bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Wave Dynamics and Small-Scale Topography for Downslope Wind Events in Southeast Greenland
Authors: Oltmanns M. , Straneo F. , Seo H. , Moore G. W. K.
Published: April 2015

In Ammassalik, in southeast Greenland, downslope winds can reach hurricane intensity and represent a hazard for the local population and environment. They advect cold air down the ice sheet and over the Irminger Sea, where they drive large ocean–atmosphere heat fluxes over an important ocean convection region. Earlier studies have found them to be associated with a strong katabatic acceleration over the steep coastal slopes, flow convergence inside the valley of Ammassalik, and—in one instance—mountain wave breaking. Yet, for the general occurrence of strong downslope wind events, the importance of mesoscale processes is largely unknown. Here, two wind events—one weak and one strong—are simulated with the atmospheric Weather Research and Forecasting (WRF) Model with different model and topography resolutions, ranging from 1.67 to 60 km. For both events, but especially for the strong one, it is found that lower resolutions underestimate the wind speed because they misrepresent the steepness of the topography and do not account for the underlying wave dynamics. If a 5-km model instead of a 60-km model resolution in Ammassalik is used, the flow associated with the strong wind event is faster by up to 20 m s−1. The effects extend far downstream over the Irminger Sea, resulting in a diverging spatial distribution and temporal evolution of the heat fluxes. Local differences in the heat fluxes amount to 20%, with potential implications for ocean convection.
Elections in the Arab World
Authors: de Miguel Carolina , Jamal Amaney A. , Tessler Mark
Published: April 2015

This article examines the determinants of voting in competitive authoritarian regimes in the Arab world. In contrast to scholars who view elections in the Arab World purely as patronage contests, we argue that citizens also care about policy outputs and use turnout as a way to signal their approval or disapproval with the regime. We draw on the literature on economic voting in democratic regimes to develop an argument about economic voting under authoritarian conditions, and we propose a mediation model to get at the mechanisms of economic voting. We test our argument with original data based on surveys conducted in seven Arab countries between 2006 and 2009. Our results show that although patronage helps to explain turnout, especially among high-income citizens, policy outcomes are also important in the calculus of voting. Most voters turn out to vote to show approval of the regime and its economic performance.
Executive Power and Media Freedom in Central and Eastern Europe
Authors: Bairett Richard L.
Published: April 2015

Political executives often influence how effectively citizens can monitor them, yet the link between executives and government transparency is not well developed in the literature. I begin filling that void by illuminating the relationship between media freedom—one dimension of transparency—and executive power. I theorize that politicians prefer to avoid monitoring and negative publicity, and that both presidents and prime ministers often can do something about it via their constitutional powers and influence accrued through partisan support. Using new panel data on Central and Eastern European prime ministers and presidents, I find that proactive legislative powers for both executive types and increased partisan support for prime ministers negatively affect media freedom. My model explains most of the variation in Central and Eastern European media freedom, predicts high press freedom in Western Europe, and has important implications for the broader relationships between executive power, transparency, and accountability.
Mutually transformative missions: A postcolonial, process-relational Pentecostal missiology
Authors: Reichard Joshua D.
Published: April 2015

This article comprises a development of Amos Yong’s three-phase Pentecostal missiology in the direction of postcolonialism fostering “mutually transformative missions.” An appropriation of theological insights from process-relational theology and a creative application of those insights to Yong’s postcolonial proposal facilitate a fuller “non-colonial” missiological model that is grounded both metaphysically and theologically. Three particular metaphysical categories from process-relational theology may support the development of a postcolonial Pentecostal missiology: panentheistic pluralism, mutual transformation, and divine vulnerability. Two case studies are presented to highlight these themes. In terms of metaphysical grounding, process-relational theology may aid Pentecostals in freeing themselves of their colonial rootedness, not just in the West, but in the burgeoning Pentecostal movements in the Global South. By embracing panentheistic pluralism, mutual transformation, and divine vulnerability, Pentecostal missiology might take another step in the postcolonial direction. In so doing, Pentecostals might ultimately articulate a global non-colonial, process-relational missiology that focuses less on coercive conquest and more on loving relationality.
Direct Participation and Employee Learning at Work
Authors: Inanc Hande , Zhou Ying , Gallie Duncan , Felstead Alan , Green Francis
Published: April 2015

The creation of a learning environment at work has been seen as an essential concomitant of the growth of an advanced economy. This article explores the implications of direct participation for different types of employee learning, drawing upon the British Skills and Employment Surveys of 2006 and 2012. It confirms that direct participation is strongly associated with enhanced learning opportunities at work but finds important differences in the benefits of specific forms of direct participation. Moreover, direct participation was found to be particularly important for those in less favorable work contexts with respect to technological level and skill.
Comparison of Nutrition Profile and Diet Record Between Veteran and Nonveteran End‐Stage Renal Disease Patients Receiving Hemodialysis in Veterans Affairs and Community Clinics in Metropolitan South‐Central Texas
Authors: Cunningham Sue E. D. , Verkaik Darlene , Gross Georgiana , Khazim Khalid , Hirachan Padam , Agarwal Gurav , Lorenzo Carlos , Matteucci Elena , Bansal Shweta , Fanti Paolo
Published: April 2015

Background: U.S. military veterans have high rates of chronic disease and social disadvantage, which are risk factors for protein‐energy wasting (PEW). It is not known whether this translates into high prevalence of PEW in veterans with end‐stage renal disease. Methods: We compared the clinical, socioeconomic, and nutrition status and the diet of 33 veteran and 38 nonveteran clinically stable patients receiving maintenance hemodialysis (MHD) in south‐central Texas. Results: The whole cohort included 82% Mexican Americans (MAs), 72% type 2 diabetics, and 73% males. The body mass index was 28.9 ± 6.2, while energy intake was 21.5 ± 8.2 kcal/kg/d and protein intake was 1.0 ± 0.4 g/kg/d. Serum albumin (bromocresol purple) was 3.5 ± 0.4 g/dL, transferrin was 171.9 ± 27.8 mg/d, C‐reactive protein was 2.9 (1.4–6.5) mg/L, interleukin‐6 (IL‐6) was 8.3 (4.2–17.9) pg/mL, neutrophil gelatinase‐associated lipocalin was 729 (552–1256) ng/mL, and the malnutrition‐inflammation score was 8.8 ± 3.0. In group comparison that adjusted for sex and ethnicity, the veterans had better household income, less MAs (60% vs 100%), more males (94% vs 55%), more use of a renin‐angiotensin‐aldosterone system blockade (66% vs 33%), and lower IL‐6 levels (4.4 [3.1–5.8] vs 15.4 [8.3–20.5] pg/mL; P = .01) than nonveterans. In regression analysis, the lower serum IL‐6 level in veterans was independently explained by dialysis clinic, sex, and, possibly, household income (intermediate significance). Conclusion: In a relatively small cohort of clinically stable MHD patients, the veterans showed equivalent nutrition status and dietary intake and less inflammation than the nonveterans, thus not supporting the possibility that veteran MHD patients may have worse nutrition than the nonveteran counterpart.
Mock Juror Perceptions of Rape Victims
Authors: Sommer Shannon , Reynolds Joshua J. , Kehn Andre
Published: April 2015

The purpose of the present study was to examine mock juror perceptions of rape victims based on the sex of the offender and victim (male offender/female victim vs. female offender/male victim), relationship to the offender (stranger vs. acquaintance vs. intimate partner), revictimization (no revictimization vs. revictimization), and individual differences in rape myth acceptance (RMA) and life history strategy (LHS). Participants ( N = 332) read a vignette describing a forcible rape scenario and completed victim and perpetrator blame scales, the Mini-K, and a gender-neutral Rape Myth Acceptance Scale. Results indicated increased victim blame in revictimization conditions, as well as female offender/male victim conditions. A significant mediation effect of LHS on victim blame through the indirect effect of RMA was found, which is predicted from life history theory. Implications of these findings are discussed.
Morphologic, molecular, and ultrastructural characterization of a feline synovial cell sarcoma and derived cell line
Authors: Cazzini Paola , Frontera-Acevedo Karelma , Garner Bridget , Howerth Elizabeth , Torres Bryan , Northrup Nicole , Sakamoto Kaori
Published: April 2015

A 2.5-year-old, male, neutered cat presented with a 5-month history of progressive right hind limb lameness and an enlarged right popliteal lymph node. Radiographs revealed significant bony lysis of the tarsus and distal tibia, and fine-needle aspirate of the bone lesion and lymph node revealed a neoplastic population of cells with uncertain origin. Amputation was elected, and the mass was submitted for histology and cellular culture for better characterization. Histologic examination revealed a mixture of spindle-shaped cells and larger, round to polygonal cells. All cells were immunoreactive for vimentin, and only the larger polygonal cells were also positive for cytokeratin. All cells were negative for desmin, smooth muscle actin, cluster of differentiation (CD)3, CD18, CD79a, macrophage antibody (MAC)387, and glial fibrillary acidic protein. Cultured neoplastic cells failed to express CD18, and were not able to secrete the pro-inflammatory cytokines tumor necrosis factor-α, interleukin-1 (IL-1)β, and IL-6 when stimulated by lipopolysaccharide, disproving that the cells originated from the macrophage or monocyte line. Ultrastructurally, neoplastic cells were characterized by abundant rough endoplasmic reticulum, interdigitating cellular processes, and membrane condensations. Based on location and cytologic, histologic, ultrastructural, and functional studies, this neoplasm was considered a synovial cell sarcoma.
Place of Care at End of Life
Authors: Loh Alvona Zi Hui , Tan Julia Shi Yu , Jinxuan Tan , Lyn Teo Yi , Krishna Lalit Kumar Radha , Goh Cynthia Ruth
Published: April 2015

Background:

Few Asian studies have elucidated factors influencing patients and their family members on their preferred place of care at the end of life. This pilot study describes the perceptions of Singaporean patients with cancer and their family members that affect their choices in place of care.

Methodology:

Patients with cancer and their family members were surveyed at a tertiary hospital in Singapore. This convenience sample was recruited from April to July 2012.

Results:

Fourteen pairs of patients and their family members (N = 28) were recruited. A majority of patients (64.3%) and family members (71.4%) were found to have a preferred place of care at the end of life. Of the respondents who expressed a preference (n = 19), 88.9% of patients and 90.0% of family members named “home” as their preferred place of care. Quality of care at home was rated “good” or “excellent” by all patients and 85.7% of family members.

Conclusion:

Home is the most favored choice among patients and family members who have a preferred place of care.
Stem Cell Research
Authors: Trounson Alan , Kolaja Kyle , Petersen Thomas , Weber Klaus , McVean Maralee , Funk Kathleen A.
Published: April 2015

Stem cells have great potential in basic research and are being slowly integrated into toxicological research. This symposium provided an overview of the state of the field, stem cell models, described allogenic stem cell treatments and issues of immunogenicity associated with protein therapeutics, and tehn concentrated on stem cell uses in regenerative medicine focusing on lung and testing strategies on engineered tissues from a pathologist’s perspective.
Factors influencing women’s choice of weight-loss diet
Authors: Calder Romana K , Mussap Alexander J
Published: April 2015

We developed a typology of eight minimally overlapping weight-loss diet methods and used it to survey 151 women dieters on their choice of diet in the previous 12 months, their motivations to diet, and their eating disorder symptomatology. Canonical correlations revealed a potentially problematic “thin, quick, and easy” association of methods and motives, as well as a more healthful “thin, natural, life-style” association. Both featured the pursuit of thinness but not health. In fact, health was rated by dieters as the poorest motivator of dieting. The results highlight the importance to women dieters of short-term aesthetic concerns over long-term health.
Natural products for chronic cough
Authors: Shergis Johannah Linda , Wu Lei , May Brian H , Zhang Anthony Lin , Guo Xinfeng , Lu Chuanjian , Xue Charlie Changli
Published: April 2015

Chronic cough is a significant health burden. Patients experience variable benefits from over the counter and prescribed products, but there is an unmet need to provide more effective treatments. Natural products have been used to treat cough and some plant compounds such as pseudoephedrine from ephedra and codeine from opium poppy have been developed into drugs. Text mining historical literature may offer new insight for future therapeutic development. We identified natural products used in the East Asian historical literature to treat chronic cough. Evaluation of the historical literature revealed 331 natural products used to treat chronic cough. Products included plants, minerals and animal substances. These natural products were found in 75 different books published between AD 363 and 1911. Of the 331 products, the 10 most frequently and continually used products were examined, taking into consideration findings from contemporary experimental studies. The natural products identified are promising and offer new directions in therapeutic development for treating chronic cough.
Alpha-melanocyte stimulating hormone inhibits monocytes adhesion to vascular endothelium
Authors: Yang Yang , Zhang Weihua , Meng Lin , Yu Haitao , Lu Na , Fu Gang , Zheng Yang
Published: April 2015

Inflammation and its subsequent endothelial dysfunction have been reported to play a pivotal role in the initiation and progression of chronic vascular diseases. Inhibiting the attachment of monocytes to endothelium is a potential therapeutic strategy for vascular diseases treatment. α-Melanocyte stimulating hormone is generated from a precursor hormone called proopiomelanocortin by post-translational processing. However, whether α-melanocyte stimulating hormone plays a role in regulating endothelial inflammation is still unknown. In this study, the effects of α-melanocyte stimulating hormone on endothelial inflammation in human umbilical vein endothelial cell lines were investigated. And the result indicated that α-melanocyte stimulating hormone inhibits the expression of endothelial adhesion molecules, including vascular adhesion molecule-1 and E-selectin, thereby attenuating the adhesion of THP-1 cells to the surface of endothelial cells. Mechanistically, α-melanocyte stimulating hormone was found to inhibit NF-κB transcriptional activity. Finally, we found that the effect of α-melanocyte stimulating hormone on endothelial inflammation is dependent on its receptor melanocortin receptor 1.
The Effects of Scenario Planning on Participant Perceptions of Creative Organizational Climate
Authors: Chermack Thomas J. , Coons Laura M. , Nimon Kim , Bradley Peggy , Glick Margaret B.
Published: April 2015

This research reports on the effects of scenario planning on participant perceptions of organizational creative climate. Participants from scenario planning projects in four different organizations were asked to contribute to the study as well as participants from four similar organizations that did not receive scenario planning. The scenario work took place over the course of 3 months and data were collected as pre- and posttests. Comparisons were made that suggest some significant changes over the course of the intervention period for the intervention group, but not for the comparison group. Results and limitations are discussed in detail and recommendations for future research are provided.
Evaporation of nanofluid droplet on heated surface
Authors: Kim Yeung Chan
Published: April 2015

In this study, an experiment on the evaporation of nanofluid sessile droplet on a heated surface was conducted. A nanofluid of 0.5% volumetric concentration mixed with 80-nm-sized CuO powder and pure water were used for experiment. Droplet was applied to the heated surface, and images of the evaporation process were obtained. The recorded images were analyzed to find the volume, diameter, and contact angle of the droplet. In addition, the evaporative heat transfer coefficient was calculated from experimental result. The results of this study are summarized as follows: the base diameter of the droplet was maintained stably during the evaporation. The measured temperature of the droplet was increased rapidly for a very short time, then maintained constantly. The nanofluid droplet was evaporated faster than the pure water droplet under the experimental conditions of the same initial volume and temperature, and the average evaporative heat transfer coefficient of the nanofluid droplet was higher than that of pure water. We can consider the effects of the initial contact angle and thermal conductivity of nanofluid as the reason for this experimental result. However, the effect of surface roughness on the evaporative heat transfer of nanofluid droplet appeared unclear.
“Snap-n-Eat”
Authors: Zhang Weiyu , Yu Qian , Siddiquie Behjat , Divakaran Ajay , Sawhney Harpreet
Published: April 2015

We present snap-n-eat, a mobile food recognition system. The system can recognize food and estimate the calorific and nutrition content of foods automatically without any user intervention. To identify food items, the user simply snaps a photo of the food plate. The system detects the salient region, crops its image, and subtracts the background accordingly. Hierarchical segmentation is performed to segment the image into regions. We then extract features at different locations and scales and classify these regions into different kinds of foods using a linear support vector machine classifier. In addition, the system determines the portion size which is then used to estimate the calorific and nutrition content of the food present on the plate. Previous approaches have mostly worked with either images captured in a lab setting, or they require additional user input (eg, user crop bounding boxes). Our system achieves automatic food detection and recognition in real-life settings containing cluttered backgrounds. When multiple food items appear in an image, our system can identify them and estimate their portion size simultaneously. We implemented this system as both an Android smartphone application and as a web service. In our experiments, we have achieved above 85% accuracy when detecting 15 different kinds of foods.
Spettroscopia protonica in vivo nello studio della sclerosi laterale amiotrofica
Authors: Sarchielli P. , Tarducci R. , Presciutti O. , Vicinanza F. , Guercini G. , Pelliccioli G.P. , Gobbi G. , Gallai V.
Published: April 2015

Il presente studio è stato volto a verificare le modificazioni di alcuni metaboliti cerebrali in corso di SLA mediante RM spettroscopica cerebrale e quantificazione assoluta dei metaboliti. Sono stati studiati 12 pazienti affetti da sclerosi laterale amiotrofica, di sesso maschile ed età media: 53,0 ± 5,32 anni, 7 nella forma definita e 5 nella forma probabile.

Lo studio ha evidenziato, a livello della sostanza grigia dell'area motoria primaria, una riduzione significativa dei livelli di N-Acetil-Aspartato rispetto ai soggetti di controllo (8,5 ± 0,6 mM vs 10,4 ± 0,7 mM, p< 0,001), più marcata nei pazienti ad esordio bulbare ed in quelli con evidenze neuroradiologiche di ipointensità di segnale a carico della corteccia motoria. Non erano evidenti differenze significative relativamente ai valori di N-Acetil-Aspartato tra pazienti con diagnosi definita e quelli con forma probabile.
Localizzazione cerebrale funzionale delle aree del linguaggio per mezzo di un compito di decisione lessicale
Authors: Basso G. , Gorno-Tempini M.L. , Calandra-Buonaura G. , Serafini M. , Pagnoni G , Mavilla L. , Porro C.A. , Baraldi P. , Nichelli P.F.
Published: April 2015

La metodica di risonanza magnetica funzionale (fMRI) permette di esplorare le funzioni cognitive in vivo sull'uomo in modo non invasivo. In questo studio presentiamo i primi risultati di un progetto volto alla localizzazione delle aree cerebrali del linguaggio a scopo clinico per la valutazione prechirurgica e per il controllo riabilitativo di pazienti cerebrolesi. Sono stati studiati 10 soggetti sani destrimani e un paziente cerebroleso sinistro. È stata valutata la differenza di segnale di risonanza registrato con sequenza ecoplanare gradient-echo sensibile al segnale T2* comparando volumi cerebrali acquisiti in blocchi di 30 secondi. I soggetti eseguivano alternativamente un compito di decisione lessicale o un compito di decisione grafemica. I risultati dei dati ottenuti dai pazienti di controllo indicano una elevata sensibilità del test mettendo in evidenza tutte le aree note coinvolte nelle funzione linguistiche. L'analisi dei dati ottenuti dal paziente cerebroleso suggeriscono che il protocollo di studio descritto può essere applicato con successo allo studio delle funzioni linguistiche anche in presenza di danno cerebrale.
L'impiego della maschera laringea in anestesia pediatrica per RM
Authors: Febi G. , Arcidiacono G. , Marchesi P. , Tosetti M. , Battini R.
Published: April 2015

Per eseguire un esame di risonanza magnetica (RM) in età pediatrica è necessario “sedare” in sicurezza il bambino per garantirne durante le scansioni I'immobilità e l'omeostasi delle funzioni vitali. Nella ricerca di una metodica che riassumesse caratteristiche di invasività minima, scarsa produzione di inquinamento ambientale e che consentisse un esatto e costante controllo del livello di anestesia e della pervietà delle vie aeree, siamo giunti all'utilizzo della maschera laringea (LMA) abbinato ad anestesia generale inalatoria in respiro spontaneo.

In un periodo di 18 mesi 482 bambini non premedicati di classe ASA I-III (5,5 + 4,3 aa; range 1 giorno − 18 aa) affetti da patologie del SNC sono stati sottoposti in sequenza ad anestesia inalatoria con LMA per eseguire una RM cerebrale.

Utilizzando un circuito Mapleson “F” modificato allungando le branche inspiratoria ed espiratoria e collegando quest'ultima ad un sistema di aspirazione “Venturi”, l'anestesia veniva indotta, in presenza di un genitore, facendo respirare al bambino alotano a concentrazioni rapidamente crescenti in una miscela gassosa di ossigeno e protossido d'azoto al 50%. Alla scomparsa del riflesso ciliare il. genitore poteva allontanarsi, si provvedeva ad incannulare una vena periferica e quindi si introduceva una maschera laringea di misura appropriata. Utilizzando un monitor amagnetico compatibile con gli alti campi magnetici presenti, si provvedeva quindi a monitorare la saturazione trans-cutanea dell'ossigeno (Sa02), l'ECG, la PA non invasiva, la pressione parziale della C02 di fine espirazione (EtPC02) e la concentrazione sia dell'alogenato che dei gas respirati.

Si posizionava poi il bambino all'interno del magnete continuando l'anestesia in respiro spontaneo con alotano a 1,5 della sua concentrazione minima alveolare inibente (MAC) in miscela gassosa di ossigeno ed aria, con un flusso respiratorio minimo di 300 ml/Kg/min. Circa alla metà della durata dell'esame la concentrazione dell'alogenato veniva diminuita a circa 1,0 MAC.

Al termine dell'esame si sospendeva l'erogazione dell'alogenato togliendo la maschera laringea alla comparsa dei primi riflessi delle vie aeree superiori. Il piccolo veniva poi adagiato su un lettino di un'altra stanza dove si risvegliava accanto allo stesso genitore che aveva precedentemente assistito all'induzione.

In tutta l'esperienza descritta, sia durante l'induzione, che nel periodo intraesame, come al risveglio, non sono stati registrati casi rilevanti di desaturazione, ipotensione, bradicardie, aritmie, convulsioni o altri incidenti clinicamente significativi. Non si è mai constatato rigurgito gastro-esofageo.

Questo lavoro durato quasi due anni ci porta senz'altro a concludere che l'utilizzo della LMA con anestesia inalatoria in respiro spontaneo per il paziente in età pediatrica in risonanza magnetica, comporta ottimi risultati in fatto di sicurezza ed efficacia anestesiologica.
Bilateral Choroidal Fissure Cysts in a Neonate
Authors: Gaikwad S.B. , Mishra N.K. , Deol P.S.
Published: April 2015

Cysts located in the choroidal fissure have rarely been reported in the literature. We present an unusual case with cysts in bilateral choroidal fissures. Sagittal MR images are very useful in diagnosing these cysts where a typical spindle shaped cystic lesion with the postero-superior end leading to the atrium of the ipsilateral lateral ventricle is seen. These benign lesions should not be confused with other cystic lesions of the central nervous system which may require surgical intervention.
Siderosi superficiale del sistema nervoso centrale
Authors: Lupo F.A. , Perrone A.
Published: April 2015

Vengono riportati due casi di siderosi superficiale del sistema nervoso accorsi in due pazienti affetti da sindrome involutiva, turbe cerebellari e dell'udito ad insorgenza lenta e ad andamento progressivamente ingravescente. Dopo una breve revisione della letteratura, viene sottolineato il ruolo svolto dalla RM nella diagnosi di tale affezione.
Microadenomi ipofisari: Aspetti RM
Authors: Calabrò F. , Michelozzi G. , Schiavoni S. , Schizzi R. , Rovere G. , Capellini C.
Published: April 2015

La RM per le sue caratteristiche specifiche ed uniche ha sostituito la TC nello studio della patologia ipofisaria in genere e dei microadenomi in particolare. La RM consente infatti nella pressoche totalità dei casi di accertare la presenza di un microadenoma di cui inoltre ne consente un agevole monitoraggio in corso di terapia medica e dopo terapia chirurgica.

La diagnostica RM dei microadenomi si avvale dell'impiego combinato di sequenze T2 e T1 prima e dopo mdc e di sequenze dinamiche in corso di iniezione di mdc: l'accertamento di microadenoma è in funzione della presenza di segni RM diretti ed indiretti. Nei rari casi per i quali la diagnostica RM non consente una diagnosi sicura e specie se esiste il sospetto di adenomi a secrezione ACTH è indicato il ricorso al cateterismo dei seni petrosi. La TC potrebbe essere utilizzata esclusivamente nei casi che per differenti ragioni non possono giovarsi dell'impiego della RM.
Patologia traumatica del massiccio facciale superiore e dell'orbita
Authors: Arcuri T. , Calabrò F. , Delucchi S. , Tartaglione A. , Capellini C.
Published: April 2015

Le lesioni del massiccio facciale superiore sono di frequente riscontro nell'ambito della patologia traumatica craniofacciale; esse si presentano con aspetti e localizzazioni molto varie ed assai spesso combinate tra di loro.

La tomografia computerizzata è ormai l'esame di elezione nello studio di tale patologia in quanto fornisce informazioni di grande precisione anatomica sia per quanto riguarda le fratture ossee (di cui permette l'evidenziazione di spostamenti di frammenti anche di piccole dimensioni), che, soprattutto, per le lesioni dei tessuti molli in particolare a livello endoorbitario. Tale sensibilità della TC in particolare nella fase acuta del trauma, viene esaltata dalla possibilità di ottenere immagini ricostruite nei vari piani dello spazio con acquisizioni di tipo volumetrico.

L'uso della risonanza magnetica è limitato alla valutazione delle complicanze quali le lesioni intrinseche del nervo ottico o nella diagnostica della rinoliquorrea postraumatica.
Swelling of the Cauda Equina Nerve Roots in Patients with Radicular Pain in the Lower Extremities
Authors: Mihale J. , Bilický J. , Traubner P. , Záhon P.
Published: April 2015

This study assessed lumbago and its radicular propagation to the lower extremities by CT myelography, interpreting possible etiopathogenetic factors. We diagnosed swelling of the cauda equina roots on the basis of clinical features, CT myelography and electromyographic findings.
La neuroendoscopia nel trattamento dei tumori endoventricolari e delle neoplasie profonde cistiche
Authors: Mascari C. , Godano U.
Published: April 2015

La metodica endoscopica negli ultimi anni si è sempre più affermata in campo neurochirurgico e le sue applicazioni si sono sempre più estese. La neuroendoscopia è stata applicata per il trattamento dei tumori endoventricolari dove permette sia la biopsia, o in casi selezionati l'exeresi di piccole neoplasie ed il trattamento contemporaneo dell'idrocefalo associato attraverso una terzoventricolostomia e per il trattamento di lesioni cistiche profonde dove è stato realizzata la biopsia e la aspirazione della cisti. Gli Autori riportano la loro esperienza nel trattamento endoscopico in 18 pazienti di cui 14 portatori di lesioni endoventricolari e 4 neoplasie cistiche profonde.
L'endoscopia stereotassica nel trattamento multimodale del craniofaringioma cistico
Authors: Nicolato A. , Zanotti B. , Rosta M.L. , Foroni R. , Pellegrino M. , Bricolo A. , Gerosa M.
Published: April 2015

Viene descritta la nostra preliminare esperienza nel trattamento di sei pazienti con craniofaringioma cistico associato o meno a componente solida, per mezzo dell'adozione di un approccio stereotattico multimodale, che comprende l'endoscopia, il posizionamento di un sistema di Ommaya, la somministrazione intracavitaria di Bleomicina e il trattamento stereotattico con Gamma-Knife sul nodulo solido o sul residuo della cisti.

Per quanto è a nostra conoscenza questa è la prima descrizione di un trattamento multimodale stereotattico del craniofaringioma. Tale approccio include l'uso della tecnica endoscopica per la fenestrazione della cisti dei possibili setti intracavitari, la somministrazione di chemioterapia intracavitaria con Bleomicina (preferita alla radioterapia intracavitaria per i suoi più modesti effetti collaterali) e la radio chirurgia con Gamma-Knife sulla componente solida (se inferiore a 10 cc) o sul residuo solido della cisti dopo il trattamento con Bleomicina allo scopo di prevenire le frequenti recidive a medio termine. I risultati preliminari di questo approccio originale sono incoraggianti e permettono un eccellente controllo della crescita tumorale (100% dei casi trattati) senza al momento, mortalità o morbidità postoperatoria. Le procedure eseguite sono risultate ben tollerate, senza importanti effetti collaterali.
Microdiscectomia Endoscopica
Authors: Cervellini P. , Curri D. , De Luca G.P. , Colombo E. , Brayda-Bruno M. , Lepori P.
Published: April 2015

L'approccio percutaneo alla discectomia lombare rimane tuttore piuttosto controverso. Una nuova tecnica percutanea, descritta nel ′97 da Foley e Smith, la Microdiscectomia Endoscopica (MED), permette non solo di trattare le ernie discali lombari contenute, ma anche le patologie discali con frammenti liberi.

Riportiamo in questo lavoro la nostra eperienza in 48 pazienti, operati con tale approccio, presso la Neurochirurgia di Vicenza dal 1998.

La tecnica si è dimostrata veramente efficace; i risultati sono stati buoni in tutti i casi; vi è stata una sola complicanza intraoperatoria, senza conseguenze per il paziente.

Questi casi sono parte di uno studio multicentrico italiano, che attualmente si avvale di un'eperienza di più di 100 casi.
Post-Gadolinium Evaluation of Intracranial Tumours: A Comparative Study of Spin Echo, Fast Spin Echo, Gradient Echo T1-Weighted Sequences, with and without Magnetization Transfer
Authors: Aprile I. , Lavaroni A. , Scott C.A. , Budai R. , Beltrami C.A. , Fabris G.
Published: April 2015

This study compares the use of six different post-gadolinium T1-weighted sequences on intracranial tumours with the aim of evaluating their efficacy in terms of lesion and edema contrast resolution and cortex visualization.

Forty-eight intracranial neoplastic lesions were evaluated after contrast media administration by means of the following T1-weighted sequences: Fast Spin-Echo (FSE), Spin-Echo (SE) and Gradient-Echo (GE) with and without Magnetization Transfer (MT) pulse. For each technique tumour/background contrast resolution (T/B CR), oedema/background contrast resolution (E/B CR) and white matter/grey matter contrast resolution (WM/GM CR) were calculated. GE sequences, with and without MT, showed the lowest contrast resolution values for all parameters. FSE MT sequences showed the highest T/B CR values. SE sequences, instead, showed the best E/B and WM/GM CR values. FSE and SE MT values were intermediate between FSE MT and SE sequences. No sequence had high values for all contrast resolution parameters. The sequence with the best T/B CR was the FSE MT, but that with the best anatomic peritumoural edema and cortex definition was SE. Both FSE MT and SE T1-weighted sequences may be acquired to obtain accurate post-gadolinium tumour evaluation.
Improvement of Intracranial Time of Flight MR-Angiography with a Subtraction Method
Authors: Aprile I. , Cappelletto B. , Dolso P. , Fabris G.
Published: April 2015

Our purpose was to evaluate a novel 3D Time-of-Flight (TOF) MR-Angiography (MRA) method, aimed at improving contrast resolution between vessels and static tissues.

The new method consists of the acquisition of two MRA sequences, the first with the conventional technique and the second with arterial saturation. After the acquisition, digital subtraction between the two sequences was carried out to obtain a set of partitions with high flow signal and very low parenchymal signal. Five healthy volunteers and 16 patients with vascular brain diseases were studied. The resulting images were then reconstructed with maximal intensity projection (MIP) and compared with TOF MRA.

In healthy volunteers subtraction-TOF showed higher contrast resolution and better visualization of small arterial vessels than the TOF technique. In the group of patients, visualization of turbulent flow lesions (i.e. aneurysms) was the same with both methods. In contrast, subtraction-TOF was superior to TOF for small vessel visualization (i.e. treated arteriovenous malformations) and for complete suppression of elevated signal intensity areas due to hematic debris (metahemoglobin).

In conclusion, subtraction-TOF is a useful technique if small brain vessel visualization is required or to suppress short T1 static tissues (i.e. metahemoglobin).
Un caso atipico di tumore epidermoide Contenuto e caratteristiche di segnale
Authors: Albertini F. , Ambrosi C. , Fontana A. , Pavia M. , Gasparotti R.
Published: April 2015

I tumori epidermoidi sono rare lesioni congenite benigne a lento accrescimento, che solitamente si rendono evidenti tra la quarta e la sesta decade di vita, con maggiore predilezione per il sesso maschile.

La cisti è nella maggioranza dei casi ben circoscritta da una sottile e irregolare capsula epiteliale. I prodotti di desquamazione dell'epitelio capsulare, costituiti in prevalenza da cheratina e cristalli di colesterolo, si accumulano all'interno della cisti stessa dando l'aspetto TC tipico di una massa ipodensa ben definita. Le caratteristiche di segnale RM e la sede anatomica coinvolta spesso consentono di porre una corretta diagnosi

Presentiamo il caso atipico di una giovane paziente con un voluminoso tumore epidermoide a partenza dalla cisterna bulbare con estensione all'angolo ponto-cerebellare, spontaneamente iperdenso in TC e, in RM, iperintenso in T1 ed isointenso in T2.
Basi farmacologiche dell'azione dell'ossigeno-ozono terapia
Authors: Richelmi P. , Valdenassi L. , Bertè F.
Published: April 2015

Le tappe fondamentali dell'O3 nell'organismo sono, a quanto oggi noto, le seguenti:

Il trattamento di 300 g di sangue con ozono 80 μg/cc induce dopo 5 minuti il massimo valore della pO2 mentre i valori del pH e della pCO2 rimangono invariati.

L'O3 ha una emivita brevissima (circa un secondo) e si decompone in modo rapidissimo nel plasma generando una cascata di prodotti ossidanti tra i quali fondamentali sono i lipoperossidi e gli ozonidi. Questi ultimi composti, pure con emivita relativamente breve, sono necessari per l'attivazione cellulare.

La presenza dei composti ossidanti generati dall'O3 non comporta effetti tossici per le cellule perché sia il plasma che l'ambiente intracellulare contengono una varietà di sostanze e sistemi enzimatici antiossidanti, capaci di bloccare l'eventuale eccesso di sostanze ossidanti.

All'interno della sacca non vi è formazione di metemoglobina e l'emolisi massima non supera 2, 4 ± 0,5%, questo valore è circa 25 volte inferiore a quello che potrebbe causare emoglobinuria da overflow.

L'aumento massimo del glutatione ossidato intraeritrocitario non supera il 10% ed è totalmente reversibile in circa 30 minuti, mentre i lipoperossidi plasmatici aumentano di 2–3 volte subito dopo l'ozonizzazione e ritornano a valori normali in circa 9 ore.

Non si osservano danni morfologici cellulari rilevabili con microscopia elettronica, né modificazioni della vitalità cellulare.

In vivo durante autoemoterapia è stato notato aumento del 2,3 difosfoglicerato (2, 3 DPG) negli eritrociti che, provocando uno spostamento a destra della curva di dissociazione della emoglobina, favorisce la cessione di O2 ai tessuti.

È interessante e significativo osservare una induzione della produzione di citochine quali interferone (IFN) α, β e γ, fattore della necrosi tumorale (TNF α), interleuchine (IL) 1,2,4,6,8 e 10, granulopoietine (GM-CSF), e transforming growth factor β (TGF β).
L'ozonoterapia con “tecnica classica” intramuscolo paravertebrale
Authors: Tabaracci G.
Published: April 2015

Il trattamento secondo la “tecnica classica” consiste nell'infiltrazione intramuscolo paravertebrale di una miscela di ossigeno ed ozono. È fondamentale porre una diagnosi corretta basandosi su un attento esame obiettivo supportato da una valutazione strumentale con TC o RM. Occorre quindi informare il paziente sulla metodica alla quale sarà sottoposto, e conseguentemente occorre fare firmare il “consenso informato”.

Nel lavoro vengono descritti i dettagli di tecnica.
New Possibilities in the Endovascular Treatment of Cerebral Aneurysms
Authors: Boccardi E.
Published: April 2015

Stenting and filling of the aneurysm sac with Onyx are new techniques which can be alternatives to different endovascular treatments for large aneurysms, in particular if wide-necked. The advantages of these promising techniques but also the difficulties and risks are described and discussed. More experience is necessary to establish the real impact of these new approaches.
Unusual Association of Kallmann Syndrome with Empty Sella and Arachnoid Cyst
Authors: Scuotto A. , Accardo C. , Rotondo M. , Profeta L. , Barbato R. , Napolitano L. , Lalli E. , Amato G. , Cirillo S.
Published: April 2015

We report the MR findings of a patient with clinical and laboratory evidence of Kallmann Syndrome (KS), a genetic disorder of gonadal and olfactory development, in which unexpected associated anomalies were found.

The patient was clinically suffering from hypogonadotropic hypogonadism and left-side hyposmia.

MR examination included thin coronal sections of the frontal region to determine presence or absence of olfactory bulb-tract and to evaluate the olfactory sulci.

On the left side, the posterior portion of the olfactory sulcus appeared hypoplastic, the bulb was unidentifiable and a dysplastic tangle was seen. Besides these abnormalities of the olfactory system, the presence of empty sella and an arachnoid cyst in the left middle fossa was disclosed.

Although not a constant finding, other anomalies have sometimes been reported with KS. The association with empty sella and arachnoid temporal cyst found in the present case, was previously described only once in literature, but in our instance hypogonadism had appeared in an adult patient. Its probable mechanism is discussed.
Tumore neuroepiteliale disembrioplastico
Authors: Moretti V. , Rigon F. , Mai R. , Russo G. Lo , Faggioli R. , Calzolari F.
Published: April 2015

Dysembryoplastic neuroepithelial tumors (DNTs) are mainly benign cortical lesions composed of glial and neuronal elements. DNTs accounted for 0.6–07% of pediatric brain tumors.

Clinically these tumors are usually associated with chronic epilepsy in adolescents and adults.

We report a case of six-year-old boy who presented drug-resistant complex partial seizures whit neurological and intellectual integrity, but a mild attention deficit.

MRI disclosed a subcortical lesion, located on the left the temporal lobe. The pathological tissue was hyperintense on both T1 and T2-weighted images; CT showed very well intratumoral calcifications. These neuroradiological findings suggested a differential diagnosis with extraventricular neurocytoma and ganglioglioma.

The child underwent surgery; the histological examination diagnosed a complex DNT (1st grade of WHO classification). At follow-up after 6 months, he was seizure-free; the neurological examination was normal.
The Cochlear Aqueduct De Aquaeductibus Auris Humanae: Part II
Authors: Palmieri A.
Published: April 2015

The Cochlear Aqueduct (CA) is a narrow bony canal connecting the cochlear with the posterior cranial fossa in the subarachnoidal space. Narrow in the otic segment, it widens in the vicinity of the petrous bone aperture. The CA contains loose connective tissue making up the periotic duct that in turn derives from primitive extroflexion of the subarachnoidal space. Alongside the CA runs an accessory canal containing the inferior cochlear vein which flows into the inferior petrosal sinus. CT investigations of the petrous bones routinely evidence the CA while the medial aperture is detected at MR. This article describes the typical appearances and provides an in-depth review of the most important studies into CA morphological variability and the possible functional implications. The CA arises in the basal coil of the scala timpani. The isthmus of the duct, located in the otic capsule and not always visible, measures between 0.05 and 0.35 mm. The canal widens funnel-like to 2 – 7 mm as it reaches the superior edge of the jugular foramen. Overall length varies between 9 and 17 mm. In contrast, neonate CA is shorter, straighter and patent. With age, patency is progressively reduced even to the point of obliteration. It has been postulated that the CA provides a direct link between CSF and perilymph in the presence of both normal labyrinth and malformations. While some studies suggest that CA patency sustains conditions involving labyrinthine hypertension, others report complete CA obliteration, thereby excluding any connection between the two districts. An enlarged, patent CA, as evidenced in Mondini type dysplasias, has been considered to enable retrograde flow of CSF into the vestibule and the spread of infection from one compartment to the other and/or induce perilymphatic hydrops with consequent loss of hearing and lesions of the window and possible cerebrospinal fluid otorrhea. More probably, however, the pathway of communication between CSF and perilymph spaces is the fundus of the internal auditory canal. Abnormally dilated CA that may be classified as a true malformation is extremely rare and has been reported in only one case as an isolated anatomic finding. As a result, it has been suggested that the yardstick for diagnosing dilated CA on CT be a diameter of more than 2 mm along the whole duct, from the cochlear end to the posterior fossa. There are also a few documented cases of the CA provide a route for infection between the two spaces. Finally, some cases of tumours invading the CA have been described in which the first clinical signs were cochlear-vestibular symptoms. These findings suggest that even if not a routinely finding, the CA may in certain cases connect the subarachnoidal space and the perilymph and thus affect auditory vestibular function. Better understanding of CA anatomy, morphological variations and their possible functional significance is therefore required since assessment of the cochlear aqueduct should be part of routine imaging diagnostics to investigate labyrinthine disorders.
Cervical MRI Findings in Intracranial Hypotension
Authors: Pierallini A. , Paolucci A. , Tinelli E. , Falcone C. , Caramia F. , Bonamini M. , Bianco F. , Bozzao L.
Published: April 2015

Intracranial hypotension is characterised by a fall in intracranial pressure presenting clinically with postural headache and cervical pain. The syndrome may arise after lumbar puncture, surgery, trauma, severe dehydration or spontaneously. We studied two patients with intracranial hypotension presenting hallmark intracranial MR features of the syndrome with different involvement of the cervical spine in terms of MR features and clinical presentation and course. MR imaging of the cervical and dorsal spine in both patients was carried out using T1, T2 and T2-FLAIR weighted sagittal spin echo sequences and T2 weighted axial turbo spin echo (TSE) sequences. In the first patient, MR disclosed an area of altered signal intensity within the cerebral canal in an extradural, anterior and lateral location both right and left, symmetrical with craniocaudal extension from C1 to D2. The area was strongly hyperintense in T2-FLAIR sequences compressing the anterolateral surface of the dura mater and was ascribed to an enlargement of the anterior vertebral venous plexus. MR examination four days later showed an almost complete resolution of the previous picture. In the second patient, MR imaging showed a fluid collection in the subdural space in the cervicodorsal spine in sagittal FLAIR and axial TSE images wth a hyperintense signal consistent with hygroma. Follow-up disclosed slow gradual resolution of the previous changes. The dilated epidural venous plexuses in the first patient could compensate the loss of CSF, as occurs intracranially where CSF volume is balanced with blood volume (Monro-Kellie's theory). The spinal hygroma evident in the second patient may have been a transudate secondary to meningeal hyperaemia. This hypothesis is supported by the raised proteins and cells found in the CSF and the meningeal enhancement after contrast administration. Intracranial hypotension is characterized not only by well-known changes in intracranial MR signal, but also by specific MR findings in the cervicodorsal spine. Knowledge of these MR features allows prompt recognition and adoption of the most suitable MR sequence with due assessment of the morphology of areas of altered signal intensity to disclose the pathogenesis.