Orbital Apex Venous Malformation: Case Report on an Unusual Clinical and Radiological Presentation.

The authors present a case of an orbital apex venous malformation that presented with an intermittent oculomotor nerve palsy over a 15-year period. Radiologically, the lesion presented as a well-circumscribed orbital mass with T2 hyperintensity and enhancement that could only be demonstrated on 2-hour delayed phase imaging. The venous malformation was initially steroid-responsive but eventually became refractory to medical treatment alone.

Graded Eyelid Crease Approach to the Superior Orbital Apex: An Anatomical Study.

Purpose: To describe a graded eyelid crease approach to access the superior orbital apex, and to quantify the working space enabled with the sequential release of structures along the superior orbital rim.

Methods: Cadaveric dissection study of 7 cadaver heads (14 orbits). This technique involved a subperiosteal approach to the superior orbital apex.

Cerebrospinal Fluid Leaks: Challenges in Localizing Spontaneous Spinal Leak Sites and Minimally Invasive Treatment.

The confirmation of cerebrospinal fluid (CSF) leaks in the setting of spontaneous intracranial hypotension (SIH) by imaging involves a growing toolset of multimodal advanced spinal and skull base imaging techniques, for which exists a unique set of challenges for each CSF leak type. Furthermore, the repertoire of minimally invasive CSF leak treatment beyond nontargeted epidural blood patch administration has grown widely, with varied practices across institutions. This review describes current diagnostic imaging and treatment modalities as they apply to the challenges of CSF leak localization and management.

Cranial and Spinal Cerebrospinal Fluid Leaks: Foundations of Identification and Management.

Cerebrospinal fluid (CSF) leaks may occur at the skull base or along the spinal column and can cause a variety of debilitating neurological symptoms for patients. Recognizing the potential presence of a CSF leak and then identifying its source are necessary for accurate diagnosis and definitive treatment. A standardized workflow can be followed for successful leak localization, which often requires several diagnostic studies, and for definitive leak treatment, which can range from minimally invasive, needle-based approaches to a variety of surgical corrections.

Inferior orbital fissure release to access the inferolateral orbital apex.

Objective: To describe release of the inferior orbital fissure (IOF) as a novel surgical technique that will improve access to the inferior and inferolateral orbital apex.

Design: Laboratory investigation.

Participants: Human cadaver heads.

Transorbital Endoscopic Approach to the Foramen Rotundum for Infraorbital Nerve Stripping.

Purpose: To develop and evaluate a transorbital endoscopic approach to the foramen rotundum to excise the maxillary nerve and infraorbital nerve branch.

Methods: Cadaveric dissection study of 10 cadaver heads (20 orbits). This technique is predicated upon 1) an inferior orbital fissure release to facilitate access to the orbital apex and 2) the removal of the posterior maxillary wall to enter the pterygopalatine fossa (PPF).

ACR Appropriateness Criteria® Sudden Onset of Cold, Painful Leg: 2023 Update.

Acute onset of a cold, painful leg, also known as acute limb ischemia, describes the sudden loss of perfusion to the lower extremity and carries significant risk of morbidity and mortality. Acute limb ischemia requires rapid identification and the management of suspected vascular compromise and is inherently driven by clinical considerations. The objectives of initial imaging include confirmation of diagnosis, identifying the location and extent of vascular occlusion, and preprocedural/presurgical planning.

Systematic Review of Use of Patient-Reported Outcomes in Interventional Radiology.

Introduction: A patient-reported outcome (PRO) is any outcome reported directly by the patient, in contradistinction to a clinician-reported outcomes, which have dominated clinical research. This systematic review evaluates the ways in which PROs have been used in the interventional radiology literature.

Methods: Systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was designed and conducted by a medical librarian.

Regional Anesthesia as an Alternative to Moderate Sedation for Perioperative Pain Control for Percutaneous Gastrostomy Tube Placement.

Percutaneous gastrostomy tube placement is typically performed under moderate sedation. However, some patients are not ideal candidates for moderate sedation because of respiratory compromise, difficult airways, or other factors. The purpose of this study was to evaluate regional anesthesia as an alternative to moderate sedation.

New clinic workflow improves compliance for routine PCN exchanges.

Purpose: To examine the effect of a clinic workflow intervention on follow-up for routine ercutaneous nephrostomy tube (PCN) exchanges.

Methods: An intervention consisting of automated electronic tracking for all PCN placements and exchanges followed by phone call reminders to schedule a follow-up exchange 60 days post-procedure was introduced on March 19, 2019. All PCN exchanges performed from March 19, 2018 to September 18, 2019 were identified through a local electronic database search to assess the impact of intervention as a quality improvement project.

Survival Analysis Using Albumin-Bilirubin (ALBI) Grade for Patients Treated with Drug-Eluting Embolic Transarterial Chemoembolization for Hepatocellular Carcinoma.

Purpose: The albumin-bilirubin (ALBI) grade has been established as an improved predictor of survival in patients with hepatocellular carcinoma (HCC) treated with conventional transarterial chemoembolization and yttrium-90 radioembolization. The purpose of the study was to investigate the utility of ALBI grade in prognosticating outcomes in patients with HCC treated with drug-eluting embolic (DEE) transarterial chemoembolization (TACE).

Materials And Methods: A single-center retrospective review was performed to compare the efficacy of ALBI grade and Child-Pugh (CP) classification in predicting the survival of patients with HCC receiving DEE-TACE.

Systematic Reviews and Meta-Analyses of Portal Vein Embolization, Associated Liver Partition and Portal Vein Ligation, and Radiation Lobectomy Outcomes in Hepatocellular Carcinoma Patients.

Purpose Of Review: To understand portal vein embolization (PVE), associated liver partition and portal vein ligation (ALPPS) and radiation lobectomy (RL) outcomes in hepatocellular carcinoma (HCC) patients. Systematic reviews of future liver remnant (FLR) percent hypertrophy, proportion undergoing hepatectomy and proportion with major complications following PVE, ALPPS, and RL were performed by searching Ovid MEDLINE, Ovid EMBASE, The Cochrane Library, and Web of Science. Separate meta-analyses using random-effects models with assessment of study heterogeneity and publication bias were performed whenever allowable by available data.

Intermittent Projectile Urethraggia: An Unusual Sequela of a Skateboarding Accident in an Adolescent Male.

Our patient suffered a perineal straddle injury, resulting in right cavernosal artery pseudoaneurysm in combination with a cavernosal-urethral fistula. The urethra failed to heal after several weeks, and the patient presented with severe intermittent urethral bleeding. The pseudoaneurysm was successfully treated by coil embolization, with resolution of the bleeding.

Percutaneous treatment of hepatocellular carcinoma in patients with cirrhosis: a comparison of the safety of cryoablation and radiofrequency ablation.

Purpose: To compare the safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis.

Materials And Methods: This retrospective HIPAA-compliant study received institutional review board approval. Forty-two adult patients with cirrhosis underwent image-guided percutaneous ablation of hepatocellular carcinoma from 2003 to 2011.

The effects of electronic polarization on water adsorption in metal-organic frameworks: H2O in MIL-53(Cr).

The effects of electronic polarization on the adsorption of water in the MIL-53(Cr) metal-organic framework are investigated using molecular dynamics simulations. For this purpose a fully polarizable force field for MIL-53(Cr) was developed which is compatible with the ab initio-based TTM3-F water model. The analysis of the spatial distributions of the water molecules within the MIL-53(Cr) nanopores calculated as a function of loading indicates that polarization effects play an important role in the formation of hydrogen bonds between the water molecules and the hydroxyl groups of the framework.

Role of secondary sialic acid binding sites in influenza N1 neuraminidase.

Within influenza viral particles, the intricate balance between host cell binding and sialic acid receptor destruction is carefully maintained by the hemagglutinin (HA) and neuraminidase (NA) glycoproteins, respectively. A major outstanding question in influenza biology is the function of a secondary sialic acid binding site on the NA enzyme. Through a series of Brownian dynamics (BD) simulations of the avian N1, human pandemic N2, and currently circulating pandemic (H1)N1 enzymes, we have probed the role of this secondary sialic acid binding site in the avian N1 subtype.

Outside CT imaging among emergency department transfer patients.

Purpose: The aim of this study was to characterize the quantity and types of outside computed tomographic (CT) examinations submitted for reinterpretation among emergency department (ED) transfers to a tertiary care, level I trauma, academic medical center and the frequency of and reasons for repeat imaging.

Methods: Reinterpretation requests for outside CT studies accompanying ED transfer patients over a 4-month period were prospectively audited. Clinicians completed forms specifying type of CT study, outside report availability, interpretational discrepancies, repeat imaging requests, and reasons for repeat imaging.

Do nonspecific deep corticomedullary sutures performed during partial nephrectomy adequately control major vascular and collecting system injury?

Objective: To critically evaluate the effectiveness of placing nonspecific deep corticomedullary sutures in the setting of major vascular and collecting system injury during laparoscopic partial nephrectomy (LPN). We also aimed to evaluate the incidence of ischaemic injury to the remaining renal remnant because of these sutures, as many laparoscopic centres have adopted this practice.

Materials And Methods: We performed open PN on eight porcine kidneys.

Geographic variations in the use of medical and surgical therapies for benign prostatic hyperplasia.

Purpose: Patients with BPH have several treatment options. Little is known about geographic variations in surgical rates for BPH and the market relationships to medical therapy, health resources and sociodemographic factors.

Materials And Methods: We conducted a cross-sectional study using administrative data from 5 states in 2000.

Location and etiology of flexible and semirigid ureteroscope damage.

Objectives: To perform an analysis of currently available manufacturer data regarding the character of ureteroscope damage. The high costs associated with the repair of flexible and semirigid ureteroscopes are well documented. Increased knowledge of the etiology of ureteroscope damage should aid urologists in prolonging the lives of these delicate instruments.

Controlled survival study of the effects of Tisseel or a combination of FloSeal and Tisseel on major vascular injury and major collecting-system injury during partial nephrectomy in a porcine model.

Purpose: We report the results of a controlled survival study in a porcine model investigating Tisseel or a combination of FloSeal and Tisseel in dealing with vascular and collecting-system injury during partial nephrectomy.

Materials And Methods: We performed an open right lower-pole partial nephrectomy on 15 large female pigs. The defect was repaired using standard open techniques (N = 5; controls), Tisseel only (N = 6; group I), or FloSeal followed by Tisseel (N = 4; group II).