Catheterization via Caudal Puncture of the Epidural Space with a 5F Angiography Catheter and a Coaxial Steerable 0.038" Guidewire for Delivery of Drugs and Adhesiolysis.

UNLABELLED: We describe a technique for epidural medication delivery with angiographic catheters and guidewires inserted via caudal puncture and advanced cephalad under fluoroscopic guidance in the treatment of painful spinal diseases. METHODS: From November 2005 to September 2006 a total of 18 consecutive patients underwent adhesiolysis by an angiographic 5 French hockey-stick tip catheter and a coaxial 0.038" steerable guidewire inserted at the sacral hiatus and advanced cephalad under fluoroscopic guidance up to the site of adhesion. We obtained pain relief for more than three months in 61% of patients. There were no periprocedural/postprocedural complications. Our system of accessing the epidural space provides a safe means of delivering epidural medication, performing mechanical adhesiolysis and may be useful in the treatment of selected patients with painful spinal diseases.

Protected carotid stenting: the usefulness of filter protection devices.

We report our experience in carotid artery stenting using a filter protection device. From July 2003 to September 2006 we treated 62 patients by internal carotid stenting using a filter protection device. Procedural success was achieved in 100% of cases. There were five periprocedural complications: one dissection of the internal carotid artery, two TIAs and two groin haematomas at the site of needle access. Neurological examination performed after the procedure and during the 30 days of follow-up did not reveal major neurological complications. Cerebral protection with a filter during carotid artery stenting seemed feasible and safe.

Short, medium and long term efficacy of epidurally injected anaesthetic-corticosteroid mixture in lumbocruralgia and lumbosciatalgia.

We assessed the efficacy of an epidural sited anaesthetic-corticosteroid mixture with transforaminal or interlaminar/interspinous access, in subjects with chronic lumbocruralgia or lumbosciatalgia caused by discal pathology or degenerative foraminal stenosis. From September 2003 to June 2005, 84 patients were treated in the transforaminal region and 32 in epidural space through back access (interlaminar or interspinous) with 2 ml cortisone (megacort) and 2ml anaesthetic (naropine 7.5mg/ml). All 116 patients underwent a minimum of two and a maximum of three treatment sessions. The results were evaluated for a follow-up period of ten months by comparing the answers given by the patients with the Visual Analogic Score. This was done prior to and after every single injection and during the follow-up period. Out of 142 spaces treated, improvement of symptoms for a period varying from one to three months was recorded in 74 cases (52%), for a period of more than three months in 53 (37%) cases, while in the remaining 15 (11%) cases no sufficient regression of pain was reported. In many cases of chronic lumbago/lumbosciatalgia, the percutaneous injection of an anaesthetic-cortisone mixture can be useful in relieving or even killing pain for a period of more than three months. No major complication was reported.

DNA fragment assembly using neural prediction techniques.

The paper describes an alternative approach to the fragment assembly problem. The key idea is to train a recurrent neural network to tracking the sequence of bases constituting a given fragment and to assign to a same cluster all the sequences which are well tracked by this network. We make use of a 3-layer Recurrent Perceptron and examine both edited sequences from a ftp site and artificial fragments from a common simulation software: the clusters we obtain exhibit interesting properties in terms of error filtering, stability and self consistency; we define as well, with a certain degree of approximation, a metric on the fragment set. The proposed assembly algorithm is susceptible to becoming an alternative method with the following properties: (i) high quality of the rebuilt genomic sequences, (ii) high parallelizability of the computing process with consequent drastic reduction of the running time.

Vulvo-vaginitis and reproduction.

The main micro-organisms able to interfere with the reproductive function have been considered. In particular, the problems concerning the vaginal environment and its interactions with spermatozoa, immunological aspects and contraception. Lastly, reference has been made to methods of prevention and study in the field of diagnostics and of clinical management.

Cyto-histological aspects of chorionepithelioma in fluorescence.

The Author illustrates cytochemical and histochemical pictures of the chorion-epithelioma, which the fluorochromization with orange acridine, according to the Bertanlanffy's method, gives with extreme clearness. The intense colouring of both nucleic acids, DNA and RNA indicates a lively functional activity and elevated trophism of the trophoblastic cells.

Asymmetric Boltzmann machines.

We study asymmetric stochastic networks from two points of view: combinatorial optimization and learning algorithms based on relative entropy minimization. We show that there are non trivial classes of asymmetric networks which admit a Lyapunov function L under deterministic parallel evolution and prove that the stochastic augmentation of such networks amounts to a stochastic search for global minima of L. The problem of minimizing L for a totally antisymmetric parallel network is shown to be associated to an NP-complete decision problem. The study of entropic learning for general asymmetric networks, performed in the non equilibrium, time dependent formalism, leads to a Hebbian rule based on time averages over the past history of the system. The general algorithm for asymmetric networks is tested on a feed-forward architecture.

[A case of thrombosis of the superior longitudinal sinus]. / Su un caso di trombosi del seno longitudinale superiore.

A case of cerebral venous sinus thrombosis is described in a forty-two years old patient. The literature is reviewed about clinical presentation and neuroradiological findings. We consider the use of NMR in diagnosis.

[Diagnostic and prognostic value of the echo-Doppler and transcranial Doppler methods in the acute phase of ischemic ictus]. / Valore diagnostico e prognostico della metodica eco-Doppler e Doppler transcranico negli ictus ischemici in fase acuta.

The ischaemic ictuses are a frequent pathology. For their annulling potentiality a quick etiopathogenetic diagnosis is necessary to institute a suitable therapy that limiting the extension of the cerebral damage. In this respect, it is fundamental the use of the duplex methods in real time together with doppler valuation of the neck vessels (carotid and vertebral) and of the intracranial big arteries. The direct observation of the endoluminal surface in the extracranial vessels and the valuation of the circulatory condition in the individual arterial districts explored give as important of haemodynamic information which, added to that obtained through a computerized axial tomography and the clinic, allows a correct diagnostic valuation with important effects on the therapy as well as a reliable prognostic formulation. Description of two clinical cases.

Antibiotic prophylaxis in neurosurgery. Study comparing two groups of patients with and without treatment.

We present the results of a study comparing two groups of patients who underwent neurosurgical operations, one pretreated with Ampicillin (184) and the other not (193), in comparable time-spans. The results of this study argue for a beneficial action of Ampicillin prophylaxis on neurosurgical infections. A brief discussion of the appropriate literature is given.