A case of cavernous dural arteriovenous fistula resulting in intracerebral extravasation during transvenous embolization

Cortical venous drainage has been described as one of the major risk factors for dural arteriovenous fistula, which may induce venous hypertension leading to venous ischemia or intracerebral hemorrhage. However, it is rather rare to observe cortical venous drainage manifesting in this way in the cavernous sinus region. We report a case of a 55-year-old gentleman with a right cavernous dural arteriovenous fistula, presenting with conjunctival chemosis, exophthalmus and ocular hypertension on the affected side. Magnetic resonance imaging showed a small intracerebral hemorrhage in the right frontal lobe. Cerebral angiography revealed a dural arteriovenous fistula in the right cavernous sinus draining into the right olfactory vein via the uncal vein, as well as into the superior and inferior ophthalmic veins. This unusual cortical venous reflux was thought to be consistent with the intracerebral hemorrhage found on the magnetic resonance imaging. The patient underwent transvenous embolization for the dural arteriovenous fistula using an inferior petrosal catheterization into the uncal vein was difficult, and the cortical venous reflux through the vein seemed to be slight. However, extravasation of the contrast material occurred in the right frontal lobe after obliteration of the ophthalmic veins during the procedure. The cause of the extravasation was suspected to be the same olfactory vein that had been involved in the previous intracerebral hemorrhage. The obliteration of the dural fistula was continued rapidly, and the fistula disappeared after the embolization. Neurologically, the patient had no noticeable troubles, except for a mild headache. The pretreatment symptoms were alleviated within several days, and the patient was discharged in a week. We emphasize the following points from this rare case in order to facilitate a safer procedure during transvenous embolization for cavernous dural arteriovenous fistula. It is important to obliterate the cortical venous drainage as early as possible, even if the reflux is small or the catheterization is difficult. Repeated, careful sinography is useful for the evaluation of the drainage pattern at certain stages during the transvenous embolization procedure.     

Digital image-based modeling applied to the homogenization analysis of composite materials

Absract The systematic methodologies to derive accurate microstructural models are developed for studying the mechanical behaviors of composite materials. Since the geometric information of a microstructure is often given by an image or a set of images, the direct interpretation of the geometry is possibly by digitizing it. By identifying each pixel or voxel with a finite element (FE) and accompanying appropriate image processing, an FE model can be automatically generated. It is also emphasized that the digitized models can be suitable for solving the FE equations by utilizing the uniformity of the FE mesh. The finite element analysis (FEA) with the homogenization method enables the prediction the thermo-mechanical behavior of the periodic microstructure (unit cell) as well as the global mechanical response of a structural component, while we are taking into account the specific effect of the geometric structural configuration of the microstructure through digitization. Several kinds of the digitizing techniques are presented to illustrate the potential of digital image-based (DIB) FE modeling of the unit cell. Keeping the microstructural design in mind, the modification of the plane image is introduced and the virtual realization of the unit cell geometry is presented so that a microstructural analysis utilizing the homogenization method would be realistic.     

A compact thin-film-based all-pass device for the compensation of the in-band dispersion in FBG filters

Fiber Bragg grating (FBG)-based bandpass filters, while possessing close to ideal sharp rolloff characteristics, can suffer from a significant amount of in-band dispersion. Results concerning the compensation of the in-band dispersion of a typical 100-GHz FBG using two thin-film all-pass filters, each composed of two coupled-cavities packaged in a compact configuration, are presented. The total peak insertion loss of the compensation package is less than 2.5 dB.     

Frontopolar ictal epileptiform discharges on scalp electroencephalogram in temporal lobe epilepsy

OBJECTIVE: To determine the prevalence of the smoking habit among Mexican physicians as well as some of their attitudes and information on specific issues concerning smoking. MATERIAL AND METHODS: In 1993, a survey was carried out among 3,568 physicians of the three major official health care institutions in Mexico City. A questionnaire designed for The Mexican National Survey of Addictions (ENA 1993) was used. Prevalence of cigarette smoking, age of onset, number of cigarettes per day; also information and attitudes concerning smoking were assessed. RESULTS: The mean age was 37, 66% were males. Of the 3,488 (98%) surveyed, 26.9% were smokers (62% daily), 20.6% were ex-smokers and 52.5% non-smokers. There were differences related to age and sex (p < 0.05). Of daily smokers, 36% smoked between 1 and 5 cigarettes. There was a significant trend among ex-smokers that linked the time they had ceased smoking with the fear to start smoking again. Physicians were well informed of the relationship between cigarette smoking and lung cancer. Over 80% considered tobacco an addictive drug but only 65% were in favor of banning smoking from their workplaces and over 10% were not aware that it is forbidden to smoke inside health care facilities. CONCLUSIONS: These results differ from other studies that find the prevalence of smoking among physicians lower than in the general population. Our study revealed a greater prevalence of the smoking habit among female physicians and the number of cigarettes smoked per day was greater than in the general population regardless of sex.     

Transmission of 2-ps optical pulses at 1550 nm over 40-km standardfiber using midspan optical phase conjugation in semiconductor opticalamplifiers

We demonstrate transmission of 2-ps optical pulses at 1550 nm over 40 km of standard fiber by employing midspan optical phase conjugation in semiconductor optical amplifiers (SOAs). The second-order group-velocity dispersion of the fiber is completely compensated and the third-order dispersion becomes a major transmission limitation. This experiment shows that the midspan optical phase conjugation system using SOAs is applicable to ultrahigh bit rates greater than 100 Gb/s     

An in-frame deletion in peripheral myelin protein-22 gene causes hypomyelination and cell death of the Schwann cells in the new Trembler mutant mice

Cloning and sequencing of the peripheral myelin protein-22 cDNA and genomic DNA from newly found Trembler mice revealed an in-frame deletion including exon IV which codes for the second (TM2) and a part of third (TM3) transmembrane domain of peripheral myelin protein-22. This mutation was distinct from those in both other allelic Trembler and Trembler-J mice, which carry point mutations within the putative transmembrane spanning regions of peripheral myelin protein-22. Inheritance was autosomal dominant. The affected mice revealed an abnormal gait, which appeared at 15-20 days of age, followed by motor and sensory ataxia, which remained throughout life. Most of the affected mice could survive more than one year. One of the most notable pathological phenotypes was a giant vacuolar formation in the sciatic nerve of homozygotes. They vary in size within the cytoplasm of Schwann cells, which failed to assemble myelin at any ages studied. Heterozygotes showed normal myelination during the early postnatal stages, followed by a segmental demyelination at an advanced stage. Vacuolar formation was not so frequent as in the homozygotes. These results suggest that the missing of transmembrane spanning region (TM2 and TM3) of peripheral myelin protein-22 may disturb a dual biological function of peripheral myelin protein-22, leading to a dysmyelination of axons and to a vacuolar formation within the cytoplasm of the Schwann cells. The latter phenotype is discussed in conjunction with the disruption of an intracellular transport system and subsequent cell death.     

No evidence of HTLV-I proviral integration in lymphoproliferative disorders associated with cutaneous T-cell lymphoma

Several recent studies have reported detection of HTLV-I genetic sequences in patients with cutaneous T-cell lymphoma (CTCL) including mycosis fungoides and Sezary syndrome. The purpose of this study was to determine whether HTLV-I was detectable in lesional tissues of patients suffering from diseases known to be associated with CTCL. Thirty-five cases were obtained from diverse geographical locations including Ohio, California, Switzerland, and Japan. Six of them had concurrent CTCL. Cases were analyzed using a combination of genomic polymerase chain reaction (PCR)/ Southern blot, dot blot, and Southern blot analyses. All assays were specific for HTLV-I provirus. Sensitivity ranged from approximately 10(-6) for PCR-based studies to 10(-2) for unamplified genomic blotting. Lesional DNA from patients with lymphomatoid papulosis (fourteen cases), Hodgkin's disease (twelve cases), and CD30+ large-cell lymphoma (nine cases) was tested for the HTLV-I proviral pX region using a genomic PCR assay followed by confirmatory Southern blot analysis with a nested oligonucleotide pX probe. All cases were uniformly negative. All of the Hodgkin's disease cases, eight of the large-cell lymphoma cases, and six of the lymphomatoid papulosis cases were then subjected to dot blot analysis of genomic DNA using a full-length HTLV-I proviral DNA probe that spans all regions of the HTLV-I genome. Again, all cases were negative. Finally, eleven of the Hodgkin's disease cases were also subjected to Southern blot analysis of EcoRI-digested genomic DNA using the same full-length HTLV-I probe. Once again, all cases were negative. These findings indicated that, despite utilization of a variety of sensitive and specific molecular biological methods, HTLV-I genetic sequences were not detectable in patients with CTCL-associated lymphoproliferative disorders. These results strongly suggest that the HTLV-I retrovirus is not involved in the pathogenesis of these diseases.     

Morphology-Properties relationship of a ternary polymer alloy

A ternary alloy of polyamide-6 (PA), poly(phenyleneether) (PPE), and rubber has a three-phase structure, in which PPE particles with rubber inclusions are dispersed in a PA matrix. This is an excellent thermoplastic with high impact strength and high heat resistance. To understand the morphology-properties relationship, we undertook a two-dimensional finite element method (FEM) analysis on the deformation mechanism of the ternary alloy. A three-phase model was constructed so that five hybrid particles of PPE-shell and rubber-core were embedded in the PA matrix. When the model was deformed at room temperature, the rubber domain induced yielding of the PPE-shell and the PA-matrix and at large strains the yielded zone expanded to pervade the whole space. This suggests that the toughening mechanism is essentially the same as in the binary alloy of PA and rubber (rubber-toughened PA). At higher temperatures (e.g., at 100°C) the stress concentration occurred not only in the PA matrix but also in the PPE-shell. It implies that the PPE-shell is highly responsible for bulk deformation, even though it is part of the dispersed phase. At high temperatures, the rigidity of PPE affects the alloy bulk rigidity so that the ternary system exhibits high heat resistance.