Ultra-distal access of the M1 segment with the 5†Fr Navien distal access catheter in acute (anterior circulation) stroke: is it safe and efficient?

BACKGROUND AND AIM: The importance of mechanical thrombectomy in acute stroke treatment has grown over recent years. Mechanical thrombectomy comprises many different techniques. Technical improvements in the catheter material have led to the development of large-bore distal access catheters which can enter tortuous intracranial vessels. This has promising applications for endovascular stroke treatment. This study evaluated the safety and success rate of ultra-distal access of the middle cerebral artery (MCA) M1 segment with the 5 Fr Navien 58 distal access catheter in the treatment of acute stroke in combination with stent retrievers. METHODS: We retrospectively analyzed 81 patients with an acute stroke of the anterior circulation in whom ultra-distal access to the M1 segment was carried out using the Navien 58 catheter with an anchoring technique with a stent retriever for mechanical thrombectomy. Technical complications, success rates of catheter placement, success rates of thrombectomy using the modified Thrombolysis In Cerebral Infarction (mTICI) score, and the procedure times were evaluated. RESULTS: Ultra-distal access with the Navien 58 was successful in 75% (61/81) of cases. Recanalization success with a mTICI score of 2b and better was achieved in 83% overall (67/81), in 90% (55/61) of cases with successful ultra-distal access and in 60% (12/20) of cases without ultra-distal access. No severe adverse effects such as dissections or perforations occurred as a result of the ultra-distal catheter placement in the M1 segment. In 4% (3/81) of the cases a reversible MCA vasospasm occurred. CONCLUSIONS: Ultra-distal placement of the Navien 58 distal access catheter into the M1 segment in acute anterior circulation stroke can be achieved consistently, is safe in practice, and results in good recanalization success rates.

[Migration of a retained intra-abdominal foreign body into the colon]. / Migration eines intraoperativ belassenen Bauchtuches in das Kolon.

Even in the era of correct precautions and risk management culture adverse and preventable adverse events, such as intraoperatively residual foreign bodies remain a hot topic. Due to legal considerations and possible image loss many cases may remain unpublished leading to an underestimation of the real incidence in literature. The following casuistic is an example for a rarely documented and in this case a partial migration of a retained surgical sponge into the colon. The causes for the delayed foreign body detection, accounting for the relative good health even during chemoradiotherapy are analyzed in order to sharpen the awareness of such serious complications.

EUROMET supplementary comparisons for photon and beta radiation--actual state and first results.

In January 2004, two EUROMET supplementary comparisons started, coordinated by Physikalisch-Technische Bundesanstalt (PTB): one for the radiation protection quantity 'personal dose equivalent' Hp(10) using X-radiation, and one for the quantity 'absorbed dose in tissue' Dt(0.07) using beta reference fields. The focus of both comparisons lies on calibrations using radiation qualities at which the dissemination of the quantities considered here is difficult. Within the scope of the two comparisons, an ionisation chamber shall be calibrated. Together with a transfer chamber optimised to measure Hp(10) and Dt(0.07), respectively, for each comparison a complete electronic measuring system is circulated. These transfer devices, as well as, a specially developed test procedure, which has to be carried out by each participant to check the instruments, are described. For both comparisons, the results of those participants who had finished their measurements and delivered the measuring protocol until February 2005 were evaluated. As the comparisons are still running these first results are shown in an anonymous form. A first assessment of the data will be given.

UV-damage-mediated induction of homologous recombination in Arabidopsis is dependent on photosynthetically active radiation.

Plants are continuously subjected to UV-B radiation (UV-B; 280-320 nm) as a component of sunlight causing damage to the genome. For elimination of DNA damage, a set of repair mechanisms, mainly photoreactivation, excision, and recombination repair, has evolved. Whereas photoreactivation and excision repair have been intensely studied during the last few years, recombination repair, its regulation, and its interrelationship with photoreactivation in response to UV-B-induced DNA damage is still poorly understood. In this study, we analyzed somatic homologous recombination in a transgenic Arabidopsis line carrying a beta-glucuronidase gene as a recombination marker and in offsprings of crosses of this line with a photolyase deficient uvr2-1 mutant. UV-B radiation stimulated recombination frequencies in a dose-dependent manner correlating linearly with cyclobutane pyrimidine dimer (CPD) levels. Genetic deficiency for CPD-specific photoreactivation resulted in a drastic increase of recombination events, indicating that homologous recombination might be directly involved in eliminating CPD damage. UV-B irradiation stimulated recombination mainly in the presence of photosynthetic active radiation (400-700 nm) irrespective of photolyase activities. Our results suggest that UV-B-induced recombination processes may depend on energy supply derived from photosynthesis.

Monitoring experimental alcelaphine herpesvirus-1 infection in cattle by nucleic-acid hybridization and PCR.

The DNA probe SW15 derived from the laboratory-attenuated Alcelaphine Herpesvirus-1 (AHV-1) strain WC11 as well as from the polymerase chain-reaction test (Hsu, Shih, Castro & Zee 1990), was used to detect viral DNA of malignant catarrhal fever (MCF) in six experimentally infected cattle. Heparinized blood samples were collected and tested at least three times a week over a period of up to 142 d. Results of hybridization and PCR tests were compared with the results of clinical examinations, and on various occasions with those of viral isolation and serum-neutralization assays as well as with those of pathology. Three animals developed clinical signs and lesions typical of MCF, while the other three animals remained clinically healthy. All cattle seroconverted, and viral nucleic acid was detected by DNA hybridization and PCR at various intervals during the observation period. Virus isolation was successful in two of the clinical cases and all cattle seroconverted. Storage of blood samples at 4 degrees C for up to 10 d did not influence the hybridization and DNA-amplification results.

[Atypical facial neuralgia or depressive facial pain. Diagnostic aspects of a well-demarcated form of masked depression]. / "Atypische Gesichtsneuralgie" oder depressiver Gesichtsschmerz? Diagnostische Aspekte einer gut abgrenzbaren Form der larvierten Depression.

In three paradigmatical cases the problem of the diagnosis "atypical face pain" is discussed. On clinical inpatients can be demonstrated, that behind an "atypical face pain" a chronic depressive illness can be hidden. The symptom "facial pain" in these cases is part of an oligosymptomatic depressive disorder. A special antidepressant therapy is necessary in the clinical management of these "masked depressions". Therefore it is necessary to be reserved on diagnosing an "atypical face pain". The exact analysis of psychopathological disturbances can prevent these patients who in reality suffer from depressive face pain from therapies in maxillary surgery or in dentistry etc. that are far from useful.