Estimation of wall shear stress dynamic fluctuations in intracranial atherosclerotic lesions using computational fluid dynamics.

Objective: Intracranial stenosis (IS) is associated with significant morbidity and mortality from hypoperfusion and thromboembolism. We used computational fluid dynamic methods to analyze luminal patterns of wall shear stress (WSS), a known critical modulator of endothelial function, within patient-based IS lesions undergoing percutaneous angioplasty and stenting.

Methods: High-resolution three-dimensional rotational angiographic data sets were reconstructed to yield a fine-resolution computational mesh allowing application of pulsatile computational fluid dynamic analysis with a non-Newtonian realistic model of blood.

Stent-mediated wedging of a calcific embolus to recanalize an occluded middle cerebral artery: technical case report.

Objective: Calcific cerebral emboli are rare yet pose a difficult therapeutic challenge because of their lack of response to thrombolytic therapy and their propensity for fragmentation.

Clinical Presentation: A 75-year-old woman developed aphasia and hemiparesis after cardiac catheterization from a near-occlusive calcific embolus to the left middle cerebral artery origin. The calcific embolus was shown to be hemodynamically limiting by computed tomographic perfusion and diffusion-weighted magnetic resonance imaging.

Disseminated tumor cells in bone marrow following definitive radiotherapy for intermediate or high-risk prostate cancer.

Background: The purpose of this study was to explore the prevalence of disseminated tumor cells (DTCs) in bone marrow (BM) of clinically progression-free prostate cancer (PC) patients at least 2 years after curatively intended radiotherapy (RT) with or without adjuvant hormone treatment.

Methods: All patients were T(1-3)N(0)M(0) with intermediate or high risk of progression. Median time from RT to BM sampling was 5 years (2-8).

Molecularly imprinted polymers for the selective solid-phase extraction of chloramphenicol.

A variety of bulk polymers for the selective separation of chloramphenicol were synthesised from 2-vinylpyridine, diethylaminoethyl methacrylate or methacrylic acid monomers. Chromatographic evaluation indicated that chloramphenicol was retained under nonpolar elution conditions (k = 58.65) through selective hydrogen bonding and ionic interactions.

Stent graft treatment of cerebrovascular wall defects: intermediate-term clinical and angiographic results.

Objective: Endovascular stent graft (SG) deployment offers a useful vessel-preserving strategy for vascular wall lesions such as pseudoaneurysms and fistulae. Although deployment of expanded polytetrafluoro-ethylene-covered SGs within the carotid and vertebral arteries is technically feasible, data on long-term efficacy, safety, and patency rate remain sparse.

Methods: Six patients with traumatic (n = 4), iatrogenic (n = 1), or spontaneous (n = 1) internal carotid and vertebral artery injuries (direct carotid-cavernous fistula, n = 2; pseudoaneurysms, n = 4) were treated with nine balloon-mounted coronary expanded polytetrafluoro-ethylene SGs.

Angiographic detection of carotid and vertebral arterial injury in the high-energy blunt trauma patient.

Background And Objective: Injury to the carotid and vertebral arteries is an identified risk to patients after blunt high-energy cranio-cervical trauma with an associated risk of thromboembolic stroke. We sought to determine the incidence, features, and risk factors of arterial injury using selective cerebral angiography in a high-risk trauma patient subset.

Methods: Blunt trauma patients with a high-energy mechanism were selected to undergo screening cerebral angiography if they met one of the following criteria: (1) cervical spine hyperextension/hyperflexion injury, (2) skull-base or facial fracture, (3) lateralizing neurologic deficit, ischemic deficit, or cerebral infarction, or (4) hemorrhage of arterial origin.

Analysis of chimpanzee history based on genome sequence alignments.

Population geneticists often study small numbers of carefully chosen loci, but it has become possible to obtain orders of magnitude for more data from overlaps of genome sequences. Here, we generate tens of millions of base pairs of multiple sequence alignments from combinations of three western chimpanzees, three central chimpanzees, an eastern chimpanzee, a bonobo, a human, an orangutan, and a macaque. Analysis provides a more precise understanding of demographic history than was previously available.

Decompressive Craniectomy.

Decompressive Craniectomy (DC) is used to treat elevated intracranial pressure that is unresponsive to conventional treatment modalities. The underlying cause of intracranial hypertension may vary and consequently there is a broad range of literature on the uses of this procedure. Traumatic brain injury (TBI), middle cerebral artery (MCA) infarction, and aneurysmal subarachnoid hemorrhage (SAH) are three conditions for which DC has been predominantly used in the past.

Preventing intraperitoneal adhesions with vitamin E and sodium hyaluronate/carboxymethylcellulose: a comparative study in rats.

Purpose: To compare the effectiveness of intraperitoneally administered vitamin E with the sodium hyaluronate/carboxymethylcellulose membrane (HA/CBMC) in preventing postoperative intraperitoneal adhesion formation.

Methods: Sixty Wistar rats underwent a laparotomy and adhesions were induced (IA). The animals were divided into four groups: group 1, control (IA); group 2 (IA + Vitamin E): group 3 (IA+HA/CBMC) and group 4 (IA+ Vitamin E + HA/CBMC).

Iatrogenic vasospasm in carotid artery stent angioplasty with distal protection devices.

Object: Distal protection devices (DPDs) have decreased the risk of embolic stroke among patients with carotid artery (CA) disease undergoing CA stent placement. The FilterWire EX is a first-generation fixed-basket DPD with a filter rigidly attached to a guidewire. Second-generation mobile-basket DPDs (RX Accunet or SpiderFX) allow movement of the filter relative to the guidewire and can thus reduce the potential for vessel irritation, vasospasm, or intimal injury during CA stent placement.

Discerning the ancestry of European Americans in genetic association studies.

European Americans are often treated as a homogeneous group, but in fact form a structured population due to historical immigration of diverse source populations. Discerning the ancestry of European Americans genotyped in association studies is important in order to prevent false-positive or false-negative associations due to population stratification and to identify genetic variants whose contribution to disease risk differs across European ancestries. Here, we investigate empirical patterns of population structure in European Americans, analyzing 4,198 samples from four genome-wide association studies to show that components roughly corresponding to northwest European, southeast European, and Ashkenazi Jewish ancestry are the main sources of European American population structure.

Mechanisms of visual loss in papilledema.

The term "papilledema" indicates swelling of the optic discs secondary to increased intracranial pressure. Papilledema can be caused by an intracranial mass lesion or by other factors. Visual symptoms frequently accompany papilledema, which can lead to permanent visual loss if left untreated.

Wall shear stress gradient analysis within an idealized stenosis using non-Newtonian flow.

Objective: The endothelium is functionally regulated by the magnitude and spatiotemporal gradients of wall shear stress (WSS). Although flow separation and reversal occur beyond high-grade stenoses, little is known of the WSS pattern within clinically relevant mild to moderate stenoses.

Methods: An axisymmetric geometry with 25, 50, and 75% stenosis criteria (quantified in accordance with the North American Symptomatic Carotid Endarterectomy Trial) was used to generate a high-resolution, hybrid, tetrahedral-hexahedral computational mesh with boundary-layer enrichment to improve near-wall shear stress gradient (WSSG) computation.

Prediction of complex flow patterns in intracranial atherosclerotic disease using computational fluid dynamics.

Objective: Although carotid and vertebral intracranial atherosclerotic disease (ICAD) can lead to both hemodynamic insufficiency and thromboembolism, its fluid dynamic properties remain undefined because of its intricate features and complex three-dimensional geometry. We used computational fluid dynamic (CFD) analysis to model the hemodynamics of symptomatic ICAD lesions.

Methods: Nine ICAD lesions (six carotid, two vertebral, one middle cerebral) underwent high-resolution catheter-based digital rotational angiography.

c-Myc overexpression is strongly associated with metaplasia-dysplasia-adenocarcinoma sequence in the esophagus.

We aim to determine the expression of the proto-oncogene c-Myc in patients with Barrett's esophagus (BE) and esophageal adenocarcinoma, and to evaluate the prevalence of such expression in relation to the metaplasia-dysplasia-adenocarcinoma sequence. BE develops as a result of a severe esophageal mucosa injury from gastroesophageal reflux. BE is a premalignant lesion and plays an important role in the development of esophageal adenocarcinoma.

A genomewide admixture map for Latino populations.

Admixture mapping is an economical and powerful approach for localizing disease genes in populations of recently mixed ancestry and has proven successful in African Americans. The method holds equal promise for Latinos, who typically inherit a mix of European, Native American, and African ancestry. However, admixture mapping in Latinos has not been practical because of the lack of a map of ancestry-informative markers validated in Native American and other populations.

[Management of bicondylar fractures of the tibial plateau with unilateral fixed-angle plate fixation].

Background: This study was initiated to evaluate early results of a locked screw plate for unilateral fixation of bicondylar fractures of the tibial plateau. Emphasis was laid on malreduction, secondary loss of reduction, union rate, and infection.

Material And Methods: A case series of patients with AO/ASIF 41-C type fractures treated with the less invasive stabilization system for the proximal lateral tibia (LISS PLT) were prospectively followed up until 11-13 months after surgery.

Multiple regions within 8q24 independently affect risk for prostate cancer.

After the recent discovery that common genetic variation in 8q24 influences inherited risk of prostate cancer, we genotyped 2,973 SNPs in up to 7,518 men with and without prostate cancer from five populations. We identified seven risk variants, five of them previously undescribed, spanning 430 kb and each independently predicting risk for prostate cancer (P = 7.9 x 10(-19) for the strongest association, and P < 1.

Decompressive hemicraniectomy for the treatment of intractable intracranial hypertension after aneurysmal subarachnoid hemorrhage.

Background And Purpose: Decompressive hemicraniectomy and duroplasty (DHCD) can improve survival in patients with severe cerebral edema. We present our clinical experience with DHCD for the treatment of refractory elevated intracranial pressure (ICP) in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods: DHCD was performed in 16 patients (11 female; median age, 49.

Clinical assessment of language development in children at age 3 years that were born preterm.

Objective: To evaluate the influence of gestational age and birth weight on language development and neurodevelopmental outcome at age 3 years in children born preterm.

Method: Cross sectional study including 69 children followed in our developmental outpatient clinic. Patients were consecutively included at the time of the 3 years of age appointment and stratified for birth weight (<1500 grams and between 1500-2500 grams).

Prevalence of p21 immunohistochemical expression in esophageal adenocarcinoma.

Background: In western societies, the prevalence of adenocarcinoma of the gastroesophageal junction has increased in recent years. It is commonly accepted today that esophageal adenocarcinoma develops from a premalignant lesion: Barrett's esophagus. This type of carcinoma is hardly diagnosed at early stages, which results in significant mortality.

Diagnostic quality and scoring of synovitis, tenosynovitis and erosions in low-field MRI of patients with rheumatoid arthritis: a comparison with conventional MRI.

Objective: To compare dedicated low-field MRI (lfMRI) with conventional MRI (cMRI) in the detection and scoring of synovitis, tenosynovitis and erosions in patients with rheumatoid arthritis.

Patients And Methods: The wrist and finger joints of 17 patients with rheumatoid arthritis (median (range) disease duration 8 years (7-12); Disease Activity Score 3.3 (2.

Electrocautery-induced ignition of spark showers and self-sustained combustion of onyx ethylene-vinyl alcohol copolymer.

Objective: Ethylene-vinyl alcohol copolymer mixed with micronized tantalum (Ta) as radiopacifier (Onyx; Micro Therapeutics Inc., Irvine, CA) has emerged as a useful liquid embolic agent for vascular malformations. We describe intraoperative ignition of Onyx-embolized tissue and undertake an in vitro investigation to reproduce and characterize this hazard.