Computerized occlusion rating: a superior predictor of aneurysm rebleeding for ruptured embolized aneurysms.

BACKGROUND AND PURPOSE: The initial angiographic occlusion rate is the strongest predictor of later rebleeding in previously ruptured coil-embolized cerebral aneurysms. Angiographic estimations of aneurysmal occlusion rates are, however, subjective in nature and confounded by methodologic problems. COR has been developed, and its superiority has been experimentally established to overcome subjective bias. The purpose of this study was to assess the clinical value of COR as a more objective predictor of aneurysm rebleeding when compared with SOR as described in the Raymond Classification. MATERIALS AND METHODS: We applied COR in a consecutive series of 249 patients. Two DSA projections were selected independently by 2 blinded investigators. In cases of disagreement on the selected projections, a consensus decision was obtained. SOR were determined by 2 independent observers according to the Raymond classification. COR was measured by 2 blinded investigators. Interobserver variations were determined for SOR and COR. COR results were compared with SOR results and stratified as 100%, 99.9%-90%, 89.9%-70%, and <70% occlusion. SOR and COR were evaluated as predictors for aneurysm rebleeding. RESULTS: Seven aneurysms rebled (2.8%; follow-up, 59 ± 35 months). In 20.9% of all cases, DSA selection was performed by consensus evaluations. Interobserver variations were statistically significant for SOR (P = .0030) but not for COR (P = .3517). Compared with COR, SOR overestimated the degree of aneurysmal occlusion in 81.9% of all cases. Only COR predicted rebleeding (P = .0162). CONCLUSIONS: Unacceptable interobserver variations were shown for the standard SOR estimations. COR substantially reduced the impact of subjective bias. COR may, therefore, serve as an easily applicable more objective predictor of aneurysm rerupture. The remaining bias of COR, caused by 2D image analysis, may be overcome by use of direct 3D measurements.

Morphology of the male genitalia and sperm fine structure in siluroid fish.

Morphology of male genitalia and sperm fine structure of 4 siluroid fish, Callichthys thoracatus (Callichthyidae), Dysichthys coracoideus (Aspredinidae), Mystus armatus (Bagridae) and Ancistrus triradiatus (Loricariidae) were studied. In Dysichthys coracoideus and Ancistrus triradiatus the male genitalia consisted of paired testes and spermatic ducts but had no seminal vesicles. In Callichthys thoracatus the male genitalia had also paired seminal vesicles which were separated from the testis and emptied into the spermatic duct. Also in Mystus armatus seminal vesicles were found. They were not separated from the testes but the seminiferous tubules changed into seminal vesicle lobes which finally emptied into the spermatic ducts. All the investigated species had simply organized aquasperms typical for external fertilizing teleosts which were characterized by an ovoid or elliptoid head, by a small midpiece and by the absence of an acrosome. The spermatozoa of Dysichthys coracoideus and Mystus armatus were biflagellate, while they were monoflagellate in Ancistrus triradiatus and Callichthys thoracatus. The proximal centriole was reduced in Dysichthys coracoideus and Mystus armatus and the basal body attached to the nucleus. Single mitochondria were found in Dysichthys coracoideus, Ancistrus triradiatus, and Callichthys thoracatus. On the contrary, in Mystus armatus mitochondria were fused to a more complex chondriosome.

Acute action of ethanol on rat hippocampal CA1 neurons: effects on intracellular signaling.

Ethanol has a concentration dependent dual effect on electrical activity of rat CA1 hippocampal neurons. Low concentrations of ethanol (0.001%) enhance whereas high concentrations (0.5%) suppress synaptic transmission. Ethanol has no effect on cell input resistance and orthodromic or somatic threshold of action potentials. Cholera toxin, an activator of stimulatory guanine nucleotide binding regulatory protein (Gs), prevented the ethanol effects on field excitatory postsynaptic potentials (EPSPs). Staurosporine, an inhibitor of protein kinases, bisindolylmaleimide, an inhibitor of protein kinase C, and phorbol-12,13-dibutyrate (PDBu), an activator of protein kinase C, blocked the effect of ethanol on field EPSPs. Our results show that ethanol at extremely low concentrations is able to affect synaptic transmission and suggest that the molecular mechanism of ethanol action involves the activation of Gs protein and protein kinase C.