Complex intracranial aneurysms: combined operative and endovascular approaches

OBJECTIVE: Endovascular management of complex intracranial aneurysms is increasingly being considered as an alternative to standard surgical clipping. However, little attention has been paid to the complementary nature of surgery and endovascular therapy. METHODS: Between September 1992 and May 1997, 12 patients with complex intracranial aneurysms were treated with combined operative and endovascular methods. Seven patients demonstrated subarachnoid hemorrhage (two of Grade II, two of Grade III, and three of Grade IV). Five patients demonstrated unruptured aneurysms, i.e., three giant aneurysms (one vertebrobasilar junction aneurysm, one middle cerebral artery bifurcation aneurysm, and one internal carotid artery-ophthalmic artery aneurysm), one large internal carotid artery-ophthalmic artery aneurysm, and one middle cerebral artery serpentine aneurysm. Management strategies involved either surgery followed by endovascular therapy (S-E; n = 5) or endovascular therapy followed by surgery (E-S; n = 7). S-E paradigms included aneurysm exploration followed by endovascular treatment (S-E1; n = 3), partial aneurysm clipping followed by endovascular aneurysm packing (S-E2; n = 1), and extracranial-to-intracranial bypass followed by endovascular parent vessel occlusion (S-E3; n = 1). E-S paradigms included superselective angiography followed by surgical clipping (E-S1; n = 2), Guglielmi detachable coil partial dome packing followed by delayed surgical clipping (E-S2; n = 2), proximal temporary vessel balloon occlusion followed by aneurysm clipping (E-S3; n = 2), and proximal permanent vessel occlusion followed by surgical aneurysm decompression for mass effect treatment (E-S4; n = 1). RESULTS: Eleven aneurysms (92%) were completely eliminated. The remaining aneurysm was 90% obliterated and remained quiescent at the 34-month follow-up examination, despite presenting with subarachnoid hemorrhage. No patient experienced repeat bleeding (follow-up period, 23+/-28 mo). There were no deaths. One patient achieved a fair outcome (Glasgow Outcome Scale score of III); all other patients experienced excellent outcomes (Glasgow Outcome Scale score of I). In all cases, the aneurysm management paradigm chosen had a positive effect on definitive therapy. CONCLUSION: Several factors can contribute to the complexity of intracranial aneurysms. Management strategies that combine operative and endovascular techniques in a complementary way, for the best possible outcomes for these patients, can be designed accordingly.     

Early prostate cancer detection and potential for surgical cure in men with poorly differentiated tumors

Postgastrectomy osteopenia is observed generally in humans. Fructooligosaccharides increase the absorption of calcium from the large intestine of healthy rats. Thus, we have examined whether they stimulate calcium absorption and prevent osteopenia in rats following total gastrectomy. Rats were subjected to either a sham surgical operation or Billoth II gastrectomy. Seven rats from each surgical treatment group were fed a control diet, and another seven rats of each treatment group were fed a diet containing fructooligosaccharides (75 g/kg diet) for 4 wk. For 5 d each week, feces were collected, and the calcium and phosphorus contents were measured for calculation of the absorption of these minerals. At the end of the experiment, the rats were killed and bones were collected. The net calcium absorption, calcium content and bone mineral density of the femur and tibia in gastrectomized rats fed the control diet were significantly less than those in sham-operated rats fed control diet. The net calcium absorption in rats fed the fructooligosaccharides diet was greater than that in rats fed control diet. Moreover, dietary fructooligosaccharides prevented the decrease in the calcium content and bone mineral density in gastrectomized rats. Dietary fructooligosaccharides enhanced calcium absorption and prevented the changes indicative of postgastrectomy osteopenia such as decreases in bone calcium content and bone mineral density in gastrectomized rats.     

Pioneers in Partnership: Lesbian and Gay Male Couples in Civil Unions Compared With Those Not in Civil Unions and Married Heterosexual Siblings.

This study compared 212 lesbians and 123 gay men who had civil unions in Vermont (during the first year legislation made this available) with 166 lesbians and 72 gay men in their friendship network who had not had civil unions, and also with 219 heterosexual married women and 193 heterosexual married men consisting of civil union couples' siblings and their spouses. Married heterosexual couples had been together longer and had more traditional division of labor and child care than did lesbians and gay men in both types of couples. Lesbians in civil unions were more open about their sexual orientation than those not in civil unions, and gay men in civil unions were closer to their family of origin than gay men not in civil unions. This is the first study on same-sex couples with civil unions, and the first to compare lesbians and gay men with their married siblings. At a time of legal changes for same-sex couples, these results indicate that legalized same-sex relationships are related to visibility of same-sex couples to their family and the general public. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Threshold voltage and C-V characteristics of SOIMOSFET's related to Si film thickness variation on SIMOX wafers

C-V characteristics of fully depleted SOI MOSFETs have been studied using a technique for measuring silicon-film thickness using a MOSFET. The technique is based on C-V measurements between the gate and source/drain at two different back-gate voltages, and only a large-area transistor is required. Using this technique, SOI film thickness mapping was made on a finished SIMOX wafer and a thickness variation of ±150 Å was found. This thickness variation causes as much as a 100-mV variation in the device threshold voltage. The silicon-film thickness variation and threshold-voltage variation across a wafer shows a linear correlation dependence for a fully depleted device. C-V measurements of the back-gate device yield the buried-oxide thickness and parasitic capacitances. The effects of GIDL (gate-induced drain leakage) current on C-V characteristics are also discussed     

Lack of clinical utility of bronchoalveolar lavage cultures for cytomegalovirus in HIV infection

This study assessed the presence of cytomegalovirus (CMV) in bronchoalveolar lavage (BAL) in three subpopulations of HIV-infected patients and correlated its presence with clinical status during 3 mo of follow-up. Nineteen asymptomatic volunteers, six patients with CMV retinitis, and 46 patients with acute pulmonary symptoms underwent BAL and were assessed for CMV by cytopathology, conventional shell vial cultures, and antigen detection. Transbronchial biopsies were also obtained when possible and evaluated for histopathologic changes of CMV. All patients were followed for approximately 3 mo. Cytomegalovirus was detected in BAL in nine of 19 (47%) asymptomatic volunteers, in all six patients with CMV retinitis, and in 33 of 46 (72%) patients with pulmonary symptoms. Only one symptomatic patient with a positive CMV BAL culture developed clinically significant CMV pulmonary disease; this patient developed disseminated CMV and died. The only other death occurred in a patient with CMV retinitis who developed staphylococcal bacteremia. None of the asymptomatic volunteers or patients with CMV retinitis developed evidence of CMV pneumonia or any other organ disease with CMV. Cytomegalovirus is frequently detected in BAL from HIV-infected patients regardless of their pulmonary symptoms and its presence does not clinically predict significant pulmonary morbidity or mortality in 3 mo of follow-up.     

Terror management and cognitive-experiential self-theory: Evidence that terror management occurs in the experiential system.

The authors hypothesized, on the basis of terror management theory and cognitive-experiential self-theory, that participants in an experiential mode of thinking would respond to mortality salience with increased worldview defense and increased accessibility of death-related thoughts, whereas participants in a rational mode would not. Results from 3 studies provided convergent evidence that when participants were in an experiential mode, mortality salience produced the typical worldview defense effect, but when participants were in a rational mode it did not. Study 4 revealed that mortality salience also led to a delayed increase in the accessibility of death-related thoughts only when participants were in an experiential mode. These results supported the notion that worldview defense is intensified only if individuals are in an experiential mode when considering their mortality. Discussion focuses on implications for understanding terror management processes. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Use of gelatin gels as a reference material for performance evaluation of meat shear force measurements

Abstract: Establishing standards for meat tenderness based on Warner–Bratzler shear force (WBSF) is complicated by the lack of methods for certifying WBSF testing among texture systems or laboratories. The objective of this study was to determine the suitability of using gelatin gels as reference materials for performance testing of texture measurement systems. Three replications of 5 gels (15%, 20%, 25%, 30%, and 35% gelatin) were prepared, vacuum packaged, and stored at 4 °C until use. Three randomly selected strips from each gel were subjected to WBSF testing on 4 instruments (A, B, C, or D) on days 1 and 8. Additional strips from each gel were subjected to WBSF testing on instruments A and C on day 29. Regression line estimates for each set of gels were analyzed. Gel WBSF values ranged from 10 to 177 N. The WBSF by gel concentration response was highly linear (P < 0.0001) for all replications, instruments, and days of analysis. R²‐values across all sets of gels ranged from 0.9562 to 0.9998. On days 1 and 8, instruments A and D exhibited higher slope (P < 0.0001) and lower intercept (P < 0.0001) estimates than instruments B and C. Regression line parameters (slope, intercept, and R²‐values) were not influenced (P > 0.05) by length of gel storage (1, 8, and 29 d). Data from this study suggest that gelatin gels can be used for evaluating WBSF values from various instruments and for validating the performance of meat shear force testing. Practical Application: Validating the performance of meat shear force testing is vital to establishing meat tenderness standards. The gelatin gel standards developed in this study exhibited a highly linear, repeatable relationship with shear force and were found to be stable for at least a month. These gel standards would provide a tool for the meat industry to harmonize shear force measurements across laboratories and various texture measuring instruments.     

Synthesis,structural analysis and microwave dielectric properties of LnTiSb<Subscript>x</Subscript>Nb<Subscript>1−x</Subscript>O<Subscript>6</Subscript> (Ln = Ce,Pr) ceramics

LnTiSb_xNb_1−xO₆ (Ln = Ce, Pr) ceramics were prepared by the conventional solid state ceramic route for x = 0, 0.05, 0.1, 0.15, 0.2 and 0.25. The structure of the materials was analyzed using X-ray diffraction techniques. The cell parameters and the theoretical densities of the samples were calculated using least square methods. The samples are sintered to more than 90% of the theoretical density at 1,325–1,350 °C. The microwave dielectric properties were measured using the cavity resonator method. The surface morphology of the sintered sample was analyzed using Scanning Electron Microscopy. All the materials have good microwave dielectric properties and are suitable for dielectric resonator applications.