Changes in Perfusion-Weighted Magnetic Resonance Imaging after Carotid Angioplasty with Stent

Carotid artery stenosis due to arteriosclerosis increases the risk of cerebral ischemia via embolic phenomena or reduced blood flow. The changes in cerebral perfusion that may occur after treatment are not clearly understood. This study evaluated the changes in cerebral microcirculation following carotid angioplasty with stenting (CAS) under cerebral protection with filters using ultrafast gradient echo (GRE) perfusion weighted imaging (PWI) with magnetic resonance imaging (MRI). Prospectively, 21 cervical carotid stenosis patients, mean age 69.95 years, underwent MRI 12 h before and 72 h after CAS. PWI parameters were collected for statistical analysis: cerebral blood volume (CB V), mean transit time (MTT) and time to peak (TTP). Statistical analysis was applied to absolute parameters and to values normalized against those from the contralateral parenchyma. The main finding of this study was improved hemodynamics for the normalized data after CAS, shown by reduced MTT (p<0.001) and TTP (p=0.019) in the territory fed by the middle cerebral artery ipsilateral to the CAS. Absolute data showed increased blood volume in the cerebral hemispheres after CAS, which was more accentuated on the stent side (p=0.016) than the contralateral side (p=0.029). Early improvements in cerebral perfusion, mainly seen in the normalized data, were clearly demonstrated in the timing parameters - TTP & MTT - after CAS.

Transorbital stab penetrating brain injury. Report of a case

INTRODUCTION: Penetrating injury of the skull and brain is relatively uncommon, representing about 0.4% of head injuries. In this paper the Authors describe a case of patient victim of transorbital stab with brain injury with good recovery and review the literature about cranial stab wound. CASE REPORT: A 23-year-old man was involved in an altercation which resulted in the patient sustaining wounds to the head, with penetrating in left transorbital, affecting the eye. At arrival to the first trauma center the patient was conscient and complete responsive with 15 points in Glasgow Coma Scale, and motor deficit grade III. CT scan demonstrated left periventricular brain hematoma and supraorbital fracture. A four-vessel cerebral angiogram demonstrated no anormality. In this evolution patient presented good neurologic outcome. CONCLUSION: In patients conscients with no surgical lesion like our patient, the hospital discharge must occurr after the angiogram have excluded intracranial vascular lesion.

Use of alprostadil, a stable prostaglandin E(1) analogue, for the attenuation of rat skeletal muscle ischemia and reperfusion injury

Aim. Some stable prostaglandin analogues such as alprostadil have been used to attenuate the deleterious effects of ischemia and reperfusion injury. The aim of this paper was to test if alprostadil can decrease the ischemia- reperfusion injury in rat skeletal muscle using muscular enzymes as markers, such as aspartate aminotransferase (AST), creatine kinase (CPK), lactate dehydrogenase (LDH); degeneration products of cell membrane-malondialdehyde (MDA) and muscle glycogen storage. Methods. Thirty male Wistar rats were used in a model of hind limb ischemia achieved by infrarenal aortic cross-clamping. The animals were randomized into three equal groups (N=10) submitted to 5 hours of ischemia followed by one hour of reperfusion. The first group (control) received continuous intravenous infusion of saline solution and the second group (preischemia, GPI) received continuous intravenous infusion of alprostadil throughout the experiment starting 20 minutes before the aortic cross-clamping. The third group, prereperfusion (GPR), received alprostadil only during the reperfusion period, with intravenous infusion being started 10 min before the clamp release. Results. There was no difference in CPK, LDH, AST or tissue glycogen values between groups. However, a significant elevation in MDA was observed in the GPI and GPR groups compared to the control group, with no difference between the GPI and GPR. Conclusion. Under conditions of partial skeletal muscle ischemia, alprostadil did not reduce the release of muscular enzymes, the consumption of tissue glycogen or the effects of ischemia and reperfusion on the cell membrane, characterized by lipid peroxidation.

Imaging in osteoarthritis: what have we learned and where are we going?

Osteoarthritis (OA) is a widely prevalent disease of the whole joint including cartilage, bone and soft tissues. Increasing importance of imaging including assessment of all joint structures has been recognized recently. Conventional radiography is still the first and most commonly used imaging technique for evaluation of a patient with a known or suspected diagnosis of OA. However, limitations have been revealed by recent MRI-based knee OA studies. MRI plays a crucial role in understanding the natural history of the disease and in guiding future therapies due to its ability to image the knee as a whole organ and to directly and three-dimensionally assess cartilage morphology and composition. It is crucial to use the appropriate MR pulse sequences to assess various OA features, and thus support from experienced musculoskeletal radiologists should be sought for study design, image acquisition and interpretation. The aim of this article is to describe the roles and limitations of conventional radiography and MRI in imaging of OA, and also to give insight into the use of other modalities such as ultrasound, scintigraphy, computed tomography (CT) and CT arthrography in clinical practice and research in OA, particularly focusing on the assessment of knee OA in the tibiofemoral joint.

Some Preliminaries in Approaching Carlos Seixas’ Keyboard Sonatas

The figure and the oeuvre of Carlos Seixas (1704-42) were rediscovered in the 1930s chiefly by the British musicologist Macario Santiago Kastner (1908-92), whose writings and editions raised the attention of international scholars and interpreters for the Portuguese composer. Nevertheless, and in spite of an unusual editorial tradition for Portuguese standards, a critical appraisal of the body of sources of Seixas' keyboard sonatas has never been attempted, to the point of even impeding the knowledge of how many there really are. This article deals briefly with the issues of source situation, authorship attribution and the distinctive characteristics of Seixas' style, offering a preliminary catalogue of the sonatas and a description of four of the manuscript collections containing them, housed at the National Library of Portugal. Textual peculiarities and problems of works surviving in more than one source are examined and the question of text 'banalization' by means of the incorporation of performance practice gestures is also discussed, advancing the hypothesis of the existence of two different traditions for some of the sonatas―one written and one 'oral'―that merge in the texts known to us.

Mère aimée, mère domestiquée? Mères valaisannes du XVIIIème siècle et leurs fonctions sociales

Mères entre amour familial et "individualisme moderne?" Une mise en perspective (XVIIIe-XIXe siècles)

Gaston Paris - Joseph Bédier. Correspondance

Gaston Paris: le maître; Joseph Bédier: le disciple. Ces deux grands érudits, dont les car- rières glorieuses consacrent l'accession de la philologie romane, en France, au statut de dis- cipline scientifique, restent sans doute les deux figures les plus célèbres des temps héroïques de la médiévistique française.Tous deux professeurs au Collège de France et membres de l'Académie française, ils ont renouvelé l'image que non seulement les spécialistes, mais aussi le grand public se faisaient de la littérature du Moyen Âge: nous vivons aujourd'hui encore de leurs travaux.Tout les sépare (Bédier n'ayant eu de cesse de contester les idées de Paris), mais tout les unit, car tous deux professent un égal amour de la vérité et de la probité scientifique. Enfin réunie (même si on doit déplorer la perte de beaucoup de let- tres du maître), leur correspondance offre un tableau extraordinairement vivant et ins- tructif du débat incessant qu'ont mené les deux hommes et, surtout, d'une amitié profonde faite de respect mutuel et d'un désir sincère de voir la science l'emporter sur les querelles partisanes. Demandant à Bédier de se mesurer à lui de la même manière queTaras Boulba incitait ses fils à le battre, Gaston Paris répond ainsi d'avance à ceux qui après sa mort ont accusé Bédier d'avoir voulu "tuer" son maître. La présente publication ouvre une collection qui a l'ambition de nous restituer les plus belles correspondances des princi- paux représentants de la philologie romane des XIXe et XXe siècles.