bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation of Regional Cerebral Blood Flow Values Obtained by Perfusion-MRI and Stable Xenon Computed Tomography
Authors: Hagen T. , Bartylla K. , Piepgras U.
Published: April 2015

This study investigated the validity of perfusion-MRI for evaluating rCBF in comparison with stable xenon computed tomography. Xenon-CT CBF measurements were done with a wash-in method by 4 min inhalation of 30% xenon/oxygen mixture. Two brain levels including the basal ganglia were measured. For each level two baseline scans and six enhanced scans were obtained. During a bolus injection of 0.1 mmol/kg Gadolinium- DTPA a series of transversal T2*-weighted FLASH-images was recorded. Based on the indicator dilution theory rCBF was calculated and displayed in a parameter map. 8–10 regions of interest were located in the white and grey matter on the CBF images for each of ten patients. There was a good correlation of rCBF between perfusion-MRI and stable xenon-CT (r=0.85). The spatial resolution is comparable to stable xenon-CT Due to the vascular distribution, rCBF values measured near the subarachnoid spaces are higher than in stable Xenon-CT Intra- and interindividual comparisons require absolute values of perfusion which can be obtained by perfusion-MRI. The mapping allows a good anatomical localization comparable to xenon-CT. This technique may be used for measurements of human brain perfusion.
Aortic Arch and Carotid Artery Single-Shot Gadolinium-Enhanced 3D MR Angiography with an Elliptical Centric Acquisition Order
Authors: Huston J. , Fain S.B. , Wilman A.H. , Riederer S.J.
Published: April 2015

We sought to obtain high resolution 3D contrast-enhanced MR angiograms of the carotid arteries, vertebral arteries and aortic arch with venous signal suppression utilizing novel timing techniques. A secondary purpose was to compare contrast-enhanced MR angiograms with 2D time-of-flight MR angiograms of the carotid arteries.
Improved MRI Depiction of Intracranial and Spinal Cord Vascular Lesions Using Thin Section FSE T2 Imaging Sequences
Authors: Noonan P.T. , Richardson A.C. , Hsieh H. , Depper M.H. , Stockel J.B.
Published: April 2015

Conventional MR and MRA techniques may not accurately depict intracranial and spinal vascular anatomy and pathology. By relying on the intravascular signal void of flowing blood and the ability to obtain contiguous images, thin section FSE T2 imaging techniques including three dimensional imaging improve depiction of vessels and increase diagnostic accuracy.

The images produced by these techniques both compliment MRA and correlate well with findings at catheter-based diagnostic angiography. A pitfall is the imaging of vascular structures adjacent to nonvascular structures also having signal voids. As in other MR techniques differentiation between slow flow and occlusion may be difficult.
Changes in Cerebral Perfusion after Osmotherapy in Acute Cerebral Stroke Measured by Perfusion-Weighted MRI
Authors: Hagen T. , Stoll M. , Bartylla K. , Treib J. , Piepgras U.
Published: April 2015

We investigate the hemodynamic changes after osmotherapy in patients with acute cerebral stroke. Measurement of mean transit time (MTT), regional cerebral blood volume (rCBV) and regional cerebral blood flow (rCBF) with perfusion-weighted MRI. During a bolus injection of 0.1 mmol/kg Gadolinium-DTPA a series of transversal T2*-weighted FLASH-images was recorded. Based on the indicator dilution theory MTT, rCBV and rCBF were calculated and displayed in a parameter map.

In 11 patients showing local brain edema caused by cerebral infarction this technique was applied before and 30 minutes after intravenous infusion of 125 ml of 40% sorbitol. Before treatment eight patients showed pronounced inhomogeneous distribution of MTT and rCBV with increased rCBV ipsilateral to the lesion. rCBF was only slightly reduced in the ipsilateral hemisphere.

After treatment the side to side differences of rCBV and MTT were significantly (p<0.05) reduced. Perfusion-weighted MRI appears as a suitable method to assess the hemodynamic changes in patients with cerebral stroke. rCBV seems to be more influenced by acute locale brain edema than rCBF. The elevation of rCBV and MTT can be explained by an impaired, but compensated perfusion, which normalizes after osmotherapy.
Do Iodinated Contrast Agents Affect Prognosis in Acute Experimental Cerebral Ischemia?
Authors: Doerfler A. , Engelhorn T. , Von Kummer R. , Forsting M.
Published: April 2015

We studied the effects of ionic and non-ionic iodinated contrast agents in acute cerebral ischemia on infarction volume, neurological performance, and mortality in a rat model of middle cerebral artery (MCA) occlusion. We induced focal cerebral ischemia in 64 rats using an endovascular occlusion technique of the MCA. Four hours after MCA occlusion, 16 animals received sodium iothalamate (588 mg iodine/kg), 16 animals received iopromide as single bolus (518 mg iodine/kg) and 16 animals as double bolus (1036 mg iodine/kg). Sixteen animals received equivolumetric (1.4 ml/kg) saline (control group). Neurological score and body weight were recorded every 8 hours. Twenty-four hours after vessel occlusion all animals were sacrificed and their brains stained with 2,3,5 triphenyl-tetrazolium-chloride (TTC) to assess infarction size. The normal and the double clinical dose of iopromide did not affect infarction volume and neurological performance. Sodium iothalamate caused an increase in infarction volume and worsening of the neuroscore compared with the control group (p<0.05). Mortality in the iothalamate group was 25%, compared to 12.5% in the control group and 6.25% in the iopromide groups, respectively. Our results suggest that bolus injection of the non-ionic iopromide in clinically relevant doses does not significantly affect infarction volume and clinical symptoms of cerebral ischemia. Non-ionic contrast agents should be preferred to ionic contrast agents during the acute stage of cerebral ischemia.
Carotid Artery Tandem Lesions Frequency and Consequences for Endarterectomy
Authors: Rouleau P.A. , Huston J. , Gilbertson J. , Brown R.D. , Meyer F.B. , Bower T.C.
Published: April 2015

We determined the frequency of tandem carotid lesions within the carotid siphon, common carotid artery and proximal intracerebral arteries as well as incidental intracranial saccular aneurysms. We also determined the consequence of a tandem lesion on the surgeon's decision-making process when a hemodynamically significant stenosis or aneurysm was detected during the preoperative evaluation.
Osservazione dell'attivazione neuronale con RM Studio della sequenza di acquisizione
Authors: Longo R. , Rossi M. , Ukmar M. , Zanier F. , Pozzi-Mucelli R.S.
Published: April 2015

Lo studio dell'attivazione neuronale con RM funzionale (fMRI) è una delle tecniche che si va affermando sia nella pratica clinica che nella ricerca di neuroscienze. La non-riproducibilità quantitativa dei risultati pubblicati (numero di pixel attivati, intensità relativa del segnale) ha indotto gli autori ad un'analisi sistematica dei parametri di acquisizione per comprendere il loro effetto sulle mappe di attivazione, nel presente studio mappe di attivazione della corteccia motoria e visiva. è stata inoltre verificata l'importanza del contributo degli effetti di flusso nella microvascolatura alle mappe di attivazione.

Gli studi si sono svolti complessivamente su 21 volontari sani. I parametri di acquisizione che sono stati presi in esame sono i seguenti: tempo di eco, spessore della fetta, angolo di flip, omogeneità di campo, orientazione spaziale delle fette. Si è quindi scelto un protocollo ritenuto ottimale per l'applicazione della tecnica di fMRI in ambiente clinico con un tomografo a 1,5 T: TE = 40 ms, TR = 60 ms, flip angle = 25°, spessore di strato = 4 mm, matrice di acquisizione = 128 × 128, matrice di ricostruzione = 256 × 256, compensazione per gli artefatti da flusso, tecnica di contrast enhancement = T1.
Risonanza magnetica funzionale dell'encefalo in pazienti candidati ad intervento chirurgico con guida stereotassica
Authors: Ukmar M. , Zanier F. , Longo R. , Rossi M. , Skrap M. , Pozzi-Mucelli R.S.
Published: April 2015

Negli ultimi anni la risonanza magnetica funzionale dell'encefalo (fMRI) si è proposta con successo nello studio dell'attività encefalica durante lo svolgimento di determinate funzioni. Si è inoltre delineato per essa un ruolo paricolarmente interessante nell'ambito della pianificazione preoperatoria di pazienti destinati ad un intervento chirurgico in sedi encefaliche critiche, ovvero ad alto rischio di invalidtà postoperatoria.

Il presente lavoro mira alla realizzazione di mappe di attivazione motoria in pazienti con lesioni occupanti spazio nell'encefalo mediante un tomografo a 1,5 T di non recentissima tecnologia; successivamente si è voluto valutare l'informatività di tali mappe, sia dal punto di vista neurochirurgico sia dal punto di vista neurofisiologico.

Sono stati presi in esame 5 pazienti, tutti portatori di una lesione occupante spazio in prossimità della corteccia perirolandica e tutti destinati ad un intervento chirurgico in stereotassi per l'asportazione di tale lesione. I pazienti venivano sottoposti in un'unica seduta allo studio funzionale e morfologico dell'encefalo con il casco stereotassico in sede.

Lo studio di fMRI si è svolto su uno o massimo due piani assiali orientati ortogonalmente al decorso della scissura di Rolando. Esso prevedeva come prova di attivazione il movimento della mano controlaterale all'emisfero con la lesione da asportare.

In un paziente la funzione motoria è stata studiata anche intraoperatoriamente mediante la stimolazione elettrica della corteccia cerebrale.

In 4 pazienti si è avuta una netta rappresentazione della corteccia sensitivo-motoria di tale emisfero. In 3 di essi si è vista inoltre un'attivazione dell'emisfero opposto, ipsilaterale alla mano in movimento. Altre zone di attivazione visualizzate nei nostri studi sono state messe in relazione con l'area motoria supplementare (3 pazienti) e l'area premotoria (2 pazienti).

Nel paziente in cui si è proceduto intraoperatoriamente con la stimolazione elettrica della corteccia cerebrale è stata riscontrata una buona concordanza tra lo studio elettrofisiologico e l'indagine di fMRI.

Analizzando i risultati da noi conseguiti possiamo concludere che anche un tomografo a 1,5 T di tipo convenzionale si presta ad un'indagine di fMRI in pazienti con lesioni encefaliche. Le mappe di attivazione realizzate su uno o due piani assiali sono in grado di fornire delle informazioni sui rapporti tra la lesione da asportare e la corteccia sensitivo-motoria, in particolare l'area della mano. Ciò ha notevoli implicazioni dal punto di vista neurochirurgico, considerando quanto sia importante la salvaguardia dell'integrità funzionale del soggetto che si sottopone ad un intervento neurochirurgico in una sede critica come la corteccia perirolandica.
Relations between MR Images, EEGs and Clinical Findings in Neuronal Migration Disorders
Authors: Castellani G. , La Placa G. , Andreotti M. , Petronp F. , Galimberti V. , Passerini D.
Published: April 2015

We describe two clinical cases of six and four year old boys with psychomotor disturbance and generalized or partial seizures. EEGs show partial epileptiform abnormalities. Brain MR highlights in both cases pachygyria with hemispheric prevalence.
Fistola vertebro-giugulare
Authors: Tecame S. , Taliercio G. , Spena M. , Maglione F. , Caranci F.
Published: April 2015

Le fistole artero-venose vertebrali sono lesioni rare, generalmente secondarie a traumi, definite dalla presenza di una comunicazione anomala tra l'arteria vertebrale, o un suo ramo, ed una vena adiacente.

L'embolizzazione trans-arteriosa con palloncini staccabili è diventata il principale trattamento di elezione delle fistole artero-venose post-traumatiche. Comunque, in qualche caso, questo approccio può risultare difficile se la fistola appare associata a formazioni pseduoaneurismatiche. In questi casi l'embolizzazione con spirali può essere una valida alternativa.

Viene qui presentato un caso di fistola vertebro-giugulare post-traumatica trattata con palloncino staccabile e spirali dopo endoprotesi della vena a protezione del sistema venoso.
Acute Disseminated Encephalomyelitis
Authors: Roncallo F. , Murialdo A. , Gazzola P. , Inglese M. , Bisio N. , Arena E. , Bartolini A.
Published: April 2015

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder of the central nervous system usually developing in close temporal relationship to an infective illness or vaccination. This paper presents clinical, cerebrospinal fluid and MRI findings in ADEM and discusses the role of the MRI in the distinction of ADEM and MS.

We reviewed the medical records, cerebrospinal fluid (CSF) and MRI studies of six consecutive patients diagnosed as having ADEM during a three-year period. All patients had CSF, including electrophoresis for demonstration of oligoclonal bands, and MRI studies in the acute stage; five patients repeated these examinations in the subacute and chronic stages.

Four patients had clinical evidence of a multifocal neurological syndrome. In the two other cases there was clinical evidence only of transverse myelitis. The CSF was abnormal in all cases and showed a mild increase in cell count and protein. IgG synthesis and myelin basic protein were present in three patients. MRI was abnormal in all six patients in the acute stage of the illness. In five cases there were some features of the distribution of the lesions which differed from those usually seen in MS. One showed extensive asymmetric bilateral changes; two had high signal lesions in the basal ganglia and thalamus; two demonstrated a tumour-like mass. One patient died one week after clinical onset and the pathologic findings showed an acute haemorrhagic leukoencephalitis. One patient demonstrated a recurrent MRI pattern of diffuse periventricular white matter lesions, after an abrupt end of corticosteroid treatment. Five patients demonstrated a marked decrease in the size and number of the lesions after steroid treatment; no new lesions were identified.

The CNS white matter may be affected by inflammatory demyelinating disorders, including ADEM, that cause clinical diagnostic difficulty with MS. MS and ADEM may be indistinguishable in the acute phase. The clinical course of the disease together with the follow-up MRI will distinguish one entity from the other. Long-term follow-up disclosing newly appearing symptoms and lesions is against the diagnosis of ADEM, because this entity is typically a monophasic disease, unlike MS that usually has a releasing and relapsing course.
Lesioni osteodurali lombosacrali nella neurofibromatosi di von Recklinghausen
Authors: Muras I. , Scuotto A. , Conforti R. , Bernini F.P.
Published: April 2015

Il morbo di Recklinghausen è una facomatosi a trasmissione autosomica dominante caratterizzata dalle macchie cutanee color “caffè-latte” e dai neurofibromi. A queste manifestazioni possono associarsi lesioni tumorali del sistema nervoso ed alterazioni scheletriche. Anomalie osteodurali, specie se localizzate a livello lombosacrale, sono invece rare.

Gli autori, pertanto, presentano 10 casi di Recklinghausen con anomalie osteodurali lombo-sacrali selezionati dalla classifica degli ultimi dodici anni.

I pazienti di più vecchia data sono stati studiati con esame diretto e stratigrafico della colonna seguito da mielografia; quelli più recenti con TC, mielo-TC e RM. Vengono discusse le ipotesi patogenetiche delle suddette alterazioni, i quadri diagnostici e le indicazioni terapeutiche, anche alla luce della revisione della letteratura.
The Proteus Syndrome: CNS Imaging Findings
Authors: Jhaveri K.S. , Shetty RG , Shroff M.M. , Kamat N. , Bavadekar M. , Udani V.P.
Published: April 2015

The Proteus syndrome is a complex disorder characterised by a constellation of hamartomatous, mesodermal and skeletal manifestations. Major clinical findings include hemihypertrophy partial gigantism of the hands and/or feet, skin pigmentation and subcutaneous/osseous tumours. CNS manifestations of hemimegalencephaly subependymal calcified nodules, periventricular cysts and dural sinus thrombosis have been reported. We report a case of proteus syndrome in which abnormal hyperintense signal was seen in the globus pallidi and posterior limbs of internal capsule on T1 weighted image on MR in addition to cortical dysplasia, macrocephaly, ventriculomegaly and abnormal periventricular white matter.
Imaging Features of Cerebral and Craniofacial Aspergillosis in the Immunocompetent
Authors: Rammurti S. , Kalva S. Prasad , Murthy V. Subbalakshmi
Published: April 2015

Aspergillosis is an uncommon fungal infection. It is more common in immunocompromised than in immunocompetent subjects. However, in the Southern Indian population, asymptomatic and symptomatic aspergillosis in immunocompetent individuals is common. The features of aspergillosis are varied and the patterns of the disease are not well described. We evaluated 23 cases of cerebral and craniofacial aspergillosis. Paranasal sinus disease with bony desctruction and contiguous extension into the anterior cranial fossa as extradural masses were common. Isolated mucosal disease and isolated cerebral involvement were unusual patterns. Orbital involvement was also common. Pathologically all the cases showed granulomas; however in one case an additional infarct secondary to vascular occlusion was also noted.
Helical CT with Virtual Endoscopy of a Laryngeal Chondroma
Authors: Roncallo F. , Turtulici I. , Bonaldo E. , Bisio N. , Barbieri M. , Bartolini A.
Published: April 2015

A 65-year-old man had hoarseness and dyspnea. A CT scan showed a cartilaginous tumour of the subglottic larynx appearing as a submucosal calcified neck mass with cartilaginous matrix extending into the airway. Chondromas and chondrosarcomas are rare, accounting for less than 1% of all laryngeal neoplasms. The distinction between chondromas and chondrosarcomas is a histologic diagnosis that may be difficult, particularly in well differentiated neoplasms.

Often tumours initially reported as chondromas have recurred as low-grade chondrosarcomas. On direct laryngoscopy, cartilaginous tumours of the larynx are usually submucosal and are covered by intact laryngeal mucosa. The intact mucosa was identified on CT scans in this case. Radiographic examinations are useful, and coarse calcification is identified on plain films in most cases.

CT is useful in assessing the tumour's origin and extension and is more sensitive that plain films in identifying the characteristic calcifications. In the absence of metastasis, radiographic investigation is unable to differentiate benign chondroma from low-grade chondrosarcomas. Surgery is the treatment of choice for laryngeal chondromas and chondrosarcomas. Radio- and chemotherapy have in general been ineffective.
Rapid Growth of an Internal Carotid Anterior Wall Aneurysm
Authors: Okuchi K. , Nagata K. , Fujioka M. , Yokota H. , Kagoshima T.
Published: April 2015

We present three cases with ruptured internal carotid anterior aneurysm which grew rapidly within a few days. All of them were females aged 54–75 years. Overt aneurysmal dilatation was not apparent except for a small bulging shadow on the initial angiogram but was visualized on a follow-up angiogram. We operated on all 3 cases. The aneurysm wall was thin and premature rupture occurred during the microscopic procedure. We suspect that our cases were not ordinary saccular aneurysms but dissecting aneurysms and that the rapid growth resulted from extension of the arterial wall dissection.
Cerebral Aneurysms Missed by the First Angiographic Study in Subarachnoid Hemorrhages
Authors: Bradač G.B. , Bergui M. , Ferrio M.F. , Fontanella M. , Stura G.
Published: April 2015

Angiograms were negative, in 81 out of 551 patients with spontaneous subarachnoid hemorrhage (SAH), in whom an aneurysm was suspected, the angiogram was negative. One to 4 weeks later 51 patients were submitted to a second angiogram, which revealed an aneurysm in 6 cases. Three of these patients had a second hemorrhage.

In all cases diffuse bleeding with involvement of the fronto-basal interhemispheric fissure was present on CT. Four aneurysms were of the Anterior Communicans Artery (ACoA), and 2 of the carotid siphon. The reason for the false negative angiograms and the usefulness of a control angiogram are discussed.
Endovascular Treatment in 86 Cases of Recently Bled Aneurysms
Authors: Lemme-Plaghos L.A. , Ceciliano A.L. , Garbugino S.L.
Published: April 2015

We therefore analysed retrospectively our series of 86 single aneurysm cases treated within 14 days of haemorrhage, comparing the final outcome of those patients treated during the first three days (rebleedings period) and those in the following ten days (vasospasm period).

This series shows that GDC occlusion of recently bled aneurysms even in early stages of SAH significantly diminishes the rebleeding rate as previously reported with surgery and endovascular treatments. The long-term clinical outcome observed in our patients seems to be related more to the initial clinical condition than to an early endovascular procedure.
Intracranial Aneurysms with Third Nerve Palsy
Authors: Guelbenzu S. , Barrena R. , Asensio S. Garcia , Gaya A. , Mur C. Garcia , Mazas L.
Published: April 2015

To present our experience of embolization for the treatment of intracranial aneurysms with third nerve palsy, we analyzed 15 patients with posterior communicating artery aneurysms presenting third nerve palsy. Nine had subaracnoid hemorrhage.

In all of them a packing of aneurysm with different types of coils was performed. We employed in 4 cases coils with fibers, in 4 tungsten spirals and in 7 cases GDC coils.

Most posterior communicating artery aneurysms are bilobulated. We have tried to pack and close the first lobulation of aneurysm and so we tried to deposit the less coils than possible. The mean time of recovery was 2.5 months: 1–5 months if the aneurysm was packed only in its first lobule and 3 months if the technical difficulties forced complete packing of the aneurysm. Although this is not a large series, it is significant and shows that the excellent recovery in all cases does not contraindicate aneurysm embolization with coils in patients with third nerve palsy. The bilobulated aneurysms in which we packed the first lobulation completely have a faster recovery.
Evaluation of Fetal Central Nervous System Abnormalities with Ultrafast MRI
Authors: Levine D. , Barnes P.D. , Madsen J. , Hulka C. , Edelman R.R.
Published: April 2015

Central nervous system (CNS) abnormalities affect approximately 6000 neonates each year in the United States. The standard prenatal approach for evaluating these anomalies is ultrasonography (US). However, the sonographic evaluation of the fetal CNS is limited.

41 fetuses with suspected abnormal central nervous system (CNS) underwent prenatal MRI. In each case MR allowed for visualization of the region of suspected abnormality. MR added additional information to that provided by ultrasound in 28 cases.

When a CNS anomaly is detected by US, then MR may demonstrate additional findings which alter patient counseling and management.
Analysis of Hemodynamics by MR-Angio and Embolization of Klippel-Trenaunay-Weber Syndrome: Five Year Follow-up
Authors: Orszagh M. , Schulte D.M. , Korinthenberg R. , Schumacher M.
Published: April 2015

A newborn male child was admitted with hypoxemia, high output failure, hypertrophic right lower limb with a segmental pink naevus flammeus, lymphatic edema, subcutaneous varices and multiple arteriovenous fistulae (AVF) spinal and pelvine; findings of the Klippel-Trenaunay- / Parkes-Weber-Overlap Syndrom (KTW). Because of a threatening right heart insufficiency caused by the shuntvolume, the child was embolized as early as 5 months of age. In the course of 5 years, a total of 17 spinal and pelvic feeding arteries were occluded in 6 sessions using Histoacryl, Platincoils or Ethibloc. The low weight of the child's body (4.3 kg) and cardiac insufficiency (CI) limited the amount of contrast agent and fluid.

To reduce the amount of contrast agent used for diagnostic purposes we analyzed the pathological hemodynamics by magnetic resonance angiography (MRA).

Within 5 years normal bodily development took place with no sings of exponential growth of the affected leg. We understand the “newly formed” fistulae in the current angiography as a local hemodynamic activation of persistent primitive arteriovenous communication caused by mesodermal disturbances, the degree of which correlate with the prognosis.
Laryngeal Carcinomas: CT Appearance after Radiation Therapy
Authors: Roncallo F. , Turtulici I. , Bisio N. , Bartolini A.
Published: April 2015

Current treatment of head and and neck carcinomas includes also Radiation Therapy (RT). Control with RT allows the patient to retain a functioning organ in cases in which surgical cure may require an extensive demolition. Consequently a growing number of selected patients are treated with RT. To evaluate the CT appearance of laryngeal carcinomas treated with RT and the ability of Computed Tomography (CT) to differentiate persistent or residual tumor from radio-induced changes of soft tissues.

Pre- and post-treatment CT examinations (n = 325) of 132 patients with primary laryngeal cancers treated with RT (4500–7500 cGy) were retrospectively evaluated.

We subdivide the patients in three groups on the basis of the differences in the CT appearance of the primary tumors treated with RT 1) Responders (42): complete resolution of tumor or reduction in tumor size = or > 75%; 2) Non-Responders (55): persistent tumor or residual mass with reduction in tumor size — or < 50%. 3) Partial Responders (35): persistent residual mass with reduction in tumor size from 50% to 75% or persistent asimmetry of the mucosal surface.

There are some points to analyse in the interpretation of CT imaging of post-treated head and neck region: 1) Transient changes of irradiated soft tissues are more prominent during the first three month after RT. 2) Persistent changes are subgrouped in: a) Superficial (skin and platysmal thickening, reticulation of subcutaneous fat); b) Glandular (major salivary glands adenitis and fatty degeneration); c) Deep (reticulation and fibrous degeneration of anterior and posterior cervical and perivascular fat); d) Visceral (increased en-hancement of the pharyngeal mucosa and thickening of posterior pharyngeal wall, epiglottis, aryepiglottic folds, false vocal cords, anterior and posterior commissures, subglottic larynx, increased attenuation of paralaryngeal fat). 3) Progressive arytenoid cartilage sclerosis is indicative of a poor outcome. 4) The patients of the third group may be followed also with seriated CT, because they have a significant percentage of recurrence.
MR Imaging of Persistent Hyperplastic Primary Vitreous
Authors: Suzuki M. , Ueda F. , Horichi Y. , Fujinaga Y. , Kanaya E. , Takashima T. , Kawasaki K.
Published: April 2015

This report describes MR images of seven cases of PHPV. MR imaging is superior for the evaluation of PHPV. Soft tissue mass in the retrolental space and/or along the hyaloid canal was clearly demonstrated in all cases, in addition to microphthalmia, a shallow anterior chamber and lens deformity were shown.
Dynamic Gadolinium-Enhanced MR Imaging of Recurrent Inverted Papilloma
Authors: Lai P.-H. , Pan H.-B. , Yang C.-F. , Wu M.-T. , Chu S.-T. , Ger L.-P.
Published: April 2015

To evaluate the usefulness of dynamic Gd-enhanced MR imaging in distinguishing recurrent inverted papilloma (IP) from postoperative changes.

Ten patients with 13 surgical proved lesions were examined. T1-weighted (pre- and postcontrast), proton-density, and T2-weighted spin-echo images were evaluated. A total of nine dynamic FSE (fast spin-echo) images were obtained at 0, 5, 30, 60, 90, 120, 150, 180, and 300 seconds after bolus Gd-DTPA injection. Signal-time curves were obtained from dynamic scan.

Reading of the T2-weighted images yielded a sensitivity of 75%, a specificity of 80%, and an accuracy of 77%. The contrast T1-weighted studies yielded a sensitivity of 63%, a specificity of 60%, and an accuracy of 67%. With a relative signal increase (RSI) of 2.0 or higher, a 60-second imaging time provided the sensitivity of 87% for the detection of recurrence and a specificity of 80%.

There were significant differences in the RSI at 30, 60, 90, 120, 150, and 180 seconds (P < 0.01) between recurrent tumor and postoperative changes.

Dynamic MR imaging can increase the diagnostic accuracy in the local recurrence of IP, and help differentiate recurrence and postoperative changes.
Internal Anatomy and Three-Dimensional (3D) Reconstructed MR Imaging of Inner Ear Malformations in the Pediatric Population
Authors: Kollias S.S. , Sartoretti S. , Christoforidis G.A. , Valavanis A.
Published: April 2015

We evaluated the feasibility of long ETL, 3D FSE sequences, maximum intensity pixel (MIP) projection and surface rendering reconstructions in high resolution visualisation and diagnosis of normal and abnormal inner ear anatomy, in acceptable acquisition times. Five healthy children and nine children with congenital inner ear malformations were imaged using a 1.5-T MR scanner and 5 inch phased array receiver coils. Forty 0.7 mm-thick coronal sections obtained with a 3D FSE sequence (TR/TEeff: 4000/150, ETL: 31, 512×256 matrix, 20 cm 3/4 FOV, 1 NEX, scan time: 8:30 minutes) were reformatted (0.43 mm thickness, no gap). Anatomical structure visibility was scored. Oblique reformations, MIP projections and 3D surface displays (volume rendering) of all inner ears were generated on a SUN workstation using GE software. T2-weighted 3D FSE images demonstrated four nerves in the internal auditory canal, AICA loop, vestibule, semicircular canals, cochlea, modiolus, osseous spiral lamina, and the cochlear aqueduct were in all normal ears. Facial nerve visibility included labyrinthine segment (92% of cases), tympanic (96%), and mastoid (100%). Vestibular aqueduct was seen in 64%. MIP images always depicted cochlear turns, semicircular canals and ampullae. MIP and stereoscopic 3D segmented images provided a clearer understanding of extent of ear malformations. T2-weighted 3D FSE imaging enables visualisation of submillimeter inner ear structures with acceptable scan times. Volumetric imaging and segmentation analysis of the labyrinth improves the understanding of normal and abnormal inner ear anatomy in vivo, paving the way for 3D planning of intervention and quantitative volumetric studies.
Imaging of Flow through the Nasal Cavity and Paranasal Sinuses: Preliminary Work with Hyperpolarized Xenon
Authors: Phillips C.D. , Goldstein J.H. , Brookeman J.R. , Mugler J.P. , Maier T.
Published: April 2015

Experience has been gained at several imaging sites with the use of hyperpolarized gases to image the lungs and the proximal airways. The theoretical advantage to using a polarized noble gas is the dramatically higher polarization values when compared with the small fraction of the hydrogen spin polarization currently utilized in magnetic resonance imaging. Using polarized noble gases, the potential increased signal enhancement is on the order of 100 fold. Hyperpolarized gases provide the ability to image air flow and air-containing structures. Utilization of specially tuned coils on standard clinical imaging systems has enabled imaging of the lungs and airways, using the hyperpolarized gas as a positive contrast agent. We have begun work on imaging the real-time air flow through the nasal cavity and paranasal sinuses, about which little is currently known. Rapid acquisition techniques allow us to perform dynamic imaging of the pattern of airflow through the nasal cavity, and gain information regarding the patterns of air exchange within the paranasal sinuses. This technique may lead to understanding of air flow in normal and disease states.
Epithelioid Hemangioma and Epithelioid Hemangioendothelioma
Authors: Rissé N. , Hagen T. , Jacobs G. , Romeike B. , Piepgras U.
Published: April 2015

55% of all tumorous intraspinal CNS-lesions are found extradurally. Epithelioid hemangiomas (EH) and epithelioid hemangioendotheliomas (EHE) are rare vascular formations of mesenchymal origin which occur in the skin, all parenchymal organs and also infrequently in vertebral bodies.

This case report describes the morphological findings in CT, MR and angiography in correlation to the histopathological examination in 3 patients and their clinical course. Patient 1: 76 yr., progressive paraplegia, initial diagnosis: hemangioma T8 with intraspinal portions. Partial resection and histopathological diagnosis EH; embolisation and re-operation with complete resection. Patient 2: 56 yr., ataxia, initial diagnosis: metastasis with osteolytic destruction T2 and intraspinal tumor. Complete resection, histopathological diagnosis: EH. Patient 3: 71 yr., osteolytic destruction T2, initial diagnosis: metastasis/tonsillary carcinoma. Complete resection, histopathological diagnosis: EHE. CT generally reveals osteolytic and soft tissue signs but MR (T1- and T2-weighted, contrast media uptake) presents varying results. EH and EHE as possibly malignant structures cannot be differentiated radiologically from each other and other vascularized masses. Embolisation prior to complete resection is helpful. EHE can furthermore metastasize lymphatically.
RadioDB: A World-Wide Web Teaching File Database on Diagnostic Radiology-Neuroradiology
Authors: Sparacia G. , Brancatelli G. , Bartolotta T.V. , Lagalla R. , Cardinale A.E.
Published: April 2015

We present “RadioDB”, a national World Wide Web teaching file database on diagnostic radiology-neuroradiology which can be used in routine practice, training, and research activity. “RadioDB” constitutes the Italian teaching file database based on a multicentre academic collaboration and is sponsored by the Italian Society of Radiology (SIRM).
Manufacturing of nickel based cermet coatings by the HVOF process
Authors: Ang A. S. M. , Howse H. , Wade S. A. , Berndt C. C.
Published: April 2015

Advanced particle diagnostic technology has been applied to establish process parameters to deposit high quality nickel based carbide cermet coatings for marine hydraulic applications. The cermet coatings are produced via the kerosene fuelled high velocity oxygen fuel (HVOF) spray process, which uses a hypersonic flame jet to melt and accelerate feedstock particles onto the component surfaces. The traditional ‘trial and error’ procedure is not technically robust, as well as being costly and time consuming. Instead, a superior method is implemented in the current study that performs real time monitoring of the process parameters associated with the HVOF flame jets. Subsequently, coatings can be produced with the knowledge of the inflight particle size, temperature and velocity profiles. The analytical results allow identification of suitable coating process parameters, which translate to coatings of lower porosity and enhanced mechanical performance.
Regulation of thrombosis and vascular function by protein methionine oxidation
Authors: Gu Sean X. , Stevens Jeff W. , Lentz Steven R.
Published: April 2015

Redox biology is fundamental to both normal cellular homeostasis and pathological states associated with excessive oxidative stress. Reactive oxygen species function not only as signaling molecules but also as redox regulators of protein function. In the vascular system, redox reactions help regulate key physiologic responses such as cell adhesion, vasoconstriction, platelet aggregation, angiogenesis, inflammatory gene expression, and apoptosis. During pathologic states, altered redox balance can cause vascular cell dysfunction and affect the equilibrium between procoagulant and anticoagulant systems, contributing to thrombotic vascular disease. This review focuses on the emerging role of a specific reversible redox reaction, protein methionine oxidation, in vascular disease and thrombosis. A growing number of cardiovascular and hemostatic proteins are recognized to undergo reversible methionine oxidation, in which methionine residues are posttranslationally oxidized to methionine sulfoxide. Protein methionine oxidation can be reversed by the action of stereospecific enzymes known as methionine sulfoxide reductases. Calcium/calmodulin-dependent protein kinase II is a prototypical methionine redox sensor that responds to changes in the intracellular redox state via reversible oxidation of tandem methionine residues in its regulatory domain. Several other proteins with oxidation-sensitive methionine residues, including apolipoprotein A-I, thrombomodulin, and von Willebrand factor, may contribute to vascular disease and thrombosis.
Tension-type headache associated with obstructive sleep apnea: a nationwide population-based study
Authors: Chiu Yu-Chwen , Hu Hsiao-Yun , Lee Fei-Peng , Huang Hung-Meng
Published: April 2015

Background

There is still controversy regarding the association between primary headaches and obstructive sleep apnea. We explored the relationship between tension-type headache (TTH) and obstructive sleep apnea (OSA) using a large nationwide population-based data set in Taiwan.

Methods

We identified 4759 patients diagnosed with OSA from the Taiwan Longitudinal Health Insurance Database, based on polysomnography, as the OSA group. We then randomly selected 19036 subjects without OSA, matched by sex and age, to serve as the non-OSA group. The multivariate Cox proportional hazards model with matching for age and sex was used to assess the possible associations between TTH and OSA among the patients.

Results

The prevalence of TTH was 10.2% among OSA patients and 7.7% among non-OSA patients (p < 0.001). The multivariate Cox proportional hazards model revealed patients with OSA were more likely to have TTH (hazard ratio, 1.18; 95% CI, 1.06–1.31) (p = 0.003) than patients in the non-OSA group.

Conclusion

Patients with OSA had a higher likelihood of developing TTH than patients in the non-OSA group. Further studies of physiological patterns between OSA and TTH are needed to confirm the study findings.
Structural modulation of silicon nanowires by combining a high gas flow rate with metal catalysts
Authors: Seo Dongjea , Lee Jaejun , Kim Sung Wook , Kim Ilsoo , Na Jukwan , Hong Min-Ho , Choi Heon-Jin
Published: April 2015

We grew silicon nanowires (SiNWs) by a vapor-liquid-solid (VLS) mechanism using metal catalysts of gold (Au), titanium (Ti), manganese (Mn), and iron (Fe) under a high flow rate of hydrogen (H2). This combination of catalyst types and high gas flow rate revealed the potential for growing various SiNWs, including kinked SiNWs (with Au), ultra-thin SiNWs having diameters about 5 nm (with Ti), rough-surfaced SiNWs (with Mn), and ribbon-shaped SiNWs tens of microns in width (with Fe). The high flow rate of gas affects the VLS mechanism differently for each combination; for example, it induces an unstable solid-liquid interfaces (with Au), active etching of the catalyst (with Ti), sidewall deposition by a vapor-solid (VS) mechanism, and an asymmetric precipitation of Si in the catalyst (with Fe). Our combinatorial approach may provide a new path for the structural modulation of SiNWs via the VLS mechanism.

PACS:80; 81; 82
Association between biomarkers of endothelial injury and hypocoagulability in patients with severe sepsis: a prospective study
Authors: Ostrowski Sisse Rye , Haase Nicolai , Müller Rasmus Beier , Møller Morten Hylander , Pott Frank Christian , Perner Anders , Johansson Pär Ingemar
Published: April 2015

Introduction

Patients with severe sepsis often present with concurrent coagulopathy, microcirculatory failure and evidence of vascular endothelial activation and damage. Given the critical role of the endothelium in balancing hemostasis, we investigated single-point associations between whole blood coagulopathy by thrombelastography (TEG) and plasma/serum markers of endothelial activation and damage in patients with severe sepsis.

Methods

A post-hoc multicenter prospective observational study in a subgroup of 184 patients from the Scandinavian Starch for Severe Sepsis/Septic Shock (6S) Trial. Study patients were admitted to two Danish intensive care units. Inclusion criteria were severe sepsis, pre-intervention whole blood TEG measurement and a plasma/serum research sample available from baseline (pre-intervention) for analysis of endothelial-derived biomarkers. Endothelial-derived biomarkers were measured in plasma/serum by enzyme-linked immunosorbent assay (syndecan-1, thrombomodulin, protein C (PC), tissue-type plasminogen activator and plasminogen activator inhibitor-1). Pre-intervention TEG, functional fibrinogen (FF) and laboratory and clinical data, including mortality, were retrieved from the trial database.

Results

Most patients presented with septic shock (86%) and pulmonary (60%) or abdominal (30%) focus of infection. The median (IQR) age was 67 years (59 to 75), and 55% were males. The median SOFA and SAPS II scores were 8 (6 to 10) and 56 (41 to 68), respectively, with 7-, 28- and 90-day mortality rates being 21%, 39% and 53%, respectively. Pre-intervention (before treatment with different fluids), TEG reaction (R)-time, angle and maximum amplitude (MA) and FF MA all correlated with syndecan-1, thrombomodulin and PC levels. By multivariate linear regression analyses, higher syndecan-1 and lower PC were independently associated with TEG and FF hypocoagulability at the same time-point: 100 ng/ml higher syndecan-1 predicted 0.64 minutes higher R-time (SE 0.25), 1.78 mm lower TEG MA (SE 0.87) and 0.84 mm lower FF MA (SE 0.42; all P <0.05), and 10% lower protein C predicted 1.24 mm lower TEG MA (SE 0.31).

Conclusions

In our cohort of patients with severe sepsis, higher circulating levels of biomarkers of mainly endothelial damage were independently associated with hypocoagulability assessed by TEG and FF. Endothelial damage is intimately linked to coagulopathy in severe sepsis.

Trial registration

Clinicaltrials.gov number: NCT00962156. Registered 13 July 2009.
Crustal-scale structure and deformation of Lu-Zong ore district: Joint interpretation from integrated geophysical data
Authors: Lü Qingtian , Liu Zhendong , Yan Jiayong , Tang Jingtian , Wu Mingan , Xiao Xiao
Published: April 2015

We have studied five intersecting integrated geophysical profiles for the 3D crustal structure of the Lu (Lujiang)-Zong (Zongyang) ore district to obtain a better understanding of the metallogenesis and provide in-depth information for deep mineral targeting. The profiles, totaling more than 300 km, have reflection seismics and magnetotelluric sounding. Regional gravity surveys were also integrated into this study. New discoveries were obtained regarding the upper crustal structure and deformation based on the integrated analysis of these data. The Lu-Zong ore district consists of four major crustal blocks. They are the Shaxi uplift, Qianshan-Kongcheng Depression (QKD) in the west, Lu-Zong volcanic basin, and the Along-River uplift in the east. The north–south crustal elements show the northward “step-type” uplift, juxtaposed by two steplike faults, the west–northwest/east–southeast-trending Tangjiayuan-Zhuanqiao Fault and the Lujiang-Huangguzha-Tongling Detachment (LHTD) Fault. The Lu-Zong volcanic basin presents a nonsymmetrical shape with four inward-dipping boundary faults. The northern and eastern boundary faults (BF2 and LHTD) are deep faults, which control the development and evolution of the Lu-Zong volcanic basin. There are three west–northwest/east–southeast-trending faults and six northeast–southwest-trending faults cutting over the ore district. From north to south, they are the LHTD Fault, Tangjiayuan-Zhuanqiao Fault, and Yijing-Taojiaxiang Fault (BF3); from west to east, the six faults are the Tan-Lu, Chuhe, Luohe-Quekou, Zongyang-Huangtun, Taojiawan-Shijiawan, and Changjiang Thrust Fault (CTF). The formation and evolution of the ore-district are mainly affected by the Yanshanian intracontinental orogeny, and they experience the Middle to Late Jurassic compression and subsequent Cretaceous extension, possibly due to the paleo-Pacific northwest-trending subduction. Our studies determined that the CTF is a thrust system in nature and the LHTD is a southwest-dipping detachment. Two Jurassic basins were found, surrounding the northeast and southeast of Lu-Zong volcanics, which may be due to the product of postcollision extension of Indosinian orogeny during the middle and early Late Triassic.
Cx3cr1deficiency attenuates hepatic granuloma formation during acute schistosomiasis by enhancing M2-type polarization of macrophages
Authors: Ran Lin , Yu Qilin , Zhang Shu , Xiong Fei , Cheng Jia , Yang Ping , Xu Jun-Fa , Nie Hao , Zhong Qin , Yang Xueli , Yang Fei , Gong Quan , Kuczma Michal , Kraj Piotr , Gu Weikuan , Ren Bo-Xu , Wang Cong-Yi
Published: April 2015

Acute schistosomiasis is featured by pro-inflammatory responses against tissue or organ trapped parasite ova along with granuloma formation. Herein in the present report we conducted studies in Cx3cr1-/- mice and demonstrated the role of Cx3cr1 in the pathoetiology of granuloma formation during acute schistosomiasis. Mice deficient in Cx3cr1 were protected from S. japonicum egg-induced granuloma formation and hepatic injury as manifested by reduced body weight loss, attenuated hepatomegaly along with preserved liver function. Notably, S. japonicum infection induced high levels of hepatic Cx3cr1 expression, which was predominantly expressed by infiltrating macrophages. Loss of Cx3cr1 rendered macrophages preferentially toward M2 polarization, which then led to a characteristic switch of host immune defense in the setting of acute schistosomiasis from a conventional Th1 to typical Th2 response. This immune switch caused by Cx3cr1 deficiency was likely associated with enhanced STAT6/PPAR-γ signaling and increased IDO expression. Together, our data provided feasible evidence supporting that CX3CR1 could be a viable therapeutic target for treatment of acute schistosomiasis.
Synthesis of New Electron Donor ClMe3-TTP: Structures and Properties of (ClMe3-TTP)3X (X = PF6 and AsF6)
Authors: Shirahata Takashi , Kohno Shuhei , Furuta Keisuke , Oka Yusuke , Misaki Yohji
Published: April 2015

In this study, we synthesized 2-(4-chloro-5-methyl-1,3-dithiol-2-ylidene)-5-(4,5-dimethyl-1,3-dithiol-2-ylidene)-1,3,4,6-tetrathiapentalene (ClMe3-TTP). Results show that the cation radical salts of ClMe3-TTP with PF6− and AsF6− anions show high conductivities (101 S cm−1) at room temperature and semiconducting behavior with low activation energy (24–27 meV). A crystal structure analysis of the PF6− and AsF6− salts reveals a 3:1 donor–anion ratio of these salts. The ClMe3-TTP molecules form one-dimensional columns along the a axis, and tape-structures, connected by the side-by-side S···S interactions, also form along the a axis. The calculated intracolumn and intratape overlap integrals are relatively large; however, the overlap integrals between the one-dimensional columns and the tapes are approximately 1/2–1/5 the value of the intracolumn and intratape overlap integrals. The band calculations suggest that they have one-dimensional electronic structures, indicating that they would comprise a Mott insulator.