 SD below average, versus 15.4% of male survivors. The combination of visuospatial working memory problems and decreasing executive visuomotor control could result in difficulty with learning new motor skills at older ages, like walking with a cane. Deterioration of executive control and inhibition may result in decreased behavioral and emotional regulation in aging survivors. Especially the deficiency in executive visuomotor control in female survivors should be considered for (prophylactic) intervention.

  18. Long-term outcome of FFR-guided PCI for stable coronary artery disease in daily clinical practice

    DEFF Research Database (Denmark)

    De Backer, Ole; Biasco, Luigi; Lønborg, Jacob


    AIMS: Our aim was to investigate the strength of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) in daily practice. METHODS AND RESULTS: For this study, 3,512 patients with stable CAD and at least one 50-89% coronary stenosis...... were identified; those patients thought to require PCI (n=1,716) were selected. Of these, 962 (56%) were treated based on angiography (XA) alone, whereas 754 patients (44%) had an FFR-guided treatment. In the latter group, 321 patients (43%) were reallocated to another treatment, predominantly medical...

  19. Gender Related Survival Differences in ST-Elevation Myocardial Infarction Patients Treated with Primary PCI. (United States)

    Kanic, Vojko; Vollrath, Maja; Naji, Franjo Husam; Sinkovic, Andreja


    Data about gender as an independent risk factor for death in ST-elevation myocardial infarction (STEMI) patients is still contrasting. Aim was to assess how gender influences in-hospital and long-term all-cause mortality in STEMI patients with primary percutaneous coronary intervention (PCI) in our region. We analysed data from 2069 STEMI patients undergoing primary PCI in our institution from January 2009-December 2014, of whom 28.9% were women. In-hospital and long-term mortality were observed in women and men. The effect of gender on in-hospital mortality was assessed by binary logistic regression modelling and by Cox regression analysis for long-term mortality. Women were older (68.3±61.8 vs 61.8±12.0 years; p<0.0001), with a higher prevalence of diabetes (13.7% vs 9.9%; p=0.013) and tend to be more frequently admitted in cardiogenic shock (8.4% vs 6.3%; p =0.085). They were less frequently treated with bivalirudin (15.9% vs 20.3%; p=0.022). In-hospital mortality was higher among women (14.2% vs 7.8%; p<0.0001). After adjustment, age (adjusted OR: 1.05; 95% CI: 1.03 to 1.08; p < 0.001) and cardiogenic shock at admission (adjusted OR: 24.56; 95% CI: 11.98 to 50.35; p < 0.001), but not sex (adjusted OR: 1.47; 95% CI: 0.80 to 2.71) were identified as prognostic factors of in-hospital mortality. During the median follow-up of 27 months (25th, 75th percentile: 9, 48) the mortality rate (23.6% vs 15.1%; p<0.0001) was significantly higher in women. The multivariate adjusted Cox regression model identified age (HR 1.05; 95% CI 1.04-1.07; p<0.0001), cardiogenic shock at admission (HR 6.09; 95% CI 3.78-9.81; p<0.0001), hypertension (HR 1.49; 95% CI 1.02-2.18; p<0.046), but not sex (HR 1.04; 95% CI 0.74-1.47) as independent prognostic factors of follow-up mortality. Older age and worse clinical presentation rather than gender may explain the higher mortality rate in women with STEMI undergoing primary PCI.

  20. Switching from Clopidogrel to Prasugrel in patients undergoing PCI: A meta-analytic overview. (United States)

    Verdoia, Monica; Barbieri, Lucia; Suryapranata, Harry; De Luca, Giuseppe


    Despite the demonstrated benefits of Prasugrel, a new generation thienopyridine, in the prevention of thrombotic complications after percutaneous coronary interventions (PCI) for Acute Coronary Syndromes (ACS), its use is still precluded to those many patients arriving to the cath lab pre-treated with Clopidogrel. Conclusive data on the strategy of switching from Clopidogrel to Prasugrel are still missing, therefore we aimed to perform a meta-analysis of current studies evaluating the safety and efficacy of switching from Clopidogrel to Prasugrel (PS) as compared to a standard thienopyridine therapy with Clopidogrel or Prasugrel in patients undergoing PCI. Literature archives and main scientific sessions' abstracts were scanned for studies comparing a switching strategy from Clopidogrel to Prasugrel vs. Prasugrel or Clopidogrel. Primary efficacy endpoint was overall mortality. Secondary endpoints were: non-fatal myocardial infarction and definite/probable stent thrombosis. Safety endpoint was the rate of major bleedings according to a per-protocol definition. A total of 12 studies, involving 3956 patients, were included. Among them, 1396 patients (35.3%), received Prasugrel after a Clopidogrel treatment (PS), while 2560 (64.7%) received either Prasugrel or Clopidogrel. The switch from Clopidogrel to Prasugrel was in the majority of the studies periprocedural. The mortality was numerically lower, but not statistically significant, in the PS group as compared with patients who did not switch (1.7% vs. 3.8%, OR [95% CI] = 0.68 [0.40,1.15], p = 0.15, phet = 0.61), without any relationship with patients' risk profile (r = -0.68 [-2.09, 0.73], p = 0.35). Similar results were obtained for secondary efficacy endpoints and at sensitivity analysis in the majority of subgroups evaluated. Moreover, the PS strategy did not increase major bleedings as compared with standard therapy (1.4% vs. 2.5%, OR [95% CI = 0.70 [0.39, 1.25], p = 0.23, phet = 0.6). The present meta

  1. Calvarial reconstruction using high-density porous polyethylene cranial hemispheres

    Directory of Open Access Journals (Sweden)

    Nitin J Mokal


    Full Text Available Aims: Cranial vault reconstruction can be performed with a variety of autologous or alloplastic materials. We describe our experience using high-density porous polyethylene (HDPE cranial hemisphere for cosmetic and functional restoration of skull defects. The porous nature of the implant allows soft tissue ingrowth, which decreases the incidence of infection. Hence, it can be used in proximity to paranasal sinuses and where previous alloplastic cranioplasties have failed due to implant infection. Materials and Methods: We used the HDPE implant in seven patients over a three-year period for reconstruction of moderate to large cranial defects. Two patients had composite defects, which required additional soft tissue in the form of free flap and tissue expansion. Results: In our series, decompressive craniectomy following trauma was the commonest aetiology and all defects were located in the fronto-parieto-temporal region. The defect size was 10 cm on average in the largest diameter. All patients had good post-operative cranial contour and we encountered no infections, implant exposure or implant migration. Conclusions: Our results indicate that the biocompatibility and flexibility of the HDPE cranial hemisphere implant make it an excellent alternative to existing methods of calvarial reconstruction.

  2. An osteological and histological investigation of cranial joints in geckos. (United States)

    Payne, Samantha L; Holliday, Casey M; Vickaryous, Matthew K


    Cranial kinesis is a widespread feature of gekkotan lizards. Previous studies of kinesis in lizards often described the relevant, mobile joints as synovial, thus characterized by the presence of a synovial cavity lined with articular cartilage. To date however, detailed investigations of cranial joint histology are lacking. We examined eight cranial joints (quadrate-articular, quadrate-pterygoid, quadrate-otooccipital, quadrate-squamosal, epipterygoid-prootic, epipterygoid-pterygoid, basisphenoid-pterygoid, and frontal-parietal) in five gekkotan species (Oedura lesueuerii, Eublepharis macularius, Hemitheconyx caudicinctus, Tarentola annularis, and Chondrodactylous bibronii) using microcomputed tomography and serial histology. Particular focus was given to the relationship between the bony and soft-tissue components of the joint. Our results demonstrate that only three of these joints are synovial: the quadrate-articular, epipterygoid-pterygoid, and basisphenoid-pterygoid joints. The frontal-parietal and quadrate-pterygoid joints are syndesmosis (fibrous), the epipterygoid-prootic and quadrate-otooccipital joints are synchondroses (cartilaginous without a synovial cavity) and the quadrate-squamosal joint was not present. Based on previous descriptions, we determine that the structure of some cranial joints is variable among lizard taxa. We caution that osteology does not necessarily predict cranial joint histology. Although the functional implications of these findings remain to be explored we note that the development of synovial joints appears to be associated with a neural crest origin for the elements involved.

  3. Ets-1 confers cranial features on neural crest delamination.

    Directory of Open Access Journals (Sweden)

    Eric Théveneau

    Full Text Available Neural crest cells (NCC have the particularity to invade the environment where they differentiate after separation from the neuroepithelium. This process, called delamination, is strikingly different between cranial and trunk NCCs. If signalings controlling slow trunk delamination start being deciphered, mechanisms leading to massive and rapid cranial outflow are poorly documented. Here, we show that the chick cranial NCCs delamination is the result of two events: a substantial cell mobilization and an epithelium to mesenchyme transition (EMT. We demonstrate that ets-1, a transcription factor specifically expressed in cranial NCCs, is responsible for the former event by recruiting massively cranial premigratory NCCs independently of the S-phase of the cell cycle and by leading the gathered cells to straddle the basal lamina. However, it does not promote the EMT process alone but can cooperate with snail-2 (previously called slug to this event. Altogether, these data lead us to propose that ets-1 plays a pivotal role in conferring specific cephalic characteristics on NCC delamination.

  4. Measurement of human acupoints bioimpedance based on PCI8335B%一种基于PCI8335B的人体穴位生物阻抗的测量方法

    Institute of Scientific and Technical Information of China (English)

    王昱; 洪文学


    Acupoints are the positions for the Qi and Blood to be injected into human body. The changes in Qi and Blood of human body could be shown as the changes of the corresponding acupoints, such as the changes of electric properties of these acupoints. This paper designsed a hardware system based on the acquisition card PCI8335B, which is mainly composed of AD9833, AD620 and AD8302. To measure the acupoints impedance, VB language is adopted to program the PCI8335B and to collect the electric signal from acupoints.%穴位是人体经络脏腑之气血输注的部位,体内气血的变化可反应于相应的穴位,尚可表现为相应穴位电学特性的改变.设计了一种基于采集卡PCI8335B控制并采集信号,主要由AD9833,AD620,AD8302等组成的硬件系统,通过VB语言编写PCI8335B的控制信号并采集硬件产生的穴位阻抗电信号,实现穴位阻抗的测量.

  5. Development of a PCI Based Data Acquisition Platform for High Intensity Accelerator Experiments

    CERN Document Server

    Higuchi, T; Ikeno, M; Igarashi, Y; Inoue, E; Itoh, R; Kodama, H; Murakami, T; Nakao, M; Nakayoshi, K; Saitoh, M; Shimazaki, S; Suzuki, S Y; Tanaka, M; Tauchi, K; Yamauchi, M; Yasu, Y; Varner, G; Nagasaka, Y; Katayama, T; Watanabe, K; Ishizuka, M; Onozawa, S; Li, C J


    Data logging at an upgraded KEKB accelerator or the J-PARC facility, currently under commission, requires a high density data acquisition platform with integrated data reduction CPUs. To follow market trends, we have developed a DAQ platform based on the PCI bus, a choice which permits a fast DAQ and a long expected lifetime of the system. The platform is a 9U-VME motherboard consisting of four slots for signal digitization modules, readout FIFOs for data buffering, and three PMC slots, on one of which resides a data reduction CPU. We have performed long term and thermal stability tests. The readout speed on the platform has been measured up to 125 MB/s in DMA mode.

  6. Introduzione al carteggio Benelli-Gozzini, ovvero sulla militanza dei credenti nel Pci

    Directory of Open Access Journals (Sweden)

    Giambattista Scirè


    Full Text Available Questo contributo propone lo scambio epistolare tra il cardinale di Firenze Giovanni Benelli e l’intellettuale fiorentino Mario Gozzini, con una introduzione che, alla luce delle carte conservate nel Fondo Gozzini, permette di capire il contesto in cui avvenne il significativo carteggio. Il tema affrontato è il rapporto tra cristianesimo e marxismo, tra credenti e Partito comunista italiano. La vicenda va collocata tra la fine degli anni Settanta e gli inizi degli anni Ottanta, quando un intenso dibattito sul declino della politica e della cultura cattolica nella società contemporanea animava il mondo cattolico italiano (intellettuali, politici e sacerdoti e, in particolare, quello della città di Firenze. In questo contesto di crisi del partito cattolico, le proposte di ‘riaggregazione’ dell’area cattolica si scontrano con la nascita del gruppo parlamentare della Sinistra indipendente, eletto nelle file del Pci.

  7. 急诊 PCI 术前服美托洛尔降低再灌注心律失常发生率%Metoprolol administration before emergency PCI can decrease incidence rate of reperfusion arrhythmia

    Institute of Scientific and Technical Information of China (English)

    周榕; 周贻


    Objective:To explore whether metoprolol administration before emergency percutaneous coronary inter‐vention (PCI) can reduce incidence rate of reperfusion arrhythmia (RA) or not .Methods :According to random number table ,a total of 80 patients with acute anterior wall myocardial infarction (age70 beats/min ,no PR interval prolongation ) were randomly and equally divided into routine treatment group (didn't receive metoprolol tartrate tablet before emergency PCI ) and metoprolol group (received metoprolol tartrate tablet 25 mg before emergency PCI ) .Incidence rate of RA after PCI was compared between two groups .Results:In metoprolol group ,a total of 32 cases received PCI and eight cases received percutaneous transluminal coronary angioplasty (PTCA);in routine treatment group ,a total of 35 case received PCI and five cases received PTCA ,suc‐cess rates of both groups were 100% .In metoprolol group , RA occurred in 4 cases ,including one case with ventric‐ular fibrillation (VF);in routine treatment group , RA occurred in 15 cases ,including four cases with VF .Inci‐dence rate of RA after emergency PCI in metoprolol group was significantly lower than that of routine treatment group (10.0% vs .37.5% ,P=0.032) .Conclusion:Metoprolol administration before emergency PCI can reduce in‐cidence rate of reperfusion arrhythmia in patients with acute myocardial infarction .%目的:观察探讨急诊经皮冠脉介入治疗(PCI )术前服用美托洛尔是否可降低再灌注心律失常(RA )的发生率。方法:根据随机数字表法,80例急性前间壁心肌梗死(年龄<75岁、基础心率>70次/分、无 PR间期延长)患者被随机均分为常规治疗组(急诊PCI前未给予酒石酸美托洛尔片)和美托洛尔组(急诊PCI前给予酒石酸美托洛尔片25 mg嚼服)。观察并比较两组术后RA发生率。结果:美托洛尔组中32例行PCI术,8例行经腔经皮冠状动脉血管成形

  8. Independent Predictors of Bleeding Complications in Patients Undergoing PCI With Concomitant Treatment With Bivalirudin in Clinical Practice Results From the Improver Registry

    DEFF Research Database (Denmark)

    Koeth, Oliver; Gulba, Dietrich; Huber, Kurt


    Bleeding complications are associated with an adverse outcome after a percutaneous coronary intervention (PCI) is performed. Traditional risk factors for bleeding complications are age, gender, underweight, hypertension, and renal impairment. The aim of our study was to identify the independent...... predictors of bleeding complications in patients undergoing a PCI with concomitant treatment with bivalirudin....

  9. Food irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Webb, T.


    The proposed use of gamma radiation from cobalt 60 and cesium 137 for food irradiation in the United Kingdom is discussed, with particular reference to the possible dangers and disadvantages to the safety and wholesomeness of the food.

  10. Cranial ultrasound and chronological changes in molybdenum cofactor deficiency

    Energy Technology Data Exchange (ETDEWEB)

    Serrano, Mercedes; Dias, Anna P.; Perez-Duenas, Belen; Campistol, Jaume; Garcia-Cazorla, Angels [Hospital Sant Joan de Deu, Department of Pediatric Neurology, Paseo de Sant Joan de Deu, Barcelona (Spain); Lizarraga, Isabel [Hospital Sant Joan de Deu, Department of Neonatology, Barcelona (Spain); Reiss, Jochen [University of Goettingen, Institute for Human Genetics, Goettingen (Germany); Vilaseca, Maria A.; Artuch, Rafael [Hospital Sant Joan de Deu, Clinical Biochemistry Department, Barcelona (Spain)


    Molybdenum cofactor is essential for the function of three human enzymes: sulphite oxidase, xanthine dehydrogenase, and aldehyde oxidase. Molybdenum cofactor deficiency is a rare autosomal recessively inherited disease. Disturbed development and damage to the brain may occur as a result of accumulation of toxic levels of sulphite. The CT and MRI findings include severe early brain abnormalities and have been widely reported, but the cranial US imaging findings have seldom been reported. We report a chronological series of cranial US images obtained from an affected infant that show the rapid development of cerebral atrophy, calcifications and white matter cysts. Our report supports the utility of cranial US, a noninvasive bed-side technique, in the detection and follow-up of these rapidly changing lesions. (orig.)

  11. 3D Printed, Customized Cranial Implant for Surgical Planning (United States)

    Bogu, Venkata Phanindra; Ravi Kumar, Yennam; Asit Kumar, Khanra


    The main objective of the present work is to model cranial implant and printed in FDM machine (printer model used: mojo). Actually this is peculiar case and the skull has been damaged in frontal, parietal and temporal regions and a small portion of frontal region damaged away from saggital plane, complexity is to fill this frontal region with proper curvature. The Patient CT-data (Number of slices was 381 and thickness of each slice is 0.488 mm) was processed in mimics14.1 software, mimics file was sent to 3-matic software and calculated thickness of skull at different sections where cranial implant is needed then corrected the edges of cranial implant to overcome CSF (cerebrospinal fluid) leakage and proper fitting. Finally the implant average thickness is decided as 2.5 mm and printed in FDM machine with ABS plastic.

  12. Signaling mechanisms implicated in cranial sutures pathophysiology: Craniosynostosis

    Directory of Open Access Journals (Sweden)

    Maria A. Katsianou


    Full Text Available Normal extension and skull expansion is a synchronized process that prevails along the osteogenic intersections of the cranial sutures. Cranial sutures operate as bone growth sites allowing swift bone generation at the edges of the bone fronts while they remain patent. Premature fusion of one or more cranial sutures can trigger craniosynostosis, a birth defect characterized by dramatic manifestations in appearance and functional impairment. Up until today, surgical correction is the only restorative measure for craniosynostosis associated with considerable mortality. Clinical studies have identified several genes implicated in the pathogenesis of craniosynostosis syndromes with useful insights into the underlying molecular signaling events that determine suture fate. In this review, we exploit the intracellular signal transduction pathways implicated in suture pathobiology, in an attempt to identify key signaling molecules for therapeutic targeting.

  13. Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery (United States)

    Bydon, Mohamad; Abt, Nicholas B.; Macki, Mohamed; Brem, Henry; Huang, Judy; Bydon, Ali; Tamargo, Rafael J.


    Background: Preoperative anemia may affect postoperative mortality and morbidity following elective cranial operations. Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to identify elective cranial neurosurgical cases (2006-2012). Morbidity was defined as wound infection, systemic infection, cardiac, respiratory, renal, neurologic, and thromboembolic events, and unplanned returns to the operating room. For 30-day postoperative mortality and morbidity, adjusted odds ratios (ORs) were estimated with multivariable logistic regression. Results: Of 8015 patients who underwent elective cranial neurosurgery, 1710 patients (21.4%) were anemic. Anemic patients had an increased 30-day mortality of 4.1% versus 1.3% in non-anemic patients (P neurosurgery was independently associated with an increased risk of 30-day postoperative mortality and morbidity when compared to non-anemic patients. A hematocrit level below 33% (Hgb 11 g/dl) was associated with a significant increase in postoperative morbidity. PMID:25422784

  14. Functional electrical stimulation improves brain perfusion in cranial trauma patients

    Directory of Open Access Journals (Sweden)

    Bárbara Juarez Amorim


    Full Text Available OBJECTIVE: Demonstrate brain perfusion changes due to neuronal activation after functional electrical stimulation (FES. METHOD: It was studied 14 patients with hemiplegia who were submitted to a program with FES during fourteen weeks. Brain perfusion SPECT was performed before and after FES therapy. These patients were further separated into 2 groups according to the hemiplegia cause: cranial trauma and major vascular insults. All SPECT images were analyzed using SPM. RESULTS: There was a significant statistical difference between the two groups related to patient's ages and extent of hypoperfusion in the SPECT. Patients with cranial trauma had a reduction in the hypoperfused area and patients with major vascular insult had an increase in the hypoperfused area after FES therapy. CONCLUSION: FES therapy can result in brain perfusion improvement in patients with brain lesions due to cranial trauma but probably not in patients with major vascular insults with large infarct area.

  15. Smokers with ST-segment elevation myocardial infarction and short time to treatment have equal effects of PCI and fibrinolysis

    DEFF Research Database (Denmark)

    Rasmussen, Thomas; Kelbæk, Henning; Madsen, Jan Kyst


    The purpose of this study was to examine the effect of primary percutaneous coronary intervention (PCI) compared to fibrinolysis in smokers and non-smokers with ST-segment elevation myocardial infarction (STEMI). Smokers seem to have less atherosclerosis but are more prone to thrombotic disease...

  16. «Il Pci è un partito finito». Video-documentario sulla scomparsa della “piazza rossa”

    Directory of Open Access Journals (Sweden)

    Gisella Gaspari


    Full Text Available Attraverso immagini di manifestazioni a sfondo politico nelle piazze di Bologna, il video-documentario illustra una trasformazione delle forme di partecipazione collettiva alla vita pubblica, che negli anni Settanta ha visto un ridimensionamento del ruolo dei partiti di massa, e in particolare del Pci.

  17. [Food irradiation]. (United States)

    Migdał, W


    A worldwide standard on food irradiation was adopted in 1983 by Codex Alimentarius Commission of the Joint Food Standard Programme of the Food and Agriculture Organization (FAO) of the United Nations and the World Health Organization (WHO). As a result, 41 countries have approved the use of irradiation for treating one or more food items and the number is increasing. Generally, irradiation is used to: food loses, food spoilage, disinfestation, safety and hygiene. The number of countries which use irradiation for processing food for commercial purposes has been increasing steadily from 19 in 1987 to 33 today. In the frames of the national programme on the application of irradiation for food preservation and hygienization an experimental plant for electron beam processing has been established in Institute of Nuclear Chemistry and Technology. The plant is equipped with a small research accelerator Pilot (19MeV, 1 kW) and an industrial unit Elektronika (10MeV, 10 kW). On the basis of the research there were performed at different scientific institutions in Poland, health authorities have issued permission for irradiation for: spices, garlic, onions, mushrooms, potatoes, dry mushrooms and vegetables.

  18. Development of a Human Cranial Bone Surrogate for Impact Studies. (United States)

    Roberts, Jack C; Merkle, Andrew C; Carneal, Catherine M; Voo, Liming M; Johannes, Matthew S; Paulson, Jeff M; Tankard, Sara; Uy, O Manny


    In order to replicate the fracture behavior of the intact human skull under impact it becomes necessary to develop a material having the mechanical properties of cranial bone. The most important properties to replicate in a surrogate human skull were found to be the fracture toughness and tensile strength of the cranial tables as well as the bending strength of the three-layer (inner table-diplöe-outer table) architecture of the human skull. The materials selected to represent the surrogate cranial tables consisted of two different epoxy resins systems with random milled glass fiber to enhance the strength and stiffness and the materials to represent the surrogate diplöe consisted of three low density foams. Forty-one three-point bending fracture toughness tests were performed on nine material combinations. The materials that best represented the fracture toughness of cranial tables were then selected and formed into tensile samples and tested. These materials were then used with the two surrogate diplöe foam materials to create the three-layer surrogate cranial bone samples for three-point bending tests. Drop tower tests were performed on flat samples created from these materials and the fracture patterns were very similar to the linear fractures in pendulum impacts of intact human skulls, previously reported in the literature. The surrogate cranial tables had the quasi-static fracture toughness and tensile strength of 2.5 MPa√ m and 53 ± 4.9 MPa, respectively, while the same properties of human compact bone were 3.1 ± 1.8 MPa√ m and 68 ± 18 MPa, respectively. The cranial surrogate had a quasi-static bending strength of 68 ± 5.7 MPa, while that of cranial bone was 82 ± 26 MPa. This material/design is currently being used to construct spherical shell samples for drop tower and ballistic tests.

  19. An annotated history of craniofacial surgery and intentional cranial deformation. (United States)

    Goodrich, J T; Tutino, M


    The history of craniofacial surgery and the use of intentional cranial deformation is a long and varied one. Researching some of the earliest medical writings and reviews of early terracotta and stone figures from throughout the world clearly revealed that these two forms of treatment were widely extant. Intentional cranial deformation was used for a number of reasons including beautification, tribal identification, and social stature. The development of craniofacial surgery is a more modern practice and its historical evolution is reviewed in the context of techniques and the personalities involved.

  20. Tolerance of the central nervous system to photon irradiation. Endocrine complications

    Energy Technology Data Exchange (ETDEWEB)

    Wigg, D.R.; Murray, R.M.L.; Koschel, K. (Royal Adelaide Hospital (Australia))


    Dose-response isoeffect equations have been determined for hypothalamic pituitary insufficiency following cranial irradiation. Of particular importance is the occurrence of complications at doses substantially less than those commonly used for the treatment of central nervous system tumors. Such complications may be severe and potentially life threatening. These complications occur when a small midline 'target' volume containing the pituitary gland, infundibulum and adjacent inferior hypothalamic structures is irradiated. Direct pituitary irradiation is unlikely to be a factor, at least in some cases. The possible role of incidental hypothalamic irradiation in the control of acromegaly and pituitary dependent Cushing's syndrome is discussed.

  1. Treatment referral before and after the introduction of the Liverpool Patients Concerns Inventory (PCI) into routine head and neck oncology outpatient clinics. (United States)

    Ghazali, Naseem; Kanatas, Anastasios; Langley, Daniel J R; Scott, Barry; Lowe, Derek; Rogers, Simon N


    Holistic needs assessment is a key recommendation in improving supportive and palliative care in adults with cancer. The Patients Concerns Inventory (PCI) is a holistic needs assessment tool designed for head and neck cancer survivors in outpatient setting. Routine screening of potential unmet needs in a clinic may result in increased onward referrals, thus placing a burden on existing healthcare services. The aim of this study was to compare the referral trends following consultation in the time periods before and after introduction of PCI in an oncology outpatient clinic. A cross-sectional cohort of disease-free survivors of oral/oropharyngeal cancers of a single consultant was prospectively exposed to PCI from July 2007 to April 2009. The PCI is a self-completed questionnaire consisting of 55 items of patient needs/concern and a list of multidisciplinary professionals, whom patients may wish to talk to or be referred to. Retrospective analysis of referral patterns from clinic letters in two periods in the pre-PCI and post-PCI exposure was performed. Prospective analysis of consultations was performed to determine the outcome of PCI-highlighted items. There was no change in the prevalence of onward referral with the introduction of PCI, i.e. 21 referrals per 100 patients seen in outpatients. However, the proportion of referrals to oral rehabilitation and psychological support increased. Referrals to certain services, e.g. speech and language and dentistry, remained consistently in demand. Many PCI-highlighted needs were dealt in a clinic with by the consultant and/or other professionals during a multidisciplinary consultation. Routine use of PCI promotes target efficiency by directing and apportioning appropriate services to meet the needs for supportive care of head and neck cancer survivors.

  2. Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI

    Directory of Open Access Journals (Sweden)

    Tödt Tim


    Full Text Available Abstract Background Studies on the impact of time to treatment on myocardial infarct size have yielded conflicting results. In this study of ST-Elevation Myocardial Infarction (STEMI treated with primary percutaneous coronary intervention (PCI, we set out to investigate the relationship between the time from First Medical Contact (FMC to the demonstration of an open infarct related artery (IRA and final scar size. Between February 2006 and September 2007, 89 STEMI patients treated with primary PCI were studied with contrast enhanced magnetic resonance imaging (ceMRI 4 to 8 weeks after the infarction. Spearman correlation was computed for health care delay time (defined as time from FMC to PCI and myocardial injury. Multiple linear regression was used to determine covariates independently associated with infarct size. Results An occluded artery (Thrombolysis In Myocardial Infarction, TIMI flow 0-1 at initial angiogram was seen in 56 patients (63%. The median FMC-to-patent artery was 89 minutes. There was a weak correlation between time from FMC-to-patent IRA and infarct size, r = 0.27, p = 0.01. In multiple regression analyses, LAD as the IRA, smoking and an occluded vessel at the first angiogram, but not delay time, correlated with infarct size. Conclusions In patients with STEMI treated with primary PCI we found a weak correlation between health care delay time and infarct size. Other factors like anterior infarction, a patent artery pre-PCI and effects of reperfusion injury may have had greater influence on infarct size than time-to-treatment per se.

  3. Zuigelingen met een scheef hoofd [Babies with cranial deformity

    NARCIS (Netherlands)

    Feijen, M.M.; Claessens, E.A.; Dovens, A.J.; Vles, J.S.; van der Hulst, R.R.


    Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet

  4. Morphometric analysis of the cranial base in Asians. (United States)

    Chang, Hong-Po; Liu, Pao-Hsin; Tseng, Yu-Chuan; Yang, Yi-Hsin; Pan, Chin-Yun; Chou, Szu-Ting


    This study tested the hypothesis that developmental heterogeneity in cranial base morphology increases the prevalence of Class III malocclusion and mandibular prognathism in Asians. Thin-plate spline (TPS) graphical analysis of lateral cephalometric radiographs of the cranial base and the upper midface configuration were compared between a European-American group (24 females and 31 males) and four Asian ethnic groups (100 Chinese, 100 Japanese, 100 Korean and 100 Taiwanese; 50 females and 50 males per group) of young adults with clinically acceptable occlusion and facial profiles. Procrustes analysis was performed to identify statistically significant differences in each configuration of landmarks (P expansion in the anterior portion of the cranial base and upper midface region. The most posterior cranial base region also showed horizontal compression between the basion and Bolton point, with forward displacement of the articulare. Facial flatness and anterior displacement of the temporomandibular joint, resulting from a relative retrusion of the nasomaxillary complex and a relative forward position of the mandible were also noted. These features that tend to cause a prognathic mandible and/or retruded midface indicate a morphologic predisposition of Asian populations for Class III malocclusion.

  5. Symptomatic cranial neuralgias in multiple sclerosis: clinical features and treatment. (United States)

    De Santi, Lorenzo; Annunziata, Pasquale


    In multiple sclerosis, neuropathic pain is a frequent condition, negatively influencing the overall quality of life. Cranial neuralgias, including trigeminal, glossopharyngeal neuralgias, as well as occipital neuralgia, are typical expression of neuropathic pain. Neuralgias are characterised by paroxysmal painful attacks of electric shock-like sensation, occurring spontaneously or evoked by innocuous stimuli in specific trigger areas. In multiple sclerosis, demyelination in the centrally myelinated part of the cranial nerve roots plays an important role in the origin of neuralgic pain. These painful syndromes arising in multiple sclerosis are therefore considered "symptomatic", in contrast to classic cranial neuralgias, in which no cause other than a neurovascular contact is identified. At this time, the evidence on the management of symptomatic cranial neuralgias in multiple sclerosis is fragmentary and a comprehensive review addressing this topic is still lacking. For that reason, treatment is often based on personal clinical experience as well as on anecdotal reports. The aim of this review is to critically summarise the latest findings regarding the pathogenesis, the diagnosis, the instrumental evaluation and the medical as well as neurosurgical treatment of symptomatic trigeminal, glossopharyngeal and occipital neuralgia in multiple sclerosis, providing useful insights for neurologists and neurosurgeons and a broad range of specialists potentially involved in the treatment of these painful syndromes.

  6. Cranial electrotherapy stimulation for treatment of anxiety, depression, and insomnia. (United States)

    Kirsch, Daniel L; Nichols, Francine


    Cranial electrotherapy stimulation is a prescriptive medical device that delivers a mild form of electrical stimulation to the brain for the treatment of anxiety, depression, and insomnia. It is supported by more than 40 years of research demonstrating its effectiveness in several mechanistic studies and greater than 100 clinical studies. Adverse effects are rare (electrotherapy stimulation may also be used as an adjunctive therapy.

  7. Cranial Radiation Therapy and Damage to Hippocampal Neurogenesis (United States)

    Monje, Michelle


    Cranial radiation therapy is associated with a progressive decline in cognitive function, prominently memory function. Impairment of hippocampal neurogenesis is thought to be an important mechanism underlying this cognitive decline. Recent work has elucidated the mechanisms of radiation-induced failure of neurogenesis. Potential therapeutic…

  8. Teaching Parents How to Prevent Acquired Cranial Asymmetry in Infants. (United States)

    Lennartsson, Freda; Nordin, Per; Wennergren, Göran


    Acquired cranial asymmetry is prevalent in infants today. This is largely attributed to the supine sleep position recommended for infant safety. The condition can become permanent, so prevention and early detection are important. A prevention project was initiated where guidelines for Swedish child health nurses were developed, tested in a pilot study, revised, and then incorporated into a short cranial asymmetry prevention program for nurses. The program included detailed information on what to teach parents of newborns. An intervention study was initiated where one group of nurses was taught according to the program and the other group followed the standard recommendations. The aim of this survey was to compare intervention and control group parents' responses regarding the cranial asymmetry prevention information that they had received from their nurses during their infant's first four months. Participants included 272 parents (180 intervention group, 92 control group) at 26 child health centers. A checklist was distributed to parents in conjunction with infants' four month health checkup. A significantly higher percentage of intervention group parents were aware of regular recommendations - alternate direction of the infant's head when putting the child to bed (82%: 64%, p=0.001), which pillow to use (92%: 80%, p=0.01), and when to remove the pillow (48%: 31%, p=0.006) - and five newly introduced recommendations compared to controls. Results indicate that educating child health nurses on prevention of cranial asymmetry works to increase parental awareness of what to do and how to do it safely.

  9. Postnatal cranial ultrasonographic findings in feto-fetal transfusion syndrome.

    NARCIS (Netherlands)

    Breysem, L.; Naulaers, G.; Deprest, J.; Schoubroeck, D.V.; Daniels, H.; Lammens, M.M.Y.; Smet, M.H.


    Our objective was a retrospective evaluation of cranial US in survivors of twin pregnancy with feto-fetal transfusion syndrome (FFTS), with knowledge of prenatal treatment and neonatal/postnatal clinical data. In 18 pregnancies with FFTS (January 1996 to May 2000), pregnancy management and outcome,

  10. Automatic Detection of Wild-type Mouse Cranial Sutures

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Darvann, Tron Andre; Hermann, Nuno V.;

    , automatic detection of the cranial sutures becomes important. We have previously built a craniofacial, wild-type mouse atlas from a set of 10 Micro CT scans using a B-spline-based nonrigid registration method by Rueckert et al. Subsequently, all volumes were registered nonrigidly to the atlas. Using...

  11. Association of fetal cranial shape with shoulder dystocia

    NARCIS (Netherlands)

    Belfort, M. A.; White, G. L.; Vermeulen, F. M.


    Objective To evaluate whether fetal cranial shape is related to shoulder dystocia. Methods We compared shoulder dystocia cases (n = 18) with controls (normal vaginal deliveries, n = 18) in a retrospective matched- pairs observational study. Subjects were matched for known maternal and fetal risk fac

  12. Zuigelingen met een scheef hoofd [Babies with cranial deformity

    NARCIS (Netherlands)

    Feijen, M.M.; Claessens, E.A.; Dovens, A.J.; Vles, J.S.; van der Hulst, R.R.


    Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet ther

  13. A reassessment of human cranial plasticity: Boas revisited. (United States)

    Sparks, Corey S; Jantz, Richard L


    In 1912, Franz Boas published a study demonstrating the plastic nature of the human body in response to changes in the environment. The results of this study have been cited for the past 90 years as evidence of cranial plasticity. These findings, however, have never been critiqued thoroughly for their statistical and biological validity. This study presents a reassessment of Boas' data within a modern statistical and quantitative genetic framework. The data used here consist of head and face measurements on over 8,000 individuals of various European ethnic groups. By using pedigree information contained in Boas' data, narrow sense heritabilities are estimated by the method of maximum likelihood. In addition, a series of t tests and regression analyses are performed to determine the statistical validity of Boas' original findings on differentiation between American and European-born children and the prolonged effect of the environment on cranial form. Results indicate the relatively high genetic component of the head and face diameters despite the environmental differences during development. Results point to very small and insignificant differences between European- and American-born offspring, and no effect of exposure to the American environment on the cranial index in children. These results contradict Boas' original findings and demonstrate that they may no longer be used to support arguments of plasticity in cranial morphology.

  14. Association of fetal cranial shape with shoulder dystocia

    NARCIS (Netherlands)

    Belfort, M. A.; White, G. L.; Vermeulen, F. M.


    Objective To evaluate whether fetal cranial shape is related to shoulder dystocia. Methods We compared shoulder dystocia cases (n = 18) with controls (normal vaginal deliveries, n = 18) in a retrospective matched- pairs observational study. Subjects were matched for known maternal and fetal risk fac

  15. The Forgotten Cranial Nereve - clinical importance of olfaction

    DEFF Research Database (Denmark)

    Fjældstad, Alexander; Clausen, Christian H; Kjærgaard, Thomas;


    Hyposmia is often undiagnosed despite the known negative effect on taste, appetite and life quality. However, a new focus on the first cranial nerve has emerged as a consequence of a discovered connection between neurodegenerative disorders and hyposmia. In Parkinson's disease and Alzheimer's dis...

  16. Spontaneous defects between the mastoid and posterior cranial fossa. (United States)

    Rereddy, Shruthi K; Mattox, Douglas E


    Conclusions Spontaneous defects between the mastoid and the posterior cranial fossa are exceedingly rare. Patients with these lesions may have a lower BMI compared to those with middle cranial fossa encephaloceles, but are otherwise demographically similar. This study recommends repair via a transtemporal approach to allow for examination of the entire posterior face of the temporal bone. Objective To describe cases of spontaneous posterior cranial fossa defects. Methods This study reviewed all cases of spontaneous posterior fossa defects presenting to a tertiary referral center over the last decade and described clinical presentation, imaging, operative findings, and outcomes. We also compared these lesions to those previously reported in the literature as well as the more common spontaneous encephaloceles of the middle cranial fossa. Results This study identified five cases with a mean age of 61.4 years, female-to-male ratio of 4:1, and a mean BMI of 31. Three cases presented with spontaneous pneumocephalus, one with CSF otorrhea, and one as an incidental imaging finding. Four defects were found medial to the sigmoid sinus and one was in the lateral retrosigmoid air cells.

  17. State of the art cranial ultrasound imaging in neonates

    NARCIS (Netherlands)

    Ecury-Goossen, Ginette M; Camfferman, Fleur A; Leijser, Lara M; Govaert, Paul; Dudink, Jeroen


    Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a patient is unstable. In addition it is radiation-free and allows serial imaging. CUS possibilities have steadily expanded. However, in many neonatal in

  18. Bony exostosis of the atlas with resultant cranial nerve palsy

    Energy Technology Data Exchange (ETDEWEB)

    Slavotinek, J.P.; Sage, M.R. (Flinders Medical Centre, Bedford Park (Australia). Dept. of Radiology); Brophy, B.P. (Flinders Medical Centre, Bedford Park (Australia). Dept. of Neurosurgery)


    A case of tenth and twelfth nerve compression secondary to a bony exostosis of the first cervical vertebra is described. This uncommon phenomenon serves to outline the importance of imaging the course of a cranial nerve when no intracranial abnormality is demonstrable on CT or MRI. The radiologic features of spinal osteochondromas are reviewed. (orig.).

  19. Cranial trauma and the assessment of posttraumatic survival time. (United States)

    Steyn, M; De Boer, H H; Van der Merwe, A E


    Assessment of trauma on skeletal remains can be very difficult, especially when it comes to the estimation of posttraumatic survival time in partially healed lesions. The ability to reliably estimate the time an individual has survived after sustaining an injury is especially important in cases of child abuse and torture, but can also aid in determining the association between an injury and eventual death. Here a case from South Africa is reported, where the skeletal remains of an unknown individual were found with cranial and scapular fractures. These fractures all presented with macroscopic features indicative of healing. Using recently published data on the timing of fractures by De Boer et al., the two sets of cranial trauma and the scapular fracture were assessed by means of radiology, histology and microCT scanning. This was primarily done in order to obtain more information on the events surrounding the death of this individual, but also to assess the usability of the published methods on cranial fractures. It was found that the initial trauma was most likely sustained at least two weeks before death, whilst a neurosurgical procedure was performed at least one week before death. It seems that cranial fractures, especially if stable, may show some different healing features than postcranial fractures. The individual has since been identified, but unfortunately as is often the case in South Africa, limited information is available and the medical records could not be found. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Cranial nerve development requires co-ordinated Shh and canonical Wnt signaling. (United States)

    Kurosaka, Hiroshi; Trainor, Paul A; Leroux-Berger, Margot; Iulianella, Angelo


    Cranial nerves govern sensory and motor information exchange between the brain and tissues of the head and neck. The cranial nerves are derived from two specialized populations of cells, cranial neural crest cells and ectodermal placode cells. Defects in either cell type can result in cranial nerve developmental defects. Although several signaling pathways are known to regulate cranial nerve formation our understanding of how intercellular signaling between neural crest cells and placode cells is coordinated during cranial ganglia morphogenesis is poorly understood. Sonic Hedgehog (Shh) signaling is one key pathway that regulates multiple aspects of craniofacial development, but whether it co-ordinates cranial neural crest cell and placodal cell interactions during cranial ganglia formation remains unclear. In this study we examined a new Patched1 (Ptch1) loss-of-function mouse mutant and characterized the role of Ptch1 in regulating Shh signaling during cranial ganglia development. Ptch1(Wig/ Wig) mutants exhibit elevated Shh signaling in concert with disorganization of the trigeminal and facial nerves. Importantly, we discovered that enhanced Shh signaling suppressed canonical Wnt signaling in the cranial nerve region. This critically affected the survival and migration of cranial neural crest cells and the development of placodal cells as well as the integration between neural crest and placodes. Collectively, our findings highlight a novel and critical role for Shh signaling in cranial nerve development via the cross regulation of canonical Wnt signaling.

  1. The clinical effect of nicorandil on perioperative myocardial protection in patients undergoing elective PCI: A Systematic Review and Meta-Analysis (United States)

    Ye, Ziliang; Su, Qiang; Li, Lang


    Many scholars have studied the effect of nicorandil on perioperative myocardial protection in patients undergoing elective percutaneous coronary intervention (PCI), but results are inconsistent. Therefore, we performed this meta-analysis. Finally, 16 articles, including 1616 patients, were included into this meta-analysis. Meta-analysis results showed that: (1) Nicorandil can reduce the level of CK-MB after PCI, including at 6 hours, 12 hours, 18 hours and 24 hours. (2) Nicorandil can reduce the level of TnT after PCI, including at 6 hours, 12 hours, 18 hours and 24 hours. (3) Nicorandil can reduce the incidence of adverse reactions after PCI. (4) Nicorandil cannot reduce the level of MVP after PCI, including at 12 hours and 24 hours. (5) Subgroup analysis showed that nicorandil can reduce CK-MB and TnT level at 24 hours after PCI for Chinese’s population (P  0.05). Our meta-analysis indicate that nicorandil can reduce myocardial injury and reduce the incidence of adverse reaction caused by PCI for Chinese’s population, but is not obvious for non Chinese’s population. However, this conclusion still needs to be confirmed in the future. PMID:28322321

  2. Myological variability in a decoupled skeletal system: batoid cranial anatomy. (United States)

    Kolmann, Matthew A; Huber, Daniel R; Dean, Mason N; Grubbs, R Dean


    Chondrichthyans (sharks, batoids, and chimaeras) have simple feeding mechanisms owing to their relatively few cranial skeletal elements. However, the indirect association of the jaws to the cranium (euhyostylic jaw suspension) has resulted in myriad cranial muscle rearrangements of both the hyoid and mandibular elements. We examined the cranial musculature of an abbreviated phylogenetic representation of batoid fishes, including skates, guitarfishes and with a particular focus on stingrays. We identified homologous muscle groups across these taxa and describe changes in gross morphology across developmental and functional muscle groups, with the goal of exploring how decoupling of the jaws from the skull has effected muscular arrangement. In particular, we focus on the cranial anatomy of durophagous and nondurophagous batoids, as the former display marked differences in morphology compared to the latter. Durophagous stingrays are characterized by hypertrophied jaw adductors, reliance on pennate versus fusiform muscle fiber architecture, tendinous rather than aponeurotic muscle insertions, and an overall reduction in mandibular kinesis. Nondurophagous stingrays have muscles that rely on aponeurotic insertions onto the skeletal structure, and display musculoskeletal specialization for jaw protrusion and independent lower jaw kinesis, relative to durophagous stingrays. We find that among extant chondrichthyans, considerable variation exists in the hyoid and mandibular muscles, slightly less so in hypaxial muscles, whereas branchial muscles are overwhelmingly conserved. As chondrichthyans occupy a position sister to all other living gnathostomes, our understanding of the structure and function of early vertebrate feeding systems rests heavily on understanding chondrichthyan cranial anatomy. Our findings highlight the incredible variation in muscular complexity across chondrichthyans in general and batoids in particular.

  3. Cranial suture biology of the Aleutian Island inhabitants. (United States)

    Cray, James; Mooney, Mark P; Siegel, Michael I


    Research on cranial suture biology suggests there is biological and taxonomic information to be garnered from the heritable pattern of suture synostosis. Suture synostosis along with brain growth patterns, diet, and biomechanical forces influence phenotypic variability in cranial vault morphology. This study was designed to determine the pattern of ectocranial suture synostosis in skeletal populations from the Aleutian Islands. We address the hypothesis that ectocranial suture synostosis pattern will differ according to cranial vault shape. Ales Hrdlicka identified two phenotypes in remains excavated from the Aleutian Island. The Paleo-Aleutians, exhibiting a dolichocranic phenotype with little prognathism linked to artifacts distinguished from later inhabitants, Aleutians, who exhibited a brachycranic phenotype with a greater amount of prognathism. A total of 212 crania representing Paleo-Aleuts and Aleutian as defined by Hrdlicka were investigated for suture synostosis pattern following standard methodologies. Comparisons were performed using Guttmann analyses. Results revealed similar suture fusion patterns for the Paleo-Aleut and Aleutian, a strong anterior to posterior pattern of suture fusion for the lateral-anterior suture sites, and a pattern of early termination at the sagittal suture sites for the vault. These patterns were found to differ from that reported in the literature. Because these two populations with distinct cranial shapes exhibit similar patterns of suture synostosis it appears pattern is independent of cranial shape in these populations of Homo sapiens. These findings suggest that suture fusion patterns may be population dependent and that a standardized methodology, using suture fusion to determine age-at-death, may not be applicable to all populations.

  4. Tolerance of cranial nerves of the cavernous sinus to radiosurgery

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    Tishler, R.B.; Loeffler, J.S.; Alexander, E. III; Kooy, H.M. (Harvard Medical School, Boston, MA (United States)); Lunsford, L.D.; Duma, C.; Flickinger, J.C. (Univ. of Pittsburgh Medical Center, PA (United States))


    Stereotactic radiosurgery is becoming a more accepted treatment option for benign, deep seated intracranial lesions. However, little is known about the effects of large single fractions of radiation on cranial nerves. This study was undertaken to assess the effect of radiosurgery on the cranial nerves of the cavernous sinus. The authors examined the tolerance of cranial nerves (II-VI) following radiosurgery for 62 patients (42/62 with meningiomas) treated for lesions within or near the cavernous sinus. Twenty-nine patients were treated with a modified 6 MV linear accelerator (Joint Center for Radiation Therapy) and 33 were treated with the Gamma Knife (University of Pittsburgh). Three-dimensional treatment plans were retrospectively reviewed and maximum doses were calculated for the cavernous sinus and the optic nerve and chiasm. Median follow-up was 19 months (range 3-49). New cranial neuropathies developed in 12 patients from 3-41 months following radiosurgery. Four of these complications involved injury to the optic system and 8 (3/8 transient) were the result of injury to the sensory or motor nerves of the cavernous sinus. There was no clear relationship between the maximum dose to the cavernous sinus and the development of complications for cranial nerves III-VI over the dose range used (1000-4000 cGy). For the optic apparatus, there was a significantly increased incidence of complications with dose. Four of 17 patients (24%) receiving greater than 800 cGy to any part of the optic apparatus developed visual complications compared with 0/35 who received less than 800 cGy (p = 0.009). Radiosurgery using tumor-controlling doses of up to 4000 cGy appears to be a relatively safe technique in treating lesions within or near the sensory and motor nerves (III-VI) of the cavernous sinus. The dose to the optic apparatus should be limited to under 800 cGy. 21 refs., 4 tabs.

  5. PCI-9111DG数据采集卡在液压元件CAT实验中的应用%Application of PCI-9111DG Data Acquisition Card in the CAT System Of Hydraulic Element

    Institute of Scientific and Technical Information of China (English)

    杨柳; 张国贤



  6. RuvBL2 is involved in histone deacetylase inhibitor PCI-24781-induced cell death in SK-N-DZ neuroblastoma cells.

    Directory of Open Access Journals (Sweden)

    Qinglei Zhan

    Full Text Available Neuroblastoma is the second most common solid tumor diagnosed during infancy. The survival rate among children with high-risk neuroblastoma is less than 40%, highlighting the urgent needs for new treatment strategies. PCI-24781 is a novel hydroxamic acid-based histone deacetylase (HDAC inhibitor that has high efficacy and safety for cancer treatment. However, the underlying mechanisms of PCI-24781 are not clearly elucidated in neuroblastoma cells. In the present study, we demonstrated that PCI-24781 treatment significantly inhibited tumor growth at very low doses in neuroblastoma cells SK-N-DZ, not in normal cell line HS-68. However, PCI-24781 caused the accumulation of acetylated histone H3 both in SK-N-DZ and HS-68 cell line. Treatment of SK-N-DZ with PCI-24781 also induced cell cycle arrest in G2/M phase and activated apoptosis signaling pathways via the up-regulation of DR4, p21, p53 and caspase 3. Further proteomic analysis revealed differential protein expression profiles between non-treated and PCI-24781 treated SK-N-DZ cells. Totally 42 differentially expressed proteins were identified by MALDI-TOF MS system. Western blotting confirmed the expression level of five candidate proteins including prohibitin, hHR23a, RuvBL2, TRAP1 and PDCD6IP. Selective knockdown of RuvBL2 rescued cells from PCI-24781-induced cell death, implying that RuvBL2 might play an important role in anti-tumor activity of PCI-24781 in SK-N-DZ cells. The present results provide a new insight into the potential mechanism of PCI-24781 in SK-N-DZ cell line.

  7. Experimental Comparison of Cranial Particulate Bone Graft, rhBMP-2, and Split Cranial Bone Graft for Inlay Cranioplasty. (United States)

    Hassanein, Aladdin H; Couto, Rafael A; Kurek, Kyle C; Rogers, Gary F; Mulliken, John B; Greene, Arin K


    Background :  Particulate bone graft and recombinant human bone morphogenetic protein-2 (rhBMP-2) are options for inlay cranioplasty in children who have not developed a diploic space. The purpose of this study was to determine whether particulate bone graft or rhBMP-2 has superior efficacy for inlay cranioplasty and to compare these substances to split cranial bone. Methods :  A 17 mm × 17 mm critical-sized defect was made in the parietal bones of 22 rabbits and managed in four ways: Group I (no implant; n=5), Group II (particulate bone graft; n=5), Group III (rhBMP-2; n=7), and Group IV (split cranial bone graft; n=5). Animals underwent microcomputed tomography and histologic analysis 16 weeks after cranioplasty. Results :  Defects without an implant (Group I) demonstrated inferior ossification (41.4%; interquartile range [IQR], 28.9% to 42.5%) compared to those treated with particulate bone graft (Group II: 99.5%; IQR, 97.8% to 100%), rhBMP-2 (Group III: 99.6%; IQR, 99.5% to 100%), or split cranial bone (Group IV: 100%) (P inlay calvarial defect areas equally, although the thickness of bone healed with rhBMP-2 is inferior. Clinically, particulate bone graft or split cranial bone graft may be superior to rhBMP-2 for inlay cranioplasty.

  8. Cultura politica di partito e cultura politica nazionale: il caso del Pci nella Prima Repubblica

    Directory of Open Access Journals (Sweden)

    Andrea Millefiorini


    Full Text Available In the paper we are explaining those aspects of the Italian Communist Party, that, thanks to the particular organized structure, contributed, in a meaningful way, to outline some characteristic features of the Italian political culture. There are four aspects of them: the first one was represented by a strong level of ideologism that for reaction and contamination passed from its main centre of diffusion (which was just the P.C.I to the other actors of the Italian party system, whose high level of ideologization produced models of interpretation of problems and of decisions, elaboration and planning, about not so much pragmatic plans; on the contrary, concerning rhetoric or propagandistic approaches.A second, relevant effect to which contributed in this case not only the political communist culture, we are analyzing above all from this point of view: it was constituted by the leadership exerced by the political parties that acquired in the symbolic values of the Italians universe as regards the other components of the Political system; the consequences of this situation we are going to analyze in the paper.A third element was the strong statalism which constituted the political culture of the country at least till the end of seventies.The fourth factor spread by the political communist culture was given by the egualitarianism. It assumed a relevant role at the organizing and structural level concerning the burocratic machinery; the values connected to it not always produced good results in efficiency, in resources optimization and productivity.

  9. 双显卡玩游戏 不要迷信PCI-E通道速度

    Institute of Scientific and Technical Information of China (English)




  10. The Observation on Efficacy of Angio-seal Closure Device in the Femoral Arterial Puncture Site after PCI

    Institute of Scientific and Technical Information of China (English)

    Zhang Bin; Jin Lijun; Wei Shuishen; Fang Xianhong; Wu Handong; Dong Taiming; Yan hong; Liao Hongtao


    Objective To evaluatereliability and safety of Angio-seal hemostasis device applied to the femoral arterial puncture site after percutaneous coronary intervention (PCI). Methods In 40 patients after PCI in our institute during the period between May 2002 and December 2003, Angioseal device were used to seal the femoral arterial puncture site. Results All the Angioseal devices were successfully deployed in 40 patients (successful rate:100%); the mean time to hemostasis was 45±12 sec;the mean time to ambulate after angioseal closure was 1.9±0.5 hours. No major groin and systemic complication was observed. There was minor groin oozing in 2 cases and small hemotoma in 1 patient.Conclusions Angio-seal closure device of the femoral artery puncture site after a percutaneous coronary procedure is safe. It can shorten the time to hemostasis,leads to early mobilization, and reduce groin complication. The disadvantage is relatively expensive.

  11. 七彩虹携手VIA推出国内首款K8 PCI-E平台

    Institute of Scientific and Technical Information of China (English)


    七彩虹近日推出了国内首款K8 PCI-E平台,基于VIA K8T890+VT8237R芯片组的“飞龙勇士C.K8T890 MAX”。此款主板支持Socket 939的Athlon64处理器、1GHz HyperTransport总线传输、双通道DDR400内存模式、x16 PCI—Express图形串行总线接口、4条x1 PCI Expreess串行接口、提供2个Serial ATA硬盘接口,

  12. The catalytic performance of Ru–NHC alkylidene complexes: PCy3 versus pyridine as the dissociating ligand

    Directory of Open Access Journals (Sweden)

    Stefan Krehl


    Full Text Available The catalytic performance of NHC-ligated Ru-indenylidene or benzylidene complexes bearing a tricyclohexylphosphine or a pyridine ligand in ring closing metathesis (RCM, cross metathesis, and ring closing enyne metathesis (RCEYM reactions is compared. While the PCy3 complexes perform significantly better in RCM and RCEYM reactions than the pyridine complex, all catalysts show similar activity in cross metathesis reactions.

  13. Routine diversion of patients with STEMI to high-volume PCI centres: modelling the financial impact on referral hospitals


    Pathak, Elizabeth Barnett; Comins, Meg M; Forsyth, Colin J.; Strom, Joel A


    Objective To quantify possible revenue losses from proposed ST-elevation myocardial infarction (STEMI) patient diversion policies for small hospitals that lack high-volume percutaneous coronary intervention (PCI) capability status (ie, ‘STEMI referral hospitals’). Background Negative financial impacts on STEMI referral hospitals have been discussed as an important barrier to implementing regional STEMI bypass/transfer protocols. However, there is little empirical data available that directly ...

  14. Direct Cranial Nerve Involvement by Gliomas: Case series and review of the literature (United States)

    Mabray, Marc C.; Glastonbury, Christine M.; Mamlouk, Mark D.; Punch, Gregory E.; Solomon, David A.; Cha, Soonmee


    Malignant gliomas are characterized by infiltrative growth of tumor cells, including along white matter tracts. This may result in clinical cranial neuropathy due to direct involvement of a cranial nerve rather than by leptomeningeal spread along cranial nerves. Gliomas directly involving cranial nerves III-XII are rare with only eleven cases reported in the literature prior to 2014, including eight with imaging. We present eight additional cases demonstrating direct infiltration of a cranial nerve by glioma. Asymmetric cisternal nerve expansion as compared to the contralateral nerve was noted with a mean length of involvement of 9.4 mm. Based on our case series, the key imaging feature to recognize direct cranial nerve involvement by a glioma is the detection of an intra-axial mass in the pons or midbrain that is directly associated with expansion, signal abnormality, and/or enhancement of the adjacent cranial nerve(s). PMID:25857757

  15. Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI. (United States)

    Sağ, Saim; Yıldız, Abdülmecit; Aydin Kaderli, Aysel; Gül, Bülent Cuma; Bedir, Ömer; Ceğilli, Ercan; Özdemir, Bülent; Can, Fatma Ezgi; Aydınlar, Ali


    Contrast induced nephropathy (CIN) has been proven to be a clinical condition related to adverse cardiovascular outcomes. In recent studies, the monocyte to high density lipoprotein ratio (MHR) has been postulated as a novel parameter associated with adverse renal and cardiovascular outcomes. In this study we investigated the association of MHR with CIN in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Consecutive STEMI patients treated with primary PCI were prospectively recruited. Subjects were categorized into two groups; as patients who developed CIN (CIN+) and patients who did not develop CIN (CIN-) during hospitalization. CIN was defined as either a 25% increase in serum creatinine from baseline or 44.20 µmol/L increase in absolute value, within 72 h of intravenous contrast administration. A total number of 209 patients were included in the study. Thirty-two patients developed CIN (15.3%). In the CIN (+) patients, monocytes were higher [1.02 (0.83-1.39) vs. 0.69 (0.53-0.90) 109/L, pMHR was significantly higher in the CIN (+) group [1.16 (0.89-2.16) vs. 0.72 (0.53-0.95) 109/mmol, pMHR, Mehran score, AGEF score and CV/eGFR were independently correlated with CIN. Higher MHR levels may predict CIN development after primary PCI in STEMI patients.

  16. Comparison in curative effects of facilitated PCI and primary PCI on acute myocardial infarction:a Meta-analysis%急性心肌梗死易化PCI与直接PCI治疗效果比较的Meta分析

    Institute of Scientific and Technical Information of China (English)

    朱张国; 刘廷筑; 李羚; 毛华; 文美


    Objective To review systematically the difference in curative effects and safety between facilitated PCI and primary PCI in the treatment of acute myocardial infarction (AMI). Methods The databases of Cochrane Library, PubMed, CBM and WangFang Database were retrieved for collecting randomized controlled trials (RCT) or clinical controlled trials (CCT) about the curative effects of facilitated PCI and primary PCI taken AMI as research objects. The outcomes were compared and given Meta-analysis by using RevMan4.2 software. Results There were totally 17 RCT included involving 1498 cases, and the results of Meta-analysis showed as follows:①Compared with primary PCI group, the patency rate of infarction related artery (IRA) before PCI was significantly higher in facilitated PCI group (OR=3.51, 95%CI:2.60-4.73), especially the TIMI 3 flow of IRA (OR=4.31, 95%CI:2.88-6.45). ②There were no statistical differences in mortality, incidence of cardiac events and no-reflow during hospitalization between two groups (OR=1.14, 95%CI:0.50-2.61;OR=1.05, 95%CI:0.60-1.84;OR=0.41, 95%CI:0.13-1.30). ③The amelioration of left ventricular ejection fraction (LVEF) was much better in facilitated PCI group than that in primary PCI group (WMD=4.89, 95%CI:1.49-7.44). Conclusion Facilitated PCI is safe and has better curative effect in the treatment of AMI compared with primary PCI indicated by current data. Because the quality of total included RCT is lower, more RCT with higher quality are required for further identifying the results.%目的:系统评价易化PCI与直接PCI治疗急性心肌梗死疗效和安全性的差异。方法检索1990年1月~2012年12月Cochrane图书馆、PUBMED、生物医学文献数据库、万方数据库,以急性心肌梗死为研究对象,比较易化PCI与直接PCI治疗效果的随机对照试验或临床对照试验文献,并对研究结果采用RevMan4.2软件进行Meta分析。结果共纳入17项研究结果,包括1498例患者。Meta

  17. Primitive neuroectodermal tumor presenting as a delayed sequela to cranial irradiation and intrathecal methotrexate

    Energy Technology Data Exchange (ETDEWEB)

    Barasch, E.S.; Altieri, D.; Decker, R.E.; Ahmed, S.; Lin, J.


    A patient developed a primitive neuroectodermal tumor (PNET) many years after therapeutic cerebral radiation and methotrexate treatment for leukemia. The differential radiologic and histologic diagnoses, as well as the possible co-oncogenic effects of radiation and methotrexate, are evaluated.

  18. [Complex diagnosis of congenital cranial dysostosis in children]. (United States)

    Iakubov, R K; Azimov, M I


    Ten patients (aged 3-15 years) with congenital cranial dysostosis were examined by a pediatrician, geneticist, gastroenterologist, neuropathologist, ophthalmologist, endocrinologist, and orthopaedist. In addition to the clinical signs characteristic of hereditary multiple developmental defects, the study revealed changes in the jaws and temporomandibular joint and local factors promoting the progress of deformations of the jaws. Manifest and inapparent pathological changes and dysfunctions in gastrointestinal organs were paralleled by dysfunctions of the central and autonomic nervous systems, risk of maxillofacial and general deformations, and signs of congenital disorders in calcium, lactic acid, and pyridoxine metabolism. The results necessitate analyses of the blood and urine and development of new methods for the diagnosis of congenital cranial dysostosis and improvement of methods for the correction of this condition.

  19. Cranial electrotherapy stimulation for the treatment of depression. (United States)

    Gunther, Mary; Phillips, Kenneth D


    More prevalent in women than men, clinical depression affects approximately 15 million American adults in a given year. Psychopharmaceutical therapy accompanied by psychotherapy and wellness interventions (e.g., nutrition, exercise, counseling) is effective in 80% of diagnosed cases. A lesser known adjunctive therapy is that of cranial electrotherapy stimulation (CES). The major hypothesis for the use of CES in depression is that it may reset the brain to pre-stress homeostasis levels. It is conjectured that the pulsed electrical currents emitted by cranial electrical stimulators affect changes in the limbic system, the reticular activating system, and/or the hypothalamus that result in neurotransmitter secretion and downstream hormone production. While evidence is good for applied research, basic research about the mechanisms of action for CES remains in its infancy. A review of the literature provides an overview of current research findings and implications for clinical mental health practice.

  20. Motonuclear changes after cranial nerve injury and regeneration. (United States)

    Fernandez, E; Pallini, R; Lauretti, L; La Marca, F; Scogna, A; Rossi, G F


    Little is known about the mechanisms at play in nerve regeneration after nerve injury. Personal studies are reported regarding motonuclear changes after regeneration of injured cranial nerves, in particular of the facial and oculomotor nerves, as well as the influence that the natural molecule acetyl-L-carnitine (ALC) has on post-axotomy cranial nerve motoneuron degeneration after facial and vagus nerve lesions. Adult and newborn animal models were used. Massive motoneuron response after nerve section and reconstruction was observed in the motonuclei of all nerves studied. ALC showed to have significant neuroprotective effects on the degeneration of axotomized motoneurons. Complex quantitative, morphological and somatotopic nuclear changes occurred that sustain new hypotheses regarding the capacities of motoneurons to regenerate and the possibilities of new neuron proliferation. The particularities of such observations are described and discussed.

  1. MR of acoustic neuromas; Relationship to cranial nerves

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Masayuki; Takashima, Tsutomu; Kadoya, Masumi; Takahashi, Shiroh; Miyayama, Shiroh; Taira, Sakae; Kashihara, Kengo; Yamashima, Tetsumori; Itoh, Haruhide (Kanazawa Univ. (Japan). School of Medicine)


    In this report, the relationship of acoustic neuromas to the adjacent cranial nerves is discussed. On T{sub 1}-weighted images, the trigeminal nerve was detected in all 13 cases. Mild to marked compression of these nerves by the tumors was observed in eight cases. The extent of compression did not always correspond to the clinical symptoms. In four cases with a maximum tumor diameter of 2 cm or less, the 7th and 8th cranial nerves were identified. There was no facial palsy in these patients. Two patients with a tumor diameter of more than 2 cm also had no facial palsy. All patients, including those with small tumors, complained of hearing loss and/or tinnitus. While MR imaging has some limitations, it is an effective imaging modality for showing the relationship between tumors and nerves. (author).

  2. Madurella mycetoma--a rare case with cranial extension. (United States)

    Maheshwari, Shradha; Figueiredo, Antonio; Narurkar, Swati; Goel, Atul


    Madurella species of fungus causes chronic subcutaneous infection of lower extremities; the infection is commonly labeled as Madura foot. We report a case of Madurella infection involving the cranial cavity. Such an involvement by Madurella fungal infection is not recorded in the literature. A 31-year-old non-immunocompromised male patient presented with complaints of left hemifacial pain for 1 year and diplopia on looking toward left side for a period of 2 weeks. On examination, he had ipsilateral sixth nerve paresis. Investigations revealed a large paranasal sinus lesion that extended in the cavernous sinus. The lesion was partially resected. Histologic examination revealed that the lesion was a fungus Madurella mycetomi. A rare cranial extension of Madurella fungal infection is reported. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  3. Distraction Osteogenesis Update: Introduction of Multidirectional Cranial Distraction Osteogenesis. (United States)

    Gomi, Akira; Sunaga, Ataru; Kamochi, Hideaki; Oguma, Hirofumi; Sugawara, Yasushi


    In this review, we discuss in detail our current procedure for treating craniosynostosis using multidirectional cranial distraction osteogenesis (MCDO). The MCDO method allows all phenotypes of skull deformity to be reshaped by distraction osteogenesis, except in patients who are 5 months of age or younger and patients with posterior cranial vault problems. We report the results of clinical data of 36 children with craniosynostosis who underwent MCDO between 2005 and 2014 in our institute. This method has the following benefits, such as a high flexibility of reshaping, shorter treatment period and less invasive secondary intervention. We also discuss the other distraction osteogenesis techniques that are used to treat craniosynostosis and compare them with MCDO. The preferred procedure for correction of craniosynostosis may depend on the patient's age, the extent of deformity, and the extent of correction achievable by surgery. We can arrange the combinations of various methods according to the advantage and disadvantage of each technique.

  4. Tracking modern human population history from linguistic and cranial phenotype. (United States)

    Reyes-Centeno, Hugo; Harvati, Katerina; Jäger, Gerhard


    Languages and genes arguably follow parallel evolutionary trajectories, descending from a common source and subsequently differentiating. However, although common ancestry is established within language families, it remains controversial whether language preserves a deep historical signal. To address this question, we evaluate the association between linguistic and geographic distances across 265 language families, as well as between linguistic, geographic, and cranial distances among eleven populations from Africa, Asia, and Australia. We take advantage of differential population history signals reflected by human cranial anatomy, where temporal bone shape reliably tracks deep population history and neutral genetic changes, while facial shape is more strongly associated with recent environmental effects. We show that linguistic distances are strongly geographically patterned, even within widely dispersed groups. However, they are correlated predominantly with facial, rather than temporal bone, morphology, suggesting that variation in vocabulary likely tracks relatively recent events and possibly population contact.

  5. Clinical characteristics and diagnostic imaging of cranial osteoblastoma. (United States)

    Pelargos, Panayiotis E; Nagasawa, Daniel T; Ung, Nolan; Chung, Lawrance K; Thill, Kimberly; Tenn, Stephen; Gopen, Quinton; Yang, Isaac


    Benign osteoblastoma is a rare, vascular, osteoid-forming bone tumor that occurs even less frequently in the cranial bones. Benign osteoblastoma of the cranium affects women slightly more often than men and typically presents in the first three decades of life. Although clinical presentation can vary depending on location, cranial osteoblastoma usually presents as a painful, non-mobile, subcutaneous mass or swelling. On CT scan, it generally presents as a well-demarcated, mixed lytic and sclerotic lesion, with enlarged diploe, thinning outer and/or inner tables, and varying degrees of calcification. It is hypo to isointense on T1-weighted MRI and has variable presentation on T2-weighted MRI. Gross total resection is the definitive treatment, while subtotal resection is utilized when it is necessary to preserve critical adjacent neurovascular structures.

  6. Use and outcomes of multivessel percutaneous coronary intervention in patients with acute myocardial infarction complicated by cardiogenic shock (from the EHS-PCI Registry). (United States)

    Bauer, Timm; Zeymer, Uwe; Hochadel, Matthias; Möllmann, Helge; Weidinger, Franz; Zahn, Ralf; Nef, Holger M; Hamm, Christian W; Marco, Jean; Gitt, Anselm K


    The value of multivessel percutaneous coronary intervention (MV-PCI) in patients with cardiogenic shock (CS) and multivessel disease (MVD) is still unclear because randomized controlled trials are missing. Therefore, we sought to evaluate the impact of MV-PCI on in-hospital outcomes of patients with MVD presenting with CS: 336 patients with acute myocardial infarction complicated by CS and ≥70% stenoses in ≥2 major epicardial vessels were included in this analysis of the Euro Heart Survey PCI registry. Patients undergoing MV-PCI (n = 82, 24%) were compared to those with single-vessel PCI (n = 254, 76%). The rate of 3-vessel disease (60% vs 57%, p = 0.63) was similar in the 2 cohorts. Presentation with resuscitation (48 vs 46%, p = 0.76) and ST-segment elevation myocardial infarction (83 vs 87%, p = 0.31) was frequent in patients with MV-PCI and single-vessel PCI. Patients with ventilation were more likely to receive MV-PCI (30% vs 19%, p = 0.05). There was a tendency toward a higher hospital mortality in patients with MV-PCI (48.8% vs 37.4%, p = 0.07). After adjustment for confounding variables, no significant difference for in-hospital mortality (odd ratio [OR] 1.28, 95% confidence interval [CI] 0.72 to 2.28) could be observed between the 2 groups. Age (OR 1.41, 95% CI 1.13 to 1.77), 3-vessel disease (OR 1.78, 95% CI 1.04 to 3.03), ventilation (OR 3.01, 95% CI 1.59 to 5.68), and previous resuscitation (OR 2.55, 95% CI 1.48 to 4.39) were independent predictors of hospital death. In conclusion, MV-PCI is currently used in only 1/4 of patients with CS and MVD. An additional nonculprit PCI was not associated with a survival benefit in these high risk patients.

  7. Value research on thromboelastogram(TEG) in the monitoring of platelet activity variation tendency of PCI surgery patients

    Institute of Scientific and Technical Information of China (English)

    Xing-Bin Zou; He Huang


    Objective:To discuss the value research on thromboelastogram (TEG) in the monitoring of platelet activity variation tendency of PCI surgery patients.Method:180 cases of patients with coronary heart disease who have proceeded PCI surgery were selected and divided into AMI group, UAP group and AP group. To compare the coagulation indicator, TEG and pathological changes of these three groups; all patients were adopted conventional therapy, after operation, divided them into anti-platelet low reaction group (platelet high reaction group) and normal group according to platelet aggregation rate monitored by TEG, and compared the clotting all items, clinical indicator, PCI postoperative platelet aggregation inhibition rate and clinical ischemia cases occurrence rate within 6 months follow up visit of both groups.Results: TEG parametric R value and K value in AMI group and UAP group were obviously lower than that in AP group, MA value and angle value were obviously higher than AP group, significant difference; TEG image in AMI group and UAP group mainly featured hypercoagulability, while TEG image had no hypercoagulability in AP group; Chi-square test showed that hypercoagulability image percentage differences between these three groups had statistical significance; ADP and AA induced platelet inhibition rate determined by TEG in high reaction group was obviously lower than that in normal group; 6 cases in platelet high reaction group: CK-MB rose and exceeded normal value upper limit (10.90%), 9 cases: cTnI rose and exceeded normal value upper limit (19.6%), compared with normal group (3 cases, 2.4%; 5 cases, 4%), the value in platelet high reaction group was higher, and the difference was significant; platelet high reaction group: totally 10 cases of ischemia, occurrence rate was 10.5%, while platelet normal reaction group: totally 3 cases (2.4%), chi-square test showed that the difference between these two groups had statistical significance


    Directory of Open Access Journals (Sweden)

    Mihai BERCA


    Full Text Available The Pedoclimatic Index (PCI calculated by us is the product between the Aridity Index (AR and the soil fertility status expressed through number of creditworthiness points (CWS – Creditworthiness of Soil: PCI = AR x CWS .Was used AR calculated after UNEP (United Nations Environment Programme instead of the older De Martonne index. Determinations were performed in 6 different pedoclimatic areas, in which PCI has varied from 12 to 47. Taking into account that AR varies between 0,20 and 1,00 in Romania, while CWS is between 0 and 100, theoretically PCI can range in the interval 0-100 and practically from 10 to 50. For each PCI was calculated the wheat production according to the Technological Processes Intensity (TPI, Creditworthiness (CWS, them also with marks from 1 to 10, and the wheat production pattern was made based on the two parameters. It appears that at a very reduced and reduced index of the technological processes (TPI between 1-4 the wheat yields level is very slightly influenced by the pedoclimatic quality of the culture area. In the areals of culture with PCI below 15 the production can’t reach 30 q/ha, irrespective of the quality of technological processes. At PCI of over 40 the production achieves 60 q/ha if there are applied superior technologies and if the working capital is optimum used. At PCI between 30 and 40 the maximum yield that can be reached in conditions of highest technical and qualitative value of production slightly exceeds 50 q/ha. All these models and nomograms are useful to agricultural management in order to estimate the production, but also for her optimization

  9. Effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after PCI

    Institute of Scientific and Technical Information of China (English)

    Jing Peng; Li Chen


    Objective:To study the effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after percutaneous coronary intervention (PCI).Methods:A total of 130 angina pectoris patients who received PCI treatment in our hospital from May 2012 to October 2015 were selected for study, patients' medical records were retrospectively analyzed, they were divided into the experimental group and the control group based on the different medication schemes after PCI, experimental group received routine treatment combined with salvianolate and meglumine adenosine cyclphosphate treatment after operation, and control group received conventional medical treatment after operation. The changes of perioperative blood viscosity, inflammatory factor and NT-proBNP content were compared between two groups.Results:After PCI, the blood viscosity indexes as well as inflammatory factor and NT-proBNP levels of experimental group were significantly lower than those before PCI (P0.05), inflammatory factor and NT-proBNP levels were significantly lower than those before PCI (P<0.05); 7 days after PCI, the high-shear whole blood viscosity, low-shear whole blood viscosity, plasma viscosity and aggregation index as well as TNF-α, sICAM-1, sVCAM-1, LP-PLA2, NT-proBNP, D-dimer and PTEN levels of experimental group were significantly lower than those of control group (P<0.05).Conclusions: Salvianolate combined with meglumine adenosine cyclphosphate can reduce the blood viscosity of patients with angina pectoris after PCI, and can also reduce inflammation and improve heart pump function.

  10. [Minor cranial injury: clinical, audiovestibular and medico-legal aspects]. (United States)

    Tripodi, D; D'Ambrosio, L; Palladino, V; Paduano, F


    Minor cranial trauma is a common pathology upon which there is no general agreement. This is why the verification and quantification of the damages should not depend on the analysis of subjective data and objective elements which are not quantifiable. By careful clinical and instrumental examination of 42 patients, the authors come to the conclusion that ENG and ABR can often provide objective and documentable data of clinical and forensic relevance.

  11. Severe cranial neuropathies caused by falls from heights in children. (United States)

    Zahavi, A; Luckman, J; Yassur, I; Michowiz, S; Goldenberg-Cohen, N


    Falls from heights are the most common traumatic event associated with emergency department visits in children. This study investigated the incidence and clinical course of cranial neuropathies caused by falls from heights in children. The computerized records of a tertiary pediatric medical center were searched for all patients admitted to the emergency department in 2004-2014 with a head injury caused by falling from a height. Those with cranial neuropathies involving optic and eye-motility disturbances were identified, and their clinical, imaging, and outcome data were evaluated. Of the estimated 61,968 patients who presented to the emergency department during the study period because of a fall, 18,758 (30.3 %) had head trauma. Only 12 (seven boys, five girls, average age 6.7 years) had a visual disturbance. Eight were diagnosed with traumatic optic neuropathy, one after a 6-month delay, including two with accompanying cranial nerve (CN) III injuries. Five patients had anisocoria or an abnormal pupillary response to light at presentation, one patient had CN VI paralysis and temporary vision loss, and one patient had an isolated CN III injury diagnosed on follow-up. Visual improvement varied among the patients. Cranial neuropathies due to falls from heights are rare in children and are associated with high visual morbidity. Vision or ocular motility impairment, especially monocular vision loss, may be missed during acute intake to the emergency department, and a high index of suspicion is needed. Assessment of the pupillary response to light is essential.

  12. Cranial magnetic resonance imaging in chronic demyelinating polyneuropathy.


    Hawke, S H; Hallinan, J M; McLeod, J G


    Twenty one patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and five patients with chronic demyelinating polyneuropathy associated with benign monoclonal paraproteinaemia none of whom had signs or symptoms of central nervous system disease, had cranial magnetic resonance imaging (MRI) on a 1.5 Tesla unit. Areas of increased white matter signal intensity were seen in one of 10 patients aged less than 50 years and in five of 16 patients aged more than 50 years. In ...

  13. Cranial skeletogenesis and osteology of the redeye tetra Moenkhausia sanctaefilomenae. (United States)

    Walter, B E


    The skeletogenesis and osteology of the syncranium of the redeye tetra Moenkhausia sanctaefilomenae is described. Skeletal development is rapid, with many elements of the chondrocranium and splanchnocranium well formed prior to the onset of ossification. The chondrocranium develops from an initial set of cartilaginous precursors, and continued elaboration proceeds from a series of processes which expand and converge to form the floor of the cranial vault, the otic capsule, the supraorbital bridge and the ethmoid region. Prodigious growth is observed for a number of splanchnocranial elements, including the Meckel's cartilage and the ceratohyal cartilage. Ossification occurs in overlapping phases with initial ossification of the jaws and neurocranial floor followed by the splanchnocranium, the supraorbital bridges and the ethmoid and cranial vault. Teeth are observed primarily on the premaxilla and dentary, while a single tooth is present on the maxilla. Particular cartilages, which had originally formed in the early larva, appear to degenerate and have no ossified representative in the adult syncranium. The cranial development for M. sanctaefilomenae is compared to those of other characiforms.

  14. Brief communication: Artificial cranial modification in Kow Swamp and Cohuna. (United States)

    Durband, Arthur C


    The crania from Kow Swamp and Cohuna have been important for a number of debates in Australian paleoanthropology. These crania typically have long, flat foreheads that many workers have cited as evidence of genetic continuity with archaic Indonesian populations, particularly the Ngandong sample. Other scientists have alleged that at least some of the crania from Kow Swamp and the Cohuna skull have been altered through artificial modification, and that the flat foreheads possessed by these individuals are not phylogenetically informative. In this study, several Kow Swamp crania and Cohuna are compared to known modified and unmodified comparative samples. Canonical variates analyses and Mahalanobis distances are generated, and random expectation statistics are used to calculate statistical significance for these tests. The results of this study agree with prior work indicating that a portion of this sample shows evidence for artificial modification of the cranial vault. Many Kow Swamp crania and Cohuna display shape similarities with a population of known modified individuals from New Britain. Kow Swamp 1, 5, and Cohuna show the strongest evidence for modification, but other individuals from this sample also show evidence of culturally manipulated changes in cranial shape. This project provides added support for the argument that at least some Pleistocene Australian groups were practicing artificial cranial modification, and suggests that caution should be used when including these individuals in phylogenetic studies.

  15. Heterochrony and developmental modularity of cranial osteogenesis in lipotyphlan mammals

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    Koyabu Daisuke


    Full Text Available Abstract Background Here we provide the most comprehensive study to date on the cranial ossification sequence in Lipotyphla, the group which includes shrews, moles and hedgehogs. This unique group, which encapsulates diverse ecological modes, such as terrestrial, subterranean, and aquatic lifestyles, is used to examine the evolutionary lability of cranial osteogenesis and to investigate the modularity of development. Results An acceleration of developmental timing of the vomeronasal complex has occurred in the common ancestor of moles. However, ossification of the nasal bone has shifted late in the more terrestrial shrew mole. Among the lipotyphlans, sequence heterochrony shows no significant association with modules derived from developmental origins (that is, neural crest cells vs. mesoderm derived parts or with those derived from ossification modes (that is, dermal vs. endochondral ossification. Conclusions The drastic acceleration of vomeronasal development in moles is most likely coupled with the increased importance of the rostrum for digging and its use as a specialized tactile surface, both fossorial adaptations. The late development of the nasal in shrew moles, a condition also displayed by hedgehogs and shrews, is suggested to be the result of an ecological reversal to terrestrial lifestyle and reduced functional importance of the rostrum. As an overall pattern in lipotyphlans, our results reject the hypothesis that ossification sequence heterochrony occurs in modular fashion when considering the developmental patterns of the skull. We suggest that shifts in the cranial ossification sequence are not evolutionarily constrained by developmental origins or mode of ossification.

  16. Hypertrophic cranial pachymeningitis in a patient with aplastic anemia. (United States)

    Asano, T; Hayashida, M; Ogawa, K; Adachi, K; Teramoto, A; Yamamoto, M


    We report on a 13-year old girl with severe aplastic anemia and hypertrophic cranial pachymeningitis. She was admitted to our hospital with severe headache and vomiting. A computerized tomographic (CT) scan of the brain on the third day of symptoms showed a hyperdense area in the tentorial region. Magnetic resonance imaging (MRI) showed iso-intensity in the same tentorial region in T1- and T2-weighted images, and gadolinium enhancement of this region suggested a thickened dura mater. Initially, a diagnosis of subdural or subarachnoid hemorrhage was made. Since her platelet count was low (3000/microl) making the patient a poor-risk candidate for surgery, and the area was limited to the dura mater, conservative therapy, including glycerol administration and platelet transfusion, was carried out. Despite clinical improvement 10 days after admission without specific therapy, the iso-intense region on the left side of the tentorial region remained unchanged on MRI. On the other hand, the iso-intense area on the right side of the tentorial region became hyperdense on T1-weighted MRI images and was also enhanced by gadolinium. Cerebrospinal fluid findings were normal except for slightly elevated protein at 62 mg/dl. A diagnosis of hypertrophic cranial pachymeningitis of the tentorial dura mater with hemorrhage on the right side was made. Although hypertrophic cranial pachymeningitis is a rare disease, it must be considered in the differential diagnosis of severe headache in a case of aplastic anemia.

  17. Cranial and mandibular morphometry in Leontopithecus Lesson, 1840 (Callitrichidae, primates). (United States)

    Burity, C H; Mandarim-De-Lacerda, C A; Pissinatti, A


    In this paper, we report on a craniometric analysis comparing the species of lion tamarins, Leontopithecus Lesson, 1840. Seventeen cranial and mandibular measures were taken on skulls of 59 adult crania: 20 L. rosalia (14 females and 6 males); 13 L. chrysomelas (6 females and 7 males); 23 L. chrysopygus (8 females and 15 males), and 3 L. caissara (1 female and 2 males). All specimens were from the Rio de Janeiro Primate Center (CPRJ-FEEMA, Brazil), except the specimens of L. caissara. Statistical treatment involved a one-way analysis of variance (the Bonferroni test) and discriminant analysis, comparing cranium and mandibles separately to determine variables which best distinguished groups and to group the specimens, using size corrected methods. The Mahalanobis distance was computed from the centroids of each group. Seven measures distinguished females of L. chrysopygus with L. rosalia, six to L. rosalia with L. chrysomelas, and L. chrysopygus with L. chrysomelas. In males, the numbers of measures statistically different were 5, 4, and 3 of the pairwise comparisons above mentioned. Cranial base length and orbital breadth were the only measures that were significantly different in all three dyads, considering both sexes. For the cranium, function 1 of the Discriminant Analysis accounted for 52.4% of the variance and function 2 accounted for 40.3%. Both functions exhibited a significant value for Wilks' lambda (PLeontopithecus. Despite of sample size, L. caissara shows morphological distances to L. chrysopygus in cranial analysis. However, other investigations are necessary to confirm this.

  18. Phylogeny, diet, and cranial integration in australodelphian marsupials.

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    Anjali Goswami

    Full Text Available Studies of morphological integration provide valuable information on the correlated evolution of traits and its relationship to long-term patterns of morphological evolution. Thus far, studies of morphological integration in mammals have focused on placentals and have demonstrated that similarity in integration is broadly correlated with phylogenetic distance and dietary similarity. Detailed studies have also demonstrated a significant correlation between developmental relationships among structures and adult morphological integration. However, these studies have not yet been applied to marsupial taxa, which differ greatly from placentals in reproductive strategy and cranial development and could provide the diversity necessary to assess the relationships among phylogeny, ecology, development, and cranial integration. This study presents analyses of morphological integration in 20 species of australodelphian marsupials, and shows that phylogeny is significantly correlated with similarity of morphological integration in most clades. Size-related correlations have a significant affect on results, particularly in Peramelia, which shows a striking decrease in similarity of integration among species when size is removed. Diet is not significantly correlated with similarity of integration in any marsupial clade. These results show that marsupials differ markedly from placental mammals in the relationships of cranial integration, phylogeny, and diet, which may be related to the accelerated development of the masticatory apparatus in marsupials.

  19. Surgical pitfalls with custom-made porous hydroxyapatite cranial implants

    Directory of Open Access Journals (Sweden)

    Bruno Zanotti


    Full Text Available Aim: Cranioplasty implants are used primarily in cases of surgical cranial decompression following pathological elevations of intracranial pressure. Available bone substitutes include porous hydroxyapatite (HA and polymethylmethacrylate. Whichever material is used, however, prosthetic cranial implants are susceptible to intra- and postsurgical complications and even failure. The aim of this study was to investigate such occurrences in HA cranioplasty implants, seeking not only to determine the likely causes (whether correlated or not with the device itself but also, where possible, to suggest countermeasures. Methods: We analyzed information regarding failures or complications reported in postmarketing surveillance and clinical studies of patients treated worldwide with custom-made HA cranial implants (Custom Bone Service Fin-Ceramica Faenza, Italy in the period 1997-2013. Results: The two most common complications were implant fractures (84 cases, 2.9% of the total fitted and infections (51 cases, 1.77%. Conclusion: Although cranioplasties are superficial and not difficult types of surgery, and use of custom-made implants are often considered the "easy" option from a surgical perspective, these procedures are nonetheless plagued by potential pitfalls. If performed well they yield more than satisfactory results from the points of view of both the patient and surgeon, but lack of appropriate care can open the door to numerous potential sources of failure, which can compromise-even irreparably-the ability to heal.

  20. Effect of rosuvastatin on serum cTNI, Cys-C, Hcy and myocardial enzyme, Inflammatory cytokines in acute myocardial infarction with PCI surgery

    Institute of Scientific and Technical Information of China (English)

    Na Shen; Zeng-Xin Yang


    Objective:To observe the effect of rosuvastatin on serum cTNI, Cys-C, Hcy and myocardial enzyme, inflammatory factors in acute myocardial infarction with percutaneous coronary intervention (PCI) surgery.Methods:A total of 80 patients with acute myocardial infarction were randomly divided into control group (40 cases) and experiment group (40 cases), the control group were given atorvastatin on the basis of basic therapy, and the experiment group were given rosuvastatin on the basis of basic therapy. The change of serum cTNI, Cys-C, Hcy, LDH, CK, CK-MB, IL-1β, IL-6, IL-17 in 24 hours and 8 weeks after PCI surgery of two groups were compared.Results:The serum cTNI, Cys-C, Hcy, LDH, CK, CK-MB, IL-1β, IL-6, IL-17 in 8 weeks after PCI surgery of two groups were significantly lower than that of 24 hours after PCI surgery (P<0.05). The serum cTNI, Cys-C, Hcy, LDH, CK, CK-MB, IL-1β, IL-6, IL-17 in 8 weeks after PCI surgery of experiment group were significantly lower than that of 8 weeks in control group (P<0.05).Conclusions: Rosuvastatin can significantly decrease the myocardial enzyme, inflammatory cytokines in acute myocardial infarction with PCI surgery. It plays an important role in protecting the heart function, reversing myocardial damage, and inhibiting cardiac remodeling.

  1. Motexafin gadolinium: gadolinium (III) texaphyrin, gadolinium texaphyrin, Gd-Tex, GdT2B2, PCI 0120. (United States)


    Motexafin gadolinium [gadolinium (III) texaphyrin, gadolinium texaphyrin, Gd-Tex, GdT2B2, PCI 0120] is a radiosensitising agent developed for use in cancer therapy. It is cytotoxic in haematological malignancies by selectively localising in cancer cells that have high rates of metabolism. Motexafin gadolinium inhibits cellular respiration resulting in the production of reactive oxygen species and inducing apoptosis. It is being developed by Pharmacyclics in the US. Bulk motexafin gadolinium is supplied to Pharmacyclics by the US company, Celanese, through a manufacturing and supply agreement between the two companies. In June 2003, at the 39th Annual Meeting of the American Society of Clinical Oncology (ASCO-2003), the importance of having an agent for the treatment of brain metastases from lung cancer was highlighted. Results of a phase III study were presented that showed that motexafin gadolinium treatment was associated with a delay in time to neurological and neurocognitive progression in lung cancer patients. This was an important finding, as 46.6% of lung cancer patients already have brain metastases at the time of initial diagnosis, compared with only 2.7% of breast cancer patients. Brain metastases are also often the only site of metastatic disease in patients with lung cancer. In December 2002, Pharmacyclics began a phase III trial of motexafin gadolinium in patients with brain metastases (brain cancer in phase table) from lung cancer in the US, Europe, Canada and Australia. The trial is known as the Study of neurologic progression with Motexafin gadolinium And Radiation Therapy (SMART) and will compare whole-brain irradiation with whole-brain irradiation plus motexafin gadolinium in 550 patients. The primary efficacy endpoint is time to neurological progression and the secondary endpoints are survival and neurocognitive function. In January 2003, the US FDA completed its Special Protocol Assessment (SPA) of the SMART trial with a positive result and by

  2. Preactivation of the quadriceps muscle could limit cranial tibial translation in a cranial cruciate ligament deficient canine stifle. (United States)

    Ramirez, Juan M; Lefebvre, Michael; Böhme, Beatrice; Laurent, Cédric; Balligand, Marc


    Cranial cruciate ligament (CrCL) deficiency is the leading cause of lameness of the canine stifle. Application of tension in the quadriceps muscle could trigger cranial tibial translation in case of CrCL rupture. We replaced the quadriceps muscle and the gastrocnemius muscle by load cells and turn-buckles. First, eight canine limbs were placed in a servo-hydraulic testing machine, which applied 50% of body weight (BW). In a second phase, the CrCL was transected, and the limbs were tested in a similar manner. In a third phase, a quadriceps pretension of 15% BW was applied and limbs were again tested in a similar manner. Cranial tibial translation was significantly decreased in CrCL deficient stifles (p quadriceps pretension was applied. These findings indicate that quadriceps pretension could play a role in the stability of a CrCL deficient stifle and should then be considered in rehabilitation programs and conservative treatment of CrCL rupture in dogs.

  3. Demonstration of the Safety and Feasibility of Robotically Assisted Percutaneous Coronary Intervention in Complex Coronary Lesions: Results of the CORA-PCI Study (Complex Robotically Assisted Percutaneous Coronary Intervention). (United States)

    Mahmud, Ehtisham; Naghi, Jesse; Ang, Lawrence; Harrison, Jonathan; Behnamfar, Omid; Pourdjabbar, Ali; Reeves, Ryan; Patel, Mitul


    The aims of this study were to evaluate the feasibility and technical success of robotically assisted percutaneous coronary intervention (R-PCI) for the treatment of coronary artery disease (CAD) in clinical practice, especially in complex lesions, and to determine the safety and clinical success of R-PCI compared with manual percutaneous coronary intervention (M-PCI). R-PCI is safe and feasible for simple coronary lesions. The utility of R-PCI for complex coronary lesions is unknown. All consecutive PCI procedures performed robotically (study group) or manually (control group) over 18 months were included. R-PCI technical success, defined as the completion of the procedure robotically or with partial manual assistance and without a major adverse cardiovascular event, was determined. Procedures ineligible for R-PCI (i.e., atherectomy, planned 2-stent strategy for bifurcation lesion, chronic total occlusion requiring hybrid approach) were excluded for analysis from the M-PCI group. Clinical success, defined as completion of the PCI procedure without a major adverse cardiovascular event, procedure time, stent use, and fluoroscopy time were compared between groups. A total of 315 patients (mean age 67.7 ± 11.8 years; 78% men) underwent 334 PCI procedures (108 R-PCIs, 157 lesions, 78.3% type B2/C; 226 M-PCIs, 336 lesions, 68.8% type B2/C). Technical success with R-PCI was 91.7% (rate of manual assistance 11.1%, rate of manual conversion 7.4%, rate of major adverse cardiovascular events 0.93%). Clinical success (99.1% with R-PCI vs. 99.1% with M-PCI; p = 1.00), stent use (stents per procedure 1.59 ± 0.79 with R-PCI vs. 1.54 ± 0.75 with M-PCI; p = 0.73), and fluoroscopy time (18.2 ± 10.4 min with R-PCI vs. 19.2 ± 11.4 min with M-PCI; p = 0.39) were similar between the groups, although procedure time was longer in the R-PCI group (44:30 ± 26:04 min:s vs. 36:34 ± 23:03 min:s; p = 0.002). Propensity-matched analysis confirmed that procedure time was longer


    Directory of Open Access Journals (Sweden)

    V. A. Sulimov


    Full Text Available Ambiguous data about comparability regarding clinical outcomes for prehospital thrombolysis, coupled with timely coronary angiography, and primary percutaneous coronary intervention (PCI in the early after acute ST-segment elevation myocardial infarction (STEMI, there are now.In the STREAM trial 1892 patients with STEMI diagnosed within 3 hours after onset of symptoms, and whom it was impossible to perform primary PCI within 1 h after the first medical contact, were randomly assigned into two treatment groups: a primary PCI b prehospital thrombolytic therapy with bolus tenecteplase (dose decreased by half in patients aged ≥75 years in combination with clopidogrel and enoxaparin followed by admission to the hospital, where it was possible to perform PCI. Emergency coronary angiography performed if thrombolysis failed. Coronary angiography and PCI of the infarct-related artery were performed in the period from 6 to 24 hours after randomization and thrombolytic therapy in the case of an effective thrombolysis. Primary endpoints include a composite of death, shock, congestive heart failure, or reinfarction up to 30 days.The primary endpoint occurred in 116 of 939 patients (12.4 % of the thrombolysis group and in 135 of 943 patients (14.3% of the primary PCI group (relative risk in the group thrombolysis 0.86, 95% confidence interval 0.68-1.09, p=0.21. Emergency angiography was required in 36.3% of patients in the thrombolysis, and the remaining patients, coronary angiography and PCI were performed at a mean of 17 hours after randomization and thrombolytic therapy. Thrombolysis group had more intracranial hemorrhages than primary PCI group (1.0% vs 0.2%, p=0.04; after correction protocol and dose reduction by half of tenecteplase in patients ≥75 years: 0.5% vs. 0.3%, p=0.45. The rate of non- intracranial bleeding in two treatment groups did not differ.Prehospital thrombolysis followed by coronary angiography and timely PCI provide effective


    Directory of Open Access Journals (Sweden)

    V. A. Sulimov


    Full Text Available Ambiguous data about comparability regarding clinical outcomes for prehospital thrombolysis, coupled with timely coronary angiography, and primary percutaneous coronary intervention (PCI in the early after acute ST-segment elevation myocardial infarction (STEMI, there are now.In the STREAM trial 1892 patients with STEMI diagnosed within 3 hours after onset of symptoms, and whom it was impossible to perform primary PCI within 1 h after the first medical contact, were randomly assigned into two treatment groups: a primary PCI b prehospital thrombolytic therapy with bolus tenecteplase (dose decreased by half in patients aged ≥75 years in combination with clopidogrel and enoxaparin followed by admission to the hospital, where it was possible to perform PCI. Emergency coronary angiography performed if thrombolysis failed. Coronary angiography and PCI of the infarct-related artery were performed in the period from 6 to 24 hours after randomization and thrombolytic therapy in the case of an effective thrombolysis. Primary endpoints include a composite of death, shock, congestive heart failure, or reinfarction up to 30 days.The primary endpoint occurred in 116 of 939 patients (12.4 % of the thrombolysis group and in 135 of 943 patients (14.3% of the primary PCI group (relative risk in the group thrombolysis 0.86, 95% confidence interval 0.68-1.09, p=0.21. Emergency angiography was required in 36.3% of patients in the thrombolysis, and the remaining patients, coronary angiography and PCI were performed at a mean of 17 hours after randomization and thrombolytic therapy. Thrombolysis group had more intracranial hemorrhages than primary PCI group (1.0% vs 0.2%, p=0.04; after correction protocol and dose reduction by half of tenecteplase in patients ≥75 years: 0.5% vs. 0.3%, p=0.45. The rate of non- intracranial bleeding in two treatment groups did not differ.Prehospital thrombolysis followed by coronary angiography and timely PCI provide effective

  6. Five-year outcomes of percutaneous versus surgical coronary revascularization in patients with diabetes mellitus (from the CREDO-Kyoto PCI/CABG Registry Cohort-2). (United States)

    Marui, Akira; Kimura, Takeshi; Nishiwaki, Noboru; Mitsudo, Kazuaki; Komiya, Tatsuhiko; Hanyu, Michiya; Shiomi, Hiroki; Tanaka, Shiro; Sakata, Ryuzo


    We investigated the impact of diabetes mellitus on long-term outcomes of percutaneous coronary intervention (PCI) in the drug-eluting stent era versus coronary artery bypass grafting (CABG) in a real-world population with advanced coronary disease. We identified 3,982 patients with 3-vessel and/or left main disease of 15,939 patients with first coronary revascularization enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2 (patients without diabetes: n = 1,984 [PCI: n = 1,123 and CABG: n = 861], and patients with diabetes: n = 1,998 [PCI: n = 1,065 and CABG: n = 933]). Cumulative 5-year incidence of all-cause death after PCI was significantly higher than after CABG both in patients without and with diabetes (19.8% vs 16.2%, p = 0.01, and 22.9% vs 19.0%, p = 0.046, respectively). After adjusting confounders, the excess mortality risk of PCI relative to CABG was no longer significant (hazard ratio [HR] 1.16; 95% confidence interval [CI] 0.88 to 1.54; p = 0.29) in patients without diabetes, whereas it remained significant (HR 1.31; 95% CI 1.01 to 1.70; p = 0.04) in patients with diabetes. The excess adjusted risks of PCI relative to CABG for cardiac death, myocardial infarction (MI), and any coronary revascularization were significant in both patients without (HR 1.59, 95% CI 1.01 to 2.51, p = 0.047; HR 2.16, 95% CI 1.20 to 3.87, p = 0.01; and HR 3.30, 95% CI 2.55 to 4.25, p <0.001, respectively) and with diabetes (HR 1.45, 95% CI 1.00 to 2.51, p = 0.047; HR 2.31, 95% CI 1.31 to 4.08, p = 0.004; and HR 3.70, 95% CI 2.91 to 4.69, p <0.001, respectively). There was no interaction between diabetic status and the effect of PCI relative to CABG for all-cause death, cardiac death, MI, and any revascularization. In conclusion, in both patients without and with diabetes with 3-vessel and/or left main disease, CABG compared with PCI was associated with better 5-year outcomes in terms of cardiac death, MI, and any coronary

  7. The Research and Implementation of Data Acquisition System Based on PC104 and FPGA%基于PCI04和FPGA的数据采集系统的研究和实现

    Institute of Scientific and Technical Information of China (English)

    程艳; 孙树敏; 张海涛; 李广磊; 袁帅; 赵鹏; 毛庆波


    In order to detect the operating state of the dynamic reactive power compensation devicein wind farm, the im plementation of data acquisition system,which is based on PCI04 and FPGA ,has been proposed. PCI04, which is the system host, is merely responsible for the function of date reception and procession ,network communication ,Human Machine Interface, etc.; FPGA, which is the auxiliary equipment, is mainly used to complete the synchronous collection of voltage and electric current signal, and then send the signals to PCI04 by PCI9054 , which is the interface chip of PCI. PCI04 and FPGA have implemented bidirectional data transmission through PCI9054. The connection between FPGA and four six-channel high-speed synchronous A/D can realize the synchronous acquisition of up to twenty-four channel analog.%为了检测风电场动态无功补偿装置的运行状态,提出了基于PCI04工控机和FPGA的数据采集系统的实现方法。以PCI04为系统主机,主要负责数据的接收与处理、网络通信,人机接口等功能;以FPGA为从机,主要完成电压、电流信号的同步采集并通过PCI接口芯片PCI9054传送至PCI04、PCI04和FPGA通过PCI9054实现双向数据传输。FPGA与四片六通道高速同步A/D连结,可以实现最多二十四路模拟量的同步采集。

  8. An unusual case of isolated sixth cranial nerve palsy in leprosy. (United States)

    Vaishampayan, Sanjeev; Borde, Priyanka


    Cranial nerve involvement is not common in leprosy. The fifth and seventh cranial nerves are the most commonly affected in leprosy. Herein we present a patient with Hansen disease (BL) with type I reaction who developed isolated involvement of the sixth cranial nerve leading to lateral rectus muscle palsy. He responded to timely anti-reactional therapy and it produced a good response. Careful observation of patients with lepra reaction is needed to avoid damage to important organs.

  9. Previous hypertensive hemorrhage increases the risk for bleeding and ischemia for PCI patients on dual antiplatelet therapy. (United States)

    Qiao, Manli; Bi, Qi; Fu, Paul; Wang, Yixin; Song, Zhe; Guo, Fang


    The use of antiplatelet therapy after intracerebral hemorrhage remains controversial, while the use of dual antiplatelet therapy (DAPT) is required after cardiac stenting. In this study, we examine the risk of bleeding and ischemic events for PCI patients with a history of hypertensive hemorrhage on DAPT. A total of 128 cases and 153 controls were selected from Chinese patients with cardiac stenting on dual anti-platelet therapy for a single-center retrospective case-control study. Patients with a history of hypertensive hemorrhage were selected for the case group, while patients with a history of hypertension were chosen as control. All patients were on aspirin 100 mg and clopidogrel 75 mg after cardiac stenting, and were followed for a duration of 12-48 months. The primary outcomes were intracerebral hemorrhage, major bleeding, and major adverse cardiovascular and cerebrovascular events. A history of previous hypertensive hemorrhage was not found to be a risk factor for intracerebral hemorrhage and major bleeding while on dual anti-platelet therapy. However, a history of either hypertensive hemorrhage or coronary artery disease was independently found to be risk factors for major adverse cardiovascular and cerebrovascular events. On sub-group analysis, patients with a history of hypertensive hemorrhage within 12 months were found to be at higher risk for bleeding on dual anti-platelet therapy, while patients with history of hypertensive hemorrhage outside of 12 months on dual anti-platelet therapy did not have the same increased risk. A history of hypertensive hemorrhage and coronary heart disease were two independent risk factors for major adverse cardiovascular and cerebrovascular events in PCI patients taking DAPT. A history of hypertensive hemorrhage less than 12 months had an increased risk for recurrent intracerebral hemorrhage and major bleeding in PCI patients taking DAPT.

  10. Characteristics and Outcomes of Patients with Acute Myocardial Infarction at Non-PCI Capable Hospitals in 2007 and in 2014

    Directory of Open Access Journals (Sweden)

    Egle Kalinauskiene


    Full Text Available Background. There is little known about whether characteristics and outcomes of patients with acute myocardial infarction (AMI have changed over the years in non-PCI capable hospitals in real-life. Our aim was to assess them between 2007 and 2014. Methods. It was a retrospective cohort study. Characteristics and in-hospital mortality (standardized in cases of different characteristics between the groups by original simple method were assessed for all patients with non-ST elevation myocardial infarction (NSTEMI and ST elevation myocardial infarction (STEMI at two non-PCI capable hospitals: one in 2007 (n=104 and another in 2014 (n=58. Results. In 2014, females were older than in 2007 (80.18 ± 7.54 versus 76.15 ± 8.77, p=0.011, males were younger (71.61 ± 11.22 versus 79.20 ± 7.63, p=0.019, less had renal failure (RF (19% versus 34.6%, p<0.0001 and reinfarction (13.8% versus 35.6%, p<0.0001, and the proportion of males (31% versus 43.3%, p=0.001 and the proportion of NSTEMI (60.3 versus 69.2, p<0.0001 decreased. In cases of STEMI there were no differences in patient characteristics. STEMI (18.8% versus 21.7% and standardized mortalities by gender, RF, and reinfarction NSTEMI (19.47%, 15.34%, and 17.5%, resp., versus 17.1% showed no differences between 2007 and 2014. Conclusions. There were some differences in patient characteristics but not in mortality for AMI at non-PCI capable hospitals between 2007 and 2014.

  11. Sensations experienced and patients' perceptions of osteopathy in the cranial field treatment. (United States)

    Mulcahy, Jane; Vaughan, Brett


    Osteopathy in the cranial field is an approach used by manual and physical therapists. However, there is minimal information in the literature about patient experiences of this treatment. The present study was undertaken to explore patients' experiences of osteopathy in the cranial field. Patients completed the Patient Perception Measure-Osteopathy in the Cranial Field and identified sensations they experienced during treatment. Additional measures of anxiety, depression, Satisfaction With Life, and Meaningfulness of Daily Activity were completed. The Patient Perception Measure-Osteopathy in the Cranial Field was internally consistent (Cronbach's α = .85). The most frequently experienced sensations of osteopathy in the cranial field patients were "relaxed," "releasing," and "unwinding." Satisfaction With Life and Meaningfulness of Daily Activity were positively associated with Patient Perception Measure-Osteopathy in the Cranial Field scores. Negative associations were observed between the Patient Perception Measure-Osteopathy in the Cranial Field and depression. Psychometric properties of the Patient Perception Measure-Osteopathy in the Cranial Field require further testing. The observed associations of Satisfaction With Life and depression with patients' perceptions of osteopathy in the cranial field treatment needs to be tested in larger clinical manual therapy cohorts.

  12. Risk of First and Recurrent Stroke in Childhood Cancer Survivors Treated With Cranial and Cervical Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Sabine, E-mail: [Department of Neurology, University of California, San Francisco, California (United States); Department of Pediatrics, University of California, San Francisco, California (United States); Department of Neurosurgery, University of California, San Francisco, California (United States); Sear, Katherine [Department of Neurology, University of California, San Francisco, California (United States); Hills, Nancy K. [Department of Neurology, University of California, San Francisco, California (United States); Department of Epidemiology and Biostatistics, University of California, San Francisco, California (United States); Chettout, Nassim [Department of Neurology, University of California, San Francisco, California (United States); Afghani, Shervin [Undergraduate Program, University of California, Berkeley, California (United States); Gastelum, Erica [School of Medicine, University of California, San Francisco, California (United States); Haas-Kogan, Daphne [Department of Radiation Oncology, University of California, San Francisco, California (United States); Fullerton, Heather J. [Department of Neurology, University of California, San Francisco, California (United States); Department of Pediatrics, University of California, San Francisco, California (United States)


    Purpose: To assess, in a retrospective cohort study, rates and predictors of first and recurrent stroke in patients treated with cranial irradiation (CRT) and/or cervical irradiation at ≤18 years of age. Methods and Materials: We performed chart abstraction (n=383) and phone interviews (n=104) to measure first and recurrent stroke in 383 patients who received CRT and/or cervical radiation at a single institution between 1980 and 2009. Stroke was defined as a physician diagnosis and symptoms consistent with stroke. Incidence of first stroke was number of first strokes per person-years of observation after radiation. We used survival analysis techniques to determine cumulative incidence of first and recurrent stroke. Results: Among 325 subjects with sufficient follow-up data, we identified 19 first strokes (13 ischemic, 4 hemorrhagic, 2 unknown subtype) occurring at a median age of 24 years (interquartile range 17-33 years) in patients treated with CRT. Imaging was reviewed when available (n=13), and the stroke was confirmed in 12. Overall rate of first stroke was 625 (95% confidence interval [CI] 378-977) per 100,000 person-years. The cumulative incidence of first stroke was 2% (95% CI 0.01%-5.3%) at 5 years and 4% (95% CI 2.0%-8.4%) at 10 years after irradiation. With each 100-cGy increase in the radiation dose, the stroke hazard increased by 5% (hazard ratio 1.05; 95% CI 1.01-1.09; P=.02). We identified 6 recurrent strokes; 5 had available imaging that confirmed the stroke. Median time to recurrence was 15 months (interquartile range 6 months-3.2 years) after first stroke. The cumulative incidence of recurrent stroke was 38% (95% CI 17%-69%) at 5 years and 59% (95% CI 27%-92%) at 10 years after first stroke. Conclusion: Cranial irradiation puts childhood cancer survivors at high risk of both first and recurrent stroke. Stroke prevention strategies for these survivors are needed.

  13. 基于PCI9118数据采集卡的车削力测量系统设计%The Design of the Cutting Force Measuring System Based on PCI 9118 Data Acquisition Card

    Institute of Scientific and Technical Information of China (English)



    采用基于应变片式测力仪、PCI9118数据采集卡及Visual Basic编程语言的车削力测量系统,实现了对采集来的切削数据的向间标定系数的基于一元线性回归方程的计算,并分析了数据的相关性;通过实际加工测量,利用标定系数得到了实际切削力的大小,求出了3个方向的关于进给量和背吃刀量的切削力经验公式,为车削加工提供了参考数据。%By using the cutting force measuring system based on strain gage type cutting dynamometer, PCI 9118 data acquisition card and Visual Basic programming language, this paper realizes the monadic linear regression equation based calculation of the interphase calibration coefficient of the collected cutting data, and analyzes the correlation of the data, and th ough the actual processing measurement, obtains the size of the actual cutting force by using the calibration coefficient, establishes the cutting force experience formulas of the cutting feed and back cutting depth on the three directions,providing the reference data for the lathe work.

  14. 基于PCI-1712数据采集卡的骨质疏松治疗仪上位软件设计%Software Design of the Osteoporosis Treatment Therapy Based on PCI-1712 Data Acquisition Card

    Institute of Scientific and Technical Information of China (English)

    王树东; 宋国辉; 高学洪; 周盛成; 王恒星; 何巍


    This article introduce a superior performance of multi-function high-speed acquisition card PCI-1712, and apply to the actual project osteoporosis treatment therapy control system. The paper mainly describe the system architecture and the software architecture and the design method in the VB environment, and the software realize remote control of the device, a variety of waveform output, data collection, data preservation functions and waveform display. The actual running shows that the control system is running stable, reliable, and present intelligent features, belong to the field of advanced medjcal products, with good prospects.%介绍了一款性能优越的多功能高速采集卡PCI-1712,并运用到实际项目骨质疏松治疗仪的控制系统中.主要阐述了系统的结构和在VB环境下软件的结构和设计方法,软件实现了对设备的远程控制、各种波形输出、数据的采集、数据的保存与波形显示等功能.实际运行表明,系统稳定、可靠、并呈现智能化特性,属于医疗领域先进产品,有着很好的发展前景.

  15. Influence of thrombus aspiration combined tirofiban on patients with acute STEMI after primary PCI%血栓抽吸联合替罗非班对急性 STEMI 直接 PCI 术后的影响

    Institute of Scientific and Technical Information of China (English)

    邓长金; 金露萍; 成威; 魏国政; 徐晓东; 邵玲; 彭娜


    Objective:To study the influence of thrombus aspiration combined tirofiban on patients with acute ST seg-ment elevation myocardial infarction (STEMI)after primary percutaneous coronary intervention (PCI).Methods:A total of 98 patients,who received primary PCI because of STEMI in our hospital from Jan 2012 to Mar 2013,were selected.They were divided into thrombus aspiration group (n=48,received pure thrombus aspiration)and com-bined treatment group (n = 50,received thrombus aspiration combined intracoronary tirofiban injection during PCI).Coronary angiography (CAG)instantly after PCI and follow-up condition during hospitalization and six months after discharge were compared between two groups.Results:(1)Compared with thrombus aspiration group after PCI,there were significant rise in TIMI blood flow grade [(2.3±0.6)grades vs.(2.7±0.3)grades],per-centage of TIMI flow grade 3 (72.9% vs.90.0%)and ST segment regression >50% rate within 90min after PCI (52.1% vs.74.0%),P < 0.05 or < 0.01,and significant reduction in percentage of postoperative no-reflow (18.8% vs.4.0%,P =0.038)in combined treatment group in hospital;(2)After six-month follow-up,left ven-tricular ejection fraction (LVEF)of combined treatment group was significantly higher than that of thrombus aspi-ration group [(58±6.3)% vs.(51±5.6)%,P <0.05].Conclusion:Thrombus aspiration combined tirofiban can effectively reduce coronary thrombus burden and improve cardiac function in STEMI patients during primary PCI.%目的:研究血栓抽吸联合使用替罗非班对急性 ST 段抬高型心肌梗死(STEMI)直接冠脉介入治疗术(PCI)术后的影响。方法:选择荆门市第一人民医院2012年1月至2013年3月因 STEMI 行直接 PCI 治疗患者98例,其中单纯行血栓抽吸48例 (血栓抽吸组),术中应用血栓抽吸联合冠脉内注入替罗非班50例(联合治疗组),比较两组患者术后即刻冠状动脉造影以及住院期间和出院后6个

  16. Interfaz para censar velocidad en un motor utilizando la tarjeta de adquisición de datos PCI-6025E; Interface for Measure Motor Velocity Used the Adquisition Target PCI-6025E

    Directory of Open Access Journals (Sweden)

    Roberto Garrido Díaz


    Full Text Available En este artículo se implementa la elaboración de una interfaz para censar la velocidad de un motor. Se utilizaun taco generador TDP 0,09 LT 3 que se encuentra acoplado al eje de un motor asincrónico y se elabora uncircuito electrónico impreso para adecuar la señal obtenida por este taco generador a una señal que puedaser interpretada por la tarjeta de adquisición de datos de National Instrument: PCI-6025E. Se plantea unpequeño ejemplo de la utilización de esta interfaz desde un instrumento virtual desarrollado en Labview 5.1sobre Linux .  Its article is about the implementation of an interface for measure motor velocity. Is used a TDP 0,09 LT 3tachogenerator  situated in the  asynchrony motor and is elaborated a printed electronic circuit to adequatethe censor signal to a signal that can be read  for  a PCI-6025E National Instrument acquisition target. Itsshow an example of  the used of  this interface from a software based in Labview 5.1 over Linux

  17. 基于PCI-1713模块的高速数据采集系统的设计%The high-speed data acquisition system based on PCI-1713 module design

    Institute of Scientific and Technical Information of China (English)



    数据采集指将模拟信号采集,转换成数字信号后,再由计算机进行存储、处理、显示和输出的过程。数据采集系统的(DAS)是模拟量与数字量之间的转换接口,在自动测试、通信、信号处理领域占有重要地位。本设计利用PCI-1713完成高速数据采集系统的设计。%Data acquisition refers to convert analog signal acquisition,into digital signal after,again by the computer for storage,processing,display and output of the process.Data acquisition system (DAS)is the conversion between analog and digital interface,the automatic testing,communications,occupies an important position in the field of signal processing.This design using the PCI - 1713 high speed data acquisition system design.

  18. Posterior cranial fossa arteriovenous fistula with presenting as caroticocavernous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Liu, H.M.; Shih, H.C.; Huang, Y.C.; Wang, Y.H. [Dept. of Medical Imaging, National Taiwan University Hospital, Taipei (Taiwan)


    We report cases of posterior cranial fossa arteriovenous fistula (AVF) with presenting with exophthalmos, chemosis and tinnitus in 26- and 66-year-old men. The final diagnoses was vertebral artery AVF and AVF of the marginal sinus, respectively. The dominant venous drainage was the cause of the unusual presentation: both drained from the jugular bulb or marginal sinus, via the inferior petrosal and cavernous sinuses and superior ophthalmic vein. We used endovascular techniques, with coils and liquid adhesives to occlude the fistulae, with resolution of the symptoms and signs. (orig.)

  19. Nonlinear dynamical model and response of avian cranial kinesis. (United States)

    Meekangvan, Preeda; A Barhorst, Alan; Burton, Thomas D; Chatterjee, Sankar; Schovanec, Lawrence


    All modern birds have kinetic skulls in which the upper bill can move relative to the braincase, but the biomechanics and motion dynamics of cranial kinesis in birds are poorly understood. In this paper, we model the dynamics of avian cranial kinesis, such as prokinesis and proximal rhynchokinesis in which the upper jaw pivots around the nasal-frontal (N-F) hinge. The purpose of this paper is to present to the biological community an approach that demonstrates the application of sophisticated predictive mathematical modeling tools to avian kinesis. The generality of the method, however, is applicable to the advanced study of the biomechanics of other skeletal systems. The paper begins with a review of the relevant biological literature as well as the essential morphology of avian kinesis, especially the mechanical coupling of the upper and lower jaw by the postorbital ligament. A planar model of the described bird jaw morphology is then developed that maintains the closed kinematic topology of the avian jaw mechanism. We then develop the full nonlinear equations of motion with the assumption that the M. protractor pterygoideus and M. depressor mandibulae act on the quadrate as a pure torque, and the nasal frontal hinge is elastic with damping. The mechanism is shown to be a single degree of freedom device due to the holonomic constraints present in the quadrate-jugal bar-upper jaw-braincase-quadrate kinematic chain as well as the quadrate-lower jaw-postorbital ligament-braincase-quadrate kinematic chain. The full equations are verified via simulation and animation using the parameters of a Grey Heron (Ardea cinerea). Next we develop a simplified analytical model of the equations by power series expansion. We demonstrate that this model reproduces the dynamics of the full model to a high degree of fidelity. We proceed to use the harmonic balance technique to develop the frequency response characteristics of the jaw mechanism. It is shown that this avian cranial

  20. Primary extra-cranial meningioma following total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, T.J.; Beggs, I. [Royal Infirmary, Department of Radiology, Edinburgh (United Kingdom); Patton, J.T.; Porter, D. [Royal Infirmary, Department of Orthopaedics, Edinburgh (United Kingdom); Salter, D.M.; Al-Nafussi, A. [Royal Infirmary, Department of Pathology, Edinburgh (United Kingdom)


    A 61-year-old man presented with pain at the left hip and decreased mobility 10 years after total hip replacement. Imaging demonstrated a large destructive expansile mass adjacent to the prosthesis. Histological analysis confirmed the presence of an extra-cranial meningioma. Primary tumours after total hip replacement are rare and include soft tissue sarcomas, bone sarcomas and lymphomas. To our knowledge, no previous cases of primary extracranial meningioma have been identified. The imaging features, histology, pathogenesis and differential diagnosis are discussed. (orig.)

  1. 水果补钾预防 PCI 围手术期低钾血症的效果观察%Effect of fruit potassium supplement on preventing hypokalemia at peri-PCI

    Institute of Scientific and Technical Information of China (English)

    吕丽君; 余同珍; 古良


      目的探讨水果补钾预防经皮冠状动脉支架植入术(percutanous coronary intervention,PCI)围手术期低钾血症的效果。方法选择2011年7~12月本院收治的90例低钾血症拟行PCI的冠心病患者,在常规口服药物补钾治疗基础上,给予吃橙子和香蕉,每天各吃500 g,分早、中、晚3次进食,持续至术前。观察患者入院时及手术当天、术后第1 d、第3 d 血钾情况。结果患者术前口服水果补钾时间为12~45 h,平均(28�84±11�70)h;患者手术当天及术后第1 d、第3 d 血钾水平比入院当天明显升高(均 P <0�05),而且维持在正常水平。结论进食香蕉和橙子可帮助患者快速纠正低钾血症,有效预防PCI 围手术期低钾血症。%  Objective To investigate the effects of fruit potassium supplement on hypokalemia at in the perioperative period of percutanous coronary intervention(PCI)� Methods Ninety cronary herat disease patients with hypokalemia undergoing PCI during July to December 2011 involved the study� Since admission,the patients were administered with oranges and bananas each 500 g daily until the third day after PCI,on the basis of oral administration of potassium� Serum potassium was assessed in all patients at time points of the day at PCI,the first day and third day after PCI� Results The time range for the patients to take potassium supplement by eating fruits was 12-45 hours,averaged(28�84 ± 11�70)hours� The serum potassium levels on days 1 and 3 were significantly higher than that on the day for the admission(P < 0�05 for both)and even maintained at the normal level� Conclusion The oral complement of potassium by eating bananas and oranges can help patients to correct and prevent hypokalemia during the perioperative period of PCI�

  2. Identification and Treatment of Psychological Disorders during the Perioperative Period of PCI%PCI术前术后的心理障碍识别与处理

    Institute of Scientific and Technical Information of China (English)

    陶贵周; 毛慧子


    This article outlines the high incidence of coronary heart disease with psychological disorders during percutaneous coronary intervention (PCI) . These psychological disorders influence on development and prognosis of coronary heart disease ,This article analyzes the causes ,mechanisms and factors of anxiety ,depression and other psychological disorders in patients during the operation of PCI .It is high time to appeal heart physicians identify the psychological disorders in patients during PCI .Treat these symptoms by psychology and psychiatry combine cardiovascular medical treatment .That is so-called psychocardiacology .We should diagnosis and treat the patient who had a not obvious curative efficacy treated by PCI and cardiovascular medicine with psychology and psychiatry .In this way ,we can facilitate the rehabilitation and prognosis of patients undergoing PCI ,meanwhile reduce unnecessary medical examination and treatment .%概述冠心病经皮冠状动脉介入治疗(PCI)术前术后患者合并心理障碍的较高发生率以及心理障碍对冠心病发生、发展及预后的影响,分析 PCI 术前术后患者出现焦虑抑郁等心理障碍的原因、产生机制及影响因素,强调心内科医生应及时识别 PCI 术前术后患者出现的心理障碍,并以“双心医学”方式对其进行心理精神医学及心血管专科医学治疗,同时对心血管专科医学治疗效果不明显的冠心病 PCI 患者,进行相关的鉴别诊断后也要进行心理精神医学的诊断和治疗,以便有利于 PCI 术患者的康复和预后,减少不必要的检查和治疗。

  3. P53 regulates disruption of neuronal development in the adult hippocampus after irradiation (United States)

    Li, Y-Q; Cheng, ZW-C; Liu, SK-W; Aubert, I; Wong, C S


    Inhibition of hippocampal neurogenesis is implicated in neurocognitive dysfunction after cranial irradiation for brain tumors. How irradiation results in impaired neuronal development remains poorly understood. The Trp53 (p53) gene is known to regulate cellular DNA damage response after irradiation. Whether it has a role in disruption of late neuronal development remains unknown. Here we characterized the effects of p53 on neuronal development in adult mouse hippocampus after irradiation. Different bromodeoxyuridine incorporation paradigms and a transplantation study were used for cell fate mapping. Compared with wild-type mice, we observed profound inhibition of hippocampal neurogenesis after irradiation in mice deficient in p53 despite the absence of acute apoptosis of neuroblasts. The putative neural stem cells were apoptosis resistant after irradiation regardless of p53 genotype. Cell fate mapping using different bromodeoxyuridine incorporation paradigms revealed enhanced activation of neural stem cells and their consequential exhaustion in the absence of p53 after irradiation. Both p53-knockout and wild-type mice demonstrated similar extent of microglial activation in the hippocampus after irradiation. Impairment of neuronal differentiation of neural progenitors transplanted in irradiated hippocampus was not altered by p53 genotype of the recipient mice. We conclude that by inhibiting neural progenitor activation, p53 serves to mitigate disruption of neuronal development after irradiation independent of apoptosis and perturbation of the neural stem cell niche. These findings suggest for the first time that p53 may have a key role in late effects in brain after irradiation.

  4. Comparison between 3-dimensional cranial ultrasonography and conventional 2-dimensional cranial ultrasonography in neonates: impact on reinterpretation. (United States)

    Kim, Yu Jin; Choi, Young Hun; Cho, Hyun Hae; Lee, So Mi; Park, Ji Eun; Cheon, Jung-Eun; Kim, Woo Sun; Kim, In-One


    The aim of this study was to evaluate impact of 3-dimensional cranial ultrasonography (3DUS) on reinterpretation of cranial ultrasonography images in neonates in comparison with 2-dimensional cranial ultrasonography (2DUS). We retrospectively enrolled 50 consecutive young infants who simultaneously underwent both 2DUS and 3DUS scanning from February to March 2015. Two pediatric radiologists independently reviewed both scans for overall image quality on a 5-point scale. Five features were evaluated in both scans: the presence of germinal matrix hemorrhage (GMH), intraventricular hemorrhage (IVH), ventriculomegaly (VM), abnormality of periventricular echogenicity (PVE), and focal parenchymal lesions (FL). The concordance rate between the two scanning modes was calculated. The confidence level for each finding on a 3-point scale and the scanning time were compared between the two scanning modes. Interobserver agreement was evaluated using kappa statistics. Both scans demonstrated similar overall image quality in terms of reinterpretation (range of mean values, 3.81 to 4.02). GMH, IVH, VM, and FL showed perfect concordance, while PVE showed a concordance rate of 91.4% between the two modes by both reviewers. 3DUS was associated with a higher diagnostic confidence in the evaluation of GMH, IVH, and FL than 2DUS (P<0.05) for both reviewers. For PVE, 3DUS received a significantly higher confidence score than 2DUS from one of the reviewers. The mean scanning time for 2DUS and 3DUS was 92.75 seconds and 36 seconds, respectively. Interobserver agreement for qualitative scoring was moderate to substantial. In reinterpretation, 3DUS showed very high concordance with 2DUS and a similar image quality. 3DUS also increased diagnostic confidence for several image findings and significantly decreased scan time.

  5. Defining the optimal window for cranial transplantation of human induced pluripotent stem cell-derived cells to ameliorate radiation-induced cognitive impairment. (United States)

    Acharya, Munjal M; Martirosian, Vahan; Christie, Lori-Ann; Riparip, Lara; Strnadel, Jan; Parihar, Vipan K; Limoli, Charles L


    Past preclinical studies have demonstrated the capability of using human stem cell transplantation in the irradiated brain to ameliorate radiation-induced cognitive dysfunction. Intrahippocampal transplantation of human embryonic stem cells and human neural stem cells (hNSCs) was found to functionally restore cognition in rats 1 and 4 months after cranial irradiation. To optimize the potential therapeutic benefits of human stem cell transplantation, we have further defined optimal transplantation windows for maximizing cognitive benefits after irradiation and used induced pluripotent stem cell-derived hNSCs (iPSC-hNSCs) that may eventually help minimize graft rejection in the host brain. For these studies, animals given an acute head-only dose of 10 Gy were grafted with iPSC-hNSCs at 2 days, 2 weeks, or 4 weeks following irradiation. Animals receiving stem cell grafts showed improved hippocampal spatial memory and contextual fear-conditioning performance compared with irradiated sham-surgery controls when analyzed 1 month after transplantation surgery. Importantly, superior performance was evident when stem cell grafting was delayed by 4 weeks following irradiation compared with animals grafted at earlier times. Analysis of the 4-week cohort showed that the surviving grafted cells migrated throughout the CA1 and CA3 subfields of the host hippocampus and differentiated into neuronal (∼39%) and astroglial (∼14%) subtypes. Furthermore, radiation-induced inflammation was significantly attenuated across multiple hippocampal subfields in animals receiving iPSC-hNSCs at 4 weeks after irradiation. These studies expand our prior findings to demonstrate that protracted stem cell grafting provides improved cognitive benefits following irradiation that are associated with reduced neuroinflammation.

  6. Interfase para censar temperatura en un motor utilizando la tarjeta de adquisición de datos PCI-6025E

    Directory of Open Access Journals (Sweden)

    Roberto Garrido Díaz


    Full Text Available Se implementa la elaboración de una interfase para censar la temperatura de un motor . Se utiliza un censorPhilips KTY84-130 colocado en el interior de un motor asincrónico y se elabora un circuito electrónico impresopara adecuar la señal obtenida por este censor a una señal que pueda ser interpretada por la tarjeta de adquisiciónde datos de National Instrument: PCI-6025E. Se confeccionan software desarrollados en Labview 5.1 sobreLinux , para el diseño y ajuste del circuito impreso y se plantea un pequeño ejemplo de la utilización de estainterfase desde un instrumento virtual desarrollado en Labview 5.1 sobre Linux.  Its article is about the implementation of a temperature censor interface for measure motor temperature. Is useda Philips KTY84-130 censor situated inside of an asynchrony motor an is elaborated an printed electronic circuitto adequate the censor signal   to a signal that can be read  for  a PCI-6025E National Instrument acquisitiontarget. Is been construed a   software based in  Labview 5.1 over Linux.

  7. Effect of small dose of EPO after PCI on cardiac function and myocardial injury in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Guo-Min Li


    Objective:To study the effect of small dose of erythropoietin (EPO) after PCI on cardiac function and myocardial injury in patients with acute myocardial infarction.Methods:A total of 86 patients with acute ST-elevation myocardial infarction who received percutaneous coronary intervention in our hospital from April 2012 to June 2015 were selected and randomly divided into EPO group and control group, serum was collected 1 week after operation to determine myocardial injury indexes, inflammation indexes, oxidative stress indexes and ventricular remodeling indexes, and color Doppler echocardiography was conducted 6 months after surgery to determine ventricular systolic and diastolic function indexes.Results:One week after operation, serum LDH, CK, CK-MB, cTnI, cTnT, sCD40L, E-selectin, P-selectin, sICAM-1, MDA, O2-, ox-LDL, PICP, CITP and PIIINP levels of EPO group were significantly lower than those of control group while GSH-Px and SOD levels were significantly higher than those of control group; 6 months after operation, LVEF of EPO group was significantly higher than that of control group while LVEDVI and LVESVI were significantly lower than those of control group.Conclusions:Small dose of EPO after PCI can alleviate myocardial damage, relieve inflammation and oxidative stress, and improve myocardial remodeling and cardiac diastolic and systolic function in patients with AMI.

  8. Emergency percutaneous coronary intervention (PCI) for the care of patients with ST-elevation myocardial infarction (STEMI). (United States)

    Morrison, D A; Berman, M; El-Amin, O; McLaughlin, R T; Bates, E R


    There is general consensus that emergency percutaneous coronary intervention (PCI) is the preferred treatment for patients with ST-elevation myocardial infarction (STEMI), so long as it can be delivered in a timely fashion, by an experienced' operator and cardiac catheterization laboratory (CCL) team. STEMI is both a functional and structural issue. Although it has been recognized since the work of pioneering cardiologists and surgeons in Spokane, Washington, that approximately 88% of patients presenting within 6 hours of onset of STEMI have an occluded coronary artery, it is the pathophysiology of myocardial necrosis, and the varied consequences of necrosis that characterize STEMI. Accordingly, experience' of both primary operator and cardiac catheterization laboratory (CCL) crew, in performing an emergency PCI for STEMI, are as much a function of experience with the treatment of complex MI patients, as experience with coronary intervention. Rapidly achieving normal coronary artery flow, at both the macro and micro vascular levels, is the recognized key to aborting the otherwise progressive wavefront' of myocardial necrosis. The time urgency of decisions (Time is muscle') make emergency PCI for patients with on-going necrosis, more like emergency room (ER) care, than like most in-hospital or outpatient care. In general, most patients with acute coronary syndromes (ACS) are currently thought to have plaque rupture and/or erosion with subsequent thrombosis and embolization. Consequences of thrombo-embolism, such as slow flow' or no-reflow' are in addition to, the structural (anatomic) considerations of PCI in stable patients (such as ostial location; bifurcation involvement; heavy calcification; tortuosity of lesion or access to it; length of disease; caliber of infarct-artery; etc.). Good quality studies have provided strong support for the specific added value of glycoprotein IIb/IIIa inhibitors (especially abciximab), dual antiplatelet therapy (the addition of

  9. Exploring vocal recovery after cranial nerve injury in Bengalese finches. (United States)

    Urbano, Catherine M; Peterson, Jennifer R; Cooper, Brenton G


    Songbirds and humans use auditory feedback to acquire and maintain their vocalizations. The Bengalese finch (Lonchura striata domestica) is a songbird species that rapidly modifies its vocal output to adhere to an internal song memory. In this species, the left side of the bipartite vocal organ is specialized for producing louder, higher frequencies (≥2.2kHz) and denervation of the left vocal muscles eliminates these notes. Thus, the return of higher frequency notes after cranial nerve injury can be used as a measure of vocal recovery. Either the left or right side of the syrinx was denervated by resection of the tracheosyringeal portion of the hypoglossal nerve. Histologic analyses of syringeal muscle tissue showed significant muscle atrophy in the denervated side. After left nerve resection, songs were mainly composed of lower frequency syllables, but three out of five birds recovered higher frequency syllables. Right nerve resection minimally affected phonology, but it did change song syntax; syllable sequence became abnormally stereotyped after right nerve resection. Therefore, damage to the neuromuscular control of sound production resulted in reduced motor variability, and Bengalese finches are a potential model for functional vocal recovery following cranial nerve injury.

  10. Posterior cranial base natural growth and development: A systematic review. (United States)

    Currie, Kris; Sawchuk, Dena; Saltaji, Humam; Oh, Heesoo; Flores-Mir, Carlos; Lagravere, Manuel


    To provide a synthesis of the published studies evaluating the natural growth and development of the human posterior cranial base (S-Ba). The search was performed on MEDLINE, Embase, PubMed, and all EBM Reviews electronic databases. In addition, reference lists of the included studies were hand-searched. Articles were included if they analyzed posterior cranial-base growth in humans specifically. Study selection, data extraction, and risk of bias assessment were completed in duplicate. A meta-analysis was not justified. Finally, 23 published studies were selected: 5 cross-sectional and 18 cohort studies. Articles were published between 1955 and 2015, and all were published in English. The sample sizes varied between 20 and 397 individuals and consisted of craniofacial measurements from either living or deceased human skulls. Validity of the measurements was not determined in any of the studies, while six papers reported some form of reliability assessment. All the articles included multiple time points within the same population or data from multiple age groups. Growth of S-Ba was generally agreed to be from spheno-occipital synchondrosis growth. Basion displaced downward and backward and sella turcica moved downward and backward during craniofacial growth. Timing of cessation of S-Ba growth was not conclusive due to limited identified evidence. Current evidence suggests that S-Ba is not totally stable, as its dimensions change throughout craniofacial growth and a minor dimensional change is observed even in late adulthood.

  11. Biomechanical Dynamics of Cranial Sutures during Simulated Impulsive Loading

    Directory of Open Access Journals (Sweden)

    Z. Q. Zhang


    Full Text Available Background. Cranial sutures are deformable joints between the bones of the skull, bridged by collagen fibres. They function to hold the bones of the skull together while allowing for mechanical stress transmission and deformation. Objective. The aim of this study is to investigate how cranial suture morphology, suture material property, and the arrangement of sutural collagen fibres influence the dynamic responses of the suture and surrounding bone under impulsive loads. Methods. An idealized bone-suture-bone complex was analyzed using a two-dimensional finite element model. A uniform impulsive loading was applied to the complex. Outcome variables of von Mises stress and strain energy were evaluated to characterize the sutures’ biomechanical behavior. Results. Parametric studies revealed that the suture strain energy and the patterns of Mises stress in both the suture and surrounding bone were strongly dependent on the suture morphologies. Conclusions. It was concluded that the higher order hierarchical suture morphology, lower suture elastic modulus, and the better collagen fiber orientation must benefit the stress attenuation and energy absorption.

  12. Recurring fibrous dysplasia of anthro maxillary with cranial base invasion

    Directory of Open Access Journals (Sweden)

    Sousa, Kátia Maria Marabuco de


    Full Text Available Introduction: Fibrous dysplasia is an osseous lesion with an unknown etiology. It is characterized by the osseous maturation insufficiency. It may affect any bone, but the affection of craniofacial bones is the most critical for otorhinolaryngology. Maxilla is the most affected facial bone and the orbitary invasion is an uncommon event. The symptoms are unspecific and for its low suspicion and uncommonness, the diagnosis is generally late. The monostotic form presents a slow growth and asymptomatic course and needs to be followed up. The polyostotic type has a progressive behavior and is associated to recurrence and complications. Objective: To present two cases of patients with fibrous dysplasia diagnosis and describe the clinical presentation, radiological findings and the treatment of this pathology. Cases Report: Two cases of fibrous dysplasia are reported, which initially presented unspecific symptomatology, but with characteristic radiologic signs. They were submitted to surgical treatment for resection of the lesions and evolved with frequent recurrences with extensive affection of the facial sinuses, one patient had cranial base invasion and frontal craniotomy was needed for tumoral excision. Final Comments: Fibrous dysplasia is an uncommon osteopathy. The tomography is the choice method for characterization of the tumoral expansion, and helps in the surgical planning. The surgical strategy is indicated for symptomatic lesions, functions alterations or anatomic disorders. This article describes two uncommon manifestations of recurrent fibrous dysplasia with an extensive affection of anthro maxillary, ethmoidal and sphenoid sinuses, in addition to orbitary and cranial base invasion.

  13. Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa

    Directory of Open Access Journals (Sweden)

    Takafumi Nishizaki


    Full Text Available Facial nerve schwannomas involving posterior and middle fossas are quite rare. Here, we report an unusual case of cerebellopontine angle facial schwannoma that involved the middle cranial fossa, two years after the first operation. A 53-year-old woman presented with a 3-year history of a progressive left side hearing loss and 6-month history of a left facial spasm and palsy. Magnetic resonance imaging (MRI revealed 4.5 cm diameter of left cerebellopontine angle and small middle fossa tumor. The tumor was subtotally removed via a suboccipital retrosigmoid approach. The tumor relapsed towards middle cranial fossa within a two-year period. By subtemporal approach with zygomatic arch osteotomy, the tumor was subtotally removed except that in the petrous bone involving the facial nerve. In both surgical procedures, intraoperative monitoring identified the facial nerve, resulting in preserved facial function. The tumor in the present case arose from broad segment of facial nerve encompassing cerebellopontine angle, meatus, geniculate/labyrinthine and possibly great petrosal nerve, in view of variable symptoms. Preservation of anatomic continuity of the facial nerve should be attempted, and the staged operation via retrosigmoid and middle fossa approaches using intraoperative facial monitoring, may result in preservation of the facial nerve.

  14. Brain mass and cranial nerve size in shrews and moles. (United States)

    Leitch, Duncan B; Sarko, Diana K; Catania, Kenneth C


    We investigated the relationship between body size, brain size, and fibers in selected cranial nerves in shrews and moles. Species include tiny masked shrews (S. cinereus) weighing only a few grams and much larger mole species weighing up to 90 grams. It also includes closely related species with very different sensory specializations - such as the star-nosed mole and the common, eastern mole. We found that moles and shrews have tiny optic nerves with fiber counts not correlated with body or brain size. Auditory nerves were similarly small but increased in fiber number with increasing brain and body size. Trigeminal nerve number was by far the largest and also increased with increasing brain and body size. The star-nosed mole was an outlier, with more than twice the number of trigeminal nerve fibers than any other species. Despite this hypertrophied cranial nerve, star-nosed mole brains were not larger than predicted from body size, suggesting that magnification of their somatosensory systems does not result in greater overall CNS size.

  15. Cranial implant design using augmented reality immersive system. (United States)

    Ai, Zhuming; Evenhouse, Ray; Leigh, Jason; Charbel, Fady; Rasmussen, Mary


    Software tools that utilize haptics for sculpting precise fitting cranial implants are utilized in an augmented reality immersive system to create a virtual working environment for the modelers. The virtual environment is designed to mimic the traditional working environment as closely as possible, providing more functionality for the users. The implant design process uses patient CT data of a defective area. This volumetric data is displayed in an implant modeling tele-immersive augmented reality system where the modeler can build a patient specific implant that precisely fits the defect. To mimic the traditional sculpting workspace, the implant modeling augmented reality system includes stereo vision, viewer centered perspective, sense of touch, and collaboration. To achieve optimized performance, this system includes a dual-processor PC, fast volume rendering with three-dimensional texture mapping, the fast haptic rendering algorithm, and a multi-threading architecture. The system replaces the expensive and time consuming traditional sculpting steps such as physical sculpting, mold making, and defect stereolithography. This augmented reality system is part of a comprehensive tele-immersive system that includes a conference-room-sized system for tele-immersive small group consultation and an inexpensive, easily deployable networked desktop virtual reality system for surgical consultation, evaluation and collaboration. This system has been used to design patient-specific cranial implants with precise fit.

  16. Cranial CT revisited: do we really need contrast enhancement?

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P.; Buelens, C.; Wilms, G.; Baert, A.L. [Department of Radiology, University Hospitals, Leuven (Belgium)


    The aim of this study was to define guidelines for intravenous contrast administration in cranial CT, as currently there are no recent guidelines based on a large series of patients. In 1900 consecutive patients (1480 adults and 420 children) pre- and post-contrast scan was analysed in order to assess the contribution of contrast enhancement to the diagnosis. The findings were grouped according to whether abnormalities were seen on the pre- and/or post-contrast scan, or whether no abnormalities were seen at all. Sensitivity, specificity, positive predictive value, negative predictive value and accurracy of a pre-contrast scan were used to determine validity. Intravenous contrast enhancement only contributes to the diagnosis if a suspicious abnormality is seen on the unenhanced scan or in the appropriate clinical setting (33.6 %). In the remaining patients (65.6 %) there is no diagnostic contribution, except for a small number of abnormalities (0.8 %). These are often anatomical variants and have no therapeutic impact. The number of contrast-enhanced cranial CT examinations can significantly be reduced by using four general guidelines for contrast administration resulting in considerable cost savings without affecting the quality of service to the patient. These guidelines are defined by the clinical findings/presentation or by the findings on the unenhanced scan. The number of contrast-related complications will be reduced, which may have medicolegal implications. These guidelines can be applied in any radiology department. (orig.) (orig.) With 2 tabs., 13 refs.

  17. Preclinical pathways to treatment in infants with positional cranial deformity. (United States)

    Kluba, S; Lypke, J; Kraut, W; Krimmel, M; Haas-Lude, K; Reinert, S


    Positional plagiocephaly in infants is frequent. As well as positioning, physiotherapy, and osteopathy, helmet therapy is an effective treatment option. The outcome also depends on the timely initiation of treatment. We investigated the preclinical pathways to treatment. Parents of 218 affected children were interviewed. Data were collected regarding detection and the treatments used prior to the first craniofacial consultation at the study clinic in Germany. Descriptive and statistical analyses were performed. For 78.4% of the children, the cranial deformities were first detected at ≤4 months of age. One hundred and twenty-two children received helmet therapy. Parents consulted the paediatrician with a mean latency of 0.4 months; 3.3 months passed until the first craniofacial consultation. Approximately 90% were treated with repositioning and 75.2% received additional physiotherapy or osteopathy prior to presentation. Children treated with physiotherapy/osteopathy presented significantly later (P=0.023). The time lapse to craniofacial consultation was not significantly different between children with and without later helmet therapy. We identified a relevant delay between the detection of positional cranial deformity and consultation with a craniofacial specialist. For affected children, this may potentially compromise the outcome of helmet therapy. Early referral to a specialist and if necessary the simultaneous application of different treatments should be preferred.

  18. A Rare Case of Cranial Osteomyelitis Caused by Proteus Vulgaris

    Directory of Open Access Journals (Sweden)

    Hakan Uslu


    Full Text Available Osteomyelitis of the calvarial bones can cause serious complications such as brain abscess, due to the close proximity to adjacent brain structures. Development of the purulent secretion in surgery and traumatic scalp injuries must be considered as a possibility of osteomyelitis possibility. Generally gram positive, rarely gram negative bacteria and mix agents, can be isolated in infection. Especially chronic pyogenic osteomyelitis agents can be isolated from chronic infections such as tuberculosis. In cranial osteomyelitis diagnosis, radiological diagnosis has a very important place together with the clinical diagnosis. However, infection can usually show late findings radiologically. In treatment, antibiotic treatment is absolutely essential as well as removal of the infected part of the bone. Due to antibiotic treatment lasting between 6-12 weeks, organizing the antibiotic protocols according to the results of culture-antibiograms, which were provided from purulent secretions, has the most important role in the success of surgical treatment. In Proteus sp. infections, for choice of suitable treatment, determination of the type of bacteria is important. For exact diagnosis, histopathological examination of the bone tissue must be carried out. In this report, a case with cranial osteomyelitis caused by Proteus vulgaris which is a gram negative bacteria causing anaerobic infections and classified in the Enterobacteriaceae family is presented. The patient was treated with surgery and appropriate antibiotics. Early recognition of this condition, planning the best treatment strategy and taking precautions to prevent complications, is mandatory for a better outcome.

  19. [Structural anatomy of cranial nerves (V, VII, VIII, IX, X)]. (United States)

    Guclu, B; Meyronet, D; Simon, E; Streichenberger, N; Sindou, M; Mertens, P


    This study reports a review of the literature on the structural anatomy of the Vth, VIIth, VIIIth, IXth, and Xth cranial nerves, known to harbor dysfunction syndromes in humans. Because these dysfunctions are hypothesized to be caused by neurovascular conflicts at the root entry/exit zone and the transitional zone between central and peripheral myelinization, this investigation focused on the study and description of this junction. All the cranial nerves, except the optic and olfactory nerves, which are considered to be more a direct expansion of the central nervous system, have a transitional zone between central myelin (coming from oligodendrocytes) and peripheral myelin (produced by Schwann cells). The human studies reported in the literature argue in favor of a dome-shaped transitional zone directed to the periphery. It seems that this junctional region is situated more peripherally in sensory nerves than in motor nerves. The transitional zone is situated very peripherally for the cochlear and vestibular nerves, and on the contrary very close to its exit from the brain stem for the facial nerve.

  20. The name cranial ovarian suspensory ligaments in mammalian anatomy should be used only to indicate the structures derived from the foetal cranial mesonephric and gonadal ligaments


    van der Schoot, P.


    textabstractThe term ovarian suspensory ligament appears ambiguous when human adult anatomy textbooks are compared with human embryology or with general mammalian anatomy textbooks. The term ovarian suspensory ligament in laboratory rodents and domestic animals indicates homologous structures during foetal (the cranial mesonephric and gonadal ligaments) and later life (the cranial mesonephric ligament derivatives). In human foetal anatomy textbooks ovarian suspensory ligament is generally app...

  1. Apparent paradoxical vault changes with middle cranial fossa arachnoid cysts - Implication for aetiology

    Energy Technology Data Exchange (ETDEWEB)

    Redla, Sridhar; Husami, Yahya; Colquhoun, Iain R


    Three cases of middle cranial fossa arachnoid cyst with paradoxical bone changes in the adjacent vault are described, namely, a small middle cranial fossa and pneumosinus dilatans. This association is unusual and unique. The existing literature is reviewed and the probable aetiological factors discussed. Redla, S., Husani, Y. and Colquhoun, I.R. (2001)

  2. A novel AMER1 frameshift mutation in a girl with osteopathia striata with cranial sclerosis. (United States)

    Enomoto, Yumi; Tsurusaki, Yoshinori; Harada, Noriaki; Aida, Noriko; Kurosawa, Kenji


    Osteopathia striata with cranial sclerosis (OSCS) (MIM #300373) is a rare X-linked dominant bone dysplasia characterized by cranial sclerosis and linear striations in the long bones of females, and fetal or neonatal lethality in affected males. This article is protected by copyright. All rights reserved.

  3. Cranial vault trauma and selective mortality in medieval to early modern Denmark

    DEFF Research Database (Denmark)

    Boldsen, Jesper L; Milner, George R; Weise, Svenja


    To date, no estimates of the long-term effect of cranial vault fractures on the risk of dying have been generated from historical or prehistoric skeletons. Excess mortality provides a perspective on the efficacy of modern treatment, as well as the human cost of cranial injuries largely related...

  4. Apparent paradoxical vault changes with middle cranial fossa arachnoid cysts--implication for aetiology. (United States)

    Redla, S; Husami, Y; Colquhoun, I R


    Three cases of middle cranial fossa arachnoid cyst with paradoxical bone changes in the adjacent vault are described, namely, a small middle cranial fossa and pneumosinus dilatans. This association is unusual and unique. The existing literature is reviewed and the probable aetiological factors discussed.

  5. Determining the Optimal Number of Stimuli per Cranial Site during Transcranial Magnetic Stimulation Mapping (United States)

    Schabrun, Siobhan M.


    The delivery of five stimuli to each cranial site is recommended during transcranial magnetic stimulation (TMS) mapping. However, this time-consuming practice restricts the use of TMS mapping beyond the research environment. While reducing the number of stimuli administered to each cranial site may improve efficiency and decrease physiological demand, doing so may also compromise the procedure's validity. Therefore, the aim of this study was to determine the minimum number of stimuli per cranial site required to obtain valid outcomes during TMS mapping. Map volume and centre of gravity (CoG) recordings obtained using five stimuli per cranial site were retrospectively compared to those obtained using one, two, three, and four stimuli per cranial site. For CoG longitude, one stimulus per cranial site produced valid recordings (ICC = 0.91, 95% CI 0.82 to 0.95). However, this outcome is rarely explored in isolation. As two stimuli per cranial site were required to obtain valid CoG latitude (ICC = 0.99, 95% CI 0.99 to 0.99) and map volume (ICC = 0.99, 95% CI 0.99 to 0.99) recordings, it is recommended that a minimum of two stimuli be delivered to each cranial site during TMS mapping in order to obtain valid outcomes. PMID:28331848

  6. Coexistence of congenital giant melanocytic nevus of the scalp with cranial defect, poliosis, and hair loss. (United States)

    Lee, Woo J; Lee, Sang M; Won, Chong H; Chang, Sung E; Lee, Mi W; Choi, Jee H; Moon, Kee C


    Congenital melanocytic nevi (CMN) are pigmented lesions presenting on the skin in approximately 1% of all newborns at or shortly after birth. CMN have been described as being associated with several anomalies, including cranial bone hypertrophy, scoliosis, and spina bifida. This is the first report to describe a giant congenital melanocytic nevus on the scalp associated with cranial involvement, poliosis, and alopecia.

  7. Stereotactic radiotherapy using Novalis for skull base metastases developing with cranial nerve symptoms. (United States)

    Mori, Yoshimasa; Hashizume, Chisa; Kobayashi, Tatsuya; Shibamoto, Yuta; Kosaki, Katsura; Nagai, Aiko


    Skull base metastases are challenging situations because they often involve critical structures such as cranial nerves. We evaluated the role of stereotactic radiotherapy (SRT) which can give high doses to the tumors sparing normal structures. We treated 11 cases of skull base metastases from other visceral carcinomas. They had neurological symptoms due to cranial nerve involvement including optic nerve (3 patients), oculomotor (3), trigeminal (6), abducens (1), facial (4), acoustic (1), and lower cranial nerves (1). The interval between the onset of cranial nerve symptoms and Novalis SRT was 1 week to 7 months. Eleven tumors of 8-112 ml in volume were treated by Novalis SRT with 30-50 Gy in 10-14 fractions. The tumors were covered by 90-95% isodose. Imaging and clinical follow-up has been obtained in all 11 patients for 5-36 months after SRT. Seven patients among 11 died from primary carcinoma or other visceral metastases 9-36 months after Novalis SRT. All 11 metastatic tumors were locally controlled until the end of the follow-up time or patient death, though retreatment for re-growth was done in 1 patient. In 10 of 11 patients, cranial nerve deficits were improved completely or partially. In some patients, the cranial nerve symptoms were relieved even during the period of fractionated SRT. Novalis SRT is thought to be safe and effective treatment for skull base metastases with involvement of cranial nerves and it may improve cranial nerve symptoms quickly.

  8. Successive Torsion of the Right Middle and Left Cranial Lung Lobes in a Dog


    Breton, Luc; DiFruscia, Rocky; Olivieri, Michel


    This case report describes the torsion of two lung lobes in a dog. The animal was first presented for a torsion of the right middle lung lobe. Following the surgical resection of that lobe, the dog suffered another torsion of the left cranial lung lobe (cranial and caudal segments).

  9. Asymmetric class III malocclusion: association with cranial base deformation and occult torticollis. (United States)

    Yuan, Joyce T; Teng, Edward; Heller, Justin B; Kawamoto, Henry K; Bradley, James P


    The etiology of Angle class III malocclusion with facial asymmetry has not been fully elucidated. To investigate the etiology, patients with asymmetric prognathism (n = 30) from a single institution were assessed for previously undiagnosed torticollis and cranial base asymmetry. Presence of torticollis was determined by measuring restricted head movement when turning the head against a wall and cranial base tilt with upward gaze. Cranial base asymmetry was evaluated by preoperative three-dimensional computed tomography scans. Thirty-one percent of patients with prognathism presented with concurrent facial asymmetry. In patients with asymmetric prognathism, cranial base tilt was present on upward gaze in all patients; mean angle between head and wall was 31 degrees greater than that in control patients, and a 22% to 36% difference in the angle was present when comparing one side with the other. Based on these findings, all patients with asymmetric prognathism were found to be affected by torticollis. By computed tomography scan, 85% of these torticollis patients showed slight anteromedial displacement of the glenoid fossa ipsilateral to torticollis, and 73% demonstrated temporal fossa shift of 4 mm or greater. The current study demonstrates a strong association between asymmetric class III malocclusion, torticollis, and cranial base asymmetry. We conclude that undiagnosed torticollis is a likely etiology for otherwise idiopathic cranial base asymmetry and that cranial base asymmetry in turn causes facial asymmetry and malocclusion. This study highlights the importance of evaluating cranial base asymmetry and torticollis in patients with class III malocclusion to allow for earlier treatment and improved outcomes.

  10. Differences in types of artificial cranial deformation are related to differences in frequencies of cranial and oral health markers in pre-Columbian skulls from Peru

    Directory of Open Access Journals (Sweden)

    Mercedes Okumura

    Full Text Available Artificial cranial deformation is a cultural practice that modifies the shape of the skull during the early infancy. It is not related to rites of passage, but to different social status in a group. Therefore, the deformed cranium is an expression of individual affirmation and affiliation to a given social group. Osteological material from Pasamayo (AD 1200-1450, a cemetery in central coast of Peru, was analyzed to test whether individuals presenting different types of cranial deformation (interpreted as a sign of different social status present differences in health status. Three types of cranial deformation were observed and five osteological markers (cribra orbitalia, cranial trauma, antemortem tooth loss, dental caries, and periodontal cavities related to health status were analyzed in 78 crania. No significant differences were found in terms of these osteological markers among females in relation to the different types of cranial deformation. However, males presenting occipital deformation had significantly less caries and periodontal cavities than the others. Moreover, males presenting fronto-lambdoid deformation had more antemortem tooth loss than the other males. Therefore, although different types of cranial deformation can be potentially associated to distinct social status, differences in health status could only be observed in the male sample.

  11. Cervical vertebrae, cranial base, and mandibular retrognathia in human triploid fetuses

    DEFF Research Database (Denmark)

    Sonnesen, Liselotte; Nolting, Dorrit; Engel, Ulla


    On profile radiographs of adults, an association between fusions of cervical vertebrae, deviations in the cranial base and mandibular retrognathia has been documented radiographically. An elaboration of this association on a histological level is needed. In human triploid fetuses severe mandibular...... and the uppermost vertebra in the body axis. As the notochord connects the cervical column and the cranial base in early prenatal life, molecular signaling from the notochord may in future studies support the notochord as the developmental link between abnormal development in the spine and the cranial base....... retrognathia and deviations in the cranial base have previously been described radiographically (without cephalometry) and cervical column fusions radiographically as well as histologically. Therefore, triploid fetuses were chosen to elucidate the cranial base cephalomterically and histologically...

  12. A propósito de un caso: terapia oro-facial como tratamiento complementario de la espasticidad en niños con PCI



    Introducción: Debido a la prevalencia de niños con PCI espástica y buscando el avance en esta patología, siempre será de utilidad la búsqueda de otras alternativas de tratamiento, en este caso en fisioterapia, para poder valernos de un mayor número de herramientas. En este caso, se valorará la eficacia del tratamiento fisioterápico oro-facial en la espasticidad. Objetivo: Evaluar la eficacia de la terapia oro-facial en la disminución de la espasticidad en un paciente con PCI. Metodo...

  13. A propósito de un caso: terapia oro-facial como tratamiento complementario de la espasticidad en niños con PCI


    González Alberdi, Miriam


    Introducción: Debido a la prevalencia de niños con PCI espástica y buscando el avance en esta patología, siempre será de utilidad la búsqueda de otras alternativas de tratamiento, en este caso en fisioterapia, para poder valernos de un mayor número de herramientas. En este caso, se valorará la eficacia del tratamiento fisioterápico oro-facial en la espasticidad. Objetivo: Evaluar la eficacia de la terapia oro-facial en la disminución de la espasticidad en un paciente con PCI. Metodo...

  14. 基于 PCI-E 总线的智能变电站网络记录分析仪研制%Development of a Network Recording Analyzer in the Smart Substation Based on PCI-E Bus

    Institute of Scientific and Technical Information of China (English)

    檀永; 侯明国; 沈健


    The network recording analyzer is a device for recording,monitoring and analyzing network data in the smart substation,which can find weak links and the malfunction equipment of the communication network in advance,prevent failures in the electric power system,and restore the faulty waveform of the primary equipment of the power system as well as the records of the action and behavior of its secondary equipment in case of power system failures,thus facilitating analysis and quick trouble-shooting once an accident happens.Real-time acquisition,high-speed storage and efficient extraction of massive network data in the smart substation are the difficult points in the development of a network recording analyzer.Based on a deep analysis of PCI-E,this paper gives a details introduction of a hardware platform for the network recording analyzer of the smart substation based on PCI-E bus,and briefly describes the key points for the design of the driver software,thus providing a feasible implementation scheme for the acquisition and storage of massive network data in the network recording analyzer.%网络记录分析仪是智能变电站内的网络数据记录、监视、分析设备,它可提前发现通信网络的薄弱环节和故障设备,预防电力系统事故的发生,并在发生电力系统故障时,还原电力系统一次设备故障波形以及二次设备动作行为记录,便于事故发生后进行分析和快速查找故障原因。智能变电站内海量网络数据的实时采集、高速存储、高效提取是研制网络记录分析仪的难点。在深入分析第三代总线通信接口标准 PCI-E 总线的基础上,详细介绍了一种基于 PCI-E 总线的智能变电站网络记录分析仪硬件平台,同时简要概述了驱动软件的设计要点,为网络记录分析仪海量网络数据的采集、存储提供了一个切实可行的实现方案。

  15. 基于PCI-1750 I/O卡的测试枪自动检测系统设计%Design of contact cassette test system based on data acquisition card PCI-1750

    Institute of Scientific and Technical Information of China (English)



    In order to increase the production capacity, Realize the function of auto test contact cassette off line, we designed the auto test system based on data acquisition PCI-1750 card. Using language of , we can control the cylinder movement and test the sensor state lively through the function library in control card.%  为了方便线下维修测试枪,提高设备的利用率,设计了基于PCI数据采集控制卡的系统控制方案.通过 调用数据采集控制卡中的函数库,手动或自动控制气缸运动,测试传感器状态,从而实现测试枪的手动和自动检测。

  16. PCI 手术患者血清 TSH 水平与心血管疾病严重程度的相关性研究%Correlation between serum TSH concentrations and cardiovascular severity in patients undergoing PCI

    Institute of Scientific and Technical Information of China (English)

    吴卫云; 邬升超; 颜红梅; 吴炯; 郭玮; 张春燕; 宋斌斌; 潘柏申


    Objective To investigate the correlation between serum thyroid-stimulating hormone ( TSH ) concentrations and cardiovascular severity in patients undergoing percutaneous coronary intervention (PCI).Methods Of 1 122 patients undergoing PCI, 1 000 who met inclusion criteria were classified into 3 groups according to serum TSH concentrations: normal,subclinical hypothyroidism and subclinical hyperthyroidism groups.The main outcomes were Gensini score with Gensini scores >50 defined as high cardiac risk and the percentage undergoing stent implantation. Results The percentages of patients with Gensini scores >50 differed significantly in normal and subclinical hypothyroidism groups (P =0.003).Binary Logistic regression analysis showed that subclinical hypothyroidism was an independent risk factor for cardiovascular disease [odds ratio (OR) =1.855, 95% confidence interval (CI): 1.244-2.766, P =0.002].In contrast,Gensini score >50 and stent implantation did not correlate with TSH concentration in normal group.Conclusions Subclinical hypothyroidism is a risk factor for cardiovascular disease in patients undergoing PCI.The correlation between normal TSH concentrations and cardiovascular disease requires further investigation.%目的:研究经皮冠状动脉介入术(PCI)手术患者血清促甲状腺激素(TSH)水平与心血管疾病严重程度的相关性。方法初次入组1122名行 PCI 术患者,根据所设定的筛选标准最后入组1000名患者。根据 TSH检测结果,将人群分为正常组、亚临床甲状腺功能减退组(简称亚临床甲减组)和亚临床甲状腺功能亢进组(简称亚临床甲亢组)。将 Gensini 积分和患者是否接受支架治疗作为主要的临床终点事件,以 Gensini 积分>50表示心血管疾病严重程度较高。结果正常人群组和亚临床甲减组中,Gensini 积分>50的患者在两人群中的分布情况存在明显差异(P =0.003)。二元 Logistic 回归分析

  17. Ophthalmoplegic and lower cranial nerve variants merge into each other and into classical Guillain-Barre syndrome

    NARCIS (Netherlands)

    ter Bruggen, JP; van der Meche, FGA; de Jager, AEJ; Polman, CH

    We delineated the place of cranial nerve variants within the concept of clinically defined Guillain-Barre syndrome (GBS), In the ophthalmoplegic variant (n = 7) the oculomotor nerves were early involved, In a lower cranial nerve variant (n = 9) the cranial nerves IX, X, and XI were early involved.

  18. Ophthalmoplegic and lower cranial nerve variants merge into each other and into classical Guillain-Barre syndrome

    NARCIS (Netherlands)

    ter Bruggen, JP; van der Meche, FGA; de Jager, AEJ; Polman, CH


    We delineated the place of cranial nerve variants within the concept of clinically defined Guillain-Barre syndrome (GBS), In the ophthalmoplegic variant (n = 7) the oculomotor nerves were early involved, In a lower cranial nerve variant (n = 9) the cranial nerves IX, X, and XI were early involved. D

  19. A 3-year review of cranial nerve palsies from the University of Port Harcourt Teaching Hospital Eye Clinic, Nigeria

    Directory of Open Access Journals (Sweden)

    Chinyere Nnenne Pedro-Egbe


    Conclusion: This is the first study in the literature on ocular cranial nerve palsies in Southern Nigeria. Third and sixth cranial nerve palsies were the most common cases to present to the University of Port Harcourt Teaching Hospital Eye Clinic. There was a statistically significant association to systemic disorders such as hypertension and DM and majority of cases with 6 th cranial nerve palsy.

  20. Ophthalmoplegic and lower cranial nerve variants merge into each other and into classical Guillain-Barre syndrome

    NARCIS (Netherlands)

    ter Bruggen, JP; van der Meche, FGA; de Jager, AEJ; Polman, CH


    We delineated the place of cranial nerve variants within the concept of clinically defined Guillain-Barre syndrome (GBS), In the ophthalmoplegic variant (n = 7) the oculomotor nerves were early involved, In a lower cranial nerve variant (n = 9) the cranial nerves IX, X, and XI were early involved. D

  1. Quantification of Cranial Asymmetry in Infants by Facial Feature Extraction

    Institute of Scientific and Technical Information of China (English)

    Chun-Ming Chang; Wei-Cheng Li; Chung-Lin Huang; Pei-Yeh Chang


    In this paper, a facial feature extracting method is proposed to transform three-dimension (3D) head images of infants with deformational plagiocephaly for assessment of asymmetry. The features of 3D point clouds of an infant’s cranium can be identified by local feature analysis and a two-phase k-means classification algorithm. The 3D images of infants with asymmetric cranium can then be aligned to the same pose. The mirrored head model obtained from the symmetry plane is compared with the original model for the measurement of asymmetry. Numerical data of the cranial volume can be reviewed by a pediatrician to adjust the treatment plan. The system can also be used to demonstrate the treatment progress.

  2. Meningitis tuberculosa: Clinical findings and results of cranial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Trautmann, M.; Loddenkemper, R.; Hoffmann, H.G.


    Guided by 9 own observations between 1977 and 1981, new diagnostic facilities in tuberculous meningitis are discussed. For differentiation from viral meningitis, measurement of CSF lactic acid concentration in addition to that of CSF glucose has proved to be of value in recent years. In accordance with the literature, two cases of this series which were examined for CSF lactic acid concentration showed markedly elevated levels of 8,4 rsp. 10,4 mmol/l. In contrast to this, in viral meningitis usually values of less than 3.5 mmol/l are found. Additionally, the presence of hypochlor- and hyponatremia, which could be demonstrated in 6 of our 9 patients, may raise the suspicion of tuberculous etiology. In the series presented, cranial computed tomography was of greatest diagnostic value, enabling the diagnosis of hydrocephalus internus in 5, and basal arachnoiditis in 2 cases.

  3. Cranial arachnoid membranes: some aspects of microsurgical anatomy. (United States)

    Lü, Jian; Zhu, Xian-Li


    Although the arachnoid membranes have been known for more than 300 years, the anatomy of the arachnoid membranes has not been studied in detail. This study was performed to explore the microanatomical features of the cranial arachnoid membranes. The arachnoid membranes and cisterns were observed in eight Han Chinese adult human cadaveric brains with an operating microscope, without staining of intracranial structures or injection of colored material into blood vessels. Twenty seven arachnoid membranes and 21 subarachnoid cisterns were identified. The topographical features of each arachnoid membrane were described. On the basis of the arachnoid membranes we identified, the arachnoidal limits of the cisterns were discussed. The microsurgical anatomical research on the arachnoid membranes is a supplement to the anatomical study of the subarachnoid cisterns. The understanding of the topographical features of the arachnoid membranes is valuable to the reasonable dissection of the cisterns and the minimally invasive manipulations during microsurgical procedures.

  4. An Isolated Bee Sting Involving Multiple Cranial Nerves

    Directory of Open Access Journals (Sweden)

    Hassan Motamed


    Full Text Available Hymenoptera stings are self-limiting events or due to allergic reactions. Sometimes envenomation with Hymenoptera can cause rare complications such as acute encephalopathy, peripheral neuritis, acute renal failure, nephrotic syndrome, silent myocardial infarction, rhabdomyolysis, conjunctivitis, corneal infiltration, lens subluxation, and optic neuropathy. The mechanism of peripheral nervous system damage is not clearly known. In our studied case after bee sting on face between the eyebrows with little erythema and  cm in size, bilateral blindness developed and gradually improved. Lateral movement of eyes was restricted with no pain. Involvement of cranial nerves including II, V, and VI was found. With conservative therapy after a year significant improvement has been achieved.

  5. Cranial MR imaging of sequelae of prefrontal lobotomy. (United States)

    Uchino, A; Kato, A; Yuzuriha, T; Takashima, Y; Kudo, S


    Although prefrontal lobotomy is an obsolete treatment for schizophrenia, we still encounter patients who have undergone this procedure. The purpose of this study was to describe the MR imaging findings of sequelae of prefrontal lobotomy. We retrospectively reviewed cranial MR images of eight patients with schizophrenia who underwent prefrontal lobotomy approximately 50 years previously. In all patients, a bilateral cavitary lesion with a thick wall was found in the frontal white matter. The genu of the corpus callosum was mildly to markedly atrophic. The size and location of the cavity and the degree of callosal atrophy were correlated. MR imaging is useful for the diagnosis of sequelae of prefrontal lobotomy, including cavitary lesions with dense walls of gliosis and secondary degeneration of the genu of the corpus callosum.

  6. Scoring of nonmetric cranial traits: a methodological approach. (United States)

    Gualdi-Russo, E; Tasca, M A; Brasili, P


    The purpose of the present study was to analyse the replicability of the scoring of discontinuous traits. This was assessed on a sample of 100 skulls from the Frassetto collection (Dipartimento di Biologia Evoluzionistica Sperimentale of Bologna University) analysed through intraobserver comparisons: the discontinuous traits were determined on the same skulls and by the same observer on 3 separate occasions. The scoring was also assessed through interobserver comparisons: 3 different observers performed an independent survey on the same skulls. The results show that there were no significant differences in the discontinuous trait frequencies between the 3 different scorings by the same observer, but there were sometimes significant differences between different observers. Caution should thus be taken in applying the frequencies of these traits to population research. After an indispensable control of material conditions (subject age included), consideration must be given to standardisation procedures between observers, otherwise this may be an additional source of variability in cranial discontinuous trait scoring.

  7. Perineural tumor spread - Interconnection between spinal and cranial nerves. (United States)

    Kozić, Duško; Njagulj, Vesna; Gaćeša, Jelena Popadić; Semnic, Robert; Prvulović, Nataša


    The secondary neoplastic involvement of the cervical plexus in patients with head and neck malignancies is extremely rare. MR examination of the neck revealed the diffuse neoplastic infiltration of the right C2 root, in a 57-year-old patient with several months long pain in the right ear region and a history of the tongue squamous cell carcinoma. Associated perineural tumor spread and consequent distal involvement of great auricular nerve and vagus nerve were evident. Best of our knowledge, this is the first reported involvement of the cervical plexus in patients with head and neck cancers, associated with the clearly documented interconnection between the cervical plexus and cranial nerves via great auricular nerve.

  8. Osteology and cranial musculature of Caiman latirostris (crocodylia: Alligatoridae). (United States)

    Bona, Paula; Desojo, Julia Brenda


    Caiman latirostris Daudin is one of the extant species of Caimaninae alligatorids characterized taxonomically only by external morphological features. In the present contribution, we describe the cranial osteology and myology of this species and its morphological variation. Several skull dissections and comparisons with other caimans were made. Although jaw muscles of living crocodiles show the same general "Bauplan" and alligatorids seem to have a similar cranial musculature pattern, we describe some morphological variations (e.g., in C. latirostris the superficial portion of the M. adductor mandibulae externus did not reach the postorbital; the M. adductor mandibulae internus pars pterygoideus dorsalis did not reach the pterygoid and lacrimal and contrary to the case of C. crocodilus the M. adductor mandibulae internus pars pterygoideus ventralis attaches to the posterodorsal surface of the pterygoid and the pterygoid aponeurosis, without contacting the dorsal and ventral surface of the pterygoid margin; the M. intermandibularis is attached to the anterior half of the splenial and posteriorly inserts medially by a medial raphe that serves as attachment zone for M. constrictor colli, and the M. constrictor colli profundus presents a medial notch in its anterior margin). In addition, the skull of C. latirostris differs from that of other caimans and possesses several characters that are potential diagnostic features of this species (e.g., outline of glenoid cavity in dorsal view, extension of the rostral ridges, and occlusion of the first dentary tooth). Nevertheless, these characters should be analyzed within the phylogenetic context of the Caimaninae to evaluate its evolutionary implications for the history of the group.

  9. Cranial nerve involvement in Charcot-Marie-Tooth Disease. (United States)

    Das, Nirav; Kandalaft, Savannah; Wu, Xiao; Malhotra, Ajay


    Charcot-Marie-Tooth Disease (CMT) is a rare disorder with less than 200,000 cases reported in the US every year, making diagnosis challenging. MR and CT imaging has become more common in the evaluation of CMT to identify areas of disease involvement. A 27-year-old female from Guatemala with a past history of polio initially presented to the emergency room for necrotizing pneumonia. MRI images demonstrated smoothly enlarged, mildly enhancing trigeminal nerves. CT showed bony widening of the skull base foramina. The patient was noted to have atrophy and weakness of her extremities with decreased sensation, distal more than proximal, and pes cavus. An electromyogram demonstrated absent response in the right median, ulnar, peroneal, and tibial motor studies and bilateral radial and right sural sensory studies. MRI of the spine demonstrated smooth, symmetric enlargement and mild enhancement of the distal spinal nerve roots and cauda equine. CMT is a group of disorders with a wide range of clinical presentations and abnormalities. Cranial nerve involvement is infrequently described in CMT 1A. In our case and prior studies, there does not appear to be a correlation between cranial nerve involvement and symptoms. Trigeminal neuralgia has been described in patients in CMT, but is not common and was not seen in our patient despite abnormal trigeminal nerve findings on imaging. Our patient also demonstrated involvement of the facial nerve without facial muscle weakness. Clinical features are key in distinguishing CMT 1A from other forms of HMSN. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Hemiplegic peripheral neuropathy accompanied with multiple cranial nerve palsy

    Directory of Open Access Journals (Sweden)

    Hirohisa Okuma


    Full Text Available A 32-year-old man experienced double vision around January, 2010, followed by weakness of his left upper and lower extremities. Articulation disorders and loss of hearing in his left ear developed, and he was admitted to our hospital on February 14, 2010. Physical examination was normal, and neurological examination showed clear consciousness with no impairment of cognitive function, but with articulation disorders. Olfactory sensation was reduced. Left ptosis and left gaze palsy, complete left facial palsy, perceptive deafness of the left ear, and muscle weakness of the left trapezius muscle were observed. Paresis in the left upper and lower extremities was graded 4/5 through manual muscle testing. Sensory system evaluation revealed complete left-side palsy, including the face. Deep tendon reflexes were slightly diminished equally on both sides; no pathologic reflex was seen. No abnormality of the brain parenchyma, cerebral nerves or cervicothoracolumbar region was found on brain magnetic resonance imaging. On electroencephalogram, alpha waves in the main frequency band of 8 to 9 Hz were recorded, indicating normal findings. Brain single photon emission computed tomography (SPECT scan showed reduced blood flow in the right inner frontal lobe and both occipital lobes. Nerve biopsy (left sural nerve showed reduction of nerve density by 30%, with demyelination. The patient also showed manifestations of multiple cranial nerve disorder, i.e., of the trigeminal nerve, glossopharyngeal nerve, vagus nerve, and hypoglossal nerve. Whole-body examination was negative. Finally, based on ischemic brain SPECT images, spinal fluid findings and nerve biopsy results, peripheral neuropathy accompanied with multiple cranial nerve palsy was diagnosed.

  11. Outcome Analysis of Cranial Molding Therapy in Nonsynostotic Plagiocephaly

    Directory of Open Access Journals (Sweden)

    Han-Su Yoo


    Full Text Available BackgroundIt is known that nonsynostotic plagiocephaly does not spontaneously improve, and the craniofacial deformities that result from it. This study was conducted to analyze the effectiveness of helmet therapy for the nonsynostotic plagiocephaly patient, and to suggest a new treatment strategy based on this analysis.MethodsA total of 108 pediatric patients who had undergone helmet therapy after being diagnosed with nonsynostotic plagiocephaly were included in this study. The patients were classified according to the initiation age of the helmet therapy, severity, and helmet wearing time. The treatment effect was compared using cranial vault asymmetry (CVA and the cranial vault asymmetry index (CVAI, which were obtained from diagonal measurements before and after therapy.ResultsThe discrepancy of CVA and CVAI of all the patients significantly decreased after helmet therapy. According to the initiation time of helmet therapy, the treatment effect was best at 5 months old or less. The helmet wearing time per day was proportional to the treatment effect up to 20 hours. In addition, the rate of the successful treatment (final CVA ≤5 mm significantly decreased when the initiation age was 9.1 months or older and the treatment period was less than 7.83 months.ConclusionsThis study showed the effectiveness of the helmet therapy for nonsynostotic plagiocephaly patients. Based on analysis of this study, helmet therapy should be started at the age of 9 months or younger for 7.83 months or more, and the helmet wearing time should be more than 20 hours a day.

  12. Percutaneous transvenous mitral commissurotomy (PTMC) and percutaneous coronary intervention (PCI) successfully applied in one patient in same sitting. (United States)

    Sial, Jawaid Akbar; Farman, Muhammad Tariq; Saghir, Tahir; Zaman, Khan Shah


    Sixty years old male with severe rheumatic mitral stenosis (MS), presented with dyspnoea New York Heart Association (NHYA) class III to IV. Coronary angiogram revealed severe occlusive coronary artery disease in left anterior coronary artery (LAD). Percutaneous Transvenous Mitral Commissurotomy (PTMC) and Percutaneous Coronary Intervention (PCI) of Left Anterior Descurery (LAD) were done in same sitting. Both procedures were successful and ended without complication. After, half an hour while shifting to coronary care unit (CCU) patient developed cardiac tamponade, which was managed successfully. Patient was followed up for three month, he is doing well and recent echocardiogram showed mild mitral stenosis with normal left ventricular function. This case demonstrates the feasibility of the combined appliance on interventional techniques in selected patients as an alternative to cardiac surgery.

  13. Long-term clinical outcome in STEMI patients treated with primary PCI and drug-eluting or bare-metal stents: insights from a high-volume single-center registry

    DEFF Research Database (Denmark)

    Pedersen, Sune; Galatius, Soren; Mogelvang, Rasmus


    Use of drug-eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI) during routine primary percutaneous coronary intervention (pPCI) is controversial.......Use of drug-eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI) during routine primary percutaneous coronary intervention (pPCI) is controversial....

  14. Peripheral doses of cranial pediatric IMRT performed with attenuator blocks; Doses perifericas de IMRT cranial pediatrica realizada com blocos atenuadores

    Energy Technology Data Exchange (ETDEWEB)

    Soboll, Danyel Scheidegger; Schitz, Ivette; Schelin, Hugo Reuters, E-mail:, E-mail:, E-mail: [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil); Silva, Ricardo Goulart da, E-mail: [Hospital Angelina Caron, Campina Grande do Sul, PR (Brazil); Viamonte, Alfredo, E-mail: [Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil)


    This paper presents values of peripheral doses measured at six vital points of simulator objects which represent the ages of 2, 5 and 10 years old, submitted to a cranial IMRT procedure that applied compensator blocks interposed to 6 MV beams. The found values indicate that there is independence of dose with position of measurements and age of the patient, as the peripheral dose at the points nearest and the 2 year old simulator object where larger. The doses in thyroid reached the range of 1.4 to 2.9% of the dose prescribed in the isocenter, indicating that the peripheral doses for IMRT that employ compensator blocks can be greater than for the IMRT produced with sliding window technique

  15. A firmware implementation of a Quad HOLA S-LINK to PCI Express interface for use in the ATLAS Trigger DAQ system

    CERN Document Server

    Slenders, Daniel


    The firmware for a PCI Express interface card with four on-board high-speed optical S-LINKS (FILAREXPRESS) has been developed. This was done for an Altera Stratix II GX FPGA. Furthermore, detection of the available channels through a pull-up resistor and a readout of the on-board temperature sensor were implemented.

  16. Use of platelet glycoprotein IIb/IIIa inhibitors in diabetics undergoing PCI for non-ST-segment elevation acute coronary syndromes: impact of clinical status and procedural characteristics

    NARCIS (Netherlands)

    T. Bauer (Timm); H. Möllmann (Helge); F. Weidinger (Franz); U. Zeymer (Uwe); R. Seabra-Gomes (Ricardo); F.R. Eberli (Franz Robert); P.W.J.C. Serruys (Patrick); A. Vahanian (Alec); S. Silber (Sigmund); W. Wijns (William); M. Hochadel (Matthias); H.M. Nef (Holger); C.W. Hamm (Christian); J. Marco (Jean); A.K. Gitt (Anselm)


    textabstractBackground: The most recent ESC guidelines for percutaneous coronary intervention (PCI) recommend the use of glycoprotein IIb/IIIa inhibitors (GPI) in high risk patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), particularly in diabetics. Little is known about th

  17. Platelet HPA-1 a/HPA-1 b polymorphism and the risk of periprocedural myocardial infarction in patients undergoing elective PCI

    NARCIS (Netherlands)

    Verdoia, M.; Secco, G.G.; Barbieri, L.; Cassetti, E.; Schaffer, A.; Sinigaglia, F.; Marino, P.; Suryapranata, H.; Luca, G. De


    Periprocedural myocardial infarction (PMI) represents a relatively common complication of percutaneous coronary intervention (PCI) and large interests have been focused on platelets in order to prevent such a complication. The single nucleotide polymorphism Leu33Pro of platelet glycoprotein IIIa has

  18. PCI in AMI: concern and objective appraisal%急性心梗患者的介入治疗:考虑及客观评估

    Institute of Scientific and Technical Information of China (English)

    张建; 齐向前


    @@ 1 Stent thrombosis PCI has become the most frequently used method of myocardial revascularization:Within 2 years of being introduced,4.5 million DES were implanted worldwide,helping to treat 3 million patient.No permanent,implantable medical device has experienced such rapid market penetration and acceptance.

  19. The relationship between admission monocyte HDL-C ratio with short-term and long-term mortality among STEMI patients treated with successful primary PCI. (United States)

    Çiçek, Gökhan; Kundi, Harun; Bozbay, Mehmet; Yayla, Cagrı; Uyarel, Hüseyin


    Monocyte to HDL-C ratio (MHR) represents a simple assessment method for inflammatory status. The aim of the present study was to investigate whether MHR may be of short-term and long-term prognostic value in ST-elevation myocardial infarction (STEMI) patients who have undergone a primary percutaneous coronary intervention (PCI). A total of 682 consecutive STEMI patients who underwent successful primary PCI between March 2013 and September 2015 were included in this study. Patients were divided into groups according to their admission MHR values. Clinical follow-up data of participating patients were obtained through an outpatient examination 30 months after PCI. The study population included 172 patients with an MHR less than 1.16 (Q1), 169 patients with an MHR 1.16-1.59 (Q2), 161 patients with an MHR 1.60-2.21 (Q3), and 180 patients with an MHR greater than 2.21 (Q4). Rates of in-hospital mortality, major adverse cardiovascular events, cardiopulmonary resuscitation, dialysis, use of inotropic agents, shock, late mortality, target vessel revascularization, stroke, and reinfarct were higher in the Q4 group compared with the other MHR quartile groups. The results of this study have indicated that admission MHR is associated independently and significantly with short-term and long-term mortality in STEMI patients who undergo successful primary PCI.

  20. Dose-Effect Relationships for Adverse Events After Cranial Radiation Therapy in Long-term Childhood Cancer Survivors

    Energy Technology Data Exchange (ETDEWEB)

    Dijk, Irma W.E.M. van, E-mail: [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Cardous-Ubbink, Mathilde C. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Pal, Helena J.H. van der [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Heinen, Richard C. [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Leeuwen, Flora E. van [Department of Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands); Oldenburger, Foppe; Os, Rob M. van [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Ronckers, Cécile M. [Dutch Childhood Oncology Group, Long-term Effects after Childhood Cancer, The Hague (Netherlands); Schouten–van Meeteren, Antoinette Y.N. [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Caron, Huib N. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Koning, Caro C.E. [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Kremer, Leontien C.M. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands)


    Purpose: To evaluate the prevalence and severity of clinical adverse events (AEs) and treatment-related risk factors in childhood cancer survivors treated with cranial radiation therapy (CRT), with the aim of assessing dose-effect relationships. Methods and Materials: The retrospective study cohort consisted of 1362 Dutch childhood cancer survivors, of whom 285 were treated with CRT delivered as brain irradiation (BI), as part of craniospinal irradiation (CSI), and as total body irradiation (TBI). Individual CRT doses were converted into the equivalent dose in 2-Gy fractions (EQD{sub 2}). Survivors had received their diagnoses between 1966 and 1996 and survived at least 5 years after diagnosis. A complete inventory of Common Terminology Criteria for Adverse Events grade 3.0 AEs was available from our hospital-based late-effect follow-up program. We used multivariable logistic and Cox regression analyses to examine the EQD{sub 2} in relation to the prevalence and severity of AEs, correcting for sex, age at diagnosis, follow-up time, and the treatment-related risk factors surgery and chemotherapy. Results: There was a high prevalence of AEs in the CRT group; over 80% of survivors had more than 1 AE, and almost half had at least 5 AEs, both representing significant increases in number of AEs compared with survivors not treated with CRT. Additionally, the proportion of severe, life-threatening, or disabling AEs was significantly higher in the CRT group. The most frequent AEs were alopecia and cognitive, endocrine, metabolic, and neurologic events. Using the EQD{sub 2}, we found significant dose-effect relationships for these and other AEs. Conclusion: Our results confirm that CRT increases the prevalence and severity of AEs in childhood cancer survivors. Furthermore, analyzing dose-effect relationships with the cumulative EQD{sub 2} instead of total physical dose connects the knowledge from radiation therapy and radiobiology with the clinical experience.

  1. Achieving timely percutaneous reperfusion for rural ST-elevation myocardial infarction patients by direct transport to an urban PCI-hospital (United States)

    Bennin, Charles-Lwanga K; Ibrahim, Saif; Al-Saffar, Farah; Box, Lyndon C; Strom, Joel A


    Backgrounds ST-elevation myocardial infarction (STEMI) guidelines recommend reperfusion by primary percutaneous coronary intervention (PCI) ≤ 90 min from time of first medical contact (FMC). This strategy is challenging in rural areas lacking a nearby PCI-capable hospital. Recommended reperfusion times can be achieved for STEMI patients presenting in rural areas without a nearby PCI-capable hospital by ground transportation to a central PCI-capable hospital by use of protocol-driven emergency medical service (EMS) STEMI field triage protocol. Methods Sixty STEMI patients directly transported by EMS from three rural counties (Nassau, Camden and Charlton Counties) within a 50-mile radius of University of Florida Health-Jacksonville (UFHJ) from 01/01/2009 to 12/31/2013 were identified from its PCI registry. The STEMI field triage protocol incorporated three elements: (1) a cooperative agreement between each of the rural emergency medical service (EMS) agency and UFHJ; (2) performance of a pre-hospital ECG to facilitate STEMI identification and laboratory activation; and (3) direct transfer by ground transportation to the UFHJ cardiac catheterization laboratory. FMC-to-device (FMC2D), door-to-device (D2D), and transit times, the day of week, time of day, and EMS shift times were recorded, and odds ratio (OR) of achieving FMC2D times was calculated. Results FMC2D times were shorter for in-state STEMIs (81 ± 17 vs. 87 ± 19 min), but D2D times were similar (37 ± 18 vs. 39 ± 21 min). FMC2D ≤ 90 min were achieved in 82.7% in-state STEMIs compared to 52.2% for out-of-state STEMIs (OR = 4.4, 95% CI: 1.24–15.57; P = 0.018). FMC2D times were homogenous after adjusting for weekday vs. weekend, EMS shift times. Nine patients did not meet FMC2D ≤ 90 min. Six were within 10 min of target; all patient achieved FMC2D ≤ 120 min. Conclusions Guideline-compliant FMC2D ≤ 90 min is achievable for rural STEMI patients within a 50 mile radius of a PCI-capable hospital by use

  2. A Case of Transient, Isolated Cranial Nerve VI Palsy due to Skull Base Osteomyelitis

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    Brijesh Patel


    Full Text Available Otitis externa affects both children and adults. It is often treated with topical antibiotics, with good clinical outcomes. When a patient fails to respond to the treatment, otitis externa can progress to malignant otitis externa. The common symptoms of skull bone osteomyelitis include ear ache, facial pain, and cranial nerve palsies. However, an isolated cranial nerve is rare. Herein, we report a case of 54-year-old female who presented with left cranial nerve VI palsy due to skull base osteomyelitis which responded to antibiotic therapy.

  3. Information Needs in Relation to Physical Activity among Angina Patients before Percutaneous Coronary Intervention (PCI at a Private Hospital in Penang, Malaysia

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    Ho Siew Eng


    Full Text Available Background: Episodes experienced by angina patients are potentially frightening and life threatening. Angina patients lack awareness regarding Percutaneous Coronary Intervention (PCI as a prognostic benefit. Aim and Objectives: To identify the information needs in relation to physical activity among angina patients before PCI at a private hospital in Penang, Malaysia. Material and Methods: A cross-sectional study was conducted from April to July 2016; 150 respondents who fulfilled the inclusion criteria were recruited. A 16-item questionnaire related to physical limitations was adapted and modified from Seattle Angina Questionnaire (SAQ. Results: The findings reported that majority of respondents (103; 69% possessed more than one co-morbidity, while 47respondents (31% single co-morbidity. Those with secondary level education showed (M=15.98, SD±6.14 while tertiary level education reported (M=16.61, SD±6.11, with no significant difference (t= -0.623, p= 0.534 between respondents' education level and physical activity. In terms of occupation, employed (M=15.58, SD±6.42 and unemployed (M=17.31, SD±5.52 also reported significant difference with (t= -1.70, p= 0.04. There was likewise a significant difference between respondents with single co-morbidity (M=18.09, SD±6.88 and multiple co-morbidity (M=15.46, SD± 5.58 with (t= 2.475, p= 0.01.However, there was no significant difference between respondents with previous admission and physical activity (t= 0.868, p= 0.387, as well as respondents' age group with physical activity (t=-0.675, p= 0.501.Conclusion: In conclusion, respondents' information needs regarding PCI are significantly associated with occupation and co-morbidity towards physical activity before PCI. Age, educational level and previous admission did not have any effect on respondents' physical activity before PCI.

  4. Food irradiation makes progress

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    Kooij, J. van (Joint FAO/IAEA Div. of Isotope and Radiation Applications of Atomic Energy for Food and Agricultural Development, Vienna (Austria))


    In the past fifteen years, food irradiation processing policies and programmes have been developed both by a number of individual countries, and through projects supported by FAO, IAEA and WHO. These aim at achieving general acceptance and practical implementation of food irradiation through rigorous investigations of its wholesomeness, technological and economic feasibility, and efforts to achieve the unimpeded movement of irradiated foods in international trade. Food irradiation processing has many uses.

  5. Food irradiation in China

    Energy Technology Data Exchange (ETDEWEB)

    Wedekind, L.


    The paper concerns food irradiation in The People's Republic of China. Its use is envisaged to prolong storage times and to improve the quality of specific foodstuffs. Commercialisation in China, demonstration plants, seasonal shortages and losses, Shanghai irradiation centre, health and safety approval, prospects for wider applications and worldwide use of food irradiation, are all discussed.

  6. Percutaneous coronary intervention versus coronary artery bypass grafting in patients with end-stage renal disease requiring dialysis (5-year outcomes of the CREDO-Kyoto PCI/CABG Registry Cohort-2). (United States)

    Marui, Akira; Kimura, Takeshi; Nishiwaki, Noboru; Mitsudo, Kazuaki; Komiya, Tatsuhiko; Hanyu, Michiya; Shiomi, Hiroki; Tanaka, Shiro; Sakata, Ryuzo


    Ischemic heart disease is a major risk factor for morbidity and mortality in patients with end-stage renal disease. However, long-term benefits of percutaneous coronary intervention (PCI) relative to coronary artery bypass grafting (CABG) in those patients is still unclear in the drug-eluting stent era. We identified 388 patients with multivessel and/or left main disease with end-stage renal disease requiring dialysis among 15,939 patients undergoing first coronary revascularization enrolled in the Coronary REvascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2 (PCI: 258 patients and CABG: 130 patients). The CABG group included more patients with 3-vessel (38% vs 57%, p <0.001) and left main disease (10% vs 34%, p <0.001). Preprocedural Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score in the CABG group was significantly higher than that in the PCI group (23.5 ± 8.7 vs 29.4 ± 11.0, p <0.001). Unadjusted 30-day mortality was 2.7% for PCI and 5.4% for CABG. Cumulative 5-year all-cause mortality was 52.3% for PCI and 49.9% for CABG. Propensity score-adjusted all-cause mortality was not different between PCI and CABG (hazard ratio [HR] 1.33, 95% confidence interval [CI] 0.85 to 2.09, p = 0.219). However, the excess risk of PCI relative to CABG for cardiac death was significant (HR 2.10, 95% CI 1.11 to 3.96, p = 0.02). The risk of sudden death was also higher after PCI (HR 4.83, 95% CI 1.01 to 23.08, p = 0.049). The risk of myocardial infarction after PCI tended to be higher than after CABG (HR 3.30, 95% CI 0.72 to 15.09, p = 0.12). The risk of any coronary revascularization after PCI was markedly higher after CABG (HR 3.78, 95% CI 1.91 to 7.50, p <0.001). Among the 201 patients who died during the follow-up, 94 patients (47%) died from noncardiac morbidities such as stroke, respiratory failure, and renal failure. In patients with multivessel and/or left main disease undergoing dialysis, 5-year

  7. Cranial Reconstruction following the Removal of an Infected Synthetic Dura Mater Substitute

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    Nobutaka Yoshioka, MD


    Conclusions: Staged cranial reconstruction after the removal of an infected synthetic dura mater substitute using an algorithmic approach is feasible and safe, produces satisfactory cosmetic results, and is not associated with any complications.

  8. Bony cranial ornamentation linked to rapid evolution of gigantic theropod dinosaurs (United States)

    Gates, Terry A.; Organ, Chris; Zanno, Lindsay E.


    Exaggerated cranial structures such as crests and horns, hereafter referred to collectively as ornaments, are pervasive across animal species. These structures perform vital roles in visual communication and physical interactions within and between species. Yet the origin and influence of ornamentation on speciation and ecology across macroevolutionary time scales remains poorly understood for virtually all animals. Here, we explore correlative evolution of osseous cranial ornaments with large body size in theropod dinosaurs using a phylogenetic comparative framework. We find that body size evolved directionally toward phyletic giantism an order of magnitude faster in theropod species possessing ornaments compared with unadorned lineages. In addition, we find a body mass threshold below which bony cranial ornaments do not originate. Maniraptoriform dinosaurs generally lack osseous cranial ornaments despite repeatedly crossing this body size threshold. Our study provides novel, quantitative support for a shift in selective pressures on socio-sexual display mechanisms in theropods coincident with the evolution of pennaceous feathers.

  9. Fossil cranial walrus material from the North Sea and the estuary of the Schelde (Mammalia, Carnivora)

    NARCIS (Netherlands)

    Bosscha Erdbrink, D.P.; Bree, van P.J.H.


    Six cranial odobenid remains in a public collection, which have come to our notice since the publication of two earlier papers, are described and discussed. Identification of several specimens with Odobenus antverpiensis (Rutten, 1907) cannot be ruled out.

  10. Malignant otitis externa with bilateral cranial nerve involvement: Report of a unique case

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    Somnath Saha


    Full Text Available Malignant otitis externa is an inflammatory condition caused by pseudomonas infection usually in the elderly diabetics, or an immunosuppressive condition that presents with diffuse otitis externa along with excruciating pain and granulations tissue in the external auditory meatus. Facial paralysis is common along with occasional involvement of other cranial nerves. Case report describing a patient of malignant otitis externa who presented to a tertiary referral hospital of eastern India. This patient had ipsilateral facial and tenth cranial nerve paralysis along with delayed-onset contralateral sixth and twelfth cranial nerve palsy. The patient was treated initially with intravenous anti-pseudomonal antibody followed by tympanic platectomy, facial nerve decompression and medialisation thyroplasty. The contralateral cranial nerve palsy was managed conservatively with partial recovery of function. Malignant otitis externa, though a common disease, may occasionally present with uncommon or unexplained presentations. The management of these cases should be prompt and aggressive and specifically address each of the debilitating complications.

  11. The spectrum of cranial ultrasound and magnetic resonance imaging abnormalities in congenital cytomegalovirus infection

    NARCIS (Netherlands)

    Vries, L.S. de; Gunardi, H.; Barth, P.G.; Bok, L.A.; Verboon-Maciolek, M.; Groenendaal, F.


    Congenital cytomegalovirus (CMV) infection can lead to severe neurological sequelae and (progressive) sensorineural deafness. Neonatal imaging data is mainly based on cranial ultrasound (US) and computed tomography (CT). The additional value of magnetic resonance imaging (MRI) was assessed in

  12. Structural and mechanical characterization of custom design cranial implant created using additive manufacturing

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    Khaja Moiduddin


    Conclusions: The study reveals that the use of mesh implants in cranial reconstruction satisfies the need of lighter implants with an adequate mechanical strength, thus restoring better functionality and esthetic outcomes for the patients.

  13. Preoperative surgical planning and simulation of complex cranial base tumors in virtual reality

    Institute of Scientific and Technical Information of China (English)

    YI Zhi-qiang; LI Liang; MO Da-peng; ZHANG Jia-yong; ZHANG Yang; BAO Sheng-de


    @@ The extremely complex anatomic relationships among bone,tumor,blood vessels and cranial nerves remains a big challenge for cranial base tumor surgery.Therefore.a good understanding of the patient specific anatomy and a preoperative planning are helpful and crocial for the neurosurgeons.Three dimensional (3-D) visualization of various imaging techniques have been widely explored to enhance the comprehension of volumetric data for surgical planning.1 We used the Destroscope Virtual Reality (VR) System (Singapore,Volume Interaction Pte Ltd,software:RadioDexterTM 1.0) to optimize preoperative plan in the complex cranial base tumors.This system uses patient-specific,coregistered,fused radiology data sets that may be viewed stereoscopically and can be manipulated in a virtual reality environment.This article describes our experience with the Destroscope VR system in preoperative surgical planning and simulation for 5 patients with complex cranial base tumors and evaluates the clinical usefulness of this system.

  14. A Development of a Human Cranial Bone Surrogate for Impact Studies

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    Jack C Roberts


    Full Text Available In order to replicate the fracture behavior of the intact human skull under impact it becomes necessary to develop a material having the mechanical properties of cranial bone. The most important properties to replicate in a surrogate human skull were found to be the fracture toughness and tensile strength of the cranial tables as well as the bending strength of the 3-layer (inner table-diplöe-outer table architecture of the human skull. The materials selected to represent the surrogate cranial tables consisted of two different epoxy resins systems with random milled glass fiber to enhance the strength and stiffness and the materials to represent the surrogate diplöe consisted of three low density foams. Forty-one three-point bending fracture toughness tests were performed on nine material combinations. The materials that best represented the fracture toughness of cranial tables were then selected and formed into tensile samples and tested. These materials were then used with the two surrogate diplöe foam materials to create the three layer surrogate cranial bone samples for three point bending tests. Drop tower tests were performed on flat samples created from these materials and the fracture patterns were very similar to the linear fractures seen in pendulum impacts of intact human skulls. The surrogate cranial tables had the quasi-static fracture toughness and tensile strength of 2.5 MPa√m and 53 ± 4.9 MPa, respectively, while the same properties of human compact bone were 3.1 ± 1.8 MPa√m and 68 ± 18 MPa, respectively. The cranial surrogate had a quasi-static bending strength of 68 ± 5.7 MPa, while that of cranial bone was 82 ± 26 MPa. This material/design is currently being used to construct spherical shell samples for drop tower and ballistic tests.

  15. Random genetic drift, natural selection, and noise in human cranial evolution. (United States)

    Roseman, Charles C


    This study assesses the extent to which relationships among groups complicate comparative studies of adaptation in recent human cranial variation and the extent to which departures from neutral additive models of evolution hinder the reconstruction of population relationships among groups using cranial morphology. Using a maximum likelihood evolutionary model fitting approach and a mixed population genomic and cranial data set, I evaluate the relative fits of several widely used models of human cranial evolution. Moreover, I compare the goodness of fit of models of cranial evolution constrained by genomic variation to test hypotheses about population specific departures from neutrality. Models from population genomics are much better fits to cranial variation than are traditional models from comparative human biology. There is not enough evolutionary information in the cranium to reconstruct much of recent human evolution but the influence of population history on cranial variation is strong enough to cause comparative studies of adaptation serious difficulties. Deviations from a model of random genetic drift along a tree-like population history show the importance of environmental effects, gene flow, and/or natural selection on human cranial variation. Moreover, there is a strong signal of the effect of natural selection or an environmental factor on a group of humans from Siberia. The evolution of the human cranium is complex and no one evolutionary process has prevailed at the expense of all others. A holistic unification of phenome, genome, and environmental context, gives us a strong point of purchase on these problems, which is unavailable to any one traditional approach alone. Am J Phys Anthropol 160:582-592, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. The Trigeminal (V) and Facial (VII) Cranial Nerves: Head and Face Sensation and Movement


    Sanders, Richard D.


    There are close functional and anatomical relationships between cranial nerves V and VII in both their sensory and motor divisions. Sensation on the face is innervated by the trigeminal nerves (V) as are the muscles of mastication, but the muscles of facial expression are innervated mainly by the facial nerve (VII) as is the sensation of taste. This article briefly reviews the anatomy of these cranial nerves, disorders of these nerves that are of particular importance to psychiatry, and some ...

  17. Comparative study between cortical bone graft versus bone dust for reconstruction of cranial burr holes


    Worm, Paulo Valdeci; Ferreira,Nelson Pires; Faria, Mário de Barros; Ferreira, Marcelo Paglioli; Kraemer,Jorge Luiz; Collares, Marcus Vinicius Martins


    Background: As a consequence of the progressive evolution of neurosurgical techniques, there has been increasing concern with the esthetic aspects of burr holes. Therefore, the objective of this study was to compare the use of cortical bone graft and bone dust for correcting cranial deformities caused by neurosurgical trephines. Methods: Twenty-three patients were enrolled for cranial burr hole reconstruction with a 1-year follow-up. A total of 108 burr holes were treated; 36 burr holes were ...

  18. High-frequency cranial electrostimulation (CES) in patients with probable Alzheimer's disease. (United States)

    Scherder, Erik J A; van Tol, M J; Swaab, D F


    In a previous study, low-frequency cranial electrostimulation did not improve cognition and (affective) behavior in patients with probable Alzheimer's disease. In the present study, 21 Alzheimer's disease patients, divided into an experimental (n = 11) and a control group (n = 10), were treated for 30 mins/day, 5 days/wk, for 6 wks with high-frequency cranial electrostimulation. Similar to the previous study, no improvements on cognition and (affective) behavior were found.

  19. Evaluation of vertical forces in the pads of Pitbulls with cranial cruciate ligament rupture


    Souza, Alexandre N A; Tatarunas, Angelica C; Matera,Julia M.


    Abstract Background Cranial cruciate ligament rupture (CCLR) is one of the most important stifle injuries and a common cause of lameness in dogs. Our objective was to measure the vertical forces in the pads of Pitbulls with cranial cruciate ligament rupture (CCLR) using a pressure sensitive walkway. A pressure sensitive walkway was used to collect vertical force data from the pads of 10 Pitbulls affected with unilateral CCLR. Ten healthy...

  20. Facial nerve neurinoma presenting as middle cranial fossa and cerebellopontine angle mass : a case report.

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    Devi B


    Full Text Available Facial nerve neurinomas are rare. The tumours arising from the geniculate ganglion may grow anteriorly and superiorly and present as a mass in the middle cranial fossa. Only a few cases of facial nerve neurinomas presenting as middle cranial fossa mass have so far been reported. These tumours present with either long standing or intermittent facial palsy along with cerebellopontine angle syndrome.

  1. Comparison of Mandibular Surgical Techniques for Accessing Cranial Base Vascular Lesions


    Devlin, Michael A.; Hoffmann, Keith D.; Johnson, Walter D.


    This study compared mandibular distraction and vertical ramus osteotomy in terms of their effectiveness at increasing access to the cranial base and distal internal carotid artery. Five fresh–frozen cadavers were used to obtain a total of ten cranial base exposures. The following two techniques were evaluated on each of the ten exposures: (1) anterior distraction of the mandible without violation of the temporomandibular joint capsule, and (2) vertical ramus osteotomy of the mandible with dis...

  2. Autologous cranial bone graft use for trepanation reconstruction. (United States)

    Worm, Paulo Valdeci; Ferreira, Nelson Pires; Finger, Guilherme; Collares, Marcus Vinicius Martins


    Esthetic deformities in the human skull are a subject of concern among neurosurgical patients and neurosurgeons; they can be disfiguring and harm the patient's social relationships. To access inner structures, neurosurgical operations require skull trepanation, a process that frequently involves loss of bone tissue and leads to esthetic problems. Satisfactory reconstruction is a challenge, and neurosurgeons search for an implant which ideally is organic and low cost and does not cause an immunological or allergic reaction. Therefore, autologous bone tissue remains the gold standard for reconstruction. To develop a technique that allows neurosurgeons to rebuild the trepanation hole with a better esthetic outcome. Craniotomy orifices in 108 patients were closed with a graft obtained from the cranial bone inner layer. In order to remove the graft a specially made trephine was used. No grafts dislocated during follow-up. Cosmetic outcomes and results seen on image examinations were favorable for this new technique when compared with others previously described in medical literature. The authors present a new and feasible trepanation reconstruction technique that allows a better esthetic outcome without increasing the surgical risk for the patient, or making the surgical procedure longer or more expensive. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  3. The role of cranial computed tomography in carotid surgery. (United States)

    Vollman, R W; Eldrup-Jorgensen, J; Hoffman, M A


    In patients who present with TIA, RIND, or CVA, the cranial CT scan can rule out other etiologies for neurologic symptoms. In addition to the clinical presentation, the CT scan allows further stratification of patients being considered for carotid endarterectomy. We propose that patients be classified as TIA (+), TIA (-), RIND (+), or CVA (-). The CT scan has defined a new subgroup of patients, TIA (+) and RIND (+)--the Silent Cerebral Infarction. Patients who are categorized as TIA (+), RIND (+), and CVA (+) (cerebral infarction on CT or by history) are at increased risk for intraoperative ischemia and postoperative neurologic deficit. As such, they should be selectively shunted based on intraoperative EEG monitoring or routinely shunted. There is a strong association between ulcerative plaque at the carotid bifurcation and cerebral infarction on CT. The CT scan is a critical diagnostic procedure in evaluating the patient with an acute neurologic event. Patients with negative CT scans are candidates for early operation. Carotid endarterectomy should generally be delayed for 4 to 6 weeks in patients with positive CT scans.

  4. Promoting central nervous system regeneration: lessons from cranial nerve I. (United States)

    Ruitenberg, Marc J; Vukovic, Jana


    The olfactory nerve differs from cranial nerves III-XII in that it contains a specialised type of glial cell, called 'olfactory ensheathing cell' (OEC), rather than Schwann cells. In addition, functional neurogenesis persists postnatally in the olfactory system, i.e. the primary olfactory pathway continuously rebuilds itself throughout adult life. The presence of OECs in the olfactory nerve is thought to be critical to this continuous growth process. Because of this intrinsic capacity for self-repair, the mammalian olfactory system has proved as a useful model in neuroregeneration studies. In addition, OECs have been used in transplantation studies to promote pathway regeneration elsewhere in the nervous system. Here, we have reviewed the parameters that allow for repair within the primary olfactory pathway and the role that OECs are thought to play in this process. We conclude that, in addition to intrinsic growth potential, the presence of an aligned substrate to the target structure is a fundamental prerequisite for appropriate restoration of connectivity with the olfactory bulb. Hence, strategies to promote regrowth of injured nerve pathways should incorporate usage of aligned, oriented substrates of OECs or other cellular conduits with additional intervention to boost neuronal cell body responses to injury and/or neutralisation of putative inhibitors.

  5. The first virtual cranial endocast of a lungfish (sarcopterygii: dipnoi.

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    Alice M Clement

    Full Text Available Lungfish, or dipnoans, have a history spanning over 400 million years and are the closest living sister taxon to the tetrapods. Most Devonian lungfish had heavily ossified endoskeletons, whereas most Mesozoic and Cenozoic lungfish had largely cartilaginous endoskeletons and are usually known only from isolated tooth plates or disarticulated bone fragments. There is thus a substantial temporal and evolutionary gap in our understanding of lungfish endoskeletal morphology, between the diverse and highly variable Devonian forms on the one hand and the three extant genera on the other. Here we present a virtual cranial endocast of Rhinodipterus kimberleyensis, from the Late Devonian Gogo Formation of Australia, one of the most derived fossil dipnoans with a well-ossified braincase. This endocast, generated from a Computed Microtomography (µCT scan of the skull, is the first virtual endocast of any lungfish published, and only the third fossil dipnoan endocast to be illustrated in its entirety. Key features include long olfactory canals, a telencephalic cavity with a moderate degree of ventral expansion, large suparaotic cavities, and moderately enlarged utricular recesses. It has numerous similarities to the endocasts of Chirodipterus wildungensis and Griphognathus whitei, and to a lesser degree to 'Chirodipterus' australis and Dipnorhynchus sussmilchi. Among extant lungfish, it consistently resembles Neoceratodus more closely than Lepidosiren and Protopterus. Several trends in the evolution of the brains and labyrinth regions in dipnoans, such as the expansions of the utricular recess and telencephalic regions over time, are identified and discussed.

  6. Prenatal cranial ossification of the humpback whale (Megaptera novaeangliae). (United States)

    Hampe, Oliver; Franke, Helena; Hipsley, Christy A; Kardjilov, Nikolay; Müller, Johannes


    Being descendants of small terrestrial ungulate mammals, whales underwent enormous transformations during their evolutionary history, that is, extensive changes in anatomy, physiology, and behavior were evolved during secondary adaptations to life in water. However, still only little is known about whale ontogenetic development, which help to identify the timing and sequence of critical evolutionary events, such as modification of the cetacean ear. This is particularly true for baleen whales (Mysticeti), the group including the humpback whale Megaptera novaeangliae. We use high-resolution X-ray computed tomography to reinvestigate humpback whale fetuses from the Kükenthal collection at the Museum für Naturkunde, Berlin, thus, extending historic descriptions of their skeletogenesis and providing for the first time sequences of cranial ossification for this species. Principally, the ossification sequence of prenatal Megaptera follows a typical mammalian pattern with the anterior dermal bones being the first ossifying elements in the skull, starting with the dentary. In contrast to other mammals, the ectotympanic bone ossifies at an early stage. Alveolar structure can be observed in both the maxillae and dentaries in these early prenatal specimens but evidence for teeth is lacking. Although the possibility of obtaining new embryological material is unlikely due to conservation issues, our study shows that reexamination of existing specimens employing new technologies still holds promise for filling gaps in our knowledge of whale evolution and ontogeny.

  7. Serial cranial computed tomography in acute infantile hemiplegia

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    Kataoka, Kenkichi; Nakagawa, Yoshihiro; Hojo, Hiroatsu; Yamasaki, Shun (Shizuoka Prefectural Children' s Hospital (Japan)); Mochizuki, Yasuhiro; Nakano, Shozo


    Serial cranial computed tomography (CCT) was studied in 20 children with acute infantile hemiplegia. These children were devided into two groups: hemiplegia following fever, hemiconvulsion and unconsiousness (the convulsive group) and hemiplegia without convulsion (the non-convulsive group). There were 15 cases in the convulsive group and 5 cases in the non-convulsive group. We could investigate the CCT immediately after the onset in 6 convulsive cases and 3 non-convulsive cases, but the immediate CCT revealed no abnormalities in both groups. Within several days after the onset the abnormally low density area appeared on the CCT in both groups. In three cases there were abnormally high density areas complicating these abnormalities. Over more than a month, the hemispheric low density area changed into the hemispheric atrophy and the lobar low density area changed into the focal wedge-shaped atrophy or diminished. The small or lacunar low density area changed into the low density spot and the hemorrhagic infarction into the porencephaly. The occlusion of the internal carotid artery were found in two non-convulsive cases and the stenosis of the internal carotid artery in a convulsive case with purulent meningitis.

  8. Assessments of whole body scan images (PCI) obtained in patients undergoing treatment of radioiodine (pre and post-treatment); Avaliacoes das imagens de pesquisa de corpo inteiro (PCI) obtidas em pacientes submetidos ao tratamento de radioiodoterapia (pre e pos-tratamento)

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    Costa, Fernanda Karolina Mendonca da; Lopes Filho, Ferdinand de Jesus; Vieira, Jose Wilson; Souza, Milena Thays Barbosa de, E-mail:, E-mail:, E-mail:, E-mail: [Instituto Federal de Educacao, Ciencia e Tecnologia de Pernambuco (IFPE), Recife, PE (Brazil)


    Nuclear medicine is a medical specialty used for diagnosis and therapy of some diseases. For the treatment of differentiated thyroid carcinoma (papillary and follicular) Radioiodine therapy is employed, in order to eliminate the rest of thyroid tissue after removal of the thyroid (thyroidectomy). In radioiodine therapy is used radioisotope iodine-131 ({sup 131}I) as Sodium Iodide (NaI). The amount of the activity (dose) of {sup 131}I administered is generally the responsibility of nuclear medicine, which is based on an image Research Length of the patient (pre-dose therapy PCI). PCI is also used after treatment (post-PCI therapeutic dose) to evaluate possible metastasis. The purpose of this study was to investigate the distribution of biokinetic {sup 131}I at length and in some organs of the patient, in order to note any similarity. Exams PCI pre-dose and post-dose were analyzed, the anterior and posterior projections of ten patients. Contours in these images (ROI - Region Of Interest) were made in the whole body and in areas with high uptake of {sup 131}I. The total score was used in the calculation to obtain the percentage distribution of {sup 13I} in the organs of the patient. The results showed that there similarity on the biodistribution of {sup 131}I between pre-dose and post-dose PCI. Therefore, it was found that it is valuable images of PCI pre-dose therapy as a way to assist the nuclear medicine physician in choosing the best activity to be administered to the patient in order to minimize the dose to adjacent organs. (author)

  9. Differential sensitivity of cranial and limb motor function to nigrostriatal dopamine depletion. (United States)

    Plowman, Emily K; Maling, Nicholas; Rivera, Benjamin J; Larson, Krista; Thomas, Nagheme J; Fowler, Stephen C; Manfredsson, Fredric P; Shrivastav, Rahul; Kleim, Jeffrey A


    The present study determined the differential effects of unilateral striatal dopamine depletion on cranial motor versus limb motor function. Forty male Long Evans rats were first trained on a comprehensive motor testing battery that dissociated cranial versus limb motor function and included: cylinder forepaw placement, single pellet reaching, vermicelli pasta handling; sunflower seed opening, pasta biting acoustics, and a licking task. Following baseline testing, animals were randomized to either a 6-hydroxydopamine (6-OHDA) (n=20) or control (n=20) group. Animals in the 6-OHDA group received unilateral intrastriatal 6-OHDA infusions to induce striatal dopamine depletion. Six-weeks following infusion, all animals were re-tested on the same battery of motor tests. Near infrared densitometry was performed on sections taken through the striatum that were immunohistochemically stained for tyrosine hydroxylase (TH). Animals in the 6-OHDA condition showed a mean reduction in TH staining of 88.27%. Although 6-OHDA animals were significantly impaired on all motor tasks, limb motor deficits were more severe than cranial motor impairments. Further, performance on limb motor tasks was correlated with degree of TH depletion while performance on cranial motor impairments showed no significant correlation. These results suggest that limb motor function may be more sensitive to striatal dopaminergic depletion than cranial motor function and is consistent with the clinical observation that therapies targeting the nigrostriatal dopaminergic system in Parkinson's disease are more effective for limb motor symptoms than cranial motor impairments. Published by Elsevier B.V.

  10. Cranial dural arteriovenous shunts. Part 1. Anatomy and embryology of the bridging and emissary veins. (United States)

    Baltsavias, Gerasimos; Parthasarathi, Venkatraman; Aydin, Emre; Al Schameri, Rahman A; Roth, Peter; Valavanis, Anton


    We reviewed the anatomy and embryology of the bridging and emissary veins aiming to elucidate aspects related to the cranial dural arteriovenous fistulae. Data from relevant articles on the anatomy and embryology of the bridging and emissary veins were identified using one electronic database, supplemented by data from selected reference texts. Persisting fetal pial-arachnoidal veins correspond to the adult bridging veins. Relevant embryologic descriptions are based on the classic scheme of five divisions of the brain (telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon). Variation in their exact position and the number of bridging veins is the rule and certain locations, particularly that of the anterior cranial fossa and lower posterior cranial fossa are often neglected in prior descriptions. The distal segment of a bridging vein is part of the dural system and can be primarily involved in cranial dural arteriovenous lesions by constituting the actual site of the shunt. The veins in the lamina cribriformis exhibit a bridging-emissary vein pattern similar to the spinal configuration. The emissary veins connect the dural venous system with the extracranial venous system and are often involved in dural arteriovenous lesions. Cranial dural shunts may develop in three distinct areas of the cranial venous system: the dural sinuses and their interfaces with bridging veins and emissary veins. The exact site of the lesion may dictate the arterial feeders and original venous drainage pattern.

  11. Imaging the cranial nerves: Part I: Methodology, infectious and inflammatory, traumatic and congenital lesions

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil- Centro de Lisboa, Department of Radiology, Lisboa Codex (Portugal); Casselman, Jan [A.Z. St. Jan Brugge Hospital, Department of Radiology, Brugge (Belgium); A.Z. St. Augustinus Antwerpen Hospitals, Department of Radiology, Antwerpen (Belgium)


    Many disease processes manifest either primarily or secondarily by cranial nerve deficits. Neurologists, ENT surgeons, ophthalmologists and maxillo-facial surgeons are often confronted with patients with symptoms and signs of cranial nerve dysfunction. Seeking the cause of this dysfunction is a common indication for imaging. In recent decades we have witnessed an unprecedented improvement in imaging techniques, allowing direct visualization of increasingly small anatomic structures. The emergence of volumetric CT scanners, higher field MR scanners in clinical practice and higher resolution MR sequences has made a tremendous contribution to the development of cranial nerve imaging. The use of surface coils and parallel imaging allows sub-millimetric visualization of nerve branches and volumetric 3D imaging. Both with CT and MR, multiplanar and curved reconstructions can follow the entire course of a cranial nerve or branch, improving tremendously our diagnostic yield of neural pathology. This review article will focus on the contribution of current imaging techniques in the depiction of normal anatomy and on infectious and inflammatory, traumatic and congenital pathology affecting the cranial nerves. A detailed discussion of individual cranial nerves lesions is beyond the scope of this article. (orig.)

  12. Imaging the cranial nerves: part II: primary and secondary neoplastic conditions and neurovascular conflicts

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil- Centro de Lisboa, Radiology Department, Lisboa Codex (Portugal); Casselman, Jan [A. Z. St Jan Brugge and A. Z. St Augustinus Antwerpen Hospitals, Department of Radiology, Antwerp (Belgium)


    There have been unprecedented improvements in cross-sectional imaging in the last decades. The emergence of volumetric CT, higher field MR scanners and higher resolution MR sequences is largely responsible for the increasing diagnostic yield of imaging in patients presenting with cranial nerve deficits. The introduction of parallel MR imaging in combination with small surface coils allows the depiction of submillimetric nerves and nerve branches, and volumetric CT and MR imaging is able to provide high quality multiplanar and curved reconstructions that can follow the often complex course of cranial nerves. Seeking the cause of a cranial nerve deficit is a common indication for imaging, and it is not uncommon that radiologists are the first specialists to see a patient with a cranial neuropathy. To increase the diagnostic yield of imaging, high-resolution studies with smaller fields of view are required. To keep imaging studies within a reasonable time frame, it is mandatory to tailor the study according to neuro-topographic testing. This review article focuses on the contribution of current imaging techniques in the depiction of primary and secondary neoplastic conditions affecting the cranial nerves as well as on neurovascular conflicts, an increasingly recognized cause of cranial neuralgias. (orig.)

  13. X Irradiation Induces Acute Cognitive Decline via Transient Synaptic Dysfunction. (United States)

    Puspitasari, Anggraeini; Koganezawa, Noriko; Ishizuka, Yuta; Kojima, Nobuhiko; Tanaka, Natsume; Nakano, Takashi; Shirao, Tomoaki


    Cranial X irradiation can severely impair higher brain function, resulting in neurocognitive deficits. Radiation-induced brain injury is characterized by acute, early and late delayed changes, and morbidity is evident more than 6 months after irradiation. While the acute effects of radiation exposure on the brain are known, the underlying mechanisms remain unclear. In this study, we examined the acute effect of X radiation on synaptic function using behavioral analysis and immunohistochemistry. We found that 10 Gy whole-brain irradiation immediately after conditioning (within 30 min) impaired the formation of fear memory, whereas irradiation 24 h prior to conditioning did not. To investigate the mechanisms underlying these behavioral changes, we irradiated one hemisphere of the brain and analyzed synaptic function and adult neurogenesis immunohistochemically. We focused on drebrin, whose loss from dendritic spines is a surrogate marker of synaptopathy. The intensity of drebrin immunoreactivity started to decrease in the irradiated hemisphere 2 h after exposure. The immunostaining intensity recovered to preirradiation levels by 24 h, indicating that X radiation induced transient synaptic dysfunction. Interestingly, the number of newly generated neurons was not changed at 2 h postirradiation, whereas it was significantly decreased at 8 and 24 h postirradiation. Because irradiation 24 h prior to conditioning had no effect on fear memory, our findings suggest that radiation-induced death of newly-generated neurons does not substantially impact fear memory formation. The radiation-induced synaptic dysfunction likely caused a transient memory deficit during the critical period for fear memory formation (approximately 1-3 h after conditioning), which coincides with a change in drebrin immunostaining in the hippocampus, a structure critical for fear memory formation.

  14. Reconstruction of cranial defects with individually formed cranial prostheses made of polypropylene polyester knitwear: an analysis of 48 consecutive patients. (United States)

    Kasprzak, Piotr; Tomaszewski, Grzegorz; Kotwica, Zbigniew; Kwinta, Borys; Zwoliński, Jerzy


    This article presents a new method of cranioplasty in which polypropylene polyester knitwear was used as the filling material. The basis for prosthesis shaping was a three-dimensional model of the defect made according to the patient's CT scans. Previously, such material has never been a subject of computer-aided design and computer-aided manufacturing (CAD/CAM) individual forming. The process of the prosthesis design included CT bone scans and mold preparation for each patient. Such prostheses were implanted in 48 patients with cranial defects. The total number of prostheses applied was 51. The follow-up time was at least 6 months up to 36 months. The group of treated patients is described here, and sample pictures are shown to illustrate the results. The smallest defect had a size of 15 cm(2); the biggest, 178 cm(2). The coverage and the aesthetic results were very good in all cases. Two patients had postoperative complications. The cranioplastic solution described here is a valuable addition to the existing reconstructive methods, because of the low cost of the implant, the ease of its adjustment to the shape of the defect, and the short time of preparation.

  15. A high-throughput readout architecture based on PCI-Express Gen3 and DirectGMA technology (United States)

    Rota, L.; Vogelgesang, M.; Ardila Perez, L. E.; Caselle, M.; Chilingaryan, S.; Dritschler, T.; Zilio, N.; Kopmann, A.; Balzer, M.; Weber, M.


    Modern physics experiments produce multi-GB/s data rates. Fast data links and high performance computing stages are required for continuous data acquisition and processing. Because of their intrinsic parallelism and computational power, GPUs emerged as an ideal solution to process this data in high performance computing applications. In this paper we present a high-throughput platform based on direct FPGA-GPU communication. The architecture consists of a Direct Memory Access (DMA) engine compatible with the Xilinx PCI-Express core, a Linux driver for register access, and high- level software to manage direct memory transfers using AMD's DirectGMA technology. Measurements with a Gen3 x8 link show a throughput of 6.4 GB/s for transfers to GPU memory and 6.6 GB/s to system memory. We also assess the possibility of using the architecture in low latency systems: preliminary measurements show a round-trip latency as low as 1 μs for data transfers to system memory, while the additional latency introduced by OpenCL scheduling is the current limitation for GPU based systems. Our implementation is suitable for real-time DAQ system applications ranging from photon science and medical imaging to High Energy Physics (HEP) systems.

  16. Penyusunan Panduan Pengelolaan Keamanan Informasi Untuk Firewall Configuration Berdasarkan Kerangka Kerja PCI DSS v.3.1 dan COBIT 5

    Directory of Open Access Journals (Sweden)

    Bagus Puji Santoso


    Full Text Available Information security systems must be protected from all attacks and interuptions by an unauthorized user. Firewall is a mechanism that can be applied to improve the security information which done by filtering data packets that enter and exit the network. IT governance is needed to manage good information security. IT governance can use to make the arrangement of guidelines for the management of information security. This research aims to create a reference guide to information security such as an information security management guide for firewall configuration that refers to the framework of PCI DSS v.3.1 and COBIT 5 by taking a case study at the DSIK Universitas Airlangga.Arrangement of guidelines for information security management for firewall configuration will be done in three stages. The first stage was the arrangement of information security management procedures for firewall configuration which consists of mapping analysis stage process, arrangement procedure’s stage and determining roles and job description’s stage. In the second stage was the verification of the information security management guidance using a questionnaire. The third stage was improvement of the information security management guidance. These improvements was done to correct deficiencies that were produced when verification. The verification results show that 42.86% of respondents said that management guidelines are operationally very easy to be implemented.

  17. Analysis of the Best Timing for Applying Tirofiban in PCI Operation for the Patients with ST Segment Elevation Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Lei Zhang


    Full Text Available This study is a comparative analysis of the best timing for applying tirofiban in the PCI emergency treatment for STEMI patients. We selected 109 patients with ST-segment elevation myocardial infarction from October 2013 to October 2014 and divided them into two groups, the early treatment group (53 cases received tirofiban during the operation and the later treatment group (56 cases received tirofiban after operation. The analysis was then conducted. Results: The proportion of IRA forward flow in TIMI2-3 for the 1st group during the radiography was higher than 2nd group, 50 cases with TIMI3 blood flow and 52 cases with TIMI3 blood flow in later treatment group. Comparing the TIMI3 flow of both groups, the difference was not statistically significant; for the CK-MB 4h and 8h after operation as well as the LVEF after operation, the differences are were not statistically significant. The occurrence rate of hemorrhage complication was low for both groups. The early use of tirofiban can make the thrombus fully dissolve and coronary blood flow remains in a good state, which is not only beneficial for myocardial perfusion but also helpful for deciding the length and side branch situation of coronary artery pathological changes.

  18. Developing primary PCI as a national reperfusion strategy for patients with ST-elevation myocardial infarction: the UK experience. (United States)

    McLenachan, James M; Gray, Huon H; de Belder, Mark A; Ludman, Peter F; Cunningham, David; Birkhead, John


    In 2004 in the United Kingdom (UK), the infrastructural and organisational changes required for implementation of primary PCI for treatment of STEMI were unclear, and the cost-effectiveness and sustainability of a changed reperfusion strategy had not been tested. In addition, any proposed change was to be made against the background of a previously successful in-hospital thrombolysis strategy, with plans for greater use of pre-hospital administration. A prospective study (the "National Infarct Angioplasty Project - NIAP") was set up to collect information on all patients presenting with STEMI in selected regions in the UK over a one year period (April 2005 - March 2006). The key findings from the NIAP project included that PPCI could be delivered within acceptable treatment times in a variety of geographical settings and that the shortest treatment times were achieved with direct admission to a PPCI-capable cardiac catheter laboratory. The transformation from a dominant lytic strategy to one of PPCI across the UK was achieved both swiftly and consistently with the help of 28 cardiac networks. By the second quarter of 2011, 94% of those STEMI patients in England who received reperfusion treatment were being treated by PPCI compared with 46% during the third quarter of 2008.

  19. High speed huge capacity and real time data acquisition method based on PCI controller%基于PCI总线控制器的高速大容量实时数据采集

    Institute of Scientific and Technical Information of China (English)



    The constitution of PCI controller S5933 is introduced. The concepts,performances and applied methods of Mailboxes, FIFO and Pass-Thru are described. By using S5933 PCI controller as a basic component, a method for obtaining double-route high speed, huge capacity and real time data acquisition for high resolution imaging spectrometer is presented. In this method, PCI controller′s FIFO working model and double-route parallel technique are adopted to achieve real time data acquisition and storage. Experiments prove that the speed can reach to 8MB/s, meeting the demand completely. This method has the features of simple circuite, high speed and easy extending.

  20. [Cranial osteopathy as a complementary treatment of postural plagiocephaly]. (United States)

    Amiel-Tison, C; Soyez-Papiernik, E


    For the majority of neonates and young infants, appropriate postures and standard physiotherapy succeed in preventing or correcting acquired cranial deformations (fetal due to restricted mobility in utero or postnatal secondary to exclusive dorsal decubitus). However in some cases, when postural management is not efficient, pediatricians will be asked by the parents about the potential benefits of osteopathy. What is osteopathic treatment? At first, diagnostic palpation will identify which suture is normally mobile with the respiratory cycle, and which has limited or absent mobility secondary to abnormal postures. Later on, the goal of the therapeutic phase is to mobilise impaired sutures, by various gentle maneuvers depending on the topography of the impairment. The treatment is not restricted to the skull but extended to the spine, pelvis and lower extremities which contribute to the deformative sequence. Osteopathic treatment belongs to complementary medicine, therefore demonstration of its scientific value and favorable results have to be provided. Based on randomized studies, the answer is yes, it significantly decreases the degree of asymmetry. Do postural deformations matter to the development of an healthy infant? It seems that the prejudice is not only esthetic but also functional, however more research is necessary. In conclusion, pediatricians should be more aware of the method and expectations: major deformative sequence since birth and increasing deformations despite preventive postures and standard physiotherapy are reasonable indications for such complementary treatment. "Preventive" osteopathy in maternity is not justified. Moreover osteopathy has no place in the treatment of craniosynostosis ; the latter belong to malformations, completely distinct from postural deformations.

  1. Skeletogenic fate of zebrafish cranial and trunk neural crest.

    Directory of Open Access Journals (Sweden)

    Erika Kague

    Full Text Available The neural crest (NC is a major contributor to the vertebrate craniofacial skeleton, detailed in model organisms through embryological and genetic approaches, most notably in chick and mouse. Despite many similarities between these rather distant species, there are also distinct differences in the contribution of the NC, particularly to the calvariae of the skull. Lack of information about other vertebrate groups precludes an understanding of the evolutionary significance of these differences. Study of zebrafish craniofacial development has contributed substantially to understanding of cartilage and bone formation in teleosts, but there is currently little information on NC contribution to the zebrafish skeleton. Here, we employ a two-transgene system based on Cre recombinase to genetically label NC in the zebrafish. We demonstrate NC contribution to cells in the cranial ganglia and peripheral nervous system known to be NC-derived, as well as to a subset of myocardial cells. The indelible labeling also enables us to determine NC contribution to late-forming bones, including the calvariae. We confirm suspected NC origin of cartilage and bones of the viscerocranium, including cartilages such as the hyosymplectic and its replacement bones (hymandibula and symplectic and membranous bones such as the opercle. The cleithrum develops at the border of NC and mesoderm, and as an ancestral component of the pectoral girdle was predicted to be a hybrid bone composed of both NC and mesoderm tissues. However, we find no evidence of a NC contribution to the cleithrum. Similarly, in the vault of the skull, the parietal bones and the caudal portion of the frontal bones show no evidence of NC contribution. We also determine a NC origin for caudal fin lepidotrichia; the presumption is that these are derived from trunk NC, demonstrating that these cells have the ability to form bone during normal vertebrate development.

  2. An evaluation of cranial CT scanning in clinical psychiatry. (United States)

    Colohan, H; O'Callaghan, E; Larkin, C; Waddington, J L


    From 6,300 psychiatric admissions over a 37 month period, all 54 patient referrals for CT were identified and their charts reviewed. CT influenced diagnosis, management or prognosis in 11.7 percent of patients scanned. There was poor correlation between organicity on CT scan and findings on physical examination, laboratory testing, EEG and psychological testing. The mental state examination was the single significant correlate of CT abnormality. We suggest that the use of a formalised mental state examination such as the Mini Mental State, in addition to the usual clinical assessment of mental state, may improve the accuracy of prediction of abnormality on CT scan. The introduction of X-ray computed tomography (CT) is recognised to be one of the most important innovations in the recent history of clinical medicine. In neurology the value of a non-invasive technique for examining the intracranial contents was quickly realised in the areas of diagnosis, particularly in the detection of vascular accidents and tumours. CT has also attained a significant place in psychiatry. In research studies, it has provided important information on schizophrenia, alcoholism and chronic organic reactions. The place of CT in clinical psychiatry is less clear. As its availability has increased, such scans are being requested with increasing frequency in psychiatric patients. Cranial CT is a highly sensitive diagnostic procedure which, when used unselectively, may result in the discovery of incidental findings. Until recently, a function of the psychiatrist in relation to diagnosis was to first seek to distinguish symptoms produced by organic pathology from those produced by functional illness.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Review of 3-Dimensional Printing on Cranial Neurosurgery Simulation Training. (United States)

    Vakharia, Vejay N; Vakharia, Nilesh N; Hill, Ciaran S


    Shorter working times, reduced operative exposure to complex procedures, and increased subspecialization have resulted in training constraints within most surgical fields. Simulation has been suggested as a possible means of acquiring new surgical skills without exposing patients to the surgeon's operative "learning curve." Here we review the potential impact of 3-dimensional printing on simulation and training within cranial neurosurgery and its implications for the future. In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive search of PubMed, OVID MEDLINE, Embase, and the Cochrane Database of Systematic Reviews was performed. In total, 31 studies relating to the use of 3-dimensional (3D) printing within neurosurgery, of which 16 were specifically related to simulation and training, were identified. The main impact of 3D printing on neurosurgical simulation training was within vascular surgery, where patient-specific replication of vascular anatomy and pathologies can aid surgeons in operative planning and clip placement for reconstruction of vascular anatomy. Models containing replicas of brain tumors have also been reconstructed and used for training purposes, with some providing realistic representations of skin, subcutaneous tissue, bone, dura, normal brain, and tumor tissue. 3D printing provides a unique means of directly replicating patient-specific pathologies. It can identify anatomic variation and provide a medium in which training models can be generated rapidly, allowing the trainee and experienced neurosurgeon to practice parts of operations preoperatively. Future studies are required to validate this technology in comparison with current simulators and show improved patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. 基于LabVIEW的PCI数据采集系统设计%Design of PCI data acquisition system based on LabVIEW

    Institute of Scientific and Technical Information of China (English)



    A virtual instrument system is established by using Lab VIEW and PCI data acquisition card. This paper introduced the operation process of calling PCI data acquisition card driving function by Lab VIEW CLF node, and the development of Lab VIEW block diagram. The instrument has the ability of data acquisition, waveform display, overload alarm, data storage, and so on.%利用虚拟仪器技术与PCI数据采集卡构建了一个虚拟仪器系统.详细介绍了通过LabVIEW CLF节点调用PCI数据采集卡驱动函数的操作过程,以及LabVIEW程序框图的开发流程.该仪器具有数据采集、波形显示、超限报警、数据存储等功能.

  5. Evaluation of acute ischemia in pre-procedure ECG predicts myocardial salvage after primary PCI in STEMI patients with symptoms >12hours

    DEFF Research Database (Denmark)

    Fakhri, Yama; Busk, Martin; Schoos, Mikkel Malby


    -presenters). The Anderson-Wilkin's score (AW-score) estimates the acuteness of myocardial ischemia from the electrocardiogram (ECG) in STEMI patients. We hypothesized that the AW-score is superior to symptom duration in identifying substantial salvage potential in late-presenters. METHODS: The AW-score (range 1......-4) was obtained from the pre-pPCI ECG in 55 late-presenters and symptoms 12-72 hours. Myocardial perfusion imaging was performed to assess area at risk before pPCI and after 30days to assess myocardial salvage index (MSI). We correlated both the AW-score and pain-to-balloon with MSI and determined the salvage...

  6. Prognostic value of C-reactive protein levels within 6 hours after the onset of acute anterior myocardial infarction with primary PCI

    Institute of Scientific and Technical Information of China (English)

    刘君; 傅向华; 马宁


    Prognostic value of C-reactive protein levels within 6 hours after the onset of acute anterior myocardial infarction with primary PCI!050000$河北医科大学第二医院@刘君 !050000$河北医科大学第二医院@傅向华 !050000$河北医科大学第二医院@马宁

  7. Storia in immagini del PCI. Modalità di comunicazione e di propaganda audiovisiva tra attendibilità storica e mercato contemporaneo


    Nicoletti, Chiara


    Il progetto di tesi dottorale qui presentato intende proporsi come il proseguimento e l’approfondimento del progetto di ricerca - svoltosi tra il e il 2006 e il 2008 grazie alla collaborazione tra l’Università di Bologna, la Cineteca del Comune e dalla Fondazione Istituto Gramsci Emilia-Romagna - dal titolo Analisi e catalogazione dell’Archivio audiovisivo del PCI dell’Emilia-Romagna di proprietà dell’Istituto Gramsci. La ricerca ha indagato la menzionata collezione che costitu...

  8. Perfusion and kinetic variations of left ventricle after primary PCI for acute myocardial infarction: correlation between clinico-angiographic and scintigraphic parameters

    Directory of Open Access Journals (Sweden)

    E Varani


    Full Text Available Background: The aim of the present study was to evaluate which of theclinico-angiographic parameters of acute ischemic extension and efficacy ofreperfusion in AMI treated with primary PCI are predictive of infarct size andone month left ventricular ejection fraction (LVEF.Patients and Method: Thirty-five patients with first AMI treated withprimary PCI underwent two rest 99mTc-sestamibi gated SPECT, 4-6 days and 30-40days after PCI. Clinical, electrocardiographic, angiographic and scintigraphicparameters for ischemic extent in acute phase, effective reperfusion,perfusional and kinetic outcome were collected.Results: There was a significant linear correlation among indices ofinitial ischemic extension and early perfusion defect and infarct size, whiletime to treatment (symptom onset to balloon correlated with reperfusion indices(ST resolution, corrected TIMI frame count cTFC, myocardial perfusion grade MPGand with late functional outcomes (smaller infarct size and better LVEF. A timeto treatment of <240 minutes was the most accurate predictor of effectivereperfusion and functional outcome. A late LVEF ≥50% was correlated with sum ofST elevation, ST resolution, time to treatment, CK-MB peak value, early LVEF,and early and late infarct size. An improvement in LVEF in 1 month was seen in60% of patients, who showed a shorter time to treatment and a lower cTFC.Conclusions: Improvements of perfusion and left ventricular function werefrequent one month after primary PCI in AMI. A total ischemic time ≤240 minutesand secondary ST resolution and angiographic parameters of effective reperfusionwere the best indicators of infarct size, late LVEF and improvement of LVEF.

  9. Effects of home-based exercise rehabilitation on quality of life after coronary artery bypass graft and PCI early post-discharge

    Directory of Open Access Journals (Sweden)

    Shadi Moafi


    Full Text Available Background: The barriers to participation in cardiac rehabilitation programs are individual and economic problems and limited availability and access of rehabilitation services. Because of the important role of rehabilitation, home based exercise rehabilitation is a new approach to participate in such programs. The purpose of this study was to evaluate the effects of home-based rehabilitation on quality of life (QoL in patients with coronary artery disease after coronary artery bypass graft (CABG and PCI.Materials and Method: Participants included 18 CABG (3 women, 15 men and 40 PCI (12 women, 28 men low to moderate risk patients. Finally 17 patients in the exercise group and 16 patients in the control group remained. The SF-36 was used to evaluate changes in QoL before and after the program.Result: forty-three percent was dropped out from the program. Before and after program, the exercise group was better in all domains of QoL (p<0.05. After 8 weeks of cardiac rehabilitation, significant improvements were observed in quality of life in both groups (p<0.05 but the exercise group showed more improvements in three domains.Conclusion: Home-based exercise rehabilitation after CABG and PCI may improve QoL and provide an efficient low-cost approach to cardiac rehabilitation. It may be helpful due to limited availability and resources in Iran. Nevertheless, for increasing participation and decreasing drop out it needs more training

  10. The effect of statin treatment on the prevention of stent mediated flow limited edge dissections during PCI in patients with stable angina. (United States)

    Oksuz, Fatih; Yarlioglues, Mikail; Yayla, Cagrı; Canpolat, Ugur; Murat, Sani Namık; Aydogdu, Sinan


    The effect of statin therapy before PCI with direct stenting may reduce the development of flow limited edge dissections (ED) in patients with stable angina. Flow limited ED after PCI is associated with an increased risk of major adverse cardiovascular events. Statin therapy induces important changes in the plaque composition which have been previously identified as strong predictors of ED. 100 patients complicated with flow limited ED and 100 control patients with successful procedure were enrolled into the study. EDs were described as the 5-mm regions that were immediately adjacent to the stent borders, both distally and proximally on the coronary angiography. Rate of statin use and duration of statin use were significantly higher in patients with non-ED group (63%) versus ED group (25%) (p<0.001). In addition, patients in ED group had significantly higher levels of C-reactive protein (CRP) at admission (9.9mg/dL (5.89-16.45) vs. 4.40mg/dL (3.5-7.09), respectively, p=0.014). Our findings suggested that maintenance statin treatment before PCI with direct stenting may reduce the development of flow limited ED in patients with stable angina. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Effect of PCI on inflammatory factors, cTnI, MMP-9 and NT-pro BNP in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Ke-Tong Liu; Xin Wang; Di Zhao


    Objective:To investigate the effect of PCI on inflammatory factors, cTnI, MMP-9and NT-pro BNP in patients with unstable angina pectoris.Methods:A total of 80 unstable angina pectoris patients were divided into observation group (40 cases) and control group (40 cases). The observation group was given the therapy of PCI, and the control group was given coronary angiography. To observe the of inflammatory factors, cTnI, MMP-9 and NT-pro BNP were tested and compared before and after operation.Results:At 24 h after operation, CRP and IL-18 levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups; At 24 h after operation, cTnI, MMP-9 and NT-pro BNP levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups.Conclusion: PCI therapy can induce inflammation and myocardial injury in patients with unstable angina pectoris.

  12. An Investigation into the Treatment of Acute ST Segment Elevated Myocardial Infarction with Early and Selective PCI after Thrombolysis with Urokinase and Recanalization%尿激酶溶栓再通后早期与择期 PCI 术治疗急性 ST 段抬高型心肌梗死的研究

    Institute of Scientific and Technical Information of China (English)



    Objective:To study the treatment of acute ST segment elevated myocardial infarction with early and selective PCI after thrombolysis with urokinase and recanalization .Methods:Select 90 patients with acute ST segment elevated myocardial infarction received in cardiology department in some hospital during the period from .and randomly divided them into control group and intervention group (n =45).the patients in both group received thrombolysis with urokinase,the intervention group underwent PCI 6 hours later after they had thrombolysis had been recanalized ,the control group had selective PCI in 10 days after they had thrombolysis had been recanalized.observe the occurrence rate of MACE during their stay ,and compare the recovery patients'cardic function and their walking distance with 6min 1 week and 6 months later after they had PCI .Results:(1 )the total incidence of MACE of intervention group is lower than that of the control group,the difference is statistically significant (P 0.05 );6 months later after PCI,in intervention group ,the index values of cardiac function,including left ventricular end-systolic dimension,left ventricular end-diastolic dimension and LVEF and walking distance in 6 min were superior to that of the control group,the differences were statistically significant (P 0.05);PCI 术后6月,干预组患者的心功能指标值(左室收缩末内径、舒张末内径、左室射血分数)及6min 步行距离均优于对照组,差异具有统计学意义(P <0.01)。结论:急性 ST 段抬高型心肌梗死溶栓后早期行 PCI 术治疗,能有效改善患者术后心功能指标恢复,降低不良事件的发生率。

  13. Sexual dimorphism and interspecific cranial form in two capuchin species: Cebus albifrons and C. apella. (United States)

    Masterson, T J


    Ontogenetic patterns of sexual dimorphism and cranial form in two capuchin monkeys, Cebus albifrons and C. apella, are investigated by means of univariate, bivariate, and multivariate statistics. The analyses are based on 23 linear variables. Univariate analyses indicate that similar ontogenetic patterns of cranial sexual dimorphism are present; however, interspecific differences exist in timing. Ontogenetic scaling is present in both species' crania; however, it is more prevalent in C. albifrons. Several departures are present in cranial regions associated with orbital shape, the dental arcade, and the muscles of mastication. The latter two indicate that sexual differences in diet and/or foraging strategies may exist. Sexual selection is suggested as being the primary selective regime underlying the observed patterns of cranial sexual dimorphism in each species. Interspecific comparisons confirm that C. apella possesses a more dimorphic cranium than C. albifrons and that sexual dimorphism in C. apella begins earlier in development. Although interspecific ontogenetic scaling is present in some cranial variables, C. apella is not just a scaled-up version of C. albifrons. These sympatric congeners seem to be differentiated by variables related to the orbital region and the masticatory apparatus, as indicated by both departures from ontogenetic scaling and results of the discriminant function analysis. Ecological selection, rather than varying degrees of sexual selection, is likely to be responsible for this finding given that C. apella is known to consume hard-object foods. This is consistent with the predicted outcome of the competitive exclusion principle.

  14. Cranial trauma in iron age Samnite agriculturists, Alfedena, Italy: implications for biocultural and economic stress. (United States)

    Paine, R R; Mancinelli, D; Ruggieri, M; Coppa, A


    The Samnites are an Iron Age protohistoric people from the central region of Italy. The skeletal remains are from the Alfedena necropolis, 6th through 5th centuries B.C. Macchiarelli et al. (Antropologia Contemporanea 4 (1981) 239-243) were the first to report on cranial trauma for this population, presenting four cases with extreme injuries. We re-examined this well documented skeletal population for additional examples of trauma. Previously unexamined remains from Alfedena, excavated at the turn of the 20th century, are also included in our analysis (Mariani. 1901. "Aufidena", ricerche archeologiche e storiche del Sannio settentrionale. Roma: Acc Naz Dei Lincei). Of the 209 adult crania examined, 12.9% of them exhibited trauma. Analysis of location and frequency of cranial trauma revealed that cranial injuries to the head appear to originate from all directions. The high rate of cranial trauma underscores the violent circumstances experienced during the Iron Age protohistoric period of central Italy. Males are much more likely to exhibit cranial injury than females (P = 0.009). We conclude that the injuries received by Samnite male farmer-warriors occurred while defending pastoral-agricultural resources. Trauma rates are similar for some Iron Age populations and not for others. Behavior associated with violence during the Iron Age period can not be generalized for all populations found in Italy. (c) 2006 Wiley-Liss, Inc

  15. Effectiveness of ultrasonographic evaluation of the cranial sutures in children with suspected craniosynostosis

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    Simanovsky, Natalia; Hiller, Nurith; Koplewitz, Benjamin; Rozovsky, Katya [Hadassah Hebrew University Medical Center, Department of Medical Imaging, Mount, Scopus, P.O. Box 24035, Jerusalem (Israel)


    Computed tomography (CT) is the 'gold standard' for evaluation of the cranial sutures. While prenatal cranial suture evaluation with ultrasound (US) is common, US has not been established as a postnatal screening tool. We evaluated the effectiveness of US for diagnosis of craniosynostosis (CS). During 2006, 24 infants with questionable CS were assessed with US of the sagittal, metopic, and bilateral coronal and lambdoid sutures. US findings and clinical records were reviewed retrospectively. Sixteen boys and eight girls (ages 1-11 months, mean 4.3) underwent US. The correct diagnosis was provided in 23 (95%), with equivocal findings in one patient. Cranial sutures appeared normal in 15 infants, who had normal clinical presentation at mean 5.8 months follow-up; CT confirmation was obtained in two. In eight children, US identified premature closure of one or more cranial sutures. Three-dimensional CT was performed as a preparation for surgery in four, with classical CS findings. In one case with inconclusive US findings, CT showed narrow but open sutures. Sonographic examination of cranial sutures may serve as a first imaging tool for evaluation of craniosynostosis. CT may be reserved for children with abnormal or equivocal ultrasound and for preoperative planning. (orig.)

  16. Cranial nerves in the Australian lungfish, Neoceratodus forsteri, and in fossil relatives (Osteichthyes: Dipnoi). (United States)

    Kemp, A


    Three systems, two sensory and one protective, are present in the skin of the living Australian lungfish, Neoceratodus forsteri, and in fossil lungfish, and the arrangement and innervation of the sense organs is peculiar to lungfish. Peripheral branches of nerves that innervate the sense organs are slender and unprotected, and form before any skeletal structures appear. When the olfactory capsule develops, it traps some of the anterior branches of cranial nerve V, which emerged from the chondrocranium from the lateral sphenotic foramen. Cranial nerve I innervates the olfactory organ enclosed within the olfactory capsule and cranial nerve II innervates the eye. Cranial nerve V innervates the sense organs of the snout and upper lip, and, in conjunction with nerve IX and X, the sense organs of the posterior and lateral head. Cranial nerve VII is primarily a motor nerve, and a single branch innervates sense organs in the mandible. There are no connections between nerves V and VII, although both emerge from the brain close to each other. The third associated system consists of lymphatic vessels covered by an extracellular matrix of collagen, mineralised as tubules in fossils. Innervation of the sensory organs is separate from the lymphatic system and from the tubule system of fossil lungfish.

  17. Spontaneous Coronary Artery Dissection and Hemodynamic Instability: Can Emergent PCI Be Life Saving? Report of Two Cases and Literature Review. (United States)

    Al Emam, Abdel Rahman A; Almomani, Ahmed; Gilani, Syed A


    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. It occurs predominantly among younger females and typically in the absence of atherosclerotic coronary artery disease. It is associated with peripartum period, connective tissue disorders, vasculitides, and extreme exertion. Presentations vary greatly, and this condition can be fatal. Given its rarity, there are no guidelines for management of SCAD. We present the cases of two female patients, with no coronary artery disease risk factors or recent pregnancy, who were presented with non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI), respectively, secondary to SCAD. Both had excellent outcome after emergent percutaneous intervention. Our first patient was presented with NSTEMI with ongoing chest pain and dynamic electrocardiogram (ECG). Emergent left heart catheterization was significant for first obtuse marginal (OM1) dissection, confirmed by optical coherence tomography. Percutaneous coronary intervention (PCI) with two bare metal stents was performed with resolution of symptoms and ECG changes. The second patient is known to have syndrome, presented with STEMI and emergent coronary angiography showed left anterior descending dissection with intramural hematoma confirmed by intravascular ultrasound and treated with a drug-eluting stent with resolution of symptoms and ST changes. Her hospital course was complicated by post-myocardial infarction pericarditis that was improved with colchicine. Both the patients were observed in the coronary care unit for 24 hours. Both remained asymptomatic at 6-month follow-up. SCAD is a rare cause of acute coronary syndrome. In patients with early presentation, limited disease, and ongoing symptoms, emergent cardiac catheterization with percutaneous intervention has excellent outcome. More studies are needed to establish evidence-based management guidelines.


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    Sanal Mohan


    socio-economic group which amounted to thirty nine cases. Nine cases belonged to middle class and six cases belonged to high socio-economic group. Based on extra cranial complications, twenty one cases presented with acute mastoiditis features, nineteen cases presented with discharging sinuses. Eight cases presented with features of petrositis, four cases presented with features of labyrinthitis, and two cases presented with facial nerve palsy. CONCLUSION In this study it was noted that usually the poor who suffer, may be because of financial constraints, lack of health care facilities or general neglect on the patient’s part. Maintaining proper hygiene and early treatment can reduce the number of complications in such cases.

  19. Utility of emergency cranial computed tomography in patients without trauma. (United States)

    Narayanan, Vignesh; Keniston, Angela; Albert, Richard K


    The objectives of this study were to determine, in patients admitted to the hospital from the emergency department (ED) without evidence of trauma, 1) the prevalence of clinically important abnormalities on cranial computed tomography (CCT) and 2) the frequency of emergent therapeutic interventions required because of these abnormalities. The authors retrospectively reviewed the records of all patients from 2007 between the ages of 18 and 89 years who had CCT as part of their ED evaluations prior to hospitalization. Patients with any indication of trauma were excluded, as were those who had a lumbar puncture (LP). Chief complaint, results of the ED neurologic examination, tomogram findings, and whether patients had emergent interventions were recorded. Patients presenting with altered mental status (AMS) were analyzed separately. Of the 766 patients meeting inclusion criteria, 83 (11%) had focal neurologic findings, and 61 (8%) had clinically important abnormalities on computed tomography. Emergent interventions occurred in only 12 (1.6%), 11 (92%) of whom had focal neurologic findings. In the subgroup of 287 patients with AMS as their presenting problem, 14 (4.9%) had focal findings, six (2%) had clinically important abnormalities on tomography, and only two (0.7%) required emergent interventions, both of whom had focal findings. Patients presenting with AMS were less likely to have positive findings on tomography (odds ratio [OR] = 0.16, 95% confidence interval [CI] = 0.07 to 0.39). Patients presenting with motor weakness or speech abnormalities, or who were unresponsive, were more likely to have positive findings on tomography (OR = 4.7, 95% CI = 2.6 to 8.6; OR = 4.4, 95% CI = 1.5 to 2.7; and OR = 3.3, 95% CI = 1.6 to 7.1, respectively). Of patients without evidence of trauma who receive CCT in the ED, the prevalence of focal neurologic findings and clinically important abnormalities on tomography is low, the need for emergent intervention is very low, and the

  20. Risk of Hippocampal Metastases in Small Cell Lung Cancer Patients at Presentation and After Cranial Irradiation: A Safety Profile Study for Hippocampal Sparing During Prophylactic or Therapeutic Cranial Irradiation

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    Kundapur, Vijayananda, E-mail: [Saskatoon Cancer Center, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan (Canada); Ellchuk, Tasha [Department of Radiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan (Canada); Ahmed, Shahid [Saskatoon Cancer Center, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan (Canada); Gondi, Vinai [Cadence Health Brain Tumor Center and Cadence Health Proton Center, Chicago, Illinois (United States)


    Purpose: Neurocognitive impairment (NI) in patients with small cell lung cancer (SCLC) after whole brain radiation treatment (WBRT) is a significant cause of morbidity. Hippocampal avoidance (HA) during WBRT may mitigate or prevent NI in such patients. However, this has not been tested in SCLC patients. The estimated risk of metastases in the HA region (HM) in patients with SCLC at diagnosis or after WBRT is unknown. Our study aimed to determine the risk of HM in patients with SCLC and to assess correlated clinical factors. Methods and Materials: Patients with SCLC who experienced brain metastases (BM) at presentation (de novo) or after WBRT treated at the Saskatoon Cancer Centre between 2005 and 2012 were studied. Relevant neuroimaging was independently reviewed by a neuroradiologist. HM was defined as metastases within 5 mm of the hippocampus. Logistic regression analysis was performed to assess correlation between various clinical variables and HM. Results: Seventy eligible patients were identified. Of 59 patients presenting with de novo BM, 3 patients (5%, 95% confidence interval [CI]: 0%-10.7%) had HM. Collectively there were 359 (range, 1-33) de novo BM with 3 (0.8%, 95% CI: 0%-1.7%) HM deposits. Twenty patients experienced progression of metastatic disease in the brain after WBRT. Of the 20 patients, only 1 patient (5%, 95% CI: 0%-14.5%) experienced HM. On logistic regression, no factors significantly correlated with HM. Conclusion: The overall incidence of HM before or after WBRT in SCLC patients is low, providing preliminary support for the safety of HA during planned clinical trials of HA-WBRT for SCLC.