bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-024 Scepter C™ Balloon Occlusion Device use for Liquid Embolisation of Vascular Malformations, a Pilot Study
Authors: Grupke S , Alhajeri A , Fraser J 
Published: July 2013

ObjectiveThe Scepter C™ balloon occlusion catheter (Microvention, Tustin CA) is an endovascular device designed with a polyurethane balloon that elongates with inflation to allow it to conform to the lumen of the target vessel. The device has a double lumen, allowing passage over a 0.014-inch guidewire, and/or passage of Onyx embolisation distal to the balloon. We reviewed our initial use of this device as a conduit for liquid embolisation of vascular malformations as compared to the Marathon™ microcatheter (ev3, Plymouth, MN) alone, outlining indications for and outcomes with use.MethodsWe performed a retrospective review of patients who underwent Onyx embolisation of an arterovenous malformation or a dural A-V fistula from October 2011 to February 2013 at the University of Kentucky Hospital.Results14 Scepter C™ devices were used in 8 patients over the course of 10 endovascular interventions. We compared this to 8 patients treated with 11 embolisations over the course of 9 interventions without balloon assistance. Technical success was achieved in 13/14 (93%) deployments of the balloon. There were no complications related to Scepter C™ use. Scepter C™ permitted distal navigation, while facilitating faster Onyx injection with more extensive and distal casting. This led to a trend of decreased fluoro time per embolisation with Scepter C™, though not statistically significant (23.0 ± 8.8 min vs 34.0 ± 10.4 min). There were no cases of Onyx fixation of the device in the parent artery; no significant tension was required to remove the device after Onyx injection. This represents a significantly different experience from the typically used Onyx microcatheter (Marathon), which carries a known risk of tip-adhesion to the Onyx cast. We detail technical nuances used to maximise the benefits of the Scepter C™ for such applications.ConclusionsThe Scepter C balloon catheter has, thus far, proven to be a safe and effective device for the endovascular treatment of vascular malformations through Onyx embolisation. A larger prospective study should be undertaken to ascertain any potential advantages or disadvantages compared to the current standard delivery catheters.DisclosuresS. Grupke: None. A. Alhajeri: None. J. Fraser: None.
E-007 Analysis of endovascular intervention on emergent postoperative bleeding control after Head & Neck cancer surgery
Authors: Kim S 
Published: July 2013

BackgroundIn clinical practice, endovascular intervention may be considered as a treatment option in managing patients with active bleeding following head and neck cancer surgery. This study aims to evaluate treatment outcome of patients undergone with selective endovascular embolisation as therapeutic alternative when surgery is not possible.Material and MethodRetrospective chart review of cancer patients treated by the Head and Neck Service of Severance Hospital underwent endovascular embolisation for control of actual or threatened postoperative bleeding, from 2005.January to 2013.February. 10 patients underwent endovascular embolisation for control postoperative bleeding. Demographic variables, location of primary tumour, material for embolisation, and clinical outcomes including incidence of recurrent bleeding were recorded.Results10 patients received emblotherapy for acute bleeding after surgery. 9 of 10 cases has allowed patients to undergo successful embolisation. In 1 patient, the procedure failed due to diffuse bleeding without main bleeder and progression of disseminated intravascular coagulopathy. The most common cancerous lesion associated with wound bleeding was oral cavity and oropharynx. This was followed by nasopharynx, hypopharynx, respectively. The main bleeding focus was recorded as common carotid artery (4), bifurcation of CCA (1), branch of ECA (distal maxillary artery (2), superior thyroid artery (1)), and thyrocervical trunk (1). The patients underwent interventional embolisation using stent (3),coil (3),vascular plug and microparticles (NBCA)(3).ConclusionThis study demonstrates that selective embolisation was shown to be a feasible and effective method to control acute postoperative bleeding of head and neck cancer.DisclosuresS. Kim: None.
E-012 Long-Term Follow-Up of Unruptured Cerebral Aneurysms without Treatment; Compared with Those Treated by Endovascular Surgery
Authors: Nemoto S 
Published: July 2013

PurposeAnnual bleeding rate of unruptured cerebral aneurysms have been reported relatively low. Indication of treatment for these patients is controversial. Results of long-term follow-up of unruptured aneurysms without treatment are analysed in comparison with coiled unruptured aneurysms.Material and Method917 patients with unruptured cerebral aneurysm were included in this study. All the patients were referred to single physician over the past 12 years. Indication of endovascular treatment was decided according to aneurysm size, shape, location, and family history of SAH. 661 patients selected observation and 256 patients endovascular treatment. In observation group MRA was repeated every 6–12 months. When MRA disclosed aneurysm growth, treatment is considered. In treated group angiography was performed year after treatment and MRA was repeated every year afterwards.ResultsFollow-up was performed from 6–144 months, with average follow-up period 39.7 months (6-144) in observation group and 76.5 months in treated group respectively.Aneurysm rupture occurred in 15 patients in observation group (2.1%). Final outcome of ruptured patients is GR 3 cases (20.0%), MD 2 (13.3%), SD 4 (26.7%), Dead 6 (40.0%). Annual bleeding rate is 0.7%. Rupture rate is higher (1.0%) in aneurysms over 10mm in diameter. In 7 patients aneurysm growth is observed in follow-up and aneurysms were treated with good results. In treated group results are GR 249 cases (97.3%), MD 3 (1.2%), SD 2 (0.8%), Dead 2 (0.8%) respectively. Kaplan- Meyer survival rate of both groups are similar without significant difference.ConclusionObservation has better outcome in unruptured small cerebral aneurysms. 2. Treatment is indicated when aneurysm growth is detected in follow-up.DisclosuresS. Nemoto: None.
E-019 Clinical, Angiographic, and Radiographic Outcomes Differences Amongst Mechanical Thrombectomy Devices: Initial Experience of a Large-Volume Centre
Authors: Kass-Hout T , Kass-Hout O , Sun C , Gupta R , Nogueira R 
Published: July 2013

Background and purposeEarly Reperfusion is critical for favourable outcome in patients with acute ischaemic stroke (AIS). There are limited data on the comparative performance of FDA approved devices for mechanical thrombectomy. Here, we compare the angiographic, radiographic, and clinical outcomes amongst the three device categories currently available in the U.S. when used in routine clinical practice.MethodsRetrospective review of a prospective collected database of endovascularly treated large vessel AIS in a large academic centre. Data from all consecutive patients who underwent clot retrieval using Merci, Penumbra, or Stent-Retrievers from September 2010 to July 2012 were analysed. Baseline characteristics including age, gender, NIHSS, ASPECTS score, and co-morbidities were compared across the 3 groups. The outcome measures included the rates of recanalisation (TICI 2b-3), symptomatic intracebral haemorrhage (sICH, defined as any parenchymal haematoma e.g. PH-1/PH-2), final infarct volume, 90-day mortality, and independent functional outcomes (modified Rankin Scale, mRS 0–2) at 90 days.ResultsThe entire cohort included 287 patients with a mean age of 65.5 ± 14.2 and median baseline NIHSS 20. Of the patients 49.38% were females. The median ASPECTS score was 8. There were no significant differences in terms of baseline characteristics amongst the 3 device groups. There were not statistically differences in the rate of sICH (7% vs 7% vs 6%, for Stent retrieval, Merci and Penumbra respectively, P-value = 0.921), and the volume of infarction (66.9, 69.5, and 59.8 cc for Stent retrieval, Merci and Penumbra respectively, P-value = 0.621). However, the rates of TICI 2b-3 reperfusion (86 % vs 70% vs 78 %, p=: 0.027) were significantly higher with Stent-Retrievers and Penumbra system as compared to Merci treatments. This effect remained significant when controlling, for time of stroke onset, ASPECTS score, infarction volume, and co-morbidities. There was no significant difference in the 90-day functional independence (33 % vs 25 % vs 41%, p=0.079) amongst the different devices (for Stent-Retriever, Merci, and Penumbra groups, respectively).ConclusionOur initial data confirms the superiority of the Stent-Retriever technology over the Merci device in achieving higher rates of reperfusion and better outcomes. No significant difference in near complete/complete reperfusion, final infarct volumes, or clinical outcomes could be established between Stent-Retrievers and Penumbra thromboaspiration. This supports the need for a randomised clinical trial comparing these two technologies.DisclosuresT. Kass-Hout: None. O. Kass-Hout: None. C. Sun: None. R. Gupta: None. R. Nogueira: None.
E-024 Intra-arterial Vasodilator Therapy for Severe Vasospasm in Acute Bacterial Meningitis
Authors: Taqui A , Burgess R , Hui F , Toth G 
Published: July 2013

Introduction and PurposeCerebrovascular complications of acute bacterial meningitis may include vasculitis, vasospasm, venous and arterial thrombosis, intracranial aneurysm formation and others. These complications have been shown to be important predictors of prognosis. The role of invasive endovascular therapies has not been well studied for meningitis-related vasospasm. We present a patient with acute bacterial meningitis who received intra-arterial (IA) vasodilator therapy to arrest worsening intracranial vasculopathy.Materials and MethodsCase report and review of literature.ResultsA 38 year old male with history of recurrent ear infections presented to the hospital with depressed mental status and fever requiring intubation. He was diagnosed with diffuse cerebral oedema, hydrocephalus, left mastoiditis, and severe Streptococcus Pneumoniae meningitis and ventriculitis. He was administered antibiotics, steroids and seizure prophylaxis. An extraventricular drain was placed. The patient underwent mastoidectomy. MRI brain on day 5 showed acute infarcts in bilateral inferior cerebellar hemispheres. Noninvasive MRA study on day 7 was suggestive of only mild vasocontrictive segments in anterior and posterior circulations. He was started on nimodipine and triple-H therapy. On day 9, patient developed bradycardia, worsened mental status and motor deficits. A CTA brain demonstrated significant narrowing of the vertebrobasilar system with associated new scattered infarcts on MRI. An angiogram confirmed severe vasospasm in the distal vertebral arteries, basilar artery, and moderate vasospasm in bilateral supraclinoid internal carotid arteries. IA verapamil was infused in these vasospastic regions with improved vessel calibre and distal flow. The patient’s neurological exam also improved after the intervention. A followup angiogram on day 14 revealed further improvement in the intracranial vasospasm.ConclusionVasospasm causing delayed ischaemic neurologic deficit is a rare, but severe cerebrovascular complication of acute bacterial meningitis. It can be a significant predictor of prognosis, and the disease may progress despite maximal medical therapy. Interventional therapy may be an important adjunctive treatment along with conservative medical modalities.DisclosuresA. Taqui: None. R. Burgess: None. F. Hui: None. G. Toth: None.
E-025 Initial Multicentre Experience Using the Penumbra 5Max,4MAX and 3MAX Reperfusion Catheters in Acute Stroke Therapy
Authors: Farkas J , Arcot K , Kumar R , Delbrune J , Papamitsakis N , Margulis Y , Walzman D , Dash S , Levin K , Azhar S 
Published: July 2013

PurposeThe Penumbra MAX System (5MAX, 4MAX, and 3MAX) refers to a new generation of reperfusion catheters with a larger, tapered lumen and new material composition in the distal end designed to enhance aspiration efficiency with improve trackability. Results from a retrospective multicentre study with the Penumbra System 5 MAX, 4MAX and 3MAX reperfusion catheters in acute stroke patients with large vessel occlusion are reported.MethodsA retrospective case-review of 22 consecutive acute ischaemic stroke cases from July 2012 through March 2013 treated by the Penumbra System (5 MAX, 4MAX and 3MAX) was performed. The case experience from three institutions was collected in the initial months after the device was released. Results are reported from cases which involved occlusions in the ICA (n=6), proximal MCA M1 (n=10), distal MCA M2 (n=3) and vertebrobasilar arteries (n=3).ResultsPrior to intervention, all patients presented with TICI 0 or 1. Successful revascularisation was primarily achieved in 86.3% (Tici 2b & Tici 3 ) using the Penumbra System with 5 MAX, 4MAX and 3MAX reperfusion catheters. Mean age was 71.45 ± 14.4 years; median baseline NIHSS score was 20.5 ± 3.96. In 1 patient, embolisation of new territory was found and treated by IA rtPA. One case of intracerebral haemorrhage (ICH) was noted with haemorrhage in a previously unaffected region, possibly secondary to IV rtPA treatment.ConclusionEarly clinical experience suggests that the 5 MAX, 4MAX and 3MAX appear to have improved aspiration efficiency and tracking. Follow-up data and additional cases are critical in confirming these initial results.DisclosuresJ. Farkas: None. K. Arcot: None. R. Kumar: None. J. Delbrune: None. N. Papamitsakis: None. Y. Margulis: None. D. Walzman: None. S. Dash: None. K. Levin: None. S. Azhar: None.
Cardiovascular Effects of Aldosterone
Authors: Escoubet Brigitte , Couffignal Camille , Laisy Jean-Pierre , Mangin Laurence , Chillon Sylvie , Laouénan Cédric , Serfaty Jean-Michel , Jeunemaitre Xavier , Mentré France , Zennaro Maria-Christina 
Published: July 2013

Background—

High plasma aldosterone has deleterious cardiovascular effects that are independent of blood pressure, but the role of the mineralocorticoid receptor remains unclear. Renal pseudohypoaldosteronism type 1 is a rare autosomal-dominant disease caused by
NR3C2
loss-of-function mutations, which is characterized by renal salt loss and compensatory high renin and aldo secretion. We aimed to assess the cardiovascular outcomes in adults carrying NR3C2 mutations.

Methods and Results—

In this case-control study, 39
NR3C2
mutation carriers were compared with sex- and age-paired noncarriers. Patients underwent cardiac and vascular ultrasound, cardiac MRI with gadolinium injection, measurement of pulse wave velocity, extracellular water, 24-hour ambulatory blood pressure, and autonomous nervous system activity. Mutation carriers showed increased aldo and renin plasma levels (4.5- and 1.6-fold, respectively;
P
<0.0001), together with increased salt appetite (1.8-fold;
P
=0.002), with normal extracellular water and blood pressure, and no autonomous nervous system activation. Cardiac and vascular parameters were not significantly different between mutation carriers and noncarriers (no left ventricular remodeling or fibrosis, normal left ventricular systolic function, and aorta stiffness). Tissue Doppler showed better diastolic left ventricular function in mutation carriers (e′,
P
=0.001; E/e′,
P
=0.003). Mutation carriers had significantly more frequent history of slow body weight recovery at birth, symptomatic hypotension, and miscarriage in women.

Conclusions—
Despite life-long increase in plasma aldosterone and renin levels, no adverse cardiovascular outcome occurred in pseudohypoaldosteronism type 1, but rather an improved diastolic left ventricular function. This suggests that the cardiovascular consequences of aldosterone excess require full mineralocorticoid receptor signaling.

Clinical Trial Registration—

http://www.clinicaltrials.gov
; unique identifier: NCT00646828.
Simple Solutions to Steady-State Cumulus Regimes in the Convective Boundary Layer
Authors: Schalkwijk Jerôme , Jonker Harmen J. J. , Siebesma A. Pier 
Published: July 2013

Abstract
A modeling framework is developed that extends the mixed-layer model to steady-state cumulus convection. The aim is to consider the simplest model that retains the essential behavior of cumulus-capped layers. The presented framework allows for the evaluation of stationary states dependent on external parameters. These states are completely independent of the initial conditions, and therefore represent an asymptote that might help deepen understanding of the dependence of the cloudy boundary layer on external forcings. Formulating separate equations for the lifting condensation level and the mixed-layer height, the dry and wet energetics can be distinguished. Regimes that can support steady-state cumulus clouds and regimes that cannot are identified by comparison of the dry and wet buoyancy effects. The dominant mechanisms that govern the creation and eventual depth of the cloud layer are identified. Model predictions are tested by comparison with a large number of independent large-eddy simulations for varying surface and large-scale conditions and are found to be in good agreement.
Impact of Climate Drift on Twenty-First-Century Projection in a Coupled Atmospheric–Ocean General Circulation Model
Authors: Liang Mao-Chang , Lin Li-Ching , Tung Ka-Kit , Yung Yuk L. , Sun Shan 
Published: July 2013

Abstract
Reducing climate drift in coupled atmosphere–ocean general circulation models (AOGCMs) usually requires 1000–2000 years of spinup, which has not been practical for every modeling group to do. For the purpose of evaluating the impact of climate drift, the authors have performed a multimillennium-long control run of the Goddard Institute for Space Studies model (GISS-EH) AOGCM and produced different twentieth-century historical simulations and subsequent twenty-first-century projections by branching off the control run at various stages of equilibration. The control run for this model is considered at quasi equilibration after a 1200-yr spinup from a cold start. The simulations that branched off different points after 1200 years are robust, in the sense that their ensemble means all produce the same future projection of warming, both in the global mean and in spatial detail. These robust projections differ from the one that was originally submitted to the Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report (AR4), which branched off a not-yet-equilibrated control run. The authors test various common postprocessing schemes in removing climate drift caused by a not-yet-equilibrated ocean initial state and find them to be ineffective, judging by the fact that they differ from each other and from the robust results that branched off an equilibrated control. The authors' results suggest that robust twenty-first-century projections of the forced response can be achieved by running climate simulations from an equilibrated ocean state, because memory of the different initial ocean state is lost in about 40 years if the forced run is started from a quasi-equilibrated state.
Revisiting an Old Concept: The Gradient Wind*
Authors: Brill Keith F. 
Published: July 2013

Abstract
The gradient wind is defined as a horizontal wind having the same direction as the geostrophic wind but with a magnitude consistent with a balance of three forces: the pressure gradient force, the Coriolis force, and the centrifugal force arising from the curvature of a parcel trajectory. This definition is not sufficient to establish a single way of computing the gradient wind. Different results arise depending upon what is taken to be the parcel trajectory and its curvature. To clarify these distinctions, contour and natural gradient winds are defined and subdivided into steady and nonsteady cases. Contour gradient winds are based only on the geostrophic streamfunction. Natural gradient winds are obtained using the actual wind. Even in cases for which the wind field is available along with the geostrophic streamfunction, it may be useful to obtain the gradient wind for comparison to the existing analyzed or forecast wind or as a force-balanced reference state. It is shown that the nonanomalous (normal) solution in the case of nonsteady natural gradient wind serves as an upper bound for the actual wind speed. Otherwise, supergradient wind speeds are possible, meaning that a contour gradient wind or the steady natural gradient wind used as an approximation for an actual wind may not be capable of representing the full range of actual wind magnitude.
Scaling of GNSS Radio Occultation Impact with Observation Number Using an Ensemble of Data Assimilations
Authors: Harnisch F. , Healy S. B. , Bauer P. , English S. J. 
Published: July 2013

Abstract
An ensemble of data assimilations (EDA) approach is used to estimate how the impact of Global Navigation Satellite System (GNSS) radio occultation (RO) measurements scales as a function of observation number in the ECMWF numerical weather prediction system. The EDA provides an estimate of the theoretical analysis and short-range forecast error statistics, based on the ensemble “spread,” which is the standard deviation of the ensemble members about the ensemble mean. This study is based on computing how the ensemble spread of various parameters changes as a function of the number of simulated GNSS RO observations. The impact from 2000 up to 128 000 globally distributed simulated GNSS RO profiles per day is investigated. It is shown that 2000 simulated GNSS RO measurements have an impact similar to real measurements in the EDA and that the EDA-based impact of real data can be related to the impact in observing system experiments. The dependence of the ensemble statistics on observation error statistics assumed when assimilating the data, rather than the actual observation errors, is emphasized. There is no evidence of “saturation” of forecast impact even with 128 000 GNSS RO profiles per day. However, this result is a well-known consequence of always improving the theoretical analysis and short-range forecast error statistics when adding new observations that are assumed to have uncorrelated observation errors. In general, it is found that 16 000 GNSS RO profiles per day have around half the impact of 128 000 profiles, based on the reduction of ensemble spread values where the GNSS RO measurements have the largest impact.
SLiMScape: a protein short linear motif analysis plugin for Cytoscape
Authors: O’Brien Kevin T , Haslam Niall J , Shields Denis C 
Published: July 2013

Abstract

Background
Computational protein short linear motif discovery can use protein interaction information to search for motifs among proteins which share a common interactor. Cytoscape provides a visual interface for protein networks but there is no streamlined way to rapidly visualize motifs in a network of proteins, or to integrate computational discovery with such visualizations.

Results
We present SLiMScape, a Cytoscape plugin, which enables both de novo motif discovery and searches for instances of known motifs. Data is presented using Cytoscape’s visualization features thus providing an intuitive interface for interpreting results. The distribution of discovered or user-defined motifs may be selectively displayed and the distribution of protein domains may be viewed simultaneously. To facilitate this SLiMScape automatically retrieves domains for each protein.

Conclusion
SLiMScape provides a platform for performing short linear motif analyses of protein interaction networks by integrating motif discovery and search tools in a network visualization environment. This significantly aids in the discovery of novel short linear motifs and in visualizing the distribution of known motifs.