bluuebunny/crossref_metadata_2025 huggingface dataset:
Male‐only fresh‐frozen plasma for transfusion‐related acute lung injury prevention: before‐and‐after comparative cohort study
Authors: Wiersum‐Osselton Johanna C. , Middelburg Rutger A. , Beckers Erik A.M. , van Tilborgh Anita J.W. , Zijlker‐Jansen Pauline Y. , Brand Anneke , van der Bom Johanna G. , Schipperus Martin R.
Published: December 2010

BACKGROUND: Transfusion‐related acute lung injury (TRALI) is one of the most serious complications of blood transfusion. It can be caused by incompatible white blood cell antibodies in transfused plasma. The objective of this study was to quantify the reduction of TRALI after introduction of male‐only plasma for transfusion as a preventive measure, which took effect in 2007.

STUDY DESIGN AND METHODS: In the Netherlands all cases of TRALI are reported to the national hemovigilance office. All reported cases of TRALI from 2002 to November 2009 were considered for inclusion. Those meeting the Canadian consensus clinical definition were included and subdivided according to whether or not the patient had received quarantine fresh‐frozen plasma (Q‐FFP) in the 6‐hour period before the reaction. The numbers of TRALI cases involving plasma donated before the measure and of those involving plasma donated after the measure were compared to TRALI cases that did not involve Q‐FFP to adjust for reporting bias.

RESULTS: A total of 110 cases were included in the analysis. Of 68 cases before the measure, 36 involved Q‐FFP. Thirty‐one cases occurred after the measure of which eight involved Q‐FFP. Eleven occurred in the transitional period, of which four involved Q‐FFP. The population‐attributable risk of premeasure plasma among TRALI cases occurring before the measure was 0.33 (95% confidence interval, 0.09‐0.51).

CONCLUSIONS: In the Netherlands the male‐only Q‐FFP measure was associated with a 33% reduction of TRALI cases.
A compact early-type galaxy at z = 0.6 under a magnifying lens: evidence for inside-out growth
Authors: Auger M. W. , Treu T. , Brewer B. J. , Marshall P. J.
Published: December 2010

We use Keck laser guide star adaptive optics imaging and exploit the magnifying effects of strong gravitational lensing (the effective resolution is FWHM ≈ 200 pc) to investigate the sub-kpc scale of an intermediate-redshift (z = 0.63), massive early-type galaxy being lensed by a foreground early-type galaxy; we dub this class of strong gravitational lens systems EELs, i.e. early-type/early-type lenses. We find that the background source is massive (M* = 1010.9 M⊙) and compact (re = 1.1 kpc), and a two-component fit is required to model accurately the surface brightness distribution, including an extended low-surface-brightness component. This extended component may arise from the evolution of higher redshift ‘red nuggets’ or may already be in place at z∼ 2 but is unobservable due to cosmological surface brightness dimming.
Into the Mainstream? Labor Market Outcomes of Mexican-Origin Workers
Authors: Luthra Renee Reichl , Waldinger Roger
Published: December 2010

We evaluate recent revisions of assimilation theory by comparing the labor market performance of Mexican immigrants and their descendents to those of native white and black Americans. Using the Current Population Survey Contingent Worker Series, we examine public and non-standard employment and fringe benefits in addition to earnings. We find little evidence that Mexican Americans cluster in non-standard work, noting instead intergenerational improvement in benefits and pay. However, all Mexican-origin workers are disadvantaged relative to native whites in terms of benefits. It is only within the public sector that the labor market outcomes of Mexican-origin workers converge with native whites.
The Effects of Educational-Occupational Mismatch on Immigrant Earnings in Australia, with International Comparisons
Authors: Chiswick Barry R. , Miller Paul W.
Published: December 2010

This paper examines the way immigrant earnings are determined in Australia. It uses the overeducation/required education/undereducation framework and a decomposition of the native-born/foreign-born differential in the payoff to schooling. This decomposition links over-education to the less-than-perfect international transferability of immigrants’ human capital, and undereducation to favorable selection in immigration. Comparisons are offered with findings from analyses for the U.S. and Canada to enable assessment of the relative impacts of favorable selection and the limited international transferability of human capital to the lower payoff to schooling for the foreign born. The sensitivity of the results of the decomposition to several measurement issues is assessed.
The Certification Role of Large Customers in the New Issues Market
Authors: Johnson William C. , Kang Jun‐Koo , Yi Sangho
Published: December 2010

This paper examines the certification role of large customers and finds that IPO firms that have product market relationships with large customers experience higher valuation and better long‐term performance compared to IPOs without such relationships. This higher valuation is more pronounced when product market relationships are able to alleviate IPO uncertainties, when the businesses of large customers and their IPO suppliers are closely related in downstream markets, and when large customers have stronger certifying abilities. Finally, we find that large customers realize significant positive abnormal returns around their suppliers’ preliminary prospectus filing dates, suggesting that some of the benefits from product market relationships accrue to large customers.
Executive Stock Option Exercise and Seasoned Equity Offerings
Authors: Cline Brandon N. , Fu Xudong
Published: December 2010

We examine executive stock option exercises around a sample of 1,268 seasoned equity offerings (SEOs) from 1996 to 2004 focusing on a subset of exercises we identify as potentially informed. Consistent with the theory that firms issue equity when stock is overvalued, we document a surge in informed exercise in the months surrounding the SEO. From six months prior to the announcement date to six months after issuance, an average 1.76% of the total market capitalization for issuing firms is exercised and sold. Interestingly, we find a positive association between informed option exercises and long‐run performance. Overall, our collective evidence indicates that insiders are not particularly good at timing exercises around SEOs.
Clinical Predictors of High Posttreatment Platelet Reactivity to Clopidogrel in Koreans
Authors: Park Kyung Woo , Park Jin Joo , Jeon Ki‐Hyun , Kang Si‐Hyuk , Oh Il‐Young , Yang Han‐Mo , Cho Hyun‐Jai , Lee Hae‐Young , Kang Hyun‐Jae , Koo Bon‐Kwon , Oh Byung‐Hee , Park Young‐Bae , Kim Hyo‐Soo
Published: December 2010

Introduction: High posttreatment platelet reactivity to clopidogrel (HPPR) is associated with major adverse cardiac events. However, the clinical predictors of HPPR in Asians have not been studied previously.

Aims: We sought to determine clinical predictors of HPPR in Koreans.

Results: We measured platelet reactivity with the VerifyNow P2Y12 assay in 1431 consecutive patients undergoing coronary angiography. We used the cut‐off value of greater than 275 P2Y12 Reaction Unit (PRU) to define patients with HPPR. The clinical characteristics were compared between patients with HPPR (36.3%) and those without HPPR (63.7%).

The mean age (65.4 ± 9.1 vs. 62.2 ± 9.7 years) was higher, hypertension (68.5% vs. 62.0%), diabetes mellitus (35.4% vs. 28.5%), chronic kidney disease (36.3% vs. 22.5%), renal replacement treatment (1.2% vs. 0.2%), and congestive heart failure (1.3% vs. 0.3%) were more common among patients with HPPR, while male gender (72.6% vs. 54.8%) and smoking (19.9% vs. 13.1%) were more common among non‐HPPR patients. Mean glomerular filtration rate (63.5 ± 18.6 vs. 69.7 ± 16.1 mL/min/1.73 m3) was lower and C‐reactive protein (hs‐CRP) (6.6 ± 20.5 mg/L vs. 4.2 ± 12.1 mg/L) level was higher among those with HPPR. Independent predictors of HPPR were female gender (OR 1.90, P≤ 0.001), chronic kidney disease (OR 1.51, 0 = 0.004), diabetes mellitus (OR 1.35, P= 0.024), hs‐CRP ≥ 2.0 mg/L (OR 1.31, P= 0.005), and age increase in decades (OR 1.21, P= 0.002), while smoking was negative risk factor (OR 0.63, P= 0.015). The number of risk factors was linearly associated with the risk of HPPR, with most patients having one or two predictors.

Conclusion: In Korean population, independent clinical predictors of HPPR included diabetes mellitus, increased age, female gender, chronic kidney disease, and hs‐CRP ≥ 2.0 mg/L, while cigarette smoking was associated with better responsiveness. Mean platelet reactivity and HPPR prevalence steadily increased with the number of clinical predictors.
Cremanthodium latilobum sp. nov. and C. medogense sp. nov. (Asteraceae) from Chinese eastern Himalaya
Authors: Chen You‐Sheng
Published: December 2010

Cremanthodium latilobum Y. S. Chen and C. medogense Y. S. Chen, two new species from Chinese eastern Himalaya are described and illustrated. A diagnostic key to the species of Cremanthodium section Pinnatinervia Y. Ling & S. W. Liu series Cuneata Y. Ling & S. W. Liu is provided.
Subcutaneous Dirofilariosis in South‐East Serbia‐Case Report
Authors: Tasić S. , Stoiljković N. , Miladinović‐Tasić N. , Tasić A. , Mihailović D. , Rossi L. , Gabrielli S. , Cancrini G.
Published: December 2010

Human dirofilariosis is a relatively rare infection caused by filarial worms of the genus Dirofilaria. We herein report the first case of human subcutaneous dirofilariosis in the southeastern part of Serbia. A complete alive nematode was removed from a nodule in the periorbital region of a 50‐year‐old woman. The nematode was morphologically identified as a D. repens‐like immature female. The diagnosis was confirmed with molecular methods. The patient was probably infected in the South‐East Serbia as she had not travelled abroad, nor in other parts of Serbia such as Vojvodina, recently identified as a hyperendemic area for D. repens infection of dogs.
SECOND NATURE AND SPIRIT: HEGEL ON THE ROLE OF HABIT IN THE APPEARANCE OF PERCEPTUAL CONSCIOUSNESS
Authors: Forman David
Published: December 2010

abstract

Hegel's discussion of the concept of “habit” appears at a crucial point in his Encyclopedia system, namely, in the transition from the topic of “nature” to the topic of “spirit” (Geist): it is through habit that the subject both distinguishes itself from its various sensory states as an absolute unity (the I) and, at the same time, preserves those sensory states as the content of sensory consciousness. By calling habit a “second nature,” Hegel highlights the fact that incipient spirit retains a “moment” of the natural that marks a limitation compared to “pure thought” but that also makes perceptual consciousness possible. This makes Hegel's account analogous in important respects to John McDowell's “naturalism of second nature.” But Hegel's account of habit can be seen as a version of a Kantian synthesis of the productive imagination—and hence presupposes a given material that can become one's own by means of habit. This does not mean that Hegel falls into the Myth of the Given, but it does suggest that an appropriate account of second nature might be committed to something McDowell wants to deny: that nonconceptual states of consciousness play a role (even if not a justificatory role) in perception.
WANDERING AMONG SHADOWS: THE DISCORDANCE OF TIME IN LEVINAS AND BERGSON
Authors: Durie Robin
Published: December 2010

abstract

One of the earliest examples of articulating the “discordance of time”—a theme that serves as a guiding thread woven throughout much of the re‐engagement with time that is characteristic of continental philosophy—can be found in a series of essays written by Levinas in the aftermath of World War II. I show how these essays derive from a set of key texts by Bergson and how Bergson already anticipated the distinctive ways of conceptualizing the movement of time that are advanced by Levinas in his early essays. Nevertheless, as I will show, Levinas chooses not to acknowledge this Bergsonian anticipation of his theory of time, despite his recognition, repeated throughout many texts and interviews, of the influence of Bergson on the formation of his own thought. I conclude by reflecting on the complexity of the Bergsonian inheritance in Levinas's philosophy of time.
P-001 Quantification of parametric color coded digital subtraction angiography
Authors: Powers C , Aagaard-Kienitz B , Pulfer K , Royalty K , Arat A , Niemann D , Strother C
Published: December 2010

Purpose

Color coding of digital subtraction angiography (DSA) is a temporal and intensity post-processing color coded algorithm that generates a single composite image containing all information contained in a standard DSA acquisition. The composite image enhances the conspicuity of findings on DSA images done before and after therapeutic interventions. To date, analysis of images processed with this algorithm has been entirely qualitative. In a series of patients, we sought to add quantification to the color coded images.

Materials and methods

Angiographic acquisitions were obtained by a single operator using the same volume of contrast medium injected through a catheter at the same location before and after treatment. Using the time to peak parameter, the effect of neuroendovascular treatment of cerebral artery vasospasm and intracranial stenosis was quantified in three patients. A time contrast concentration curve was generated from a group of pixels in the extracranial segment of the vertebral artery or internal carotid artery (proximal to the area of pathology) to confirm that delivery of the contrast bolus was equivalent before and after treatment. Next, a time contrast concentration curve from a group of pixels in a vessel distal to the lesion was used to quantify the treatment effect. Quantitative analysis was obtained by directly comparing the time to peak before and after treatment at these two locations.

Results

Color coded DSA was quantified in two patients treated for vasospasm and in one with an intracranial stenosis. In all cases, composite color images were generated with the only variable between pretreatment and post-treatment images being the treatment itself. In all cases, time–concentration curves distal to the lesion demonstrated quantifiable changes in time to peak following treatment. Overall, there was a 1–1.25 s decrease in time to peak after verapamil infusion for vasospasm. There was a 0.5 s decrease in time to peak after angioplasty for intracranial stenosis.

Conclusions

Color coded DSA not only presents all the information from a standard acquisition as a composite qualitative image but also contains readily quantifiable parametric data. The full usefulness of these data remains to be determined and is the topic of ongoing investigations. Furthermore, animal experiments on the effects of varying stenosis on quantitative data proximal and distal to the stenosis are ongoing and will be presented.
O-018 A new hemodynamic parameter: energy loss to anticipate aneurysm rupture
Authors: Takao H , Murayama Y , Qian Y , Mohamed A , Matsuda W , Umezu M , Abe T
Published: December 2010

Purpose

Different hemodynamic models have been studied for the need to estimate the rupture risk of cerebral aneurysms with variable success. We postulated that the transfer of energy by the interaction of the hemodynamic forces with the aneurysmal wall can be related to the risk of rupture. For that reason we introduced a new hemodynamic parameter called energy loss (EL).

Methods

40 side wall, medium sized aneurysms were selected from our aneurysm database from 2003 to 2009. Four incidentally found internal carotid posterior communicating artery aneurysms ruptured during their period of conservative observation (ruptured-IA). 36 stable unruptured aneurysms (stable-IA) with the same location and similar size were examined with EL.

EL is created by separation and turbulence of the flow. We subtracted without aneurysm energy from with aneurysm energy in our model. To avoid the influence from size of aneurysms, the EL was divided by the aneurismal volume.

Results

The flow inside the ruptured IAs appeared more complex, and it crashed strongly into aneurysm surfaces. In contrast, the flow inside of stable-IAs passed smoothly through the aneurysms.

The EL in ruptured-IAs was about five times higher than that of stable-IAs.

Conclusion

The research indicated that there is a more complex flow pattern with significant turbulence inside of ruptured-IA. The EL created by aneurysms was clearly different between ruptured-IA and stable-IA. The results indicate that the EL may be an important parameter to estimate the risk of aneurysm rupture and that potentially can be developed into clinical application.

Abstract O-018 Figure 1

Flow visualization at systolic peak. The blood flow in a case before rupture had a more complex flow pattern.
O-002 Acute stroke treatment: without time limitations
Authors: Turk A , Turner R , Chaudry I
Published: December 2010

Background

Many new stroke trials are evaluating the utility of perfusion imaging for patient selection within certain time constraints. There is evidence that patients with a delayed (>12 h) clinical–diffusion mismatch have poor clinical outcomes. We present our experience utilizing perfusion imaging to triage patients for endovascular therapy irrespective of time constraints.

Methods

53 patients were treated over the past 2 years utilizing presenting National Institutes of Health Stroke Scale (NIHSS), anatomic imaging and perfusion information. Patients were excluded if they had a hemorrhage or significant completed stroke (>1/3 middle cerebral artery territory volume) on CT or cerebral blood volume maps. If perfusion imaging was limited, as in some basilar occlusion cases, then the clinical examination (NIHSS) was used. The median time to treatment from symptom onset of the patient cohort was then determined and patients were divided into two groups. Clinical outcomes were then documented and subgroup analysis was performed.

Results

The mean time to treatment was 10.36 h and the median was 6.13 h (range 1.75–72 h), suggesting several patients were treated far beyond 6 h. Utilizing a 6 h time point to identify two separate groups yielded 26 patients treated before 6 h and 27 patients treated more than 6 h from symptom onset. Angiographically, TIMI2 or better flow was restored 96% of the time. Patient outcomes in those treated less than 6 h compared with more than 6 h showed modified Rankin Score (mRS) of 0–2 in 36% and 37%, respectively, and mRS 0–3 in 56% and 52%, respectively.

Conclusion

Utilization of perfusion based techniques is a viable clinical strategy for identifying acute stroke patients for endovascular therapy. Clinical outcomes can be obtained that are similar to those of clinical trials, irrespective of time constraints in appropriately selected patients.
O-028 Effect of baseline CT scan appearance and time to recanalization on clinical outcomes in endovascular thrombolysis of acute ischemic strokes
Authors: Goyal M , Menon B , Hill M , Coutts S , Demchuk A
Published: December 2010

Purpose

The Penumbra Pivotal Stroke Trial reported a 25% good outcome rate (modified Rankin Scale (mRS) ≤2) despite 81% recanalization rate. We evaluated whether a good initial non-contrast CT (Alberta Stroke Programe Early CT Score (ASPECTS) >7) and a short time to recanalization predicted good clinical outcome in this trial.

Materials and methods

Data were from the Penumbra Pivotal Stroke Trial. Baseline scans were evaluated by two experienced readers blinded to clinical outcomes using an ASPECTS scoring system. ASPECTS was dichotomized into >7 and ≤7 for the primary analysis. Data on the degree of recanalization based on TIMI scores, stroke onset to recanalization time and CT to recanalization time were obtained. The primary clinical outcome was mRS ≤2 at 3 months.

Results

Median baseline NIHSS was 18 (range 8–34) and median baseline ASPECTS was 6 (range 0–10). 81.2% achieved recanalization (TIMI 2–3) and 27.1% good clinical outcome. There was no difference in baseline characteristics between the groups with ASPECTS >7 and ≤7 except in history of hypertension (more common in the >7 group, p=0.01). No difference in TIMI 2–3 recanalization (83.9% vs 79.6%; p=0.8), onset to recanalization (390 vs 359 min; p=0.6) or CT to recanalization time (223.8 vs 208 min; p=0.6) was noted between these two groups. Good clinical outcome however was significantly higher in the >7 group compared with the ≤7 group (50% vs 15%, risk ratio 3.3, 95% CI 1.6 to 6.8; p=0.0001). No patient with an ASPECTS score ≤4 (n=28) or without recanalization (TIMI 0–1) (n=16) had good clinical outcome. There was evidence of an interaction between baseline ASPECTS (dichotomized as >7 and ≤7) and onset to recanalization time (dichotomized as ≤300 min and >300 min) in predicting good clinical outcome (p=0.06).

Conclusion

Patients with a low baseline CT (ASPECTS ≤4) do not benefit from recanalization at any time point. Patients who do not recanalize do not benefit at all. Fast recanalization may benefit even patients with evident damage on the CT scan (ASPECTS >4). Only patients with very favorable scans (ASPECTS >7) benefit when recanalization is late. Patients benefit the most when they are recanalized rapidly and have a favorable baseline CT scans (ASPECTS>7).
O-029 Oral contraceptive and hormone replacement therapy in women with cerebral aneurysms
Authors: Feldman L , Goldstein L , Ouyang B , Chen M
Published: December 2010

Background and purpose

Although ruptured cerebral aneurysms are more common in postmenopausal women than in premenopausal women, or men, the putative hormonal role that underlies this disparity is poorly understood. Prior clinical and laboratory studies suggest that estrogen, via multiple mechanisms, is critical in maintaining arterial vascular integrity and tone. Use of oral contraceptives (OCP) and hormone replacement therapy (HRT) attenuates the sudden physiologic drops in estrogen seen during the normal menstrual cycle and at menopause. The goal of this study was to compare the rate of exogenous estrogen modifying agent use in a cohort of women with cerebral aneurysms with large sample national averages.

Methods

With IRB approval, a retrospective, case control study was performed via trained telephone interviews at a US urban tertiary center. Female patients with cerebral aneurysms under the care of a single physician (MC) from over a 2 year period were compared with a publically available data set from 4682 random female controls in the US, also interviewed via telephone using random digit dialing (Ann Epidemiol2002;12:213–22). The questions asked of both groups were similar with regard to gynecologic history and the use and duration of estrogen modifying medications. Variables included age of menarche, parity, age at birth of first child, use of oral contraceptives and duration if any, use of HRT and duration if any, and age at menopause. Univariate and multivariate analyses were performed.

Results

Between 2008 and 2009, 49 cases were successfully interviewed with an age range between 31 and 80 years. χ2tests of independence were performed to examine the relationship between OCPs or HRTs in cases compared with controls. The lower rate of OCP (χ2(1,N=)=0, p<0.0001) and HRT (χ2(1,N=)=0, p=0.0292) use among cases was statistically significant. Furthermore, an independent samples t test showed a statistically significant lower mean duration of OCP among cases compared with controls (p=0.0041).

Conclusions

Women with cerebral aneurysms not only used OCP and HRT less frequently than the general population but if they did it was of shorter duration. These results support the hypothesis that physiologic drops in estrogen that occur during the menstrual cycle and particularly at menopause may explain why cerebral aneurysms are more frequently found in women, particularly during menopause. A protective role for pharmacologic estrogen stabilization in women who are at risk for cerebral aneurysm formation warrants further study.

Abstract O-029 Table 1

Cases (n=49)Control n=4682Age years (years) (mean (SD))56 (13)49 (8.3)BMI (mean (SD))26.97 (6.9)25 (5.9)Age menarche (years) (mean (SD))12.8 (1.8)12.4 (1.6)Age first pregnancy (years) (mean (SD))20 (SD 8.3)22.9 (5.3)No of term pregnancies (mean (SD))2.47 (1.9)2.3 (1.7)Any or current use of OCP (%)5178Median duration of OCP use (years)2.65.2Any or current use of HRT (%)2441
E-010 Triple coaxial catheter technique for coil embolization of cerebral aneurysms
Authors: Uemura A , Fujii M , Yamamoto D , Matsukawa H , Kobayashi N , Numaguchi Y
Published: December 2010

Introduction

Keeping microcatheters stable in anterior cerebral artery (ACA) or middle cerebral artery (MCA) aneurysms during coil embolization is crucial in the success of the treatment. We currently use a triple coaxial catheter system by using long 4 French or 5 French Cerulean G catheters (Medikit, Tokyo, Japan) as second guiding catheter to support microcatheters in cases of distal cerebral aneurysms. The purpose of this retrospective study is to evaluate the efficacy of the triple coaxial system in the treatment of distal cerebral aneurysms.

Materials and methods

We retrospectively reviewed eight cases (five men and three women; aged 47–90 years; mean 68.1 years) of ACA and MCA ruptured aneurysms treated by endovascular coil embolization by using the triple coaxial system between April 2009 and February 2010. The location of the aneurysms included the anterior communicating artery (n=6), distal ACA (n=1) and distal MCA (n=1). A 5 French guiding sheath (n=4) or 6 French guiding catheter (n=4) was used as the primary guiding catheter. A 4 French or 5 French Cerulean G catheter was introduced up to the petrous portion of the internal carotid artery as a second guiding catheter. Evaluated subjects included success of microcatheter navigation, stability of microcatheter during the procedure and other technical issues.

Results

In all cases, a microcatheter was navigated into the aneurysms successfully. Microcatheters were kept stable inside the aneurysms during the procedure. However, to advance preshaped SL-10 microcatheters (Boston Scientific, Natick, Massachusetts, USA) inside 4 French Cerulean G catheter in two cases was so difficult that we had to exchange the microcatheter to another one. There was no complication associated with the technique. Contrast injection through the guiding catheter during the procedure was slightly hard when 6 French guiding catheters were used as the primary guiding catheter.

Conclusion

Triple coaxial system for ACA and MCA aneurysms is a safe and feasible technique. However there are several technical issues that we have to take into account.
E-011 Safety and efficacy of combined mechanical and pharmacological intervention in acute stroke patients with atrial fibrillation
Authors: Sharma J , Nanda A , Mehta S , Joshi A , Hsu D
Published: December 2010

Objective

We report on the use of combined mechanical and pharmacological intra-arterial interventions in patients with atrial fibrillation in acute stroke settings.

Background

Cardioembolic source is a major cause of ischemic stroke. However, there is limited experience regarding the use of combined mechanical and chemical intra-arterial therapy in acute stroke patients with atrial fibrillation.

Design and methods

Retrospective chart review was performed on 45 patients with atrial fibrillation who underwent interventional acute stroke treatment from January 2006 to October 2009. The study included 29 men and 16 women, with a mean age of 72 years. The mean National Institutes of Health Stroke Scale was 17 at presentation. The primary outcome measures included for analysis following the intervention were intracranial hemorrhage (ICH), mortality and recanalization rates as well as modified Ranking Score (mRS).

Results

The mean time from onset of symptoms to beginning of the angiographic procedure was within 3–6 h. 20 patients received 0.9 mg/kg intravenous tissue plasminogen activator (tPA) for 40 min as a bridging therapy prior to any endovascular management. Large vessel occlusions were noted in more than 73% of the patients (n=33) Thirty patients received intra-arterial tPA and a mechanical device was used in 16 patients during endovascular intervention. Mechanical thrombectomy devices utilized were MERCI and Penumbra in 12 and four patients, respectively. Rate of postprocedure symptomatic ICH was 15% (n=7). Nine patients died during the hospital stay (20%). Partial to complete recanalization (TIMI 2 or 3) was achieved in 25 patients (55%). mRS ≤3 was achieved in 23 patients (51%) at the time of discharge.

Conclusions

Combined mechanical and pharmacological therapies during acute stroke interventions can be safe and effective in achieving revascularization in patients with atrial fibrillation.
E-014 Effect of carotid artery stenting on cognitive function in patients with carotid artery stenosis: one year outcomes
Authors: Turk A , Pulfer K , Turski P , Niemann D , Aagaard-Kienitz B , Rowley H
Published: December 2010

Background

Carotid artery stenosis may be a cause of reduced cognitive performance. We have previously demonstrated that stent revascularization resulted in short term improvement in cognitive testing. The goal of this study was to demonstrate the long term durability of improved cognitive performance 1 year after carotid stenting.

Methods

Patients referred for stenting of a unilateral carotid artery stenosis were enrolled in the study. Neuropsychological testing was performed with a Mini-Mental Status Examination, an extended mental status examination, a subjective cognitive status measure and a psychomotor performance speed test. The severity of stenosis was measured on angiography performed prior to stenting. One year after stenting, CT angiography was performed to ensure no restenosis had occurred and neuropsychological testing was repeated. Differences in neuropsychological test scores pre- and post-stenting were calculated and tested for significance with a Student t test.

Result

13 patients with a single unilateral greater than 50% carotid stenosis completed the study. The stenosis of the carotid artery averaged 84% prior to treatment and 9% after treatment. Post-stenting, the extended mental status examination was significantly improved. There was also significant improvement in delayed memory at 1 year that was not present at the 3 month follow-up. The subjective cognitive status measure also improved. No significant change was noted in the Mini-Mental Status Examination or in the speed of psychomotor performance.

Conclusion

Carotid artery stenting in patients with a unilateral carotid artery stenosis resulted in significant long term improvements in cognitive test scores, most notably delayed memory.
E-018 Preliminary experience with the percutaneous embolization of paragangliomas at the carotid bifurcation using only Onyx
Authors: Shah H , Gemmete J , Chaudhary N , Pandey A , Ansari S
Published: December 2010

Introduction and purpose

Surgical resection of hypervascular paraganglioma can be difficult due to intraoperative blood loss. Preoperative endovascular embolization with particulate material facilitates safe and complete surgical resection. However, complete devascularization is often impossible due to an inability to selectively catherize tiny feeding arteries or short pedicles arising from the carotid bifurcation with concerns for embolic reflux. We present our initial angiographic and clinical outcomes using only Onyx (ethylene vinyl alcohol) for percutaneous embolization of paragangliomas at the carotid bifurcation.

Materials and methods

A consecutive series of five patients with five paragangliomas (carotid body tumors) located at the carotid bifurcation were treated solely with percutaneous Onyx embolization. Fluoroscopic roadmap and ultrasound guided access was utilized for percutaneous needle placement. Onyx 18 and Onyx 34 were infused under constant negative roadmap fluoroscopy. Onyx embolization was continued until devascularization was achieved by angiography or reflux occurred into the feeding arterial pedicles or draining veins.

Results

Complete devascularization of the five paragangliomas was achieved using a percutaneous embolization technique with Onyx as the sole agent without complications. An average of 2.5 needles (range 2–4) were placed into each carotid body tumor under fluoroscopic and ultrasound guidance. An average of 6.9 ml (range 5–8.5 ml) of Onyx was injected in each tumor. Complete devascularization was achieved in each case by angiography. Surgical resection was subjectively reported to be less intensive with a decreased need for cauterization and reduced intraoperative blood loss. Intraoperative blood loss averaged 80 ml (range 10–200 ml).

Conclusion

Our preliminary experience suggests that percutaneous Onyx embolization may offer a higher degree of devascularization compared with other embolic agents, allowing safe and complete surgical resection as well as reducing intraoperative blood loss. Onyx appears to be a safe embolic agent when injected percutaneously due to its inherent cohesive nature allowing controlled extended injections, ability to intermittently pause and redirect its flow into the tumor vascular bed.
E-040 Utility of Syngo iGuide needle guidance system for intraoperative navigation in percutaneous spine interventions: a cadaveric study
Authors: Kathuria S , Ehtiati T , Gandhi D
Published: December 2010

Purpose

This study was designed to evaluate the feasibility, inter-observer agreement and accuracy of Syngo iGuide intraoperative navigation planning system for percutaneous spine interventions.

Methods and materials

This cadaveric study was performed according to our institution guidelines for cadaver work. Two fresh frozen cadaver (one for thoracic and one for lumbar levels) were used to test the utility of a recently launched, commercially available flat panel application from Siemens Medical Systems that provides intraoperative virtual guidance to a user predefined needle path and target. Using this system, a total of 18 needle passes (eight thoracic and 10 lumbar levels) were performed by two experienced interventional neuroradiologists (nine passes per operator, alternate side and levels) using a unilateral transpedicular approach from T5 to T12 vertebral bodies and a bipedicular approach from L1 to L5 vertebral bodies. Entry and target points were first selected on a C arm dynaCT image to determine a safe path for the needle. The needle path, target point and three-dimensional images were registered to live fluoroscopy during the procedure and were used to guide needle placement in real time. After satisfactory placement of the needle, strictly using the guiding system, post C arm dynaCT images were obtained for measurements.

Results

Needle placement data from eight thoracic and 10 lumbar vertebral levels (T5–T12; L1–L5) were available for review. Needles were safely placed at all levels with no breach of the central canal, lateral or medial wall of pedicle or that of the anterior cortex. The average distance from the center of the predefined target to needle tip was 2.94 mm (3.07 for thoracic, 2.83 mm for lumbar) with a range from 1.4 mm to 4.8 mm. The average distance from the center of the target to the nearest part of the needle trajectory was 0.93 mm (0.97 mm for thoracic, 0.88 mm for lumbar) with a range from 0.00 mm to 2.4 mm. There was no significant difference between the two operators.

Conclusion

Use of the Syngo iGuide Needle Guidance intraoperative navigation system is feasible for spinal interventions. The needle can be placed to the target with less than 3 mm error in cadaver study. This software allows reliable and accurate needle placement by providing real time intraoperative navigation. Further testing in live subjects is needed to establish patient safety. Preliminary work on live patients is underway at our institution and appears promising.
E-053 Anomalous origin of the middle meningeal artery from mid-basilar artery
Authors: Nanda A , Chowdhry S , Blackham K
Published: December 2010

Introduction

The middle meningeal artery (MMA) most commonly originates from the maxillary artery and travels through the foramen spinosum. Most variants have been noted to originate from the ophthalmic artery or the internal carotid artery. Rarely, an origin from the basilar artery has been observed. Here we present the case of anomalous origin of the MMA from the basilar artery in a pediatric patient with left facial hemangioma also supplied by the aberrant basilar branch in the setting of PHACES syndrome.

Case history

A 2-year-old female toddler with a left facial hemangioma and left lid lag presented for diagnostic cerebral angiogram to further characterize a large fusiform left posterior communicating artery aneurysm with involvement of the left internal carotid artery, anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA).

We here report a case of anomalous origin of the MMA from the basilar artery with literature review.

Methods and results

Intracranial MR angiography, digitally subtracted cerebral angiography, including rotational three-dimensional angiography, with a left internal carotid artery injection and left vertebral artery injection was performed. A large fusiform left posterior communicating artery aneurysm was noted with involvement of the carotid terminus, as well as proximal aspects of the left ACA, MCA and PCA. Additionally, a large branch off the basilar artery at the level of the pons was noted originating between the left superior cerebellar artery and the left anterior inferior cerebellar artery, both of which were relatively diminutive. The vessel traveled anteriorly through the cavernous sinus and into the middle cranial fossa where it branched into the MMA and a vessel that traveled through the optic canal and exited beneath the superior orbital rim to supply the large left facial hemangioma. No associated intracranial vascular malformation was noted.

Conclusion

We describe a rare case of anomalous origin of the MMA from the basilar artery in a pediatric patient, in the setting of PHACES syndrome. Only seven cases of the MMA originating from the basilar artery have been reported previously, including one case of bilateral anomalous origin. In each of these cases, the MMA originated from an enlarged basilar branch between ipsilateral the superior cerebellar artery and anterior inferior cerebellar artery, as was noted in our case. This anomaly has been proposed to be the result of an anastamosis between the primitive trigeminal artery and a persistent stapedial artery.

Abstract E-053 Figure 1
E-060 Complex cerebral arteriovenous fistula: endovascular treatment using transvenous and transarterial approach
Authors: Pabon B , Vargas S , Vargas S
Published: December 2010

Background and purpose

Endovascular treatment is an accepted choice for intracranial pial and dural arteriovenous fistulas (PAVF/DAVF). We assessed the technical feasibility, safety and efficacy of the endovascular approach as monotherapy for difficult and complex cases.

Methods

Since June 2006 to Dec 2009, of 68 patients with cerebral AVMs treated, 20 cases were DAVF and six were PAVF. 10 cases presented with hemorrhage, two cases with seizures, eight cases with headache and six cases truly incidental. 16 cases were treated with a transarterial strategy while seven lesions were treated using a transvenous approach (retrograde technique). Clinical and radiological outcome were assessed and mid term follow-up is presented. Special consideration was taken into account with regard to anatomical tips and adverse events.

Results

Fistula occlusion (technical success) of 97% was achieved. Undesired distal embolization was registered in one case. In two cases we had microcatheter retention. One case of recurrence after occlusion. None case presented rebleeding during follow-up.

Conclusion

Current microsystems can be safely maneuvered through severely tortuous arterials and venous vessels although technically demanding to advance while a ‘retrograde’ technique is carried out. The combined strategy was associated with high rates of occlusion. Although immediate and mid term angiographic results are promising, long term angiographic and clinical follow-up is essential to determine occlusion stability and clinical outcome
E-061 Safety and efficacy of Neuroform 3 for intracranial aneurysms treatment
Authors: Bonafe A , Biondi A
Published: December 2010

Objectives

To assess the feasibility and the clinical performance of NF3 in intracranial aneurysms treatment. SENAT (Safety and Efficacy of Neuroform 3 for Intracranial Aneurysms Treatment) a multicenter registry, has been conducted between January through July 2009 from French centers. The registry protocol allowed for use of all types of coils and adjunctive technologies, as deemed appropriate by the participating investigator. Acute clinical and angiographic assessments were self- reported.

Methods

118 patients (79 women, 39 men) harboring a single aneurysm (109 unruptured, nine ruptured) were treated by means of stent assisted coiling and included in a prospectively maintained database.

Aneurysms were predominantly located in the anterior circulation (106 of 118) with a mean size of 6.60 mm (3.55 mm). All patients underwent a double antiplatelet regimen (clopidogrel, aspirin) before, during and after the procedure.

Results

Feasibility

Technical success defined as successful stent delivery in the proper place was achieved in 98.2% of cases with one (113 cases) or two (4 cases) devices. In one case of ruptured aneurysm the intended stenting initially considered was abandoned.

Safety

10 (8.5%) per procedural and immediate postprocedural complications occurred: one case of subarachnoid rebleeding due to aneurysmal perforation, one case of delayed bleeding in an infarcted area remote from the stent landing zone, three thrombotic complications and five groin hematomas.

Mortality/morbidity

30 day mortality and morbidity rates were 0% and 4.2% respectively. Adverse events associated with transient or permanent neurological deficit were encountered in 2.6% of cases with the majority occurring in ruptured aneurysms.

Acute results

Complete aneurysmal occlusion was achieved in 74 cases (62.7%), residual neck were noted in 28 cases (23.7%) and a residual sac was present in 16 cases (13.6%).

Conclusion

The Neuroform Stent 3 has no technical limitation, all types of aneurysm location being amenable to stenting, and does not impair adequate coil embolization. Antiplatelet agents decrease thromboembolic events rate but favor major peripheral or cerebral bleeding preventing larger use of Neuroform stents in cases of acutely rupture aneurysms.
Coherent and incoherent scattering of low-energy X-ray photons in the atomic region 13 ≤ Z ≤ 82
Authors: Rao D. V. , Cesareo R. , Gigante G. E. , Rao D. V. , Gigante G. E.
Published: December 2010

Coherent- and incoherent-scattering cross sections for the elements Al, Cu, Y, In, Au, and Pb were measured using nearly monoenergetic unpolarized 35.86 and 39.96 keV X-ray beams with high-resolution Si (Li) detectors. Bremsstrahlung radiation from an X-ray tube was used to excite nearly monoenergetic X-rays in secondary targets. To improve the efficiency of the detection system the excitation source, detector, and the target assembly were placed in a vacuum chamber and a pressure of 10−2 mbar was maintained throughout the measurements. This system considerably reduced the background and scattering effects and improved the monochromacy. Experimental coherent-scattering cross sections are compared with the normalized integrated coherent-scattering cross sections calculated using the relativistic, nonrelativistic, and relativistic-modified form factors. Experimental incoherent-scattering cross sections are compared with the theoretical values, calculated using the nonrelativistic incoherent-scattering function. Good correspondence is observed between experimental and theoretical values in the given energy region.
Unsteady planar stagnation point heat transfer in micropolar fluids
Authors: Gorla Rama Subba Reddy , Gorla Prasad
Published: December 2010

A boundary-layer analysis is presented to study the importance of a time-dependent surface temperature or heat flux on convective heat transfer in a planar stagnation point flow of a micropolar fluid on a flat plate. The governing equation for the unsteady heat-transfer response is formulated. Numerical solutions are presented for ramp and sinusoidal changes in surface heat flux or temperature. Departures from steady-state transfer coefficients are evaluated.
Deep traps in quartz and their use for optical dating
Authors: Huntley D. J. , Short M. A. , Dunphy K.
Published: December 2010

We describe a number of optical properties of a natural quartz that are related to the presence of electron traps having an optical depth of about 3 eV below the conduction band. Such traps are populated as a consequence of a radiation dose, and can be depopulated by optical excitation. An understanding of these processes is necessary in order to make use of these phenomena to determine the ages of sediments by optical dating. The recombination emission spectrum is found to consist mainly of a 0.65 eV wide band at 3.35 eV (370 nm). This and other information are used to deduce that the traps are electron traps. The excitation efficiency is found to increase with photon energy, and with temperature. The data are roughly in accordance with Urbach's rule, and an optical trap depth of about 2.9 eV is deduced. Above 100 °C thermal quenching causes a reduction in the observed luminescence. Isothermal decay studies show that there are actually several traps, possibly including a distribution of traps, with most of the luminescence arising from traps with thermal depths of about 1.6 eV and lifetimes deduced from extrapolation to be >2 × 106 years at 20 °C. The ratio of optical to thermal trap depths is in accordance with the Mott and Gurney prediction. A laboratory dose, besides filling traps, also has an effect that we attribute to population of competing recombination centres; this can be reversed with appropriate heating. Our understanding of the dose response and kinetics was tested on two samples of known age, and correct ages of ~ 120 000 years were obtained.
Multiple scattering of a plane electromagnetic wave by hemispherical bosses on an infinite plane
Authors: Hamid A.-K.
Published: December 2010

An analytic solution to the problem of scattering of a plane electromagnetic wave by a system of hemispherical bosses on a perfectly conducting ground plane is obtained using the solution of scattering by a system of full spheres and the method of images. The system considered is replaced by a system of complete spheres in the absence of the ground plane, but with the given incident plane wave and also a supplement, image plane wave, chosen such that the boundary conditions for the total field are satisfied at all points where the ground plane is located in the original problem. Numerical results for a different system of simulations are presented for the normalized backscattering cross section versus the angle of incidence.
Coherent state of the Dirac oscillator
Authors: Nogami Y. , Toyama F. M.
Published: December 2010

A coherent state of the Dirac oscillator in (1 + 1) dimensions is constructed. This is a relativistic extension of Schrödinger's coherent state of the nonrelativistic harmonic oscillator. There are interesting differences between the Dirac and the Schrödinger cases. In the Dirac case, the coherent state spreads out in time but after a while the original coherent state is nearly restored. Then it spreads again. This process recurs but in an aperiodic manner. In addition, the expectation value of coordinate x for the coherent state exhibits Zitterbewegung. The possibility of an analogue of Ehrenfest's theorem is discussed.