bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiological and Pathological Changesin the Sinus of an Experimental Arteriovenous Fistula of the Rat
Authors: Sahara Y. , Miyachi S. , Nagasaka T. , Negoro M. , Suzuki O. , Hattori K. , Kobayashi N. , Kojima T. , Yoshida J. 
Published: January 2017

The object of this study is to evaluate the radiological and pathological changes in the sinus of an experimental arteriovenous fistula of the rat. Twenty-five male Sprague-Dawley rats, including two control rats, were used for this study. A venous hypertension model in the transverse sinus was induced by means of anastomosis of a common carotid artery (CCA) to the ipsilateral external jugular vein (EJV). Rats were sacrificed 11 to 42 weeks after the procedure, then histopathological and immunohistopathological examinations were performed for the resected transverse sinus. Follow-up angiography was performed two to three weeks after the anastomosis in every case, and five months later in two rats. Patency of the anastomosed portion was confirmed in 12 of the 23 anastomosed rats. An ipsilateral carotid angiogram demonstrated a high-flow arteriovenous (AV) shunt from the CCA to the sigmoid-to-transverse sinus and draining into the contralateral juglar vein. A contralateral angiogram displayed a steal phenomenon via the communicating artery. Histopathologically, the vein of the anastomosed portion and the transverse sinus were markedly dilated in with cases. There was a thickening the connecting tissue and a proliferation of fibroblast in four (50%) of the eight cases. Thrombus formation in the transverse sinus was found in one case. VEGF stained strongly in the endothelial hypertrophied area and in fibrous connective tissue around the transverse sinus compared to the control sinuses. Our results from this long-term observation of the radiological and pathological changes in the sinus exposed to hypertension resembled the clinical findings of a dural AV fistula.
Analysis of Complications Related to Endovascular Therapy for Dural Arteriovenous Fistulae
Authors: Tsumoto T. , Terada T. , Tsuura M. , Matsumoto H. , Yamaga H. , Masuo O. , Itakura T. 
Published: January 2017

In this paper, we reviewed our cases of dural arteriovenous fistulae (dural AVFs) and analyzed periprocedural complications. In 157 procedures, we encountered 14 complications. Overall, complication rate of 9% was seen. We divided these complications into five subgroups such as cranial nerve palsy, coil-related trouble, thromboembolic complication, vessel perforation, and radiation-related trouble. There were five transient abducent nerve palsies in cases with cavernous sinus dural AVFs. There were two cases of coil unraveling and two cases of coil migration. In two cases, direct puncture of the internal jugular vein was performed to retrieve the unraveled coil by using dual microcatheter and guidewire snare technique. We encountered two thromboembolic complications. In one case, venous infarction was recognized after polyvinyl alcohol particle embolization. In two cases of vessel perforations, there were no new neurological deficits except one case with transient Gerstmann syndrome. In endovascular treatment of dural AVF, serious complications are rare and can be prevented if maximum attention is paid during the procedure.
Treatment for Intracranial Cerebral Artery Stenosis
Authors: Kawaguchi K. , Kubo T. , Takeuchi H. , Nemoto S. 
Published: January 2017

Symptomatic intracranial cerebral artery stenosis is largely resistant to drug treatment. Regardless of their locations, lesions may cause cerebral infarction with a frequency of 7–10% in a year, but the natural history of asymptomatic intracranial cerebral artery stenosis remains unclear. Revascularization is indicated for symptomatic lesions which show resistance to drug treatment, while bypass surgery is the accepted therapeutic indication for haemodynamic ischemia. Endovascular treatment is effective in haemodynamic ischemia, and is also expected to be effective against embolic symptoms. Bypass surgery for anterior circulation cases is safe because of its low incidence of complications, whereas bypass surgery for posterior circulation cases is technically difficult and has a high associated complication rate. Hence, endovascular treatment is currently favored for posterior circulation cases, and has also been introduced for anterior circulation cases. Endovascular treatment has become a widespread modality for intracranial cerebral artery stenosis, but there are many unsolved problems associated with complications, technology and devices. Therefore, in practice, endovascular treatment should be used only with a strict indication, and should be performed only after considerable thought and with appropriate informed consent.
Simulation Study of Distal Balloon Protection Systems during Carotid Artery Stenting
Authors: Kuroiwa T. , Sakai N. , Sakaguchi M. , Adachi H. , Imamura H. , Sakai C. , Morizane A. , Ishihara H. , Yano T. , Nakao S. , Kikuchi H. 
Published: January 2017

The purpose of our experimental study was to assess the pitfalls of distal balloon protection systems and to learn any technique tips to increase safety. Silicone carotid artery models were connected to a circulatory system to simulate arterial flow. A distal balloon protection device, PercuSurge GuardWire Plus (GWP, Medtronic Vascular) was delivered to the internal carotid artery (ICA), then was inflated to occlude ICA flow temporarily. A debris aspiration catheter (Export catheter) was delivered just proximal to the GuardWire Plus balloon coaxially, in order to introduce and diffuse particulate debris (200–500 micro meter in diameter) in the ICA stump. Then, after debris in the stump was aspirated, the GWP balloon was deflated. We recorded all the processes of our simulation experiments on a digital video and observed the movements of debris during these experiments. Exp 1) We simulated the movements of debris in the ICA stump when the GWP balloon was gradually deflated to produce a crevice between the balloon and vessel wall, simulating accidental movement of the GWP balloon during the procedure. Exp 2) In order to assess the optimal placement of the tip of aspiration catheter, the debris in the ICA stump was aspirated from three different sites (from just below the GuardWire balloon, from 2 cm below it, and from 5 cm below it). Exp 1) When the crevice appeared between GuardWire balloon and silicone tube, simulated debris began to concentrate just below the balloon. Then, some debris migrated distally from the crevice, and another part crowded in the crevice so that was impossible to aspirate and migrated in the end. Exp. 2) Debris aspiration was most effective from immediately below the GuardWire balloon, and the aspiration ability declined as the distance between the balloon and aspiration catheter became longer. According to our simulation studies, when the GWP balloon was moved accidentally during CAS procedures, or when the aspiration catheter was not delivered all the way to the GuardWire Plus balloon, distal embolization might still occur, even under protection.
Impact of Stent Design on Intra-Aneurysmal Flow
Authors: Ohta M. , Hirabayashi M. , Wetzel S. , Lylyk P. , Wata H. , Tsutsumi S. , Rüfenacht D.A. 
Published: January 2017

In addition to providing a skeleton for vessel reconstruction, stent implantation as used for cerebral aneurysm treatment can induce flow redirection, thus reducing vortical flow velocities within the aneurysm cavity. Further, stent characteristics such as strut size, porosity and cell shape influence the changes in intra-aneurysmal flow by analog simulations. The purpose of this computer simulation study was to visualize the flow pattern over the entire neck area of a side wall aneurysm while changing the stent parameters. A 3-D computer model aneurysm was constructed to have a parent artery of 5 mm diameter and an aneurysm of 10 mm diameter. The distance between the midline of main artery and center point of the aneurysm was 6.8 mm, providing a neck length of 5 mm, a width of 3.6 mm, and a neck area of 14 mm 2. The simulations were carried out with a Finite Element Method based flow simulation package. The incompressible Navier -Stokes equation was solved for a steady flow with a mean speed of 290 mm/s, steady viscosity of 3.83 cp, and density of 1.0 g/cm3. Two parallel stent struts (dimensions: 100 μm m 100 μm m 2.0 mm) were introduced into the plane of the aneurysm neck. The fraction of the aneurysm neck cross-section occupied by the stent was 2.83% in all cases. The velocity distribution through the neck of the aneurysm was calculated for three different choices of separation between the struts for each of two orientations of the struts (parallel and perpendicular) relative to the vessel axis. The flow pattern in the aneurysm was composed of an inflow zone at the distal neck and of an outflow zone at the proximal neck. The placement of stent struts at the aneurysm neck resulted in a decrease in the mean speed in the aneurysm. The degree of reduction and the distribution of flow through the neck did depend on the orientation of the stent struts. The struts, when placed parallel or perpendicular to the parent vessel axis affected the mean speed through the aneurysm neck differently.
Feasibility of Photocrosslinkable Chitosan as an Embolization Material for Aneurysms
Authors: Nakai K. , Kojima T. , Hattori K. , Miyachi S. , Ishihara M. , Kobayashi N. , Okamoto T. , Yoshida J. 
Published: January 2017

The purpose of this study was to evaluate the feasibility of photocrosslinkable chitosan as an embolization material for aneurysms. Three experimental aneurysms were created in three Japanese white rabbits. All of the aneurysms were packed with chitosan hydrogel. Histopathologic data were analyzed on two, seven, and 30 days after embolization. Unorganized clots and minimal inflammation around the applied chitosan hydrogel were observed two days after implantation. After seven days, the chitosan was reduced and inflammatory response appeared. At 30 days, most of the aneurysm lumen was replaced with inflammatory cells, and the remaining chitosan was not observed. Severe complications such as anaphylaxis did not occur after the embolization with the chitosan. These results suggest that photocrosslinkable chitosan might be a candidate for an embolization material for endovascular treatment of cerebral aneurysms.
Computational Fluid Dynamics for Brain Circulation and Aneurysm with Therapeutic Devices
Authors: Fukasaku K. , Negoro M. , Iwase H. , Yokoi K. , Himeno R. 
Published: January 2017

We analysed fluid dynamics at brain arteries having multiple inflow and out flow like Willis ring based on clinical imaging modalities. In addition, we analysed fluid dynamics with therapeutic devices like coils and stents to simulate their influences to blood flow. 3D CTA and MRA obtained three-dimensional structures of the brain vessels. The centreline was obtained from the three dimensional structure. Diameter of the blood vessels was measured by 3D CTA/MRA then smooth surfaced blood vessel models were created. For the fluid analysis, we developed a home brew software which can display parameters such as streamline, etc. In addition, our CFD (computational fluid dynamics) software can work in collaboration with a CAD (computer aided design) software which we also developed (VCAD: Volume CAD). So, therapeutic devices such as coils, balloons and stents could be placed in the models and CFD analysis could be performed placing devices in the models. The flow pattern in the complicated vascular structure could be calculated such as Willis ring which has multiple inputs like ICA, VA and multiple outlets like MCA and PCA with communicating arteries. CFD with therapeutic devices could also analysed with our system.
Traumatic Carotid Cavernous Fistula: Failure of Endovascular Treatment with Two Stent-Grafts
Authors: La Tessa G. , Pasqualetto L. , Catalano G. , Marino M. , Gargano C. , Cirillo L. , Zenna L. , Montemarano E. , Sirabella G. 
Published: January 2017

We describe an unconventional endovascular approach in a young patient with large high-flow traumatic carotid cavernous fistula that could not be treated by detachable balloon procedure. Two coronary stent-grafts were used to close the large tear of internal carotid artery. After the failure of stenting procedure, the fistula was successfully treated by trapping with two detachable balloons.
Outcome in Acute Stroke with Different Intra-Arterial Infusion Rate of Urokinase on Thrombolysis
Authors: Gan X. , Luo Y. , Ling F. , Ji X. , Chen J. , Ding Y. 
Published: January 2017

Intra-arterial infusion of urokinase (UK) has been widely used. However, the optimal infusion rate of the reagent has never been determined. This was investigated in the acute stage of middle cerebral artery (MCA) embolism in the present study. Sprague Dawley male rats (n=43) were randomly divided into sham-operation and five ischemic groups with urokinase administration at different infusion rates or without urokinase administration. Ischemia was induced with MCA embolism. Two hours after embolism, total urokinase (urokinase, 170,000U/kg) was given in groups A,B,C and D (n=8 each) at different rates: 1,000 U (0.03 ml/min) per minute, 4,000U (0.12 ml/min), 10,000U (0.30 ml/min), and 16,000U (0.48 ml/min), respectively. Group E received normal saline at a rate of 0.48 ml/min. The sham-operation group (no embolism) received urokinase at (170,000U/kg, 1.5 ml, 16,000 U/min). During ischemia and thrombolysis, regional cerebral blood flow (CBF) was monitored by laser Doppler flowmetry. The neurological deficits, infarct volumes and mortalities in each group were determined. The CBF in ischemic hemisphere were significantly (p<0.05) decreased after embolism in groups A!E at similar levels (27.32±8.20% to 34.71±6.84%). After different treatments, in group B 4,000U/min infusion of UK induced the best reperfusion, the least neurological deficits and infarct volume, as well as the least mortality and lowest incidence of hemorrhage. The effect of intra-artery thrombolysis of urokinase was related to the infusion rate. Our study demonstrated an optimal infusion rate at 4,000U/min, suggesting relatively low levels of infusion are better able to improve brain reperfusion and reduce brain injury after stroke.
Outcome Evaluation of Carotid Stenting in High-Risk Patients with Symptomatic Carotid near Occlusion
Authors: Choi B.S. , Park J.W. , Shin J.E. , Lü P-H. , Kim J.K. , Kim S.J. , Lee D.H. , Kim J.S. , Kim H.J. , Suh D.C. 
Published: January 2017

Management of symptomatic carotid near occlusion especially in high-risk patients is different from outcome analysis of NASCET. We evaluated outcome in high-risk patients with symptomatic near occlusion. For 48 patients with near occlusion out of 166 symptomatic high-risk patients who underwent carotid stenting, we assessed the procedural success defined as residual stenosis <30%, modified Rankin Scale (mRS) at one and six months following stenting, and the 13 cerebrovascular factors related to the outcome. Initial National Institutes of Health Stroke Scale (NIHSS) ≥4, 1–3 and 0 were 13, 14 and 21 patients each. We compared the outcome with patients who underwent CAS (n=118) due to symptomatic stenosis without near occlusion during the same period. Our procedural success rate was 98%. A good outcome (mRS ≤2) was achieved in 44 patients (92%) at six months. There were five events (10%) within six months, i.e. three minor strokes, one major stroke caused by hemorrhage, and one death excluding two deaths not related to stroke. Hyperperfusion (n=4) was the most common cause of events leading to two minor strokes and a major stroke. Although initial NIHSS (P = .012) was related to poor outcome (mRS >2) compared to the CAS group, there was no statistical significance between two groups in the event rate of stroke, death or restenosis. The outcome of carotid stenting in high-risk patients with symptomatic near occlusion did not reveal any difference compared with CAS. Poor outcome was related to the initial NIHSS (≥4). Hyperperfusion tended to be more commonly related to an event occurring after stenting.
Cervical Automated Discectomy
Authors: Theron J. , Huet H. , Coskun O. 
Published: January 2017

The lumbar automated discectomy system described by Onik has been used in the treatment of cervical disk herniations whose symptomatology resisted medical treatment. Experience on 150 patients is reported showing a 74.5% success rate. This series performed in most cases on an outpatient basis had no complications. Up to 1992 failure cases were treated by intradiscal injections of triamcinolone with 62% of success. This complementary technique was abandonned after the description of epidural calcifications secondary to this type of injections in the lumbar area. Since 1992, failure cases have been managed differently with injections of steroids in the cervical joints, especially when a hypertrophy of the ligamentum flavum supposedly a sign of an inflammatory posterior component of the pain was demonstrated on the CT. Nine patients received intradiscal injections of microdoses (600 IU) of chymopapaine with excellent results. No patient has had open surgery since 1992. It is concluded that percutaneous automated discectomy is a very promising and safe technique which can be used as a first choice technique for most cervical disk herniations resisting medical treatment.
Spinal Cord Arteriovenous Fistula Associated with a Giant Venous Pouch in a Three-Year-Old Child
Authors: Gaikwad S.B. , Mishra N.K. , Goyal M. , Padma M.V. , Sharma A. 
Published: January 2017

An unusual case of direct spinal cord arteriovenous fistula (SCAVF) associated with a large venous pouch in a three-year-old child is presented. Features of this rare vascular lesion on MRI and selective angiography are described.
Allergic Rhinitis: Natural History. A Twenty Years Follow up Study
Authors: Passàli D. , Damiani V. , Passàli G.C. , Passàli F.M. , Bellussi L. 
Published: January 2017

Although there is an agreement on the increase of the prevalence of allergic rhinitis in last decades, data emerging from various studies appear to be widely dishomogeneous. Another point that needs a clarification is the relationship between allergic rhinitis and lower airways pathologies such as asthma or bronchitis. In this study, we followed the evolution of allergic rhinitis in a group of patients in the last 20 years to highlight the efficacy of different treatments in the prevention of complications, specifically asthma. Patients who didn't receive any kind of treatment experimented a remission of symptoms in 4 cases, a stability of the disease in 6 and the development of complications in 11. In the group treated with symptomatic drugs we highlighted a recovery in 11 patients, a stability of symptoms in 2 and complications in 2. At last, patients undergone immunotherapy considered their symptoms improved in 60 % and stable in 40 % of cases. In conclusion, Immunotherapy guarantees, in a large number of patients, remission of local symptoms and valid protection against district and bronchial complications. Symptomatic treatment with antihistamines and/or cortisones represents a valid alternative, and it's always to be preferred to abstention from any treatment.
Exploring the Frequency Domain of Continuous Glucose Monitoring Signals to Improve Characterization of Glucose Variability and of Diabetic Profiles
Authors: Fico Giuseppe , Hernández Liss , Cancela Jorge , Isabel Miguel María , Facchinetti Andrea , Fabris Chiara , Gabriel Rafael , Cobelli Claudio , Arredondo Waldmeyer María Teresa 
Published: January 2017

Background: Continuous glucose monitoring (CGM) devices measure interstitial glucose concentrations (normally every 5 minutes), allowing observation of glucose variability (GV) patterns during the whole day. This information could be used to improve prescription of treatments and of insulin dosages for people suffering diabetes. Previous efforts have been focused on proposing indices of GV either in time or glucose domains, while the frequency domain has been explored only partially. The aim of this work is to explore the CGM signal in the frequency domain to understand if new indexes or features could be identified and contribute to a better characterization of glucose variability. Methods: The direct fast Fourier transform (FFT) and the Welch method were used to analyze CGM signals from three different profiles: people at risk of developing type 2 diabetes (P@R), T2D patients, and type 1 diabetes (T1D) patients. Results: The results suggests that features extracted from the FFT (ie, the localization and power of the maximum peak of the power spectrum and the bandwidth at 3 dB) are able to provide a characterization for all the three populations under study compared with the Welch approach. Conclusions: Such preliminary results can represent a good insight for futures investigations with the possibility of building and using new indexes of glucose variability based on the frequency features.
Podoplanin expression in primary brain tumors induces platelet aggregation and increases risk of venous thromboembolism
Authors: Riedl Julia , Preusser Matthias , Nazari Pegah Mir Seyed , Posch Florian , Panzer Simon , Marosi Christine , Birner Peter , Thaler Johannes , Brostjan Christine , Lötsch Daniela , Berger Walter , Hainfellner Johannes A. , Pabinger Ingrid , Ay Cihan 
Published: January 2017

Key Points
Brain tumor patients have a very high risk of VTE. Podoplanin expression by primary brain tumors induces platelet aggregation and is associated with hypercoagulability and a high risk of VTE.
Proteolytic properties of single-chain factor XII: a mechanism for triggering contact activation
Authors: Ivanov Ivan , Matafonov Anton , Sun Mao-fu , Cheng Qiufang , Dickeson S. Kent , Verhamme Ingrid M. , Emsley Jonas , Gailani David 
Published: January 2017

Key PointsThe single-chain form of FXII, a component of the plasma contact system, has proteolytic activity. Single-chain FXII activity suggests a mechanism of contact activation initiation when blood is exposed to physiologic/artificial surfaces.