bluuebunny/crossref_metadata_2025_split huggingface dataset:
E-018 Preliminary experience with the percutaneous embolization of paragangliomas at the carotid bifurcation using only Onyx
Authors: Shah H , Gemmete J , Chaudhary N , Pandey A , Ansari S 
Published: December 2010

Introduction and purposeSurgical resection of hypervascular paraganglioma can be difficult due to intraoperative blood loss. Preoperative endovascular embolization with particulate material facilitates safe and complete surgical resection. However, complete devascularization is often impossible due to an inability to selectively catherize tiny feeding arteries or short pedicles arising from the carotid bifurcation with concerns for embolic reflux. We present our initial angiographic and clinical outcomes using only Onyx (ethylene vinyl alcohol) for percutaneous embolization of paragangliomas at the carotid bifurcation.Materials and methodsA consecutive series of five patients with five paragangliomas (carotid body tumors) located at the carotid bifurcation were treated solely with percutaneous Onyx embolization. Fluoroscopic roadmap and ultrasound guided access was utilized for percutaneous needle placement. Onyx 18 and Onyx 34 were infused under constant negative roadmap fluoroscopy. Onyx embolization was continued until devascularization was achieved by angiography or reflux occurred into the feeding arterial pedicles or draining veins.ResultsComplete devascularization of the five paragangliomas was achieved using a percutaneous embolization technique with Onyx as the sole agent without complications. An average of 2.5 needles (range 2–4) were placed into each carotid body tumor under fluoroscopic and ultrasound guidance. An average of 6.9 ml (range 5–8.5 ml) of Onyx was injected in each tumor. Complete devascularization was achieved in each case by angiography. Surgical resection was subjectively reported to be less intensive with a decreased need for cauterization and reduced intraoperative blood loss. Intraoperative blood loss averaged 80 ml (range 10–200 ml).ConclusionOur preliminary experience suggests that percutaneous Onyx embolization may offer a higher degree of devascularization compared with other embolic agents, allowing safe and complete surgical resection as well as reducing intraoperative blood loss. Onyx appears to be a safe embolic agent when injected percutaneously due to its inherent cohesive nature allowing controlled extended injections, ability to intermittently pause and redirect its flow into the tumor vascular bed.
E-040 Utility of Syngo iGuide needle guidance system for intraoperative navigation in percutaneous spine interventions: a cadaveric study
Authors: Kathuria S , Ehtiati T , Gandhi D 
Published: December 2010

PurposeThis study was designed to evaluate the feasibility, inter-observer agreement and accuracy of Syngo iGuide intraoperative navigation planning system for percutaneous spine interventions.Methods and materialsThis cadaveric study was performed according to our institution guidelines for cadaver work. Two fresh frozen cadaver (one for thoracic and one for lumbar levels) were used to test the utility of a recently launched, commercially available flat panel application from Siemens Medical Systems that provides intraoperative virtual guidance to a user predefined needle path and target. Using this system, a total of 18 needle passes (eight thoracic and 10 lumbar levels) were performed by two experienced interventional neuroradiologists (nine passes per operator, alternate side and levels) using a unilateral transpedicular approach from T5 to T12 vertebral bodies and a bipedicular approach from L1 to L5 vertebral bodies. Entry and target points were first selected on a C arm dynaCT image to determine a safe path for the needle. The needle path, target point and three-dimensional images were registered to live fluoroscopy during the procedure and were used to guide needle placement in real time. After satisfactory placement of the needle, strictly using the guiding system, post C arm dynaCT images were obtained for measurements.ResultsNeedle placement data from eight thoracic and 10 lumbar vertebral levels (T5–T12; L1–L5) were available for review. Needles were safely placed at all levels with no breach of the central canal, lateral or medial wall of pedicle or that of the anterior cortex. The average distance from the center of the predefined target to needle tip was 2.94 mm (3.07 for thoracic, 2.83 mm for lumbar) with a range from 1.4 mm to 4.8 mm. The average distance from the center of the target to the nearest part of the needle trajectory was 0.93 mm (0.97 mm for thoracic, 0.88 mm for lumbar) with a range from 0.00 mm to 2.4 mm. There was no significant difference between the two operators.ConclusionUse of the Syngo iGuide Needle Guidance intraoperative navigation system is feasible for spinal interventions. The needle can be placed to the target with less than 3 mm error in cadaver study. This software allows reliable and accurate needle placement by providing real time intraoperative navigation. Further testing in live subjects is needed to establish patient safety. Preliminary work on live patients is underway at our institution and appears promising.
E-053 Anomalous origin of the middle meningeal artery from mid-basilar artery
Authors: Nanda A , Chowdhry S , Blackham K 
Published: December 2010

IntroductionThe middle meningeal artery (MMA) most commonly originates from the maxillary artery and travels through the foramen spinosum. Most variants have been noted to originate from the ophthalmic artery or the internal carotid artery. Rarely, an origin from the basilar artery has been observed. Here we present the case of anomalous origin of the MMA from the basilar artery in a pediatric patient with left facial hemangioma also supplied by the aberrant basilar branch in the setting of PHACES syndrome.Case historyA 2-year-old female toddler with a left facial hemangioma and left lid lag presented for diagnostic cerebral angiogram to further characterize a large fusiform left posterior communicating artery aneurysm with involvement of the left internal carotid artery, anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA).We here report a case of anomalous origin of the MMA from the basilar artery with literature review.Methods and resultsIntracranial MR angiography, digitally subtracted cerebral angiography, including rotational three-dimensional angiography, with a left internal carotid artery injection and left vertebral artery injection was performed. A large fusiform left posterior communicating artery aneurysm was noted with involvement of the carotid terminus, as well as proximal aspects of the left ACA, MCA and PCA. Additionally, a large branch off the basilar artery at the level of the pons was noted originating between the left superior cerebellar artery and the left anterior inferior cerebellar artery, both of which were relatively diminutive. The vessel traveled anteriorly through the cavernous sinus and into the middle cranial fossa where it branched into the MMA and a vessel that traveled through the optic canal and exited beneath the superior orbital rim to supply the large left facial hemangioma. No associated intracranial vascular malformation was noted.ConclusionWe describe a rare case of anomalous origin of the MMA from the basilar artery in a pediatric patient, in the setting of PHACES syndrome. Only seven cases of the MMA originating from the basilar artery have been reported previously, including one case of bilateral anomalous origin. In each of these cases, the MMA originated from an enlarged basilar branch between ipsilateral the superior cerebellar artery and anterior inferior cerebellar artery, as was noted in our case. This anomaly has been proposed to be the result of an anastamosis between the primitive trigeminal artery and a persistent stapedial artery.Abstract E-053 Figure 1
E-060 Complex cerebral arteriovenous fistula: endovascular treatment using transvenous and transarterial approach
Authors: Pabon B , Vargas S , Vargas S 
Published: December 2010

Background and purposeEndovascular treatment is an accepted choice for intracranial pial and dural arteriovenous fistulas (PAVF/DAVF). We assessed the technical feasibility, safety and efficacy of the endovascular approach as monotherapy for difficult and complex cases.MethodsSince June 2006 to Dec 2009, of 68 patients with cerebral AVMs treated, 20 cases were DAVF and six were PAVF. 10 cases presented with hemorrhage, two cases with seizures, eight cases with headache and six cases truly incidental. 16 cases were treated with a transarterial strategy while seven lesions were treated using a transvenous approach (retrograde technique). Clinical and radiological outcome were assessed and mid term follow-up is presented. Special consideration was taken into account with regard to anatomical tips and adverse events.ResultsFistula occlusion (technical success) of 97% was achieved. Undesired distal embolization was registered in one case. In two cases we had microcatheter retention. One case of recurrence after occlusion. None case presented rebleeding during follow-up.ConclusionCurrent microsystems can be safely maneuvered through severely tortuous arterials and venous vessels although technically demanding to advance while a ‘retrograde’ technique is carried out. The combined strategy was associated with high rates of occlusion. Although immediate and mid term angiographic results are promising, long term angiographic and clinical follow-up is essential to determine occlusion stability and clinical outcome
E-061 Safety and efficacy of Neuroform 3 for intracranial aneurysms treatment
Authors: Bonafe A , Biondi A 
Published: December 2010

ObjectivesTo assess the feasibility and the clinical performance of NF3 in intracranial aneurysms treatment. SENAT (Safety and Efficacy of Neuroform 3 for Intracranial Aneurysms Treatment) a multicenter registry, has been conducted between January through July 2009 from French centers. The registry protocol allowed for use of all types of coils and adjunctive technologies, as deemed appropriate by the participating investigator. Acute clinical and angiographic assessments were self- reported.Methods118 patients (79 women, 39 men) harboring a single aneurysm (109 unruptured, nine ruptured) were treated by means of stent assisted coiling and included in a prospectively maintained database.Aneurysms were predominantly located in the anterior circulation (106 of 118) with a mean size of 6.60 mm (3.55 mm). All patients underwent a double antiplatelet regimen (clopidogrel, aspirin) before, during and after the procedure.ResultsFeasibilityTechnical success defined as successful stent delivery in the proper place was achieved in 98.2% of cases with one (113 cases) or two (4 cases) devices. In one case of ruptured aneurysm the intended stenting initially considered was abandoned.Safety10 (8.5%) per procedural and immediate postprocedural complications occurred: one case of subarachnoid rebleeding due to aneurysmal perforation, one case of delayed bleeding in an infarcted area remote from the stent landing zone, three thrombotic complications and five groin hematomas.Mortality/morbidity30 day mortality and morbidity rates were 0% and 4.2% respectively. Adverse events associated with transient or permanent neurological deficit were encountered in 2.6% of cases with the majority occurring in ruptured aneurysms.Acute resultsComplete aneurysmal occlusion was achieved in 74 cases (62.7%), residual neck were noted in 28 cases (23.7%) and a residual sac was present in 16 cases (13.6%).ConclusionThe Neuroform Stent 3 has no technical limitation, all types of aneurysm location being amenable to stenting, and does not impair adequate coil embolization. Antiplatelet agents decrease thromboembolic events rate but favor major peripheral or cerebral bleeding preventing larger use of Neuroform stents in cases of acutely rupture aneurysms.
FUZZY SUPERVISED NONLINEAR PID CONTROL OF A CLASS OF UNKNOWN NONLINEAR SYSTEMS
Authors: REKIK L. TOUNSI , CHTOUROU MOHAMED 
Published: December 2010

Fuzzy control has been successfully applied in many cases to which conventional control algorithms are difficult to be applied. Recently, it was proven that fuzzy systems are capable of approximating any real continuous function to arbitrary accuracy. This result motivates us to use the fuzzy identifiers for nonlinear dynamic systems and then design the fuzzy supervised nonlinear PID controller based on the fuzzy system. There are two main objectives in this paper: (1) We use the Takagi and Sugeno's fuzzy models as an identifier for nonlinear dynamic systems, and derive the identification algorithm, (2) the fuzzy supervisor design method for tracking control is proposed based on this fuzzy system. In order to improve the dynamic response of the closed loop fuzzy model, the optimization of the performance of the fuzzy supervisor will be considered. To prove the potential applications of the proposed strategy, simulation was carried out for the speed control of a DC motor with serial excitation and a first order nonlinear process.
Abstract A106: Neighborhood socioeconomic deprivation is associated with higher risk of diagnosis with nonlocalized colorectal cancers
Authors: Chyke Doubeni A. , Laiyemo Adeyinka O. , Stone Rosalie Torres , Major Jacqueline , Li Wenjun , Graubard Barry , Schatzkin Arthur 
Published: December 2010

Abstract
Background: Previous studies have found that, in the US, the incidence rate for colorectal cancer (CRC) is disproportionally high among persons residing in socioeconomic deprived neighborhoods. However, no previous studies have determined if there are disparities in incidence or tumor stage at diagnosis for CRC according to socioeconomic conditions in the neighborhood of residence after adjusting for individual-level CRC risk factors.
Methods: Data were obtained from the ongoing NIH-AARP Diet and Health Study, a prospective cohort of 566,402 persons residing in 6 US states and 2 metropolitan areas who were 50-71 years of age at baseline (1995-1996). Detailed individual-level data were obtained on diet, lifestyle and other cancer risk factors using questionnaires. For this analysis, we excluded participants who reported a history of CRC at the time of the baseline questionnaire. CRC incidence was then ascertained from tumor registries through December 31,2003. We used an empirically derived neighborhood socioeconomic deprivation index from linked 2000 US census data based on participants’ home addresses at the time of the baseline questionnaire. The index was categorized into quintiles at the census-tract level. We used proportional hazards models that accounted for clustering of persons within census tracts to separately estimate the hazard ratios for CRC incidence and tumor stage at the time of diagnosis (based on SEER summary staging system). We defined regional, distant or unstaged tumors as non-localized.
Results: There were 6,934 incident cases of CRC among the 560,288 eligible participants included in the analyses, of which 59% were non-localized. The age and sex adjusted incidence of CRC among the cohort was 17.5 per 10,000 person-years. The incidence rate was 16.2% among persons residing in census-tracts in the first (least deprived) socioeconomic quintile and 19.8% for the 5th (most deprived) quintile. In proportional hazard models that adjusted for individual-level education and demographic, diet and lifestyle factors, those in the most deprived census-tracts had a higher incidence of CRC, overall (adjusted hazard ratios (HR)=1.16:95% confidence intervals (CI) 1.04-1.29); and non-localized CRC, compared to persons residing in the least socioeconomically deprived (first quintile) census-tracts.
Conclusion: Persons residing in socioeconomically deprived neighborhoods were more likely to be diagnosis with non-localized CRC. This may contribute to neighborhood socioeconomic disparities in mortality for CRC.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A106.
Abstract A112: Temporal trends in treatment and survival among white and black women with uterine cancer
Authors: Berzins Ilze , Albuquerque Kevin 
Published: December 2010

Abstract
Background: Despite the lower overall incidence rates for Uterine cancer in black compared to white women mortality rates are known to be very high in blacks. Our focus was to elucidate trends over time and describe differences in clinical characteristics by particular treatment, and survival outcomes between black and white women.
Methods: Black and white women diagnosed with uterine cancer during 1991-2000 were identified from SEER 9 database and stratified in two groups by year of diagnosis: 1991-1995 and 1996-2000. Kaplan-Meier and Cox proportional hazard models were developed to compare women by race and accounting for other prognostic variables.
Results: A total of 30,673 patients were diagnosed with Uterine cancer (adenocarcinoma Type I, Type II and Sarcoma) between 1991-2000; blacks forming 6.5% of total (1978 patients). Black women were 2 times more likely not to receive therapy (OR 2.29; p&lt;0.0001; 95% CI 1.98-2.66). Most untreated group was black women when diagnosed with Type I Uterine cancer.
Difference in treatment distribution between white and black women was significant with Type-I (p&lt;0.0001) and Type-II (p&lt;0.001) carcinomas. During years 1996-2000 percentage of surgical extirpation of cancer increased in black patients with Type-I carcinoma (56.63%), though still not reaching the level administered for whites (67.98%). The combined surgery and radiation treatment increased in black women diagnosed with Type-II and sarcoma which is an improving trend. Radiation decreased for both races in all histological types.
Black women had 32% higher risk to die from uterus cancer during 1991-2000 (HR1.32; 95% CI 1.15-1.51). Histological type, age at diagnosis, radiation therapy, advanced stage and grade were significant predictors. However a refreshing trend is that black women had 19% less risk of dying from uterus cancer in 2nd period (HR 0.81; p=0.127; 95%CI 0.63-1.05). While Type II cancers fared better black women had 47% higher risk to die from Type-I carcinoma compare to white women when diagnosed during years 1991-2000 (even after adjusting for time period, histological type, age at diagnosis, therapy, stage, and grade (HR 1.47; 95%CI 1.24-1.75).
Conclusions: Treatments for Uterine cancer improved during 2nd period in black women with consequent tendency for improved 5 year survival. Overall percentage of treated versus not-treated cases remained the same between periods, changes in treatment patterns were noted only when stratified by histological types. Black women diagnosed with Type-I Uterine cancer need special targeting with public educational policy: twice as many were not treated compare to white patient and had the greatest disparity in surgery. Overall there is a trend for the better for most recent time period for black women diagnosed with Uterine cancer but challenges remain.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A112.
Abstract A27: Developing sisters informing sisters: A peer-based intervention in treatment decision making for newly diagnosed black breast cancer patients
Authors: Sheppard Vanessa B. 
Published: December 2010

Abstract
Background: Improved treatment decision making has been suggested as a strategy to increase use of adjuvant systemic breast cancer therapies. However, few interventions address this issue particularly in black patients. The study objective was to assess the feasibility of delivering a patient education intervention to improve treatment decision making.
Methods: Seventy-six women with histologically confirmed breast cancer were recruited from the Washington, DC, metropolitan area. After a baseline telephone interview, women received an in-person educational session with a trained breast cancer survivor (survivor coach). The coach used a culturally appropriate guidebook and decision-making model TALK Back!SM, which instructs breast cancer patients to Tell your story, Ask questions, Listen actively, and Know your treatment options. After the session, patients were recontacted to assess their acceptability of the intervention and self-reported outcomes.
Results: Most (87%) found the intervention acceptable. After the intervention, participants reported: increased treatment knowledge (79%), better self-efficacy in communicating with providers (70%), and increased self-efficacy in making treatment decisions (57%). Compared to baseline scores, post-intervention communication with providers significantly increased (p&lt;.05).
Conclusions: These findings support the feasibility and acceptability of intervening with this population. Testing the impact of this intervention on decision outcomes and treatment adherence using RCTs or similar designs will be important next steps.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A27.
Abstract A30: A cancer education program for community health workers in NYC
Authors: Sanchez Martha M. , Grann Victor R. , Magai Carol , Ashby-Thomspon Maxine , Chacon Ana , Hepburn Patricia , Adjai Brenda , Neugut Alfred 
Published: December 2010

Abstract
Background: Our minority institution/comprehensive cancer center partnership is based in Brooklyn and northern Manhattan, NY. Our institutions are surrounded by the largest community of individuals from the Caribbean in the United States, representing Haiti, Jamaica, Trinidad-Tobago, Barbados, the Dominican Republic, and other parts of the West Indies. Although research on racial/ethnic health disparities in the United States has undergone tremendous growth in the past decade, few research teams have access to ethnic enclaves as large as ours.
Objective: To train community health workers (CHWs) about cancer prevention and control for breast, cervical, colorectal, and prostate cancer; and the importance of community participation in cancer clinical research, including prevention and treatment trials.
Methods: We worked with community-based organizations (CBOs) to conduct community needs assessment, review cancer educational materials and resources for appropriateness, identify gaps, develop new materials to fill the gaps, and coordinate educational activities across partner institutions. Outreach and education efforts focused on breast, cervical, colorectal, and prostate cancer and research participation. Cancer education materials from NCI, the American Cancer Society (ACS), and other national organizations were reviewed and adapted for the CBOs. Evaluation addressed development of materials; educational curricula; scheduling of, number of, and attendance at CHW trainings; number of individuals recruited by CHWs to our database; and changes in clients’ self-reported screening and cancer risk behaviors and intentions.
Results: In each of six participating CBOs serving diverse constituencies, we recruited at least six CHWs to participate in our Cancer Education Training Program and then to educate their constituencies (n≥10 each CHW) about cancer, cancer prevention, and clinical research. The trainees also obtained certification in Good Clinical Practices (GCP) and the requirements of the Health Insurance Portability and Accountability Act (HIPAA). The CHWs’ education of their clients is now in progress.
Conclusions: Community health workers are eager to receive training to provide cancer education to their clients, and to obtain certification in GCP and HIPAA. By providing this training, we are obtaining access to previously unreached constituencies in need of cancer screening.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A30.