Catheter exchange technique for the Wingspan stent: technical note.

BACKGROUND AND PURPOSE: The only Food and Drug Administration-approved implant for managing intracranial stenosis is the Wingspan stent. Modification of the standard Wingspan stent delivery procedure has not been previously reported. MATERIAL AND METHODS: Retrospective, single-patient, technical report. RESULTS: Following uneventful balloon angioplasty, a symptomatic intracranial vertebral artery stenosis was inaccessible to Wingspan stent delivery using standard procedural protocol because of poor proximal guide catheter purchase. After placing a Renegade Hi-Flo microcatheter across the stenosis, the Wingspan stent was transferred to this catheter and advanced to the lesion using a Neuroform stabilizer. Unsheathing of the stent yielded uncomplicated, precise placement of the stent with a good clinical result. CONCLUSION: The Wingspan stent transfer technique can be used successfully in the management of intracranial stenotic disease.

Transvenous embosurgery of a left sigmoid sinus dural arteriovenous fistula via a retrograde approach from the superior ophthalmic vein, cavernous and inferior petrosal sinuses.

The efficacy and safety of transvenous embosurgery for sigmoid sinus dural arteriovenous fistula (DAVF) using the internal jugular vein approach is well known. Embosurgery of cavernous sinus DAVF has also been described utilizing a superior ophthalmic vein approach. The first report of a sigmoid sinus DAVF endosurgical repair via a superior ophthalmic vein approach in a patient without internal jugular vein access is presented.

Predicting acute ischemic stroke by measuring the degree of ocular gaze deviation (Prevost's sign) on CT.

BACKGROUND AND AIM: Ocular gaze deviation (OGD) is a well known clinical observation (Prevost's sign) in patients with acute cerebral ischemic stroke. Although OGD has been observed on CT in acute stroke, no investigation has quantified the degree of OGD in acute stroke. MATERIAL AND METHODS: A blinded prospective comparison was performed of two groups of adult patients who underwent CT of the brain. Group 1 comprised patients with acute hemiplegia or hemiparesis due to middle cerebral artery ischemic stroke. Group 2 included ambulatory outpatients with a history of headache but no clinical neurologic signs or cerebral pathology on CT. The CT images were cropped to only show the orbital contents. A neuroradiologist, who was blinded to the clinical data, then measured the OGD for both groups. The OGD was quantified using the axial planes of the lenses relative to the nasal midline structures, and the bilateral OGD average was calculated. Both groups were also evaluated for conjugate or disconjugate gaze. RESULTS: were analyzed using Fisher's exact test. RESULTS: 10 of 70 patients in group 1 and 15 of 46 patients in group 2 were eligible for analysis. The frequency of conjugate and disconjugate gaze was similar in the two groups (p = 0.596). An averaged OGD of >14° and an OGD >18° in either globe was predictive of the presence of acute stroke (p = 0.0166). CONCLUSION: Measurement of OGD is useful in predicting the presence of acute ischemic stroke.

Balloon test occlusion and endosurgical parent artery sacrifice for the evaluation and management of complex intracranial aneurysmal disease.

The lifetime risk of developing a cerebral aneurysm is about 5%. For some patients, aneurysms can be reasonably managed by conservative measures, including periodic clinical and imaging surveillance. However, the definitive treatment of cerebral aneurysm disease requires securing the aneurysm by surgically excluding it from the cerebrovascular circulation. Most commonly, this can be achieved by either open surgical clipping or embosurgery. Unfortunately, for a minority of patients, these interventions are inadequate because of many aneurysmal factors, such as complex anatomy, giant and wide neck aneurysmal morphology, peripheral small branch origin and skull base location. In situations like these, sacrifice of the parent artery may be preferable, especially when clinical tolerance or image based vascular reserve can be preoperatively demonstrated during temporary occlusion of the vessel. This preoperative procedure, which is known as the Balloon Test Occlusion (BTO), has several variations and technical nuances that can assist the surgeon in predicting which patients may best benefit from parent artery sacrifice (PAS). Together, BTO and PAS are invaluable tools in the management of complicated and atypical cerebral aneurysms. With regard to cerebrovascular aneurysm disease, this review will summarize the development of these procedures, condense the predictability of the numerous BTO variations and provide an overview of the currently available PAS techniques.

Catheter exchange technique for the Wingspan stent: technical note.

BACKGROUND AND PURPOSE: The only Food and Drug Administration-approved implant for managing intracranial stenosis is the Wingspan stent. Modification of the standard Wingspan stent delivery procedure has not been previously reported. MATERIAL AND METHODS: Retrospective, single-patient, technical report. RESULTS: Following uneventful balloon angioplasty, a symptomatic intracranial vertebral artery stenosis was inaccessible to Wingspan stent delivery using standard procedural protocol because of poor proximal guide catheter purchase. After placing a Renegade Hi-Flo microcatheter across the stenosis, the Wingspan stent was transferred to this catheter and advanced to the lesion using a Neuroform stabilizer. Unsheathing of the stent yielded uncomplicated, precise placement of the stent with a good clinical result. CONCLUSION: The Wingspan stent transfer technique can be used successfully in the management of intracranial stenotic disease.

Macrofollicular encapsulated papillary thyroid carcinoma--a case report.

Macrofollicular encapsulated papillary thyroid carcinoma (MEPC) is a rare variant of papillary carcinoma of thyroid with a favourable clinical course. It could be mistaken for a follicular neoplasm or a hyperplastic nodule. We report cytological and histopathological features of this rare variant of papillary carcinoma in a 22 year old female with brief review of literature.

Plasmacytoid variant of myoepithelioma of palate: a case report.

Myoepitheliomas of intraoral minor salivary glands are rare and are usually of plasmacytoid type. Myoepitheliomas are considered difficult to diagnose without the aid of ultrastructural and histochemical studies. Here we present a case report of plasmacytoid type of myoepithelioma of palate that was diagnosed by light microscopic examination alone. Considering the non-specificity of ultrastructural and histochemical findings, it is important to pay attention to typical features of plasmacytoid myoepitheliomas to arrive at a diagnosis.

Determination of phosphorous in titanium bearing minerals by potentiometric titration using Pb-ion selective electrode.

A method for phosphorous determination in titanium bearing minerals by potentiometric titration using a Pb-ion selective electrode has been developed. Sample decomposition is achieved by means of K(2)CO(3) fusion in a platinum crucible at 800 degrees C for 30 min in a muffle furnace, and subsequent leaching with water of the fused melt. The aqueous leachate is neutralised with HClO(4) and subsequent boiling. The obtained solution is used for titration with Pb(ClO(4))(2), and the Pb-ion selective electrode detects the end point. The lowest concentration determinable is 0.02% P(2)O(5) in a solid sample. The method was applied on in-house titanium bearing mineral samples and on IGS-31 ilmenite sample (British Geological Survey, UK). Synthetic samples were prepared and analysed, and phosphorous recovery is in the range 98-106%. The recovery and accuracy of the present method have been validated by spiking experiments and by comparing with the spectrophotometric values, respectively. The precision of the proposed method in terms of relative standard deviation is 2.0%.

Cold dissolution method for the determination of uranium in various geological materials at trace levels by laser fluorimetry.

A cold dissolution procedure for the determination of uranium in various geological materials like rocks, minerals, soils etc., has been described. Samples are allowed to react with HF and HNO(3) at room temperature overnight. Boric acid is added to complex excess fluoride ions. From the clear solution thus obtained, uranium is determined directly in laser fluorimeter after the addition of fluorescence enhancing reagents. The results of few standard reference materials analysed by the present method agree with the certified values. This methodology does not require platinum or teflon ware, exhaust system and time consuming solvent extraction step. Hazardous acid vapours are not left in air, so there is no air pollution. Chemicals consumption is minimal. Therefore the method is economical. The method can be employed for high sample throughput which is the prerequisite for exploration geochemists.

Determination of carbonate, bicarbonate and phosphate in uranium leach liquors containing KMnO(4) as oxidant.

A simple, rapid and economic method has been developed for the reduction of potassium permanganate in alkaline carbonate uranium leach liquors to a colourless solution. The pink colour of permanganate, if not reduced, seriously impedes the determination of carbonate, bicarbonate and phosphate by titrimetry and spectrophotometry. Out of 17 reductants investigated, commercial sugar has been found to be the most effective, rapid, simple and interference free for further estimations. To the best of the authors' knowledge, this is the first time that sugar as a reductant has been made use of in analytical investigations.

Spectrophotometric method for the determination of vanadium in uranium rich hydrogeochemical samples using pyridyl azo resorcinol (PAR).

A simple and precise method has been developed for the determination of traces of vanadium(V), using 4-(2 pyridyl azo) resorcinol, in natural water samples, containing very high concentrations of uranium. CDTA-pyrophosphate buffer has been used for masking interferants, including uranium which otherwise interferes above 125 ppb. The reaction of vanadium with PAR in the presence of buffer requires a waiting period of 45 min. The Sandell sensitivity of the method is 0.003 microg/ml, at 545 nm at an optimum pH of 6.5 +/- 0.2. The precision of the method is +/- 15% at the 100 ppb level of vanadium(V). The method has been successfully applied to a number of natural water samples during hydrogeochemical exploration.