Electric vehicles fire protection during charge operation through Vanadium-air flow battery technology.

During the last decade, electric vehicles had a remarkable diffusion caused by Li-ion batteries lowered prices and improved performances. Meanwhile, incidents involving fire were reported for electric vehicles during charge operation or simple parking. The potential drawbacks of this technology could play a role on safety in the next years, especially for household or underground charge. This paper presents the development of a novel system concept based on a Vanadium-air flow battery, applied to provide charge and fire safety of electric vehicles through oxygen reduction in a sealed box. When the vehicle is parked inside the box and the passengers are outside of it, a nitrogen injection is operated to reduce the fire risk quickly, during the subsequent vehicle charge operation the oxygen is consumed from the box atmosphere by the cathode of the Vanadium-air battery that supplies energy, then the nitrogen reserve is restored consuming oxygen from the external ambient and the energy output can be supplied to smart grids. The system is mainly composed by the Vanadium-air flow battery, the protection box and the nitrogen reserve, it is sized relatively to the most diffused road and commercial electric vehicles for different values of on-board battery capacity and charge power Moreover, it can be integrated into vehicle-to-grid energy systems improving intersectoral flexibility.

Low-dose brain computer tomography sensitivity: a comparative study with a conventional technique.

A comparative study between brain conventional computed tomography (CT) examinations and low-dose examinations was performed. The aim of the work was to show if a low-dose technique can be used instead of a standard one. Forty patients with 51 brain lesions were studied with both techniques. The low-dose technique was optimized with mAs reduction to obtain a 25% dose reduction compared to standard acquisitions. Even if images have a poor signal-to-noise ratio, the low-dose technique visualized all the lesions disclosed by conventional examination except three chronic vascular lacunar infarcts. In conclusion, the low-dose technique can be adopted instead conventional CT scans in selected cases.

Perfusion MRI in the evaluation of cerebral blood volume and mean transit time in untreated and recurrent glioblastomas.

Perfusion MRI by means of dynamic contrast-enhanced T2-weighted MR imaging allows quantitative analysis of cerebral blood volume (CBV) and mean transit time (MTT) in intra-axial brain tumors. Our aim was to compare recurrent glioblastomas to untreated glioblastomas, determining if there are differences in perfusion parameters between the two groups. Serial MR examinations were performed in 26 patients with glioblastoma histologically demonstrated before surgical resection and in 19 patients with recurrent glioblastoma after surgery and radiotherapy. Tumor recurrence was established using both histological and clinical criteria. Normalized CBV and MTT ratios were considered and compared between the two groups. A statistically significant difference, both in average and maximum normalized CBV ratios between the two groups was found. In particular, average and maximum normalized CBV ratios were greater in untreated than in recurrent glioblastomas. On the contrary, average and maximum normalized MTT ratios were greater in the recurrent glioblastomas, than in untreated tumors. Perfusion MRI by means of dynamic contrast-enhanced T2-weighted MR imaging is a valuable adjunct to conventional MR imaging in assessing different hemodynamic features between untreated and recurrent glioblastomas. In particular, tumor recurrence must be suspected even if the average and maximum normalized CBV ratios are far below those of untreated glioblastomas. In addition, increased average and maximum MTT ratios could be considered typical markers of neoplastic recurrence in irradiated cerebral tissue.

Characterization of glioblastoma by contrast-enhanced flair sequences.

The tissues placed on the edge of a glioblastoma's necrotic cavities are more vascularized than other pseudocystic central nervous system (CNS) tumours, both benign and malignant. The post-contrast enhancement is greater in Fluid-Attenuated Inversion-Recovery (FLAIR) images than in Spin Echo T1-weighted (SE T1w) sequences above all in the CNS tissues with a low concentration of gadolinium. The purpose of this study was to distinguish pseudocystic glioblastomas from other cystic CNS tumors by comparing post-contrast pseudocystic rim enhancement in FLAIR and SE T1-w magnetic resonance (MR) images. We investigated 32 extensive sets of MR images relating to histologically diagnosed pseudocystic CNS tumors; 14/32 were glioblastoma. Fast Spin Echo (FSE) T2-weighted and Proton Density, SE T1w and FSE FLAIR sequences were acquired in all the studies. After contrast media administration SE T1w and FLAIR sequences were acquired. In post-contrast T1w SE and T2w FLAIR acquisitions, pseudocyst rim enhancement was evaluated assigning scores: 4 = rim enhancement completely surrounds perimeter; 3 = rim enhancement in ≥50% of perimeter; 2 = rim in < 50% of perimeter; 1 = rim enhancement absent. Mean scores were calculated and the results were compared with statistical methods (Student's t test) for glioblastomas and all other tumors. Moreover differences between FLAIR and SE scores was assessed in each patient. If the difference was 0 glioblastoma was assumed, if the difference was ≥ 1 another tumor was assumed; the sensitivity and specificity of this diagnosis compared to the histological diagnosis were assessed. Mean T1-weighted SE scores did not differ in glioblastomas and other tumors. FLAIR scores in glioblastomas were less than half those of other tumors (p < 0.005). Glioblastoma diagnosis based on score difference identified 13 true positives (glioblastomas), 16 true negatives (non glioblastomas), two false positives and two false negatives. The sensitivity for glioblastoma was 86.7% and the specificity was 94.1%. Comparison of post-contrast rim enhancement in T1w SE and FLAIR sequences distinguishes glioblastomas from other pseudocystic CNS tumors, assisting the differential diagnosis of glioblastomas, that in many cases are not distinguishable from metastases even with advanced MR techniques.

Prognostic impact of magnetic resonance perfusional study in cerebral metastases treated with radiosurgery.

Radiosurgery arrests metastatic growth by means of vascular thrombosis that causes tumor necrosis. We therefore evaluated whether tumor hypervascularization (studied with perfusional magnetic resonance sequences) is a positive prognostic factor predicting radiosurgery outcome. Twenty-four metastases were studied before radiosurgery with perfusional MR and then post therapy clinical and morphological status was evaluated. The group of lesions responsive to radiosurgery had the highest mean rCBV value (23.3) in comparison to the non responding lesions (14.7) with a statistically significant difference (p<0.005). High vascularization for radio-treated metastases was a positive prognostic factor because the radiosurgery thrombosis effect was more effective. Pre-treatment MR rCBv evaluation is a useful tool to establish metastatic response to radiosurgery.

MR Perfusion Imaging of Intracranial Tumors. A Retrospective Study of 218 Patients.

This retrospective study evaluated magnetic resonance (MR) perfusion imaging in the study of intracranial tumors; 218 patients were studied with 509 MR examinations. The first aim was to establish the usefulness of perfusion imaging for the differential diagnosis between neoplastic tissue and other lesions both in the first MR examination and in the post therapeutic controls (differentiation of tumor recurrence from radionecrosis). Then we evaluated the presence of infiltrating neoplastic tissue in CBV maps outside the enhancement area to differentiate infiltrating gliomas from metastases. In addition, post surgical evaluation was performed to identify residual neoplastic tissue, mainly if bleeding or inflammatory post surgical cerebral damage did not allow a definitive diagnosis with conventional morphologic images. Lastly, it was assessed whether hypervascularization (evaluated in CBV maps) is a favourable prognostic factor for a positive outcome to radiotherapy. The diagnostic gain of perfusion imaging in all these cases was established evaluating our case records.

Cerebral MR Perfusion Imaging Analysis of Peritumoral Tissue.

Highly malignant gliomas have an infiltrating growth making it impossible to establish the exact limits of the lesion with magnetic resonance images after contrast medium administration because the peripheral component of the lesion does not enhance. On the contrary, cerebral metastases have an expansive growth and therefore lack a peripheral component beyond the enhanced area. In some cases the MR perfusional technique can demonstrate neoplastic tissue even with little damage to the brain-blood barrier and therefore with no enhancement. Our study aimed to estimate in which cases the MR perfusion technique will characterize peripheral neoplastic tissue that fails to enhance in gliomas in order to make a differential diagnosis between gliomas and metastases. We studied 60 tumours in 53 patients with MR perfusion and conventional sequences. We evaluated the presence of hyperperfused tissue in CBV maps outside the enhanced area after contrast administration and estimated the tumoral tissue CBV. None of the metastases (24 cases) had hyperperfused peritumoural tissue which was present instead in 22/36 gliomas (infiltrating aspect in CBV maps). Moreover all the gliomas with infiltrating aspect had CBV values of the solid component of the lesion higher than gliomas with a non infiltrating aspect with a threshold value between 4.4 and 6.3. It was therefore possible to characterize 22 gliomas with infiltrating aspect in the perfusion maps and with CBV values higher than the threshold value. In addition, 17 metastases with a non infiltrating aspect were characterized with CBV values higher than the threshold. Fourteen gliomas and seven metastases both with a non infiltrating aspect in the perfusion maps and with CBV values below the threshold were not characterized. In conclusion, MR perfusion succeeded in characterizing 39 lesions out of 60.

Pure surgical treatment of 109 aneurysms.

AIM: Target of this study was to investigate outcomes after pure surgical treatment of intracranial aneurysms. METHODS: Patients with intracranial supratentorial circle aneurysms were retrospectively reviewed between July 1994 and October 1998. Studied cases were admitted at the Department of Neurosurgery of S. Maria-Hospital, Terni, a Government supported General Hospital. One hundred and nine Hunt and Hess Grade 0 to III patients with supratentorial circle aneurysms was studied in order to determine whether advances in the surgical management of intracranial aneurysms have improved surgical outcomes and which factors may predict outcome. All patients were managed only with standard neurosurgical aneurysms clipping procedures. Outcomes evaluation was made at patients' discharge and classified on the base of the Glasgow Outcome Scale (GOS). Surgical timing, SAH grading, pre and post surgical symptomatic vasospasm, temporary clipping, and intraoperative aneurysm rupture were correlated with outcomes. RESULTS: Surgical results showed a 75% excellent outcome. Mortality rate was 3%. Hunt and Hess grade 0 highly influenced outcome. Differences in outcomes among grades I to III were not significant. No differences in outcomes related to temporary clipping were noted. A low rate of intraoperative aneurysm rupture is reported: 5 out of 109 cases. In all these cases outcome was good, with neither mortality or morbidity. CONCLUSIONS: Results indicate a progressive improvement in surgical outcomes, suggesting that there still exist margins for improvements in pure surgical management of intracranial aneurysms.

The effect of magnetisation transfer contrast on cerebrospinal fluid on motion artefacts on fluid-attenuated inversion-recovery images.

We assessed possible advantages of the use of fluid-attenuated inversion-recovery (FLAIR) sequences with magnetisation-transfer contrast (MTC) over conventional FLAIR images. We carried out cranial MRI at 1 tesla on 50 patients with both sequences. In nine patients with multiple sclerosis (MS) we performed a quantitative comparison of the two sequences, looking at the contrast-to-noise ratio between lesions and normal white matter and counting the number of lesions shown using each method. A qualitative comparison on all patients consisted of the analysis of the appearance of the normal parenchyma, of any lesions, and of artefacts, with particular reference to cerebrospinal fluid (CSF) motion artefacts. The quantitative analysis showed no meaningful difference between the two sequences. The cerebral parenchyma and lesions appeared substantially the same with both techniques. With FLAIR MTC there was a clear, and consistent reduction in CSF motion artefacts. FLAIR MTC sequences can usefully be used in place of the conventional sequence at 1 tesla.

Perfusion MRI in the evaluation of the relationship between tumour growth, necrosis and angiogenesis in glioblastomas and grade 1 meningiomas.

Angiogenesis is a common characteristic of tumours, and it is reasonable to assume that it has an influence on tumour growth, depending on the grade of malignancy. We therefore studied angiogenesis in 25 patients: 14 with glioblastoma multiforme and 11 with grade I meningioma. Our aim was to assess how angiogenesis conditions growth and necrosis. The patients underwent MRI with standard and perfusion sequences. We calculated the volume of each tumour; for the glioblastomas the solid portion was taken as the difference between the overall volume and the volume of any necrotic portion. In the glioblastomas, we found an inverse relationship between blood volume and the size of the tumour, whereas in the meningiomas there was of a direct relationship. These correlations confirm in vivo the knowledge about necrosis in glioblastomas and its relationship to their inadequate vascular network. On the contrary, grade 1 meningiomas show an equilibrium between their microcirculation and the cellular component.

Study on the variations of the apparent diffusion coefficient in areas of solid tumor in high grade gliomas.

Present knowledge suggests that in glioblastoma multiforme the value of the apparent diffusion coefficient (ADC) is elevated in the solid part and hyperintense in T1, in spite of the elevated cellularity, and also in areas where peritumoral vasogenic edema is present. The purpose of our study has been to verify in vivo if the ADC increases in areas of solid tumor because of an increased presence of edema, like it happens in areas surrounding the tumor. Sixteen patients with histologically verified glioblastoma multiforme underwent a magnetic resonance (MR) examination with sequences: T1-weighted pre and post contrast, diffusion-weighted at b = 0 and b = 1000 s/mm(2), perfusion-weighted. One hundred sixty-five regions of interest (ROI) have been obtained for all set of patients. In each ROI we have estimated 4 parameters: ADC, intensity of T2-signal normalised to the white matter (SI(T2W)(n)), regional cerebral blood volume (rCBV), T1-signal enhancement (E%). With the SI(T2W)(n) the presence of edema was estimated. For each pair of measured parameters a statistical test of linear regression on the set of all ROI was made. A directed linear correlation between: ADC and SI(T2W)(n) (p

A Magnetic Resonance comparative study between enhancement, rCBV and ACD in brain glioblastomas.

PURPOSE: Perfusion and diffusion Magnetic Resonance Imaging (MRI) studies allow us to quantitatively evaluate the vascularisation and anaplastic grade of glioblastomas based on the regional cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) values. The aim of our study was to compare these values and enhancement % in order to determine whether enhancement of glioblastomas depends mainly on their vascularisation or anaplastic grade. MATERIALS AND METHODS: Seventeen patients with brain glioblastomas were studied with perfusion, diffusion and T1-weighted Spin-Echo MR sequences, with and without contrast medium. The quantitative evaluations were made on solid tumour tissue regions of interest (ROI), and the high vascularisation (high rCBV) and low anaplastic grade (high ADC) ROI group was separated from the low vascularisation (low rCBV) and high anaplastic grade (low ADC) group. The mean enhancement % values of the two groups were compared by using statistical METHODS. RESULTS: In 14 patients there were no statistically significant differences between the two groups. In one patient, the enhancement of high anaplastic grade and low vascularisation ROIs was significantly higher, whereas in two patients, the enhancement of high vascularisation and low anaplastic ROIs clearly prevailed. CONCLUSIONS: Given that the anaplastic grade is proportional to blood-brain barrier (BBB) impairment, our results show that, in most cases, enhancement of glioblastomas is equally dependent on vascularisation and BBB impairment.

Oligodendrocytic gliomatosis cerebri.

We describe a very unusual case of gliomatosis cerebri (GC) with oligodendrocytic differentiation. A 65-year-old man presented with a convulsive seizure. Magnetic resonance (MR) documented diffuse enlargement of cerebral hemispheres, brainstem, and right cerebellar hemisphere. After admission, the patient manifested a progressive deterioration of his neurological condition. A right temporal craniotomy and temporal lobectomy were performed to obtain brain decompression and diagnosis. Pathological findings were those of a GC consisting of neoplastic oligodendrocytes. Oligodendrocytic GC is a very rare pathological condition. Diagnosis of GC is usually made at autopsy. Our case confirms that diagnosis by a combination of MR imaging and brain biopsy.

Variable response of the Mongolian gerbil to unilateral carotid occlusion: magnetic resonance imaging and neuropathological characterization.

In the present investigation, we estimated both the evolution and the severity of ischemic damage following unilateral carotid occlusion (UCO) in Mongolian gerbils by using conventional magnetic resonance imaging (MRI, i.e. T2 weighted imaging) and histological techniques. Immediately after UCO, the animals showed different clinical effects. The mortality (46%) detected within the first 48h was considered an "stroke-sensitivity", the "stroke-resistant" animals showed wide variability in terms of both temporal evolution and the extent of ischemic damage. The signal hyperintensity and negative MRI observed during the first 30h after UCO did not always correlate with the cerebral damage presented after 14 days, although a close correlation was established between the T2 weighted images taken more than 30h after UCO and neuropathology: the gerbils negative to imaging showed no morphological changes, whereas an enhanced signal was always prognostic of ischemic injury. Moreover, late MRI documented ventricular dilatation. Histopathology showed that the ischemic damage differed among the stroke-resistant gerbils and was often bilateral. The present study confirms the differences in gerbil susceptibility to hemispheric infarction after permanent UCO and suggests that conventional MRI may be a useful non-invasive method for i) identifying the stroke-resistant animals prone to mature ischemic injury and ii) monitoring the evolution of therapeutic efficacy without sacrificing animals.

Short temperament questionnaire for children aged 8-12 years in the city of Rome.

The assessment of temperament is usually measured by means of parental questionnaires. Since temperament questionnaires in children aged 8-12 years do not exist in Italy we planned a study to develop an Italian questionnaire. Initially we tried to adapt Hegvik et al.'s questionnaire and delivered 389 questionnaires to the mothers of children aged 8-12 years, but most of them were given back uncompleted, essentially because they often described behavior not usually observed in Italian children. Then we prepared a new, short (30 items) questionnaire which we distributed to 431 mothers of children aged 8-12 years. This new questionnaire was completed by 98.76% of mothers and a high three week rating-re-rating reliability for the different temperamental characteristics under assessment was proved. We believe that this new questionnaire is reliable for temperament assessment in Italian children aged 8 to 12 years, living in a big city environment in Central Italy.

[Pharyngeal cysts of branchial origin, a review of the literature and a clinical case report]. / Cisti faringee di origine branchiale, revisione della letteratura e presentazione di un caso clinico.

Nasal pharyngeal swellings are very often treated without a previous complete clinical examination of the patient and of the disease site. For this reason the recurrence rate of this pathology is quite high. The causes for this phenomenon are likely due to the benign aspect of the tumor and the easy approach to the pharynx. Leaving aside the therapeutical aspect, there are also multiple theories concerning the etiology of pharyngeal cyst based on epidemiological and histopathological observations. Branchiogenic origin very likely seems to be the cause of cystic swelling arising at the lateral side of the pharynx, between the Eustachian tube and the posterior tonsillar pillar. Examination of the case review collected from literature, revealed that diagnostic and therapeutical procedures performed by various authors seem to be very haphazard, ranging from simple physical examination and puncture draining to CT and/or MRI scanning and external trans-mandibular approach to the cyst. The authors describe one case of a subject with a pharyngeal branchial cyst, who had been previously undergone puncture drainage. The correct diagnosis was achieved through MRI and cytologic examination of the fluid aspirated from the cyst. With MRI it was possible to make a correct topo-diagnosis, which localized the position of the cyst in the left pharyngo-tonsillar recesses, medial to the pharyngeal constrictor muscles. MRI also confirmed the absence of fistulous ducts connected to the cyst. These clinical and laboratory data induced us to use an intra-oral approach to the cyst, which was removed by blunt dissection. Physical examination and MRI were repeated six months later and showed the complete removal of the cyst and the presence of a synechia between the upper part of the left posterior pillar and the pharyngeal wall. No further treatment was given because of the absence of symptoms. The authors stress the importance of less invasive surgery in the case of pharyngeal cyst possible after detailed monitoring of the disease site with modern computed tomography CT, MRI.

[Early diagnosis of intellectual deficiency]. / Diagnosi precoce di deficit intellettivo.

The Author reports the results of some studies of the developing cognitive competences in infants. Utilizing the Hz-giris-Hunt's and the Brunet-Lezine's Scales in 18 infants during the two first months of life did not observe significant correlation between neurologic examination and development of cognitive competence. In an other study of 52 infants of less than two months old, with or without perinatal brain damage, the attentive motricity resulted to be predictive index of future cognitive abilities until twelfth month of age.

Laboratory services for psychiatric facilities.

The science and marketing of psychiatric treatment are rapidly changing, and the changes are reflected, in part, in the recent evolution of the use of laboratory services. Nevertheless, there are few, if any, articles in the literature addressing how a laboratory service can best assist a psychiatric hospital. This article presents a scaffolding of current issues to be considered when determining how a laboratory can assist the psychiatric facility. It cites the special laboratory needs of the psychiatric hospital and issues to be considered when evaluating laboratory service.