RESUMEN
Neural stimulation has widespread applications in investigating brain functions, restoring impaired neural functions, and treating numerous neurological/psychiatric diseases. Use of infrared pulses to stimulate neurons (infrared neural stimulation) offers a direct and non-invasive technique. Recent research has demonstrated that transient heating associated with the absorption of infrared light by the local aqueous medium around the cell membrane can stimulate nerves. One mechanism for this stimulation is due to a thermally induced increase in the membrane electrical capacitance, which causes cell depolarization as well as action potential production under certain physiological conditions. A theoretical and computational model helps better understand the mechanism of thermally induced electrical capacitance changes and optimize the stimulus parameters. In this article, we develop the existing theoretical models for membrane electrical capacitance and its thermally induced changes. We improve the formulation of Gouy-Chapman-Stern theory by Genet et al. and Shapiro et al. with the addition of a diffuse layer to the electrical double layer and by modifying the relation of Stern layer capacitance, to calculate the membrane capacitive charge and capacitive current. We also present a new method to calculate the membrane electrical capacitance and the rate of its thermally induced changes. In our calculations, two new factors are considered including the temperature dependence of the surface charge density and the hydrophobic core dielectric constant of the lipid bilayer. Our developed model predicts rates of 0.3 and 0.26%/°C for the thermally induced capacitance changes of the artificial lipid bilayer under two different sets of conditions previously reported by Shapiro et al. and Carvalho-de-Souza et al., respectively. Our model is in very good agreement with the corresponding experimental values given by these groups. The presented model is also able to calculate the membrane capacitive currents and investigate the voltage dependence of this current.
Asunto(s)
Rayos Láser , Membrana Dobles de Lípidos/química , Modelos Teóricos , Capacidad Eléctrica , Membrana Dobles de Lípidos/efectos de la radiación , Potenciales de la Membrana , TemperaturaRESUMEN
BACKGROUND AND PURPOSE: Controversy exists about the role of perfusion imaging in patient selection for endovascular reperfusion therapy in acute ischemic stroke. We hypothesized that perfusion imaging versus noncontrast CT- based selection would be associated with improved functional outcomes at 3 months. MATERIALS AND METHODS: We reviewed consecutive patients with anterior circulation strokes treated with endovascular reperfusion therapy within 8 hours and with baseline NIHSS score of ≥8. Baseline clinical data, selection mode (perfusion versus NCCT), angiographic data, complications, and modified Rankin Scale score at 3 months were collected. Using multivariable logistic regression, we assessed whether the mode of selection for endovascular reperfusion therapy (perfusion-based versus NCCT-based) was independently associated with good outcome. RESULTS: Two-hundred fourteen patients (mean age, 67.2 years; median NIHSS score, 18; MCA occlusion 74% and ICA occlusion 26%) were included. Perfusion imaging was used in 76 (35.5%) patients (39 CT and 37 MR imaging). Perfusion imaging-selected patients were more likely to have good outcomes compared with NCCT-selected patients (55.3 versus 33.3%, P = .002); perfusion selection by CT was associated with similar outcomes as that by MR imaging (CTP, 56.; MR perfusion, 54.1%; P = .836). In multivariable analysis, CT or MR perfusion imaging selection remained strongly associated with good outcome (adjusted OR, 2.34; 95% CI, 1.22-4.47), independent of baseline severity and reperfusion. CONCLUSIONS: In this multicenter study, patients with acute ischemic stroke who underwent perfusion imaging were more than 2-fold more likely to have good outcomes following endovascular reperfusion therapy. Randomized studies should compare perfusion imaging with NCCT imaging for patient selection for endovascular reperfusion therapy.
Asunto(s)
Isquemia Encefálica/diagnóstico por imagen , Isquemia Encefálica/cirugía , Angiografía Cerebral/estadística & datos numéricos , Revascularización Cerebral/estadística & datos numéricos , Procedimientos Endovasculares/estadística & datos numéricos , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/cirugía , Enfermedad Aguda , Anciano , Isquemia Encefálica/mortalidad , Revascularización Cerebral/mortalidad , Procedimientos Endovasculares/mortalidad , Femenino , Humanos , Illinois/epidemiología , Masculino , Prevalencia , Reproducibilidad de los Resultados , Estudios Retrospectivos , Factores de Riesgo , Sensibilidad y Especificidad , Accidente Cerebrovascular/mortalidad , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
Vertebral artery arteriovenous fistula (VAVF) is mostly known as a post-traumatic and/or iatrogenic arteriovenous complication. However, spontaneous high-flow VAVF associated with flow reversal in the basilar artery has not been reported in children. We describe a unique asymptomatic presentation of a spontaneous high-flow VAVF associated with flow reversal in the basilar artery in a pediatric patient. The literature for classification, pathophysiology, treatment strategies, and post-procedural complications is also reviewed.
Asunto(s)
Fístula Arteriovenosa/diagnóstico por imagen , Fístula Arteriovenosa/cirugía , Procedimientos Endovasculares/métodos , Arteria Vertebral/anomalías , Insuficiencia Vertebrobasilar/diagnóstico por imagen , Insuficiencia Vertebrobasilar/cirugía , Fístula Arteriovenosa/complicaciones , Niño , Humanos , Masculino , Radiografía , Resultado del Tratamiento , Arteria Vertebral/diagnóstico por imagen , Arteria Vertebral/cirugía , Insuficiencia Vertebrobasilar/etiologíaRESUMEN
Pilocytic astrocytomas are highly vascular, relatively common primary brain tumors in the pediatric population, but their association with a true arteriovenous malformation (AVM) is extremely rare. We describe an eight-year-old girl with a right supratentorial juvenile pilocytic astrocytoma (WHO grade I) with an angiographically documented AVM entangled in the tumor mass who presented with intracranial hemorrhage due to a ruptured anterior choroidal artery pseudoaneurysm encased in the lesion. The AVM nidus as well as the hemorrhage site was embolized with Onyx. A literature review revealed only one previous report of a true intermixture of these two lesions. We hypothesize whether the association of vascular malformations and primary brain tumors are merely coincidental or if they point to the existence of a distinct entity and/or a common etiologic factor.
Asunto(s)
Astrocitoma/complicaciones , Astrocitoma/diagnóstico , Malformaciones Arteriovenosas Intracraneales/diagnóstico , Malformaciones Arteriovenosas Intracraneales/etiología , Astrocitoma/terapia , Angiografía Cerebral , Niño , Medios de Contraste , Diagnóstico Diferencial , Femenino , Humanos , Malformaciones Arteriovenosas Intracraneales/terapia , Angiografía por Resonancia Magnética , Examen Neurológico , Tomografía Computarizada por Rayos XRESUMEN
Photothermal phase-shift signals in a flowing medium have been observed and found to be consistent with the theoretical predictions.