RESUMEN
Endovascular treatment of broad-necked bifurcation aneurysms remains challenging. Stent-assisted coiling has been successful but requires catheterization of the branches off the parent vessel. We present the case of a patient who failed primary and stent-assisted coiling of a large basilar tip aneurysm because the morphology of the aneurysm precluded successful distal catheterization of the posterior cerebral artery (PCA) branches. Using the PulseRider device, which does not require catheterization of bifurcation branches, we were able to treat the aneurysm successfully.
Asunto(s)
Embolización Terapéutica/instrumentación , Aneurisma Intracraneal/terapia , Stents , Insuficiencia del Tratamiento , Anciano , Arterias , Cateterismo , Angiografía Cerebral , Femenino , Humanos , Imagenología Tridimensional , Hallazgos Incidentales , Aneurisma Intracraneal/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/terapia , Retratamiento , Resultado del TratamientoRESUMEN
Endovascular treatment of broad-necked bifurcation aneurysms remains challenging. Stent-assisted coiling has been successful but requires catheterization of the branches off the parent vessel. We present the case of a patient who failed primary and stent-assisted coiling of a large basilar tip aneurysm because the morphology of the aneurysm precluded successful distal catheterization of the posterior cerebral artery (PCA) branches. Using the PulseRider device, which does not require catheterization of bifurcation branches, we were able to treat the aneurysm successfully.
Asunto(s)
Embolización Terapéutica/instrumentación , Procedimientos Endovasculares/instrumentación , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Anciano , Angiografía , Femenino , Humanos , Arteria Cerebral PosteriorRESUMEN
OBJECTIVE: To investigate the relationship between tissue-specific alterations in brain volume and neurobehavioral status in newborns with complex congenital heart defects preoperatively. STUDY DESIGN: Three-dimensional volumetric magnetic resonance imaging was used to calculate tissue-specific brain volumes and a standardized neurobehavioral assessment was performed to assess neurobehavioral status in 35 full-term newborns admitted to the hospital before cardiopulmonary bypass surgery. Multiple linear regression models were performed to evaluate relationships between neurobehavioral status and brain volumes. RESULTS: Reduced subcortical gray matter (SCGM) volume and increased cerebrospinal fluid (CSF) volume were associated with poor behavioral state regulation (SCGM, P = .04; CSF, P = .007) and poor visual orienting (CSF, P = .003). In cyanotic newborns, reduced SCGM was associated with higher overall abnormal scores on the assessment (P = .001) and poor behavioral state regulation (P = .04), and increased CSF volume was associated with poor behavioral state regulation (P = .02), and poor visual orienting (P = .02). Conversely, acyanotic newborns showed associations between reduced cerebellar volume and poor behavioral state regulation (P = .03). CONCLUSION: Abnormal neurobehavior is associated with impaired volumetric brain growth before open heart surgery in infants with complex congenital heart defects. This study highlights a need for routine preoperative screening and early intervention to improve neurodevelopmental outcomes.
Asunto(s)
Lesiones Encefálicas/etiología , Encéfalo/patología , Cardiopatías Congénitas/complicaciones , Conducta del Lactante , Lesiones Encefálicas/diagnóstico , Puente Cardiopulmonar , Femenino , Cardiopatías Congénitas/patología , Cardiopatías Congénitas/psicología , Cardiopatías Congénitas/cirugía , Humanos , Interpretación de Imagen Asistida por Computador , Imagenología Tridimensional , Recién Nacido , Modelos Lineales , Imagen por Resonancia Magnética , Masculino , Examen Neurológico , Pruebas Neuropsicológicas , Variaciones Dependientes del Observador , Tamaño de los Órganos , Periodo Preoperatorio , Estudios Prospectivos , Método Simple CiegoRESUMEN
Advances in clinical translational research have led to an explosion of interest in infrastructure development and data sharing facilitated by biorepositories of specimens and linked health information. These efforts are qualitatively different from the single-center sample collections that preceded them and pose substantial new ethics and regulatory challenges for investigators and institutions. New research governance approaches, which can address current and anticipated challenges, promote high-quality research, and provide a robust basis for ongoing research participation, are urgently required.
Asunto(s)
Bancos de Muestras Biológicas/organización & administración , Investigación Biomédica/organización & administración , Pruebas Anónimas , Humanos , Investigación Biomédica Traslacional/organización & administración , Investigación Biomédica Traslacional/tendenciasRESUMEN
We discovered a thalidomide analogue [5-hydroxy-(2,6-diisopropylphenyl)-1H-isoindole-1,3-dione (5HPP-33)] with antiproliferative activity against nine cancer cell lines in vitro. Flow cytometric analyses showed that the compound caused G2-M arrest, which occurred mainly at the mitotic phase. In addition, immunofluorescence microscopy and in vitro tubulin polymerization studies showed that 5HPP-33 has antimicrotubule activity with a paclitaxel-like mode of action. It is effective against four different paclitaxel-resistant cell lines. Thus, 5HPP-33 represents a potential antitumor agent.
