All-Weather Dry Decontaminant Polymer-HO Complex for HD Degradation.

Hydrogen peroxide (HO) is a highly effective decontaminant against chemical warfare agents (CWAs) when present both in a liquid and as a solid powder. For the latter, this can be in the form of HO being complexed to a polymer, such as polyvinylpyrrolidone (PVP). While a HO-PVP complex is indeed effective at decontaminating CWAs, it is vulnerable to environmental conditions such as high relative humidities (RH), which can dissociate the HO from the complex before it is given the opportunity to react with CWAs.

A single-institution experience in image-guided thermal ablation of adrenal gland metastases.

Purpose: To assess safety, technical success, local control, and survival associated with percutaneous image-guided adrenal ablation.

Materials And Methods: Adult patients with adrenal metastases who underwent percutaneous image-guided adrenal ablation during the years 2003-2012 were identified. There were 32 patients with 37 adrenal tumors identified.

Percutaneous image-guided adrenal cryoablation: procedural considerations and technical success.

Purpose: To assess safety, technical success, complications, and hemodynamic changes associated with the adrenal cryoablation procedure.

Materials And Methods: This retrospective review was approved by the institutional review board, with waiver of informed consent, and was compliant with the Health Insurance Portability and Accountability Act. Adult patients with adrenal metastasis who were treated with adrenal cryoablation between May 2005 and October 2009 were eligible for this review.

The Chicxulub asteroid impact and mass extinction at the Cretaceous-Paleogene boundary.

The Cretaceous-Paleogene boundary approximately 65.5 million years ago marks one of the three largest mass extinctions in the past 500 million years. The extinction event coincided with a large asteroid impact at Chicxulub, Mexico, and occurred within the time of Deccan flood basalt volcanism in India.

Modulation of cytokine expression by traditional medicines: a review of herbal immunomodulators.

Unlabelled: Modulation of cytokine secretion may offer novel approaches in the treatment of a variety of diseases. One strategy in the modulation of cytokine expression may be through the use of herbal medicines. A class of herbal medicines, known as immunomodulators, alters the activity of immune function through the dynamic regulation of informational molecules such as cytokines.

Clinical presentation and surgical management of dissecting posterior inferior cerebellar artery aneurysms: 2 case reports.

Intracranial dissection presenting with subarachnoid hemorrhage (SAH) most commonly involves the vertebral artery. The natural history of this lesion suggests frequent early rehemorrhage and need for urgent treatment. Isolated dissection of the posterior inferior cerebellar artery (PICA) is very rare.

Survival of cardiac arrest after aneurysmal subarachnoid hemorrhage.

Objective: Survival of cardiac arrest (CA) after aneurysmal subarachnoid hemorrhage (SAH) is poorly characterized. We analyzed the clinical course and outcome of patients who survived resuscitation for CA after aneurysmal SAH.

Methods: Medical records of all patients with acute SAH treated at Mayo Clinic between 1990 and 1997 were reviewed.

Influence of aspirin on outcome following aneurysmal subarachnoid hemorrhage.

Object: Previous studies have indicated an increased incidence of death in patients with subarachnoid hemorrhage (SAH) who are currently receiving anticoagulation therapy. The significance of previous aspirin use in patients with SAH is unknown. The authors analyzed the effects of prior aspirin use on clinical course and outcomes following aneurysmal SAH.

Cost of treating high-risk symptomatic carotid artery stenosis: stent insertion and angioplasty compared with endarterectomy.

Object: Definitive data characterizing the safety and efficacy of carotid angioplasty with stent placement (CAS) for symptomatic, occlusive carotid artery (CA) disease require further refinements and standardization of techniques as well as large prospective studies on a par with the North American Symptomatic Carotid Endarterectomy Trial (NASCET). Despite the absence of such data, many surgeons have performed angioplasty and stent placement in patients with clinical or anatomical features known to add significant perioperative risk and capable of disqualifying the patients from participation in NASCET: There exists no cost analysis comparing high-risk endarterectomy with percutaneous angioplasty and stent insertion.

Methods: Forty-five patients (29 men and 16 women) with high-risk, symptomatic CA stenosis have been treated with CAS at the authors' institution since 1996.

A pilot study of high-dose intraarterial cisplatin chemotherapy with concomitant accelerated radiotherapy for patients with previously untreated T4 and selected patients with T3N0-N3M0 squamous cell carcinoma of the upper aerodigestive tract.

Background: This Phase I clinical trial was developed to assess the feasibility of combining high-dose intraarterial cisplatin chemotherapy with concurrent, concomitant boost accelerated radiation therapy for patients with previously untreated T4 and select patients with T3N0-N3M0 squamous cell carcinoma of the upper aerodigestive tract.

Methods: Between July 1999, and February 2002, 19 patients were treated with 3 or 4 weekly cycles of intraarterial Cisplatin chemotherapy (150 mg/m(2)) with concurrent, concomitant boost accelerated radiation therapy (72 grays in 42 fractions over 6 weeks).

Results: Two patient deaths occurred among the first 15 patients enrolled.

Predictors of outcome after endovascular treatment of cerebral vasospasm.

Background And Purpose: Angioplasty and intra-arterial papaverine are promising treatments for severe symptomatic vasospasm after subarachnoid hemorrhage (SAH), but there is little information on the clinical factors that predict treatment outcome. We sought to determine variables for predicting functional outcome in this setting.

Methods: We reviewed 81 consecutive patients with symptomatic cerebral vasospasm from aneurysmal SAH treated with percutaneous balloon angioplasty or selective intra-arterial papaverine infusion between 1990 and 2000 (105 procedures).

Progressive neurological decline after partial spontaneous thrombosis of a Spetzler-Martin Grade 5 arteriovenous malformation in a patient with Leiden factor V mutation: management and outcome.

The coexistence of a large intracranial arteriovenous malformation (AVM) and a hypercoagulation disorder is rare. The AVM puts the patient at risk for progressive neurological deficit, seizures, and, most importantly, intracranial hemorrhage The hypercoagulation disorder may result in an increased risk of stroke. The authors describe a 42-year-old man with a Spetzler-Martin Grade 5 AVM who experienced progressive neurological decline.

Pulmonary complications of aneurysmal subarachnoid hemorrhage.

Objective: Pulmonary complications challenge the medical management of patients who have sustained aneurysmal subarachnoid hemorrhage (SAH). We assessed the frequency and types of pulmonary complications after aneurysmal SAH and analyzed the impact of pulmonary complications on patient outcome.

Methods: We reviewed the records of all patients with acute SAH treated at our institution between 1990 and 1997.

Guglielmi detachable coil treatment of ruptured saccular cerebral aneurysms: retrospective review of a 10-year single-center experience.

Background And Purpose: We retrospectively analyzed our results with Guglielmi detachable coils (GDCs) for the endovascular occlusion of acutely ruptured saccular cerebral aneurysms over 10 years.

Methods: Between 1991-2000, 83 patients (mean age, 56.1 years) with aneurysmal subarachnoid hemorrhage were treated with endovascular GDCs.

Symptomatic vasospasm and outcomes following aneurysmal subarachnoid hemorrhage: a comparison between surgical repair and endovascular coil occlusion.

Object: The authors studied patients with aneurysmal subarachnoid hemorrhage (SAH) to determine whether the incidence of symptomatic vasospasm or overall clinical outcomes differed between patients treated with craniotomy and clip application and those treated by endovascular coil occlusion.

Methods: The authors reviewed 415 consecutive patients with aneurysmal SAH who had been treated with either craniotomy and clip application or endovascular coil occlusion at a single institution between 1990 and 2000. Three hundred thirty-nine patients underwent surgical clip application procedures, whereas 76 patients underwent endovascular coil occlusion.

Delayed ischemic deficit after resection of a large intracranial dermoid: case report and review of the literature.

Objective And Importance: A unique case of delayed ischemic deficit after resection of a large intracranial dermoid is presented.

Clinical Presentation: A 23-year-old woman, 36 hours after the uneventful gross total resection of a large intracranial dermoid cyst, slowly developed a progressive mixed aphasia and right hemiparesis. Magnetic resonance imaging and magnetic resonance angiography revealed small infarcts of the left putamen and temporal-occipital junction and a vasospastic tapering of the left M1 segment.

Development of a pontine cyst after endovascular coil occlusion of a basilar artery trunk aneurysm: case report.

Objective And Importance: Cyst formation within the brain parenchyma after endovascular coil occlusion of an intracranial aneurysm is a previously undescribed occurrence. We describe a 70-year-old woman who presented with a symptomatic pontine cyst 1 year after uncomplicated stenting and Guglielmi detachable coil occlusion of an unruptured basilar artery trunk aneurysm.

Clinical Presentation: A 70-year-old woman presented with an episode of transient dysequilibrium and gait difficulty.

Computed tomographic determinants of neurologic deterioration in patients with large middle cerebral artery infarctions.

Objective: To identify specific radiographic features on computed tomographic (CT) imaging that can predict neurologic deterioration in patients with large middle cerebral artery (MCA) infarctions.

Patients And Methods: We performed a 10-year retrospective review from January 1, 1991, through December 31, 2001, of medical records and CT scans of patients with large MCA infarctions. Neurologic deterioration was defied as progressive drowsiness or signs of herniation.

Preoperative ventriculostomy and rebleeding after aneurysmal subarachnoid hemorrhage.

Object: Despite the widespread use of ventriculostomy in the treatment of acute hydrocephalus after aneurysmal subarachnoid hemorrhage (SAH), there is no consensus regarding the risk of rebleeding associated with ventriculostomy before aneurysm repair. This present study was conducted to assess the risk of rebleeding after preoperative ventriculostomy in patients with aneurysmal SAH.

Methods: The authors reviewed the records of all patients with acute SAH who were treated at a single institution between 1990 and 1997.

Complete recovery after early intraarterial recombinant tissue plasminogen activator thrombolysis of carotid T occlusion.

Carotid T occlusion (intracranial carotid bifurcation occlusion with involvement of A1 and M1 segments) is associated with poor outcome. In most cases, treatment with intraarterial thrombolysis within a 6-hour window has been unsuccessful. We describe the case of a 26-year-old woman who presented with severe neurologic deficits (National Institutes of Health Stroke Scale score of 23) secondary to angiographically proved right carotid T occlusion.

Volumetric quantification of Fisher Grade 3 aneurysmal subarachnoid hemorrhage: a novel method to predict symptomatic vasospasm on admission computerized tomography scans.

Object: Predicting which patients with aneurysmal subarachnoid hemorrhage (SAH) will develop delayed ischemic neurological deficit (DIND) due to vasospasm remains subjective and unreliable. The authors analyzed the utility of a novel software-based technique to quantify hemorrhage volume in patients with Fisher Grade 3 aneurysmal SAH.

Methods: Patients with aneurysmal SAH in whom a computerized tomography (CT) scan was performed within 72 hours of ictus and demonstrated Fisher Grade 3 SAH were analyzed.