We consider the problem of constructing prefix-free codes in which a designated symbol, a space, can only appear at the end of codewords. We provide a linear-time algorithm to construct almost-optimal codes with this property, meaning that their average length differs from the minimum possible by at most one. We obtain our results by uncovering a relation between our class of codes and the class of one-to-one codes. Additionally, we derive upper and lower bounds to the average length of optimal prefix-free codes with a space in terms of the source entropy.
The objective of this study was to investigate the osteogenic and antimicrobial effect of bioactive glass S53P4 incorporated into ß-tricalcium phosphate (ß-TCP) scaffolds in vitro and the bone neoformation in vivo. ß-TCP and ß-TCP/S53P4 scaffolds were prepared by the gel casting method. Samples were morphologically and physically characterized through X-ray diffraction (XRD) and scanning electron microscope (SEM). In vitro tests were performed using MG63 cells. American Type Culture Collection reference strains were used to determine the scaffold's antimicrobial potential. Defects were created in the tibia of New Zealand rabbits and filled with experimental scaffolds. The incorporation of S53P4 bioglass promotes significant changes in the crystalline phases formed and in the morphology of the surface of the scaffolds. The ß-TCP/S53P4 scaffolds did not demonstrate an in vitro cytotoxic effect, presented similar alkaline phosphatase activity, and induced a significantly higher protein amount when compared to ß-TCP. The expression of Itg ß1 in the ß-TCP scaffold was higher than in the ß-TCP/S53P4, and there was higher expression of Col-1 in the ß-TCP/S53P4 group. Higher bone formation and antimicrobial activity were observed in the ß-TCP/S53P4 group. The results confirm the osteogenic capacity of ß-TCP ceramics and suggest that, after bioactive glass S53P4 incorporation, it can prevent microbial infections, demonstrating to be an excellent biomaterial for application in bone tissue engineering.
Although the mortality rate among individuals diagnosed during the pre-Highly Active Antiretroviral Treatment era has been substantial, a considerable number of them survived. Our study aimed to evaluate the prevalence of HIV long-term survivors in a cohort of People Living with HIV diagnosed between 1985 and 1994 and to speculate about potential predictive factors associated to long survival. This is a retrospective single-center study. Subjects surviving more than 300 months (25 years) from HIV diagnosis were defined as Long Term Survivors. Overall, 210 subjects were enrolled. More than 75.24% of the included people living with HIV were males, with a median age of 28 years (IQR 25-34). The prevalent risk factors for HIV infection were injection drug use (47.62%), followed by unprotected sex among heterosexual individuals (23.81%). Ninety-three individuals (44.29%) could be defined as LTS with a median (IQR) survival of 333 (312-377) months. A hazard ratio of 12.45 (95% CI 7.91-19.59) was found between individuals who were exposed to Highly Active AntiRetroviral Treatment (HAART) and individuals who were not, with the latter being at greater risk of death. The availability and accessibility of effective antiretroviral therapy for people living with HIV remain the cornerstone of survival.
BACKGROUND: Risk-reducing operations are an important part of the management of hereditary predisposition to cancer. In selected cases, they can considerably reduce the morbidity and mortality associated with cancer in this population. OBJECTIVES: The Brazilian Society of Surgical Oncology (BSSO) developed this guideline to establish national benchmarks for cancer risk-reducing operations. METHODS: The guideline was prepared from May to December 2021 by a multidisciplinary team of experts to discuss the surgical management of cancer predisposition syndromes. Fourteen questions were defined and assigned to expert groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments, classified the level of evidence, and voted on the recommendations. RESULTS: For all questions including risk-reduction bilateral salpingo-oophorectomy, hysterectomy, and mastectomy, major agreement was achieved by the participants, always using accessible alternatives. CONCLUSION: This and its accompanying article represent the first guideline in cancer risk reduction surgery developed by the BSSO, and it should serve as an important reference for the management of families with cancer predisposition.
Breast Neoplasms , Gynecology , Ovarian Neoplasms , Surgical Oncology , Brazil/epidemiology , Breast Neoplasms/genetics , Breast Neoplasms/prevention & control , Breast Neoplasms/surgery , Female , Humans , Mastectomy , Ovarian Neoplasms/surgery
Since late December 2019, severe acute respiratory syndrome coronavirus 2 has spread across the world, which resulted in the World Health Organization declaring a global pandemic. Coronavirus disease 2019 (COVID-19) presents a highly variable spectrum with regard to the severity of illness. Most infected individuals exhibit a mild to moderate illness (81%); however, 14% have a serious disease and 5% develop severe acute respiratory distress syndrome (ARDS), requiring intensive care support. The mortality rate of COVID-19 continues to rise across the world. Data regarding predictors of mortality in patients with COVID 19 are still scarce but are being actively investigated. The present multicenter retrospective observational study provides a complete description of the demographic and clinical characteristics, comorbidities and laboratory abnormalities in a population of 421 hospitalized patients recruited across eight infectious disease units in Southern Italy (Sicily) with the aim of identifying the baseline characteristics predisposing COVID-19 patients to critical illness or death. In this study, older age, pre-existing comorbidities and certain changes in laboratory markers (such as neutrophilia, lymphocytopenia and increased C-reactive protein levels) at the time of admission were associated with a higher risk of mortality. Male sex, on the other hand, was not significantly associated with increased risk of mortality. Symptoms such as fatigue, older age, a number of co-pathologies and use of continuous positive airway pressure were the most significant contributors in the estimation of clinical prognosis. Further research is required to better characterize the epidemiological features of COVID-19, to understand the related predictors of death and to develop new effective therapeutic strategies.
Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) has been shown to increase the risk of thrombotic events due to a hypercoagulable state caused by several factors. The case of a 59-year-old woman affected by hypertension and metabolic disorders, treated for a COVID-19 infection who developed cardiac symptoms during the first days of hospitalization is reported. Electrocardiogram analysis and cardiac-ultrasound confirmed ST-segment elevation myocardial infarction (STEMI) diagnosis, thus the patient underwent percutaneous coronary intervention, which was successful. This case highlights a possible association between respiratory infection, particularly SARS-CoV-2 infection, and cardiovascular events, in particular Acute Coronary Syndrome. The association between these phenomena seems related to a range of factors, including a proinflammatory state and the hypoxemia. Moreover, the association amongst SARS-CoV-2 and cardiovascular diseases may be also linked to long-term sequelae. Thus, further studies are required to better understand the multifaceted and severe complications of this disease.
The smallest characteristic scales, at which electron dynamics determines the plasma behaviour, are the next frontier in space and astrophysical plasma research. The analysis of astrophysical processes at these scales lies at the heart of the research theme of electron-astrophysics. Electron scales are the ultimate bottleneck for dissipation of plasma turbulence, which is a fundamental process not understood in the electron-kinetic regime. In addition, plasma electrons often play an important role for the spatial transfer of thermal energy due to the high heat flux associated with their velocity distribution. The regulation of this electron heat flux is likewise not understood. By focussing on these and other fundamental electron processes, the research theme of electron-astrophysics links outstanding science questions of great importance to the fields of space physics, astrophysics, and laboratory plasma physics. In this White Paper, submitted to ESA in response to the Voyage 2050 call, we review a selection of these outstanding questions, discuss their importance, and present a roadmap for answering them through novel space-mission concepts.
Abstract Aim: Motor learning is considered a complex process, providing numerous investigations. Knowledge of Results (KR), a kind of extrinsic feedback, is one of the variables that are used for investigations on motor learning. There are different ways to provide KR to optimize motor learning. The bandwidth KR is one of these forms, being a factor that affects motor learning, however, the specificity of the task needs to be considered in the investigation of this theme. Thus, the objective of the study is to analyze the bandwidth of KR in the acquisition of motor skills of the overhand serve in volleyball. Methods: The sample consisted of 24 volunteers of both sexes (12 men and 12 women), 18 to 35 years of age (M = 27, SD = 3.46) and inexperienced in the task. The effect of the bandwidth was analyzed in two groups (with range and without range), in which the volunteers had to learn to control their force by performing the volleyball tennis type service in order to hit a target line. Performance was inferred by the mean and standard deviation of absolute, constant and variable errors. Results: There was no statistically significant difference between the groups and the volunteers improved both the precision (absolute error and constant error) and in the consistency (variable error) during the acquisition. There was an improvement in the groups also in the transfer test in the precision measures. Conclusion: The variable bandwidth is similar to a control condition in which the volunteers have information at each attempt, causing dependence on external information.
Humans , Adult , Muscle Strength , Volleyball , Knowledge of Results, Psychological , Motor Skills
HCV treatment became available for all infected patients regardless of their comorbidities, especially for HIV coinfected subjects, leading to an improvement in both clinical and immunological conditions. We retrospectively analyzed a cohort of HIV/HCV coinfected patients treated with DAA therapies; data regarding epidemiological, viral-immunological, and hepatic parameters before and after DAA administration have been collected. Drug-drug interactions between DAA and both antiretroviral therapy and non-ART-drugs were also evaluated; the study showed the efficacy of DAA schedules in HCV eradication also for HIV/HCV patients with multiple comorbidities and assuming many different drugs. Principal issues are still represented by drug interactions, pill burden, and patients' compliance. These concerns have to be taken into account, especially in HIV patients for whom the immunological state and ART interactions should always be considered.
INTRODUCTION: Teratomas are germ cell neoplasms that can be malignant or benign. Their occurrence is more prevalent in gonads, but there are rare extragonal reports, and splenic teratomas are exceptionally uncommon. CASE REPORT: A 44-year-old woman with a report of abdominal pain on the left flank for 12 h, was evaluated with TC that visualized spleen showing an oval, intraparenchymal, hypodense image with dense areas, submitted to conventional splenectomy, what identified mature cystic teratoma. DISCUSSION: Dermoid cysts have nonspecific symptoms, usually related to extrinsic compression of other structures or rupture of the splenic capsule; the diagnosis is complex, since the alterations in imaging exams are not very specific. Thus, the confirmation is made through anatomopathological analysis. CONCLUSION: Mature splenic cystic teratomas are rare and treatment should be evaluated according to the presence or absence of symptoms and diagnostic certainty.
BACKGROUND: CD4+ lymphocyte cell count represents the main immunological marker used to monitor HIV infection. However, frequent monitoring may be unnecessary, could cause anxiety to the patient as well as burdening healthcare with extra expenses. OBJECTIVES AND METHODS: A two-step retrospective (safety and cost-saving) analysis was performed to evaluate the probability of maintaining a safe number of more than 350 CD4+ cells/µl in HIV-positive subjects under treatment during a three-year follow up and secondarily to estimate in real life the cost of the CD4+ determinations in a 3 years period, speculating on possible cost-saving strategies. The safety analyses was conducted with Kaplan-Meyer method considering: 1) all patients independently from their viral load (VL); 2) patients with 500 > CD4+ ≥ 350 cells/µl versus (vs) CD4+ ≥ 500 cells/µl at baseline; 3) patients with VL < 20 copies/ml vs VL > 20 copies/ml. The cost-saving analysis measuring the costs of CD4+ determinations was calculated from April 1, 2013, to March 31, 2016. RESULTS: In the safety analysis, 253 subjects were enrolled. The median CD4+ count was 623 (489-805) cells/µl. Subjects maintaining ≥ 350 cells/µl in the first, second, and third year were respectively 238 (94.1%), 229 (90.5%), and 226 (89.3%), independently from VL. Within subjects with ≥ 350 CD4+/µl vs. ≥ 500 CD4+/µl at baseline, those who maintained ≥ 350 cells/µl until the third year were respectively 241 (95.3%) and 158 (98.1%). The probability of maintaining these values in the third year was 89.3% for those who had CD4+ ≥ 350/µl at baseline and 98.1% for those who had CD4+ ≥ 500/µl. This probability was around 90% vs. 99% for subjects with HIV-RNA above or below 20 copies/ml. In the real-life cost saving analysis, we evaluated subjects with a stable value or more than 500 CD4+ (respectively 343, 364 and 383 in the first, second and third period). We observed mean value of about two determinations patient/year (2.41 in 2013/2014; 2.32 in 2014/2015; 2.18 in 2015/2016), with a significant decrease between the first and the last period (p<0.001). The mean cost patient/year was 101.51 in the first year, 97.61 in the second, 92.00 in the third (p<0,001). Assuming to extend these procedures to all our patients with stable CD4+ cells/µl and monitoring CD4+ cell count once in a year, we were able to obtain an overall saving of 19,152/year. CONCLUSIONS: A very high percentage of subjects maintained a high and safe number of CD4+ cells (>350 cells/µl) during a three-year follow-up. It could be possible to save up to 66% of the costs by reducing the number of CD4+ count determinations in a year, to have other favorable consequences as well, releasing new resources for patient management.
Chronic kidney disease (CKD) is an important cause of morbidity and mortality in HIV-infected individuals, even in the antiretroviral therapy (ART) era. Inflammatory cytokines and adipokines have been suggested to play a role in the development of CKD. The aim of the present study was to examine the circulating levels of a novel proinflammatory cytokine, angiopoietin-like protein 2 (ANGPTL2), in a cohort of 72 HIV-positive subjects on ART. HIV-positive patients were on cART for at least one year. Urine and blood samples were collected. Various factors were analyzed including body mass index (BMI), smoking, and presence/treatment for comorbidities such as diabetes. The estimated glomerular filtration rate was calculated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Plasma samples obtained were stored and used to measure sCD14 and ANGPTL2 levels. Data were presented as mean (± standard deviation) or median (interquartile range) for continuous variables. Categorical variables were expressed as number (%). Variables were compared using Student's t-test, Mann-Whitney test, or χ2 test. The results showed an independent negative association between plasma ANGPTL2 and CKD-EPI values. Further prospective studies on larger cohorts are needed to evaluate the pathogenetic role of ANGPTL2 as well as its use as a diagnostic marker of renal dysfunction.
BACKGROUND: Highly active antiretroviral therapy has significantly changed the natural history of HIV infection, leading to a dramatic reduction of HIV-related morbidity and mortality. Late Presenters, Very Late Presenters and AIDS presenters still represent, also in Europe, including Italy, a huge challenge in terms of diagnostic and therapeutic management. CASE PRESENTATION: A 35-year-old male with a history of fever and back pain. HIV test resulted positive with a high HIV Viral Load and a very low T-CD4 number of cells (5 cells/mm3). Imaging investigations revealed multiple vertebral and pulmonary lesions together with abdominal and thoracic lymphadenopathy. Blood cultures were positive for Cryptococcus neoformans and for Staphylococcus haemolyticus. Lymphnode biopsy resulted positive in PCR for Non-Tuberculosis Mycobacteria (Mycobacterium chelonae). A gastric biopsy also revealed a GIST. The patient also had CMV DNA positive. Although we performed antiretroviral therapy and specific-therapies for each disease, he was transferred to intensive care unit where he died due to an Acute Respiratory Distress Syndrome. CONCLUSION: The reported case is unusual due to the relevant number of opportunistic diseases (both infectious and tumoral) emerging not long after the HIV infection had been diagnosed. Late presenters HIV patients and AIDS presenters still represent a challenge, which is often too complex for clinicians to deal with. In spite of proper management, the risk of suboptimal results cannot be excluded.
Cryptococcosis/complications , Gastrointestinal Neoplasms/complications , Gastrointestinal Stromal Tumors/complications , HIV Infections/diagnosis , Mycobacterium Infections, Nontuberculous/diagnosis , Osteomyelitis/complications , Spinal Diseases/complications , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/microbiology , Adult , Cryptococcosis/diagnosis , Cryptococcosis/microbiology , Cryptococcosis/virology , Cryptococcus neoformans/isolation & purification , Delayed Diagnosis , Fatal Outcome , Fungemia/complications , Fungemia/diagnosis , Fungemia/microbiology , Gastrointestinal Neoplasms/microbiology , Gastrointestinal Neoplasms/virology , Gastrointestinal Stromal Tumors/microbiology , Gastrointestinal Stromal Tumors/virology , HIV , HIV Infections/complications , HIV Infections/microbiology , Humans , Male , Mycobacterium Infections, Nontuberculous/complications , Mycobacterium chelonae/isolation & purification , Osteomyelitis/diagnosis , Osteomyelitis/microbiology , Osteomyelitis/virology , Spinal Diseases/microbiology , Spinal Diseases/virology
Introdução: As lesões de esôfago são consideradas graves. Avanços técnicos permitiram aplicar técnicas de cirurgia minimamente invasiva nesse tipo de lesão. Relato de caso: mulher, 22 anos, vítima de perfuração por projétil de arma de fogo transfixante. Após avaliação inicial, foi submetida à toracostomia à direita por hemopneumotórax. No segundo dia de internamento, após o início da dieta por via oral, foi flagrada uma saída de secreção mucoide pelo dreno. A paciente foi submetida à videotoracoscopia à direita, sendo realizada sutura da lesão esofágica associada a patch de pleura parietal e músculo intercostal. Conclusão: a abordagem por videotoracoscopia mostra-se segura e eficaz.(AU)
Introduction: Esophageal injuries are considered serious. Technical advances allowed the application of minimally invasive surgery techniques in this type of lesion. Case report: Woman, 22 years old, victim of transfixing gunfire wound. After initial evaluation, patient was submitted to right thoracostomy due to hemopneumothorax. On the second day of hospitalization, after starting oral diet, the elimination of mucoid secretion from the chest drain was detected. Pacient underwent right-sided videothoracoscopy, in which suturing of an esophageal lesion was performed in association with a parietal pleura and intercostal muscle patch placement. Conclusion: Thoracoscopy approach is safe and effective.(AU)
Esophageal Diseases , Thoracic Injuries , Thoracoscopy
Resumo Neste artigo descrevemos como conduzimos com sucesso um caso de úlcera neurotrófica não responsivo à terapia convencional com o uso de lente de contato escleral e as vantagens desta terapêutica.
Abstract In this paper we describe how we successfully conducted a case of neurotrophic ulcer not responsive to conventional therapy using scleral contact lens and the advantages of this therapy.
Humans , Male , Middle Aged , Corneal Ulcer/therapy , Contact Lenses , Ophthalmoscopy , Sclera , Tobramycin/therapeutic use , Trigeminal Nerve/physiopathology , Vitamin A/therapeutic use , Wound Healing , Ofloxacin/therapeutic use , Visual Acuity , Corneal Ulcer/diagnosis , Corneal Ulcer/etiology , Doxycycline/therapeutic use , Prosthesis Fitting , Cornea/innervation , Trigeminal Nerve Diseases/complications , Lubricant Eye Drops , Slit Lamp Microscopy , Gabapentin/therapeutic use , Saline Solution/therapeutic use , Hypesthesia
AIMS: The purpose of this study was to investigate the effects of the combination of constant and variable practice when both, motor program and parameters on absolute and relative dimensions of a task, are manipulated. METHOD: Twenty undergraduate students, aged between 19 and 24 years, participated in this study. Two groups practiced the task of pressing four keys of a numeric keyboard with total and relative times specified under constant conditions in the first part of the acquisition phase and under block conditions in the second part when one group varied parameters and another varied motor programs. RESULTS: Both groups improved parameters and motor program measures during the acquisition phase. In the retention test, the parameters variation resulted in higher accuracy on motor program measure that the variation of motor programs. CONCLUSION: Both combinations improve parameters and motor program accuracy. Moreover, the maintenance of GMP during the variation phase contributes to strengthening it.(AU)
Humans , Male , Female , Young Adult , Psychomotor Performance/physiology , Motor Skills/physiology , Learning
The aim of the present study was to perform a systematic review of the literature on the effects of low-level laser therapy in the treatment of TMD, and to analyze the use of different assessment tools. [Subjects and Methods] Searches were carried out of the BIREME, MEDLINE, PubMed and SciELO electronic databases by two independent researchers for papers published in English and Portuguese using the terms: "temporomandibular joint laser therapy" and "TMJ laser treatment". [Results] Following the application of the eligibility criteria, 11 papers were selected for in-depth analysis. The papers analyzed exhibited considerable methodological differences, especially with regard to the number of sessions, anatomic site and duration of low-level laser therapy irradiation, as well as irradiation parameters, diagnostic criteria and assessment tools. [Conclusion] Further studies are needed, especially randomized clinical trials, to establish the exact dose and ideal parameters for low-level laser therapy and define the best assessment tools in this promising field of research that may benefit individuals with signs and symptoms of TMD.
BACKGROUND: According to the International Association for the Study of Pain (IASP), the term temporomandibular disorder (TMD) regards a subgroup of orofacial pain, the symptoms of which include pain or discomfort in the temporomandibular joint, ears, masticatory muscles and neck on one or both sides, as well as joint sounds, limited mandibular movements or mandibular deviation and difficulties chewing. Phototherapy, such as low-level laser therapy (LLLT) and light-emitting diode (LED) therapy, is one of the resources used to treatment muscle pain. Thus, there is a need to investigate therapeutic resources that combine different wavelengths as well as different light sources (LLLT and LED) in the same apparatus. The aim of the proposed study is to evaluate the effects of four different doses of phototherapy on pain, activity of the masticatory muscles (masseter and bilateral anterior temporal) and joint mobility in individuals with temporomandibular disorder. A further aim is to determine the cumulative effect 24 and 48 hours after a single session. METHODS/DESIGN: A placebo-controlled, double-blind, randomized, clinical trial will be carried out involving 72 women between 18 and 40 years of age with a diagnosis of myogenous TMD. The participants will then be randomly allocated to four groups totaling 18 individuals per group. Three groups will be submitted to a single session of phototherapy with different light sources, and one group will receive placebo therapy: Group A (2.62 Joules); Group B (5.24 Joules); Group C (7.86 Joules); and Group D (0 Joules). The following assessment tools will be administered on four separate occasions (baseline and immediately after, 24 h after and 48 h after phototherapy). Pain intensity will be assessed using the visual analog scale for pain, while pain thresholds will be determined using algometer, and electromyographic (EMG) analysis on the masseter and anterior temporal muscles. DISCUSSION: The study will contribute to the practice of the evidence-based use of phototherapy in individuals with a myogenous TMD. Data will be published after the study is completed. TRIAL REGISTRATION: This study is registered with the Brazilian Registry of Clinical Trials, NCT02018770, date of registration: 7 December 2013.
Facial Pain/therapy , Low-Level Light Therapy/methods , Masseter Muscle/physiopathology , Research Design , Temporal Muscle/physiopathology , Temporomandibular Joint Disorders/therapy , Temporomandibular Joint/physiopathology , Adolescent , Adult , Biomechanical Phenomena , Brazil , Clinical Protocols , Double-Blind Method , Electromyography , Facial Pain/diagnosis , Facial Pain/physiopathology , Female , Humans , Pain Measurement , Pain Threshold , Range of Motion, Articular , Temporomandibular Joint Disorders/diagnosis , Temporomandibular Joint Disorders/physiopathology , Time Factors , Treatment Outcome , Young Adult
PURPOSE: Lower urinary tract symptoms are numerous, but the specific impact of each of these symptoms on the quality of life (QoL) has not been evaluated in community-dwelling men. An assessment of these symptoms and their effects on QoL was the focus of this study. METHODS: We performed a cross-sectional study with 373 men aged >50 years from a community setting. Patients completed the International Prostate Symptom Score questionnaire, which includes questions on each of the specific urinary symptoms and a question addressing health-related QoL that are graded from 0 to 5. We used the Pearson correlation test to assess the impact of each symptom on QoL. RESULTS: Nocturia (58.9%) was the most prevalent urinary symptom. The mean score was 0.9±1.4 for incomplete emptying, 1.0±1.5 for frequency, 0.9±1.3 for intermittency, 0.8±1.3 for urgency, 1.0±1.5 for weak stream, 0.5±1.0 for straining, and 2.0±1.6 for nocturia. Nocturia and frequency were the only symptoms associated with poorer QoL, with nocturia showing a stronger association. CONCLUSIONS: Nocturia affects 50% of community dwelling men aged >50 years, and is the lower urinary tract symptom with the greatest negative impact on QoL.
OBJECTIVE: Create an anatomical model which simulates the real condition of a hydrocephalus and which can be used as a tool in the training of neurosurgeons in neuroendoscopy techniques and anatomical structure study. METHODS: Case-control type study, with an experimental group consisting of ten brains, in which the injection of distilled water was performed; and the control group consisting of three brains with saline solution. Inclusion criteria were brains with no history of contagious diseases or traumatic injury. RESULTS: t student test showed that the relation between frontal horn and internal frontal diameter (FH/ID), with an average of 13 % before the experiment, had a significant difference (t = -3.47, df = 9, p < 0.01) from the relation after the subsequent experiment with an average of 20 %. The Evan's index also showed a significant difference (t = -3.57, df = 9, p < 0.01) with an initial and final average of 12 % and 19 %, respectively. Friedman test showed significant difference of the size of the temporal horn before and after the experiment (f = 8.1, df = 1, p < 0.01), indicating that there was significant increase of the temporal horn. CONCLUSION: The adequate use of the anomalous chemical-physical characteristics of the water molecule may provide a good mechanism to expand the ventricular cavity, in order to create an experimental model of hydrocephalus. The endoscope may be introduced by the usual ways, allowing anatomical observation and simulation of the same tactile sensitivity that one would find during the actual procedure.
Hydrocephalus/surgery , Lateral Ventricles/surgery , Models, Anatomic , Neuroendoscopy/education , Cadaver , Case-Control Studies , Humans
