Sample records for imaging defined cavernous

  1. Results of stereotactic radiosurgery for patients with imaging defined cavernous sinus meningiomas

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pollock, Bruce E.; Stafford, Scott L.

    2005-08-01

    Introduction: The purpose of this study was to evaluate the efficacy and safety of stereotactic radiosurgery as primary management for patients with imaging defined cavernous sinus meningiomas. Methods: Between 1992 and 2001, 49 patients had radiosurgery for dural-based masses of the cavernous sinus presumed to be meningiomas. The mean patient age was 55.5 years. The mean tumor volume was 10.2 mL; the mean tumor margin dose was 15.9 Gy. The mean follow-up was 58 months (range, 16-144 months). Results: No tumor enlarged after radiosurgery. Twelve of 38 patients (26%) with preexisting diplopia or facial numbness/pain had improvement in cranial nervemore » function. Five patients (10%) had new (n = 3) or worsened (n = 2) trigeminal dysfunction; 2 of these patients (4%) underwent surgery at 20 and 25 months after radiosurgery despite no evidence of tumor progression. Neither patient improved after partial tumor resection. One patient (2%) developed an oculomotor nerve injury. One patient (2%) had an ischemic stroke related to occlusion of the cavernous segment of the internal carotid artery. Event-free survival was 98%, 85%, and 80% at 1, 3, and 7 years after radiosurgery, respectively. Univariate analysis of patient and dosimetric factors found no analyzed factor correlated with postradiosurgical morbidity. Conclusions: Radiosurgery was an effective primary management strategy for patients with an imaging defined cavernous sinus meningioma. Except in situations of symptomatic mass effect, unusual clinical presentation, or atypical imaging features, surgery to confirm the histologic diagnosis is unlikely to provide clinical benefit.« less

  2. OCT image segmentation of the prostate nerves

    NASA Astrophysics Data System (ADS)

    Chitchian, Shahab; Weldon, Thomas P.; Fried, Nathaniel M.

    2009-08-01

    The cavernous nerves course along the surface of the prostate and are responsible for erectile function. Improvements in identification, imaging, and visualization of the cavernous nerves during prostate cancer surgery may improve nerve preservation and postoperative sexual potency. In this study, 2-D OCT images of the rat prostate were segmented to differentiate the cavernous nerves from the prostate gland. Three image features were employed: Gabor filter, Daubechies wavelet, and Laws filter. The features were segmented using a nearestneighbor classifier. N-ary morphological post-processing was used to remove small voids. The cavernous nerves were differentiated from the prostate gland with a segmentation error rate of only 0.058 +/- 0.019.

  3. SU-E-I-91: Quantitative Assessment of Early Hepatocellular Carcinoma and Cavernous Hemangioma of Live Using In-Line Phase-Contrast X-Ray Imaging

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Duan, J

    Purpose: To investigate the potential utility of in-line phase-contrast imaging (ILPCI) technique with synchrotron radiation in detecting early hepatocellular carcinoma and cavernous hemangioma of live using in vitro model system. Methods: Without contrast agents, three typical early hepatocellular carcinoma specimens and three typical cavernous hemangioma of live specimens were imaged using ILPCI. To quantitatively discriminate early hepatocellular carcinoma tissues and cavernous hemangioma tissues, the projection images texture feature based on gray level co-occurrence matrix (GLCM) were extracted. The texture parameters of energy, inertia, entropy, correlation, sum average, sum entropy, difference average, difference entropy and inverse difference moment, were obtained respectively.more » Results: In the ILPCI planar images of early hepatocellular carcinoma specimens, vessel trees were clearly visualized on the micrometer scale. Obvious distortion deformation was presented, and the vessel mostly appeared as a ‘dry stick’. Liver textures appeared not regularly. In the ILPCI planar images of cavernous hemangioma of live specimens, typical vessels had not been found compared with the early hepatocellular carcinoma planar images. The planar images of cavernous hemangioma of live specimens clearly displayed the dilated hepatic sinusoids with the diameter of less than 100 microns, but all of them were overlapped with each other. The texture parameters of energy, inertia, entropy, correlation, sum average, sum entropy, and difference average, showed a statistically significant between the two types specimens image (P<0.01), except the texture parameters of difference entropy and inverse difference moment(P>0.01). Conclusion: The results indicate that there are obvious changes in morphological levels including vessel structures and liver textures. The study proves that this imaging technique has a potential value in evaluating early hepatocellular carcinoma and cavernous hemangioma of live.« less

  4. Virtual Reality Model of the Three-Dimensional Anatomy of the Cavernous Sinus Based on a Cadaveric Image and Dissection.

    PubMed

    Qian, Zeng-Hui; Feng, Xu; Li, Yang; Tang, Ke

    2018-01-01

    Studying the three-dimensional (3D) anatomy of the cavernous sinus is essential for treating lesions in this region with skull base surgeries. Cadaver dissection is a conventional method that has insurmountable flaws with regard to understanding spatial anatomy. The authors' research aimed to build an image model of the cavernous sinus region in a virtual reality system to precisely, individually and objectively elucidate the complete and local stereo-anatomy. Computed tomography and magnetic resonance imaging scans were performed on 5 adult cadaver heads. Latex mixed with contrast agent was injected into the arterial system and then into the venous system. Computed tomography scans were performed again following the 2 injections. Magnetic resonance imaging scans were performed again after the cranial nerves were exposed. Image data were input into a virtual reality system to establish a model of the cavernous sinus. Observation results of the image models were compared with those of the cadaver heads. Visualization of the cavernous sinus region models built using the virtual reality system was good for all the cadavers. High resolutions were achieved for the images of different tissues. The observed results were consistent with those of the cadaver head. The spatial architecture and modality of the cavernous sinus were clearly displayed in the 3D model by rotating the model and conveniently changing its transparency. A 3D virtual reality model of the cavernous sinus region is helpful for globally and objectively understanding anatomy. The observation procedure was accurate, convenient, noninvasive, and time and specimen saving.

  5. Segmentation of optical coherence tomography images for differentiation of the cavernous nerves from the prostate gland

    NASA Astrophysics Data System (ADS)

    Chitchian, Shahab; Weldon, Thomas P.; Fried, Nathaniel M.

    2009-07-01

    The cavernous nerves course along the surface of the prostate and are responsible for erectile function. Improvements in identification, imaging, and visualization of the cavernous nerves during prostate cancer surgery may improve nerve preservation and postoperative sexual potency. Two-dimensional (2-D) optical coherence tomography (OCT) images of the rat prostate were segmented to differentiate the cavernous nerves from the prostate gland. To detect these nerves, three image features were employed: Gabor filter, Daubechies wavelet, and Laws filter. The Gabor feature was applied with different standard deviations in the x and y directions. In the Daubechies wavelet feature, an 8-tap Daubechies orthonormal wavelet was implemented, and the low-pass sub-band was chosen as the filtered image. Last, Laws feature extraction was applied to the images. The features were segmented using a nearest-neighbor classifier. N-ary morphological postprocessing was used to remove small voids. The cavernous nerves were differentiated from the prostate gland with a segmentation error rate of only 0.058+/-0.019. This algorithm may be useful for implementation in clinical endoscopic OCT systems currently being studied for potential intraoperative diagnostic use in laparoscopic and robotic nerve-sparing prostate cancer surgery.

  6. Segmentation of optical coherence tomography images for differentiation of the cavernous nerves from the prostate gland.

    PubMed

    Chitchian, Shahab; Weldon, Thomas P; Fried, Nathaniel M

    2009-01-01

    The cavernous nerves course along the surface of the prostate and are responsible for erectile function. Improvements in identification, imaging, and visualization of the cavernous nerves during prostate cancer surgery may improve nerve preservation and postoperative sexual potency. Two-dimensional (2-D) optical coherence tomography (OCT) images of the rat prostate were segmented to differentiate the cavernous nerves from the prostate gland. To detect these nerves, three image features were employed: Gabor filter, Daubechies wavelet, and Laws filter. The Gabor feature was applied with different standard deviations in the x and y directions. In the Daubechies wavelet feature, an 8-tap Daubechies orthonormal wavelet was implemented, and the low-pass sub-band was chosen as the filtered image. Last, Laws feature extraction was applied to the images. The features were segmented using a nearest-neighbor classifier. N-ary morphological postprocessing was used to remove small voids. The cavernous nerves were differentiated from the prostate gland with a segmentation error rate of only 0.058+/-0.019. This algorithm may be useful for implementation in clinical endoscopic OCT systems currently being studied for potential intraoperative diagnostic use in laparoscopic and robotic nerve-sparing prostate cancer surgery.

  7. Speckle reduction during all-fiber common-path optical coherence tomography of the cavernous nerves

    NASA Astrophysics Data System (ADS)

    Chitchian, Shahab; Fiddy, Michael; Fried, Nathaniel M.

    2009-02-01

    Improvements in identification, imaging, and visualization of the cavernous nerves during prostate cancer surgery, which are responsible for erectile function, may improve nerve preservation and postoperative sexual potency. In this study, we use a rat prostate, ex vivo, to evaluate the feasibility of optical coherence tomography (OCT) as a diagnostic tool for real-time imaging and identification of the cavernous nerves. A novel OCT system based on an all single-mode fiber common-path interferometer-based scanning system is used for this purpose. A wavelet shrinkage denoising technique using Stein's unbiased risk estimator (SURE) algorithm to calculate a data-adaptive threshold is implemented for speckle noise reduction in the OCT image. The signal-to-noise ratio (SNR) was improved by 9 dB and the image quality metrics of the cavernous nerves also improved significantly.

  8. The role of magnetic resonance diffusion-weighted imaging and three-dimensional arterial spin labelling perfusion imaging in the differentiation of parasellar meningioma and cavernous haemangioma.

    PubMed

    Xiao, Hua-Feng; Lou, Xin; Liu, Meng-Yu; Wang, Yu-Lin; Wang, Yan; Chen, Zhi-Ye; Shi, Kai-Ning; Ma, Lin

    2014-08-01

    To evaluate the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) and three-dimensional arterial spin labelling perfusion imaging (3D-ASL) in distinguishing cavernous haemangioma from parasellar meningioma, using histological data as a reference standard. Patients with parasellar meningioma or parasellar cavernous haemangioma underwent conventional T1- and T2-weighted magnetic resonance imaging (MRI) followed by DWI and 3D-ASL using a 3.0 Tesla MRI. The minimum apparent diffusion coefficient (minADC) from DWI and the maximal normalized cerebral blood flow (nCBF) from 3D-ASL were measured in each tumour. Diagnosis was confirmed by histology. MinADC was significantly lower and nCBF significantly higher in meningioma (n = 19) than cavernous haemangioma (n = 15). There was a significant negative correlation between minADC and nCBF (r = -0.605). DWI and 3D-ASL are useful in differentiating cavernous haemangiomas from parasellar meningiomas, particularly in situations when the appearance on conventional MRI sequences is otherwise ambiguous. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  9. [Depiction of the cranial nerves around the cavernous sinus by 3D reversed FISP with diffusion weighted imaging (3D PSIF-DWI)].

    PubMed

    Ishida, Go; Oishi, Makoto; Jinguji, Shinya; Yoneoka, Yuichiro; Sato, Mitsuya; Fujii, Yukihiko

    2011-10-01

    To evaluate the anatomy of cranial nerves running in and around the cavernous sinus, we employed three-dimensional reversed fast imaging with steady-state precession (FISP) with diffusion weighted imaging (3D PSIF-DWI) on 3-T magnetic resonance (MR) system. After determining the proper parameters to obtain sufficient resolution of 3D PSIF-DWI, we collected imaging data of 20-side cavernous regions in 10 normal subjects. 3D PSIF-DWI provided high contrast between the cranial nerves and other soft tissues, fluid, and blood in all subjects. We also created volume-rendered images of 3D PSIF-DWI and anatomically evaluated the reliability of visualizing optic, oculomotor, trochlear, trigeminal, and abducens nerves on 3D PSIF-DWI. All 20 sets of cranial nerves were visualized and 12 trochlear nerves and 6 abducens nerves were partially identified. We also presented preliminary clinical experiences in two cases with pituitary adenomas. The anatomical relationship between the tumor and cranial nerves running in and around the cavernous sinus could be three-dimensionally comprehended by 3D PSIF-DWI and the volume-rendered images. In conclusion, 3D PSIF-DWI has great potential to provide high resolution "cranial nerve imaging", which visualizes the whole length of the cranial nerves including the parts in the blood flow as in the cavernous sinus region.

  10. Brainstem Cavernous Angioma

    MedlinePlus

    ... echo” (as opposed to spin-echo or proton beam) imaging. Gradient-echo MRI is most efficient at ... radiosurgery for cavernous malformations: Kjellberg's experience with proton beam therapy in 98 cases at the Harvard Cyclotron. ...

  11. Optical Coherence Tomography Angiography of Retinal Cavernous Hemangioma.

    PubMed

    Pierro, Luisa; Marchese, Alessandro; Gagliardi, Marco; Bandello, Francesco

    2017-08-01

    Retinal cavernous hemangioma is a rare, benign, retinal tumor characterized by angiomatous proliferation of vessels within the inner retina or the optic disc.1 Here we report a case of retinal cavernous hemangioma on the margin of the optic disc in the right eye of a 61-year-old asymptomatic female. The lesion was studied with multimodal imaging which included structural optical coherence tomography, fluorescein angiography, blue fundus auto-fluorescence, optical coherence tomography angiography (OCTA) (DRI OCT Triton; Topcon, Tokyo, Japan) and visual field examination. Blood circulation inside retinal cavernous hemangioma lesion is typically low-stagnant.2 However, OCTA demonstrated blood flow inside the lesion, illustrating its vascular circulation.3 Visual field was within the normal limits, except from a slight enlargement of the blind spot. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:684-685.]. Copyright 2017, SLACK Incorporated.

  12. Preoperative diagnosis of orbital cavernous hemangioma: a 99mTc-RBC SPECT study.

    PubMed

    Burroni, Luca; Borsari, Giulia; Pichierri, Patrizia; Polito, Ennio; Toscano, Olga; Grassetto, Gaia; Al-Nahhas, Adil; Rubello, Domenico; Vattimo, Angelo Giuseppe

    2012-11-01

    This study aimed to describe 99mTc-labeled RBC scintigraphy as a diagnostic method for orbital cavernous hemangiomas and to evaluate this diagnostic tool according to surgical outcomes. Fifty-five patients with clinical and radiological (US, CT, and/or MRI) suspicion of unilateral cavernous hemangioma of the orbit underwent 99mTc-RBC SPECT study.Qualitative and semiquantitative evaluations were performed, and results were statistically analyzed. SPECT images showed focal uptake in the orbital mass in 36 of 55 patients. Nineteen patients had a negative scintigraphic pattern, with concordance of early and late absence of uptake of 99mTc-RBC.Our procedure showed 100% sensitivity and 88.9% specificity for the diagnosis of orbital cavernous hemangioma, with a positive predictive value of 90.9% and a negative predictive value of 100%. 99mTc-RBC imaging is safe, easy to perform, and highly accurate in providing adequate clinical and surgical management. As a noninvasive and highly specific method for diagnosing orbital hemangioma, 99mTc-RBC scintigraphy can avoid more invasive imaging or biopsy.

  13. Brainstem and cerebellar cavernous malformations.

    PubMed

    Atwal, Gursant S; Sarris, Christina E; Spetzler, Robert F

    2017-01-01

    Cavernous malformations are vascular lesions that occur throughout the central nervous system, most commonly in the supratentorial location, with brainstem and cerebellar cavernous malformations occurring more rarely. Cavernous malformations are associated with developmental venous anomalies that occur sporadically or in familial form. Patients with a cavernous malformation can present with headaches, seizures, sensorimotor disturbances, or focal neurologic deficits based on the anatomic location of the lesion. Patients with infratentorial lesions present more commonly with a focal neurologic deficit. Cavernous malformations are increasingly discovered incidentally due to the increasing use of magnetic resonance imaging. Understanding the natural history of these lesions is essential to their management. Observation and surgical resection are both reasonable options in the treatment of patients with these lesions. The clinical presentation of the patient, the location of the lesion, and the surgical risk assessment all play critical roles in management decision-making. © 2017 Elsevier B.V. All rights reserved.

  14. A new strategic neurosurgical planning tool for brainstem cavernous malformations using interactive computer graphics with multimodal fusion images.

    PubMed

    Kin, Taichi; Nakatomi, Hirofumi; Shojima, Masaaki; Tanaka, Minoru; Ino, Kenji; Mori, Harushi; Kunimatsu, Akira; Oyama, Hiroshi; Saito, Nobuhito

    2012-07-01

    In this study, the authors used preoperative simulation employing 3D computer graphics (interactive computer graphics) to fuse all imaging data for brainstem cavernous malformations. The authors evaluated whether interactive computer graphics or 2D imaging correlated better with the actual operative field, particularly in identifying a developmental venous anomaly (DVA). The study population consisted of 10 patients scheduled for surgical treatment of brainstem cavernous malformations. Data from preoperative imaging (MRI, CT, and 3D rotational angiography) were automatically fused using a normalized mutual information method, and then reconstructed by a hybrid method combining surface rendering and volume rendering methods. With surface rendering, multimodality and multithreshold techniques for 1 tissue were applied. The completed interactive computer graphics were used for simulation of surgical approaches and assumed surgical fields. Preoperative diagnostic rates for a DVA associated with brainstem cavernous malformation were compared between conventional 2D imaging and interactive computer graphics employing receiver operating characteristic (ROC) analysis. The time required for reconstruction of 3D images was 3-6 hours for interactive computer graphics. Observation in interactive mode required approximately 15 minutes. Detailed anatomical information for operative procedures, from the craniotomy to microsurgical operations, could be visualized and simulated three-dimensionally as 1 computer graphic using interactive computer graphics. Virtual surgical views were consistent with actual operative views. This technique was very useful for examining various surgical approaches. Mean (±SEM) area under the ROC curve for rate of DVA diagnosis was significantly better for interactive computer graphics (1.000±0.000) than for 2D imaging (0.766±0.091; p<0.001, Mann-Whitney U-test). The authors report a new method for automatic registration of preoperative imaging data from CT, MRI, and 3D rotational angiography for reconstruction into 1 computer graphic. The diagnostic rate of DVA associated with brainstem cavernous malformation was significantly better using interactive computer graphics than with 2D images. Interactive computer graphics was also useful in helping to plan the surgical access corridor.

  15. The cavernous sinus in cluster headache - a quantitative structural magnetic resonance imaging study.

    PubMed

    Arkink, Enrico B; Schoonman, Guus G; van Vliet, Jorine A; Bakels, Hannah S; Sneeboer, Marjolein Am; Haan, Joost; van Buchem, Mark A; Ferrari, Michel D; Kruit, Mark C

    2017-03-01

    Background It has been hypothesized that a constitutionally narrow cavernous sinus might predispose individuals to cluster headache. Cavernous sinus dimensions, however, have never been assessed. Methods In this case-control study, we measured the dimensions of the cavernous sinus, skull base, internal carotid and pituitary gland with high-resolution T2-weighted magnetic resonance imaging in 25 episodic, 24 chronic and 13 probable cluster headache patients, 8 chronic paroxysmal hemicrania patients and 22 headache-free controls. Dimensions were compared between groups, correcting for age, sex and transcranial diameter. Results On qualitative inspection, no relevant pathology or anatomic variants that were previously associated with cluster headache or chronic paroxysmal hemicranias were observed in the cavernous sinus or paracavernous structures. The left-to-right transcranial diameter at the temporal fossa level (mean ± SD) was larger in the headache groups (episodic cluster headache: 147.5 ± 7.3 mm, p = 0.044; chronic cluster headache: 150.2 ± 7.3 mm, p < 0.001; probable cluster headache: 146.0 ± 5.3 mm, p = 0.012; and chronic paroxysmal hemicrania: 145.2 ± 9.4 mm, p = 0.044) compared with controls (140.2 ± 8.0 mm). After adjusting for transcranial diameter and correcting for multiple comparisons, there were no differences in the dimensions of the cavernous sinus and surrounding structures between headache patients and controls. Conclusion Patients with cluster headache or chronic paroxysmal hemicrania had wider skulls than headache-free controls, but the proportional dimensions of the cavernous sinus were similar.

  16. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 4, West Hackberry site, Louisiana.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-09-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 4 focuses on the West Hackberry SPR site, located in southwestern Louisiana. Volumes 1, 2, and 3, respectively, present images for the Bayou Choctaw SPR site, Louisiana, the Big Hill SPR site, Texas, and the Bryan Mound SPR site, Texas. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes,more » the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.« less

  17. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 2, Big Hill Site, Texas.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-08-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 2 focuses on the Big Hill SPR site, located in southeastern Texas. Volumes 1, 3, and 4, respectively, present images for the Bayou Choctaw SPR site, Louisiana, the Bryan Mound SPR site, Texas, and the West Hackberry SPR site, Louisiana. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes,more » the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.« less

  18. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 1, Bayou Choctaw site, Louisiana.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-10-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 1 focuses on the Bayou Choctaw SPR site, located in southern Louisiana. Volumes 2, 3, and 4, respectively, present images for the Big Hill SPR site, Texas, the Bryan Mound SPR site, Texas, and the West Hackberry SPR site, Louisiana. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes,more » the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.« less

  19. Simultaneous and sequential hemorrhage of multiple cerebral cavernous malformations: a case report.

    PubMed

    Louis, Nundia; Marsh, Robert

    2016-02-09

    The etiology of cerebral cavernous malformation hemorrhage is not well understood. Causative physiologic parameters preceding hemorrhagic cavernous malformation events are often not reported. We present a case of an individual with sequential simultaneous hemorrhages in multiple cerebral cavernous malformations with a new onset diagnosis of hypertension. A 42-year-old white man was admitted to our facility with worsening headache, left facial and tongue numbness, dizziness, diplopia, and elevated blood pressure. His past medical history was significant for new onset diagnosis of hypertension and chronic seasonal allergies. Serial imaging over the ensuing 8 days revealed sequential hemorrhagic lesions. He underwent suboccipital craniotomy for resection of the lesions located in the fourth ventricle and right cerebellum. One month after surgery, he had near complete resolution of his symptoms with mild residual vertigo but symptomatic chronic hypertension. Many studies have focused on genetic and inflammatory mechanisms contributing to cerebral cavernous malformation rupture, but few have reported on the potential of hemodynamic changes contributing to cerebral cavernous malformation rupture. Systemic blood pressure changes clearly have an effect on angioma pressures. When considering the histopathological features of cerebral cavernous malformation architecture, changes in arterial pressure could cause meaningful alterations in hemorrhage propensity and patterns.

  20. [A case of cavernous angioma at the convexity in the dura mater: characteristics of images in the literature].

    PubMed

    Yonezawa, Ushio; Ikawa, Fusao; Hamasaki, Osamu; Hidaka, Toshikazu; Kurokawa, Yasuharu; Onuma, Hideyuki

    2014-08-01

    We describe a rare case of cavernous angioma in the dura mater and discuss published MRI findings on similar cases. The patient was a 78-year-old woman who was referred to Shimane Prefectural Central Hospital with complaints of headaches. We were subsequently able to identify a tumor at the convexity in the dura mater. The tumor showed a high intensity on T2-weighted images and was heterogeneously enhanced on contrast-enhanced T1-weighted images. The maximum size of the tumor was 35 mm. Moreover, preoperative angiography showed a slight vascularity in the tumor. We performed surgery with the expectation of finding a meningioma, metastatic brain tumor, or another mesenchymal tumor. The tumor was dark and red, attached to the dura mater, and adhered to the arachnoid. However, we were able to peel the tumor away from the meninges and achieved a total removal of the mass, successfully cutting a fine feeding cortical artery. The patient was discharged without neurological defects 9 days after surgery;the pathological diagnosis was cavernous angioma. In conclusion, it is difficult to discern between meningioma and cavernous angioma in the dura mater. However, the specificity of high intensity on T2-weighted images is relatively high, and preoperative diagnosis can be determined by MRI and angiography findings.

  1. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rautman, Christopher Arthur; Lord, Anna Snider

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 3 focuses on the Bryan Mound SPR site, located in southeastern Texas. Volumes 1, 2, and 4, respectively, present images for the Bayou Choctaw SPR site, Louisiana, the Big Hill SPR site, Texas, and the West Hackberry SPR site, Louisiana. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes,more » the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.« less

  2. Technetium tc 99m-labeled red blood cells in the preoperative diagnosis of cavernous hemangioma and other vascular orbital tumors.

    PubMed

    Polito, Ennio; Burroni, Luca; Pichierri, Patrizia; Loffredo, Antonio; Vattimo, Angelo G

    2005-12-01

    To evaluate technetium Tc 99m (99mTc) red blood cell scintigraphy as a diagnostic tool for orbital cavernous hemangioma and to differentiate between orbital masses on the basis of their vascularization. We performed 99mTc red blood cell scintigraphy on 23 patients (8 female and 15 male; mean age, 47 years) affected by an orbital mass previously revealed with computed tomography (CT) and magnetic resonance imaging (MRI) and suggesting cavernous hemangioma. In our diagnosis, we considered the orbital increase delayed uptake with the typical scintigraphic pattern known as perfusion blood pool mismatch. The patients underwent biopsy or surgical treatment with transconjunctival cryosurgical extraction when possible. Single-photon emission tomography (SPET) showed intense focal uptake in the orbit corresponding to radiologic findings in 11 patients who underwent surgical treatment and pathologic evaluation (9 cavernous hemangiomas, 1 hemangiopericytoma, and 1 lymphangioma). Clinical or histologic examination of the remaining 22 patients revealed the presence of 5 lymphoid pseudotumors, 2 lymphomas, 2 pleomorphic adenomas of the lacrimal gland, 1 astrocytoma, 1 ophthalmic vein thrombosis, and 1 orbital varix. The confirmation of the preoperative diagnosis by 99mTc red blood cell scintigraphy shows that this technique is a reliable tool for differentiating cavernous hemangiomas from other orbital masses (sensitivity, 100%; specificity, 86%) when ultrasound, CT, and MRI are not diagnostic. Unfortunately, 99mTc red blood cell scintigraphy results were positive in 1 patient with hemangiopericytoma and 1 patient with lymphangioma, which showed increased uptake in the lesion on SPET images because of the vascular nature of these tumors. Therefore, in these cases, the SPET images have to be integrated with data regarding clinical preoperative evaluation and CT scans or MRI studies. On the basis of our study, a complete diagnostic picture, CT scans or MRI studies, and scintigraphic patterns can establish the preoperative diagnosis of vascular orbital tumors such as cavernous hemangioma, adult-type lymphangioma, and hemangiopericytoma.

  3. [Cavernous sinus thrombosis as a rare cause of exophthalmos in childhood : A case report].

    PubMed

    Kamawal, A; Schmidt, M A; Rompel, O; Gusek-Schneider, G C; Mardin, C Y; Trollmann, R

    2017-05-01

    Complications of acute bacterial sinusitis mostly occur in children and adolescents. In particular, intracranial spread of the infection can lead to severe even fatal courses of the disease. This article is a case report about a 13-year-old boy suffering from left-sided headache, meningismus and exophthalmos as presenting symptoms. Cranial magnetic resonance imaging (MRI) showed merely right-sided sphenoid sinusitis; however, the diffusion-weighted MRI sequence indicated a left-sided cavernous sinus thrombosis, which could be confirmed by computed tomography (CT) angiography. Cerebrospinal fluid diagnostics showed significant leukocytosis confirming secondary meningitis. Finally, exophthalmos was explained by parainfectious cavernous sinus thrombosis and periorbital edema. This case report highlights the importance of extended and specific diagnostic imaging in cases of clinically suspected complications in children and adolescents with sinusitis and the diagnostic significance of diffusion-weighted MRI.

  4. Detection of cavernous transformation of the portal vein by contrast-enhanced ultrasound.

    PubMed

    Hwang, Misun; Thimm, Matthew A; Guerrerio, Anthony L

    2018-06-01

    Cavernous transformation of the portal vein can be missed on color Doppler exam or arterial phase cross-sectional imaging due to their slow flow and delayed enhancement. Contrast-enhanced ultrasound (CEUS) offers many advantages over other imaging techniques and can be used to successfully detect cavernous transformations of the portal vein. A 10-month-old female was followed for repeat episodes of hematemesis. Computed tomography angiography (CTA) and magnetic resonance arteriogram (MRA) and portal venography were performed. Color Doppler exam of the portal vein was performed followed by administration of Lumason, a microbubble US contrast agent. Magnetic resonance arteriogram, CTA, and color Doppler exam at the time of initial presentation was unremarkable without obvious vascular malformation within the limits of motion degraded exam. At 8-month follow-up, esophagogastroduodenoscopy revealed a vascular malformation in the distal esophagus which was sclerosed. At 6 month after sclerosis of the lesion, portal venography revealed occlusion of the portal vein with extensive collateralization. Color Doppler revealed subtle hyperarterialization and periportal collaterals. CEUS following color Doppler exam demonstrated extensive enhancement of periportal collaterals. Repeat color Doppler after contrast administration demonstrated extensive Doppler signal in the collateral vessels, suggestive of cavernous transformation. We describe a case of cavernous transformation of the portal vein missed on initial color Doppler, CTA and MRA, but detected with contrast-enhanced ultrasound technique.

  5. Dilatancy Criteria for Salt Cavern Design: A Comparison Between Stress- and Strain-Based Approaches

    NASA Astrophysics Data System (ADS)

    Labaune, P.; Rouabhi, A.; Tijani, M.; Blanco-Martín, L.; You, T.

    2018-02-01

    This paper presents a new approach for salt cavern design, based on the use of the onset of dilatancy as a design threshold. In the proposed approach, a rheological model that includes dilatancy at the constitutive level is developed, and a strain-based dilatancy criterion is defined. As compared to classical design methods that consist in simulating cavern behavior through creep laws (fitted on long-term tests) and then using a criterion (derived from short-terms tests or experience) to determine the stability of the excavation, the proposed approach is consistent both with short- and long-term conditions. The new strain-based dilatancy criterion is compared to a stress-based dilatancy criterion through numerical simulations of salt caverns under cyclic loading conditions. The dilatancy zones predicted by the strain-based criterion are larger than the ones predicted by the stress-based criteria, which is conservative yet constructive for design purposes.

  6. Wavelet denoising during optical coherence tomography of the prostate nerves using the complex wavelet transform.

    PubMed

    Chitchian, Shahab; Fiddy, Michael; Fried, Nathaniel M

    2008-01-01

    Preservation of the cavernous nerves during prostate cancer surgery is critical in preserving sexual function after surgery. Optical coherence tomography (OCT) of the prostate nerves has recently been studied for potential use in nerve-sparing prostate surgery. In this study, the discrete wavelet transform and complex dual-tree wavelet transform are implemented for wavelet shrinkage denoising in OCT images of the rat prostate. Applying the complex dual-tree wavelet transform provides improved results for speckle noise reduction in the OCT prostate image. Image quality metrics of the cavernous nerves and signal-to-noise ratio (SNR) were improved significantly using this complex wavelet denoising technique.

  7. Differentiation between cavernous hemangiomas and untreated malignant neoplasms of the liver with free-breathing diffusion-weighted MR imaging: comparison with T2-weighted fast spin-echo MR imaging.

    PubMed

    Soyer, Philippe; Corno, Lucie; Boudiaf, Mourad; Aout, Mounir; Sirol, Marc; Placé, Vinciane; Duchat, Florent; Guerrache, Youcef; Fargeaudou, Yann; Vicaut, Eric; Pocard, Marc; Hamzi, Lounis

    2011-11-01

    To test interobserver variability of ADC measurements and compare the diagnostic performances of free-breathing diffusion-weighted (FBDW) with that of T2-weighted FSE (T2WFSE) MR imaging for differentiating between cavernous hemangiomas and untreated malignant hepatic neoplasms. Thirty-five patients with cavernous hemangiomas and 35 with untreated hepatic malignant neoplasms had FBDW and T2WFSE MR imaging. Hepatic lesions were characterized with ADC measurement and visual evaluation. Interobserver agreement for ADC measurement was calculated. Association between ADC value and lesion type was assessed using univariate analysis. Sensitivity, specificity and accuracy of ADC values and visual evaluation of MR images for the diagnosis of untreated malignant hepatic neoplasm were compared. ADC measurements showed excellent interobserver correlation (intraclass correlation coefficient=0.980). Malignant neoplasms had lower ADC values than hemangiomas for the two observers (1.11×10(-3) mm2/s±.21×10(-3) vs. 1.77×10(-3) mm2/s±.29×10(-3) for observer 1 and 1.11×10(-3) mm2/s±.19×10(-3) vs. 1.79×10(-3) mm2/s±.32×10(-3) for observer 2) and univariate analysis found significant correlations between lesion type and ADC values. Depending on ADC threshold value, accuracy for the diagnosis of malignant neoplasm varied from 82.9% to 94.3%. Using visual evaluation, FBDW showed better specificity and accuracy than T2WFSE MR images for the diagnosis of malignant neoplasm (97.1% vs. 77.1% and 94.3% vs. 62.9%, respectively). FBDW imaging provides reproducible quantitative information and surpasses the value of T2WFSE MR imaging for differentiating between cavernous hemangiomas and untreated malignant hepatic neoplasms. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  8. Focal dystonia secondary to cavernous angioma of the basal ganglia: case report and review of the literature.

    PubMed

    Lorenzana, L; Cabezudo, J M; Porras, L F; Polaina, M; Rodriguez-Sanchez, J A; Garcia-Yagüe, L M

    1992-12-01

    The case of a young woman with focal dystonia of the hand due to a cavernous angioma of the basal ganglia is presented. The lesion involved the anterior third of the lentiform nucleus and a large portion of white matter anterior to this nucleus and lateral to the head of the caudate, as shown by magnetic resonance imaging; it was completely removed through a computed tomography-assisted stereotactic craniotomy by microsurgical technique, resulting in the cure of the patient. These facts support the pathophysiological hypothesis of a disruption of the striatopallidothalamic projection to the premotor cortex as the cause of symptomatic dystonia. A review of the reported cases of cavernous angiomas of the deep cerebral gray nuclei shows that this is the first case of cavernous angioma associated with movement disorder.

  9. Cavernous hemangioma of the orbit: an unusual acute presentation

    PubMed Central

    Louisraj, Sophia; Ponnudurai, Thendral; Rodriguez, Dominic; Thomas, Philip A; Nelson Jesudasan, Christadoss Arul

    2017-01-01

    We report an unusual presentation of an orbital cavernous hemangioma in a 26-year-old female, who noted sudden redness and swelling of the left eye (LE) on waking up. At presentation, upper eyelid edema with periorbital ecchymosis and subconjunctival hemorrhage were noted in the LE. Although there was transient symptomatic relief with topical medications, blurring of vision developed in the LE. When seen 10 days later, the patient’s LE showed axial proptosis. Magnetic resonance imaging revealed an intraconal soft tissue mass in the superomedial quadrant of the left orbit. Superior orbitotomy with mass excision was done; histopathological examination of the excised mass revealed a cavernous hemangioma. The patient had complete visual recovery following surgery. To our knowledge, an acute presentation of an orbital cavernous hemangioma with subconjunctival hemorrhage and periorbital ecchymosis has not previously been reported. PMID:28769595

  10. [Septic cavernous sinus thrombosis following ethmoiditis: a case report].

    PubMed

    Ben Abdallah Chabchoub, R; Kmiha, S; Turki, F; Trabelsi, L; Maalej, B; Ben Salah, M; Abdelhédi Gargouri, L; Boukédi, A; Ben Halima, N; Mahfoudh, A

    2014-01-01

    Acute ethmoiditis is a rare infection of ethmoidal cells. The pathognomonic sign is an edema of the internal corner of the eye. Imaging may be necessary to verify the absence of orbital or endocranial complications. Thrombophlebitis of the cavernous sinus is a serious complication of this infectious process. We report the case of an 11-year-old boy who presented with ethmoiditis complicated with thrombophlebitis of the cavernous sinus, with right hemiplegia and left Bell palsy sequelae. Early diagnosis of this disorder and urgent therapy are essential. Treatment is based on the antibiotic therapy. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. [Pericardial Cavernous Hemangioma;Report of a Case].

    PubMed

    Marui, Tsutomu; Azuma, Kenichirou; Arakawa, Yuki; Murakami, Eiji; Murakawa, Shinji

    2016-03-01

    A case of pericardial cavernous hemangioma is presented. A 62-year-old man had a chest pain and was referred to our hospital because of an abnormal shadow in the mediastinum. Chest computed tomography showed a hypervascular tumor of 2.0 cm in size at the left side of pulmonary artery. Magnetic resonance imaging findings suggested the mucinous part of the tumor, suggesting liposarcoma, thymoma, and neurinoma etc. At surgery, the tumor was found to be in the pericardial cavity. After pericardotomy, the tumor was resected. The diagnosis of the tumor was cavernous hemangioma. There was no evidence of recurrence 2 years after the operation.

  12. Endoscope-assisted resection of cavernous angioma at the foramen of Monro: a case report.

    PubMed

    Matsumoto, Yuji; Kurozumi, Kazuhiko; Shimazu, Yousuke; Ichikawa, Tomotsugu; Date, Isao

    2016-01-01

    Intraventricular cavernous angiomas are rare pathological entities, and those located at the foramen of Monro are even rarer. We herein present a case of cavernous angioma at the foramen of Monro that was successfully treated by neuroendoscope-assisted surgical removal, and review the relevant literature. A 65-year-old woman had experienced headache and vomiting for 10 days before admission to another hospital. Magnetic resonance imaging (MRI) showed a mass at the foramen of Monro, and obstructive hydrocephalus of both lateral ventricles. The patient was then referred to our hospital. Neurological examination on admission to our hospital showed memory disturbance (Mini-Mental State Examination 20/30) and wide-based gait. A cavernous angioma at the foramen of Monro was diagnosed based on the typical popcorn-like appearance of the lesion on MRI. The lesion was completely removed by neuroendoscope-assisted transcortical surgery with the Viewsite Brain Access System (Vycor Medical Inc., Boca Raton, FL), leading to a reduction in the size of the ventricles. The resected mass was histologically confirmed to be cavernous angioma. The patient's symptoms resolved immediately and there were no postoperative complications. Minimally invasive neuroendoscope-assisted surgery was used to successfully treat a cavernous angioma at the foramen of Monro.

  13. The Usefulness of Diffusion Tensor Imaging and Tractography in Surgery of Brainstem Cavernous Malformations.

    PubMed

    Januszewski, Jacob; Albert, Lauren; Black, Karen; Dehdashti, Amir R

    2016-09-01

    Diffusion tensor imaging (DTI) estimates the course and connectivity patterns of white matter tracts. The objective of this study is to evaluate whether findings in the brain stem modify the preoperative surgical trajectory planning or postoperative outcome in patients with brain stem cavernous malformations. Ten patients with symptomatic brainstem cavernous malformation underwent surgical resection. Five patients received preoperative DTI evaluation and the remaining 5 did not. Reconstructed DTI tracts consisted of corticospinal, medial lemnisci, and cerebellar peduncles. The surgical planning and postoperative outcome were evaluated. In 5 patients with no preoperative DTI evaluation, surgical planning was based on anatomic landmark and the 2-point technique. The other 5 patients underwent preoperative DTI, and findings were factored into the selection of the surgical approach. In 3 of the 5 cases with DTI evaluation, the 2-point technique suggested a similar trajectory. In the other 2, the DTI findings suggested a different approach to avoid damage to the white matter tract. Two patients in the group with no DTI had immediate postoperative new or worsened deficit, which improved at long-term follow-up. No patient in the DTI group had a new neurologic deficit. Compared with the standard magnetic resonance imaging, DTI provided improved visualization of cavernous malformation involvement in eloquent fiber tracts of the brainstem. This additional information might help in selecting a more appropriate surgical trajectory in selected lesions. Larger patient cohorts are needed to assess the effect of this modality in patients' outcome. Published by Elsevier Inc.

  14. Optical coherence tomography of the prostate nerves

    NASA Astrophysics Data System (ADS)

    Chitchian, Shahab

    Preservation of the cavernous nerves during prostate cancer surgery is critical in preserving a man's ability to have spontaneous erections following surgery. These microscopic nerves course along the surface of the prostate within a few millimeters of the prostate capsule, and they vary in size and location from one patient to another, making preservation of the nerves difficult during dissection and removal of a cancerous prostate gland. These observations may explain in part the wide variability in reported sexual potency rates (9--86%) following prostate cancer surgery. Any technology capable of providing improved identification, imaging, and visualization of the cavernous nerves during prostate cancer surgery would be of great assistance in improving sexual function after surgery, and result in direct patient benefit. Optical coherence tomography (OCT) is a noninvasive optical imaging technique capable of performing high-resolution cross-sectional in vivo and in situ imaging of microstructures in biological tissues. OCT imaging of the cavernous nerves in the rat and human prostate has recently been demonstrated. However, improvements in the OCT system and the quality of the images for identification of the cavernous nerves is necessary before clinical use. The following chapters describe complementary approaches to improving identification and imaging of the cavernous nerves during OCT of the prostate gland. After the introduction to OCT imaging of the prostate gland, the optimal wavelength for deep imaging of the prostate is studied in Chapter 2. An oblique-incidence single point measurement technique using a normal-detector scanning system was implemented to determine the absorption and reduced scattering coefficients, mua and m's , of fresh canine prostate tissue, ex vivo, from the diffuse reflectance profile of near-IR light as a function of source-detector distance. The effective attenuation coefficient, mueff, and the Optical Penetration Depth (OPD) were then calculated for near-IR wavelengths of 1064 nm, 1307 nm, and 1555 nm. Chapters 3 and 4 describe locally adaptive denoising algorithms applied to reduce speckle noise in OCT images of the prostate taken by experimental and clinical systems, respectively. The dual-tree complex wavelet transform (CDWT) is a relatively recent enhancement to the discrete wavelet transform (DWT), with important additional properties: It is nearly shift invariant and directionally selective in two and higher dimensions. The CDWT algorithm was implemented for denoising of OCT images. In Chapter 5, 2-D OCT images of the rat prostate were segmented to differentiate the cavernous nerves from the prostate gland. To detect these nerves, three image features were employed: Gabor filter, Daubechies wavelet, and Laws filter. The Gabor feature was applied with different standard deviations in the x and y directions. In the Daubechies wavelet feature, an 8-tap Daubechies orthonormal wavelet was implemented, and the low pass sub-band was chosen as the filtered image. Finally, Laws feature extraction was applied to the images. The features were segmented using a nearest-neighbor classifier. Morphological post-processing was used to remove small voids. In Chapter 6, a new algorithm based on thresholding and first-order derivative class of differential edge detection was implemented to see deeper in the OCT images. One of the main limitations in OCT imaging of the prostate tissue is the inability to image deep into opaque tissues. Currently, OCT is limited to an image depth of approximately 1 min in opaque tissues. Theoretical comparisons of detection performance for Fourier domain (FD) and time domain (TD) OCT have been previously reported. In Chapter 7, we compare several image quality metrics including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and equivalent number of looks (ENL) for TD-OCT and FD-OCT images taken of the rat prostate, in vivo. The results show that TD-OCT has inferior CNR, but superior SNR compared to FD-OCT, and that TD-OCT is better for deep imaging of opaque tissues. Finally, Chapter 8 summarizes the study and future directions for OCT imaging of the prostate gland are discussed.

  15. Phase II Study to Assess the Efficacy of Hypofractionated Stereotactic Radiotherapy in Patients With Large Cavernous Sinus Hemangiomas

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wang Xin; Liu Xiaoxia; Mei Guanghai

    Purpose: Cavernous sinus hemangioma is a rare vascular tumor. The direct microsurgical approach usually results in massive hemorrhage. Although radiosurgery plays an important role in managing cavernous sinus hemangiomas as a treatment alternative to microsurgery, the potential for increased toxicity with single-session treatment of large tumors is a concern. The purpose of this study was to assess the efficacy of hypofractionated stereotactic radiotherapy in patients with large cavernous sinus hemangiomas. Methods: Fourteen patients with large (volume >20 cm{sup 3}) cavernous sinus hemangiomas were enrolled in a prospective Phase II study between December 2007 and December 2010. The hypofractionated stereotactic radiotherapymore » dose was 21 Gy delivered in 3 fractions. Results: After a mean follow-up of 15 months (range, 6-36 months), the magnetic resonance images showed a mean of 77% tumor volume reduction (range, 44-99%). Among the 6 patients with cranial nerve impairments before hypofractionated stereotactic radiotherapy, 1 achieved symptomatic complete resolution and 5 had improvement. No radiotherapy-related complications were observed during follow-up. Conclusion: Our current experience, though preliminary, substantiates the role of hypofractionated stereotactic radiotherapy for large cavernous sinus hemangiomas. Although a longer and more extensive follow-up is needed, hypofractionated stereotactic radiotherapy of 21 Gy delivered in 3 fractions is effective in reducing the tumor volume without causing any new deficits and can be considered as a treatment modality for large cavernous sinus hemangiomas.« less

  16. Surgical Outcomes of Cavernous Sinus Syndrome in Pituitary Adenomas.

    PubMed

    Fu, Weilun; Duan, Lian; Geng, Sumin

    2017-11-01

    The type of pituitary adenoma with a manifestation that includes cavernous sinus syndrome is rare. Based on the clinical data of 70 patients, this study investigated the pathogenesis, imaging characteristics, and prognostic factors of pituitary adenoma with cavernous sinus syndrome. We conducted a retrospective analysis of the characteristics of patients with pituitary adenoma with cavernous sinus syndrome who received surgical treatment. The patients were classified into different prognosis groups according to the time required for them to recover from the cavernous sinus syndrome. Univariate analyses were conducted for the correlations between the prognosis and factors. Of the 3598 cases of pituitary adenomas, 70 (1.95%) presented cavernous sinus syndrome. Of the patients, 55.7% recovered within 2 weeks of surgery, 24.3% recovered from 2 weeks to 1 year after surgery, and 20% had not returned to normal after more than 1 year after surgery. Univariate analyses showed that shorter disease duration (P < 0.001), lower Knosp grade (P = 0.045), a transsphenoidal approach (P < 0.001), and associated pituitary apoplexy (P = 0.012) were predictive factors of early postoperative recovery. The prognosis of cavernous sinus syndrome differs depending on the mechanism of the syndrome. There was no significant difference in the prognosis between patients with total pituitary adenoma resection and subtotal resection. Timely surgery within 100 days of symptom occurrence, Knosp grade 0-2, and associated pituitary apoplexy are predictive factors of good prognosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Quiescent Volcano-Chest Wall Hemangioma.

    PubMed

    Saldanha, Elroy; Martis, John J S; Kumar, B Vinod; D'Cunha, Rithesh J; Vijin, V

    2017-08-01

    Chest wall hemangiomas are rare tumors that may originate within the soft tissue or from the ribs. Intramuscular hemangioma is infrequent, representing less than 1 % of all hemangiomas, and the localization in the chest wall is even less frequent. They are typically cutaneous in location, large, and poorly circumscribed and can be locally destructive. We present a case of a 34-year-old lady presented with firm lump 3 × 3 cm in left upper and inner quadrant of left breast well defined borders, non-pulsatile and restricted mobility. Sono-mammogram was suggestive of ill-defined lesion at 10 o'clock position. CT chest was conclusive of chest wall hemangioma. The patient underwent excision of the lump. HPE was suggestive of cavernous hemangioma. Cavernous hemangioma typically manifest at birth or before the age of 30 years. CT is more sensitive than plain radiography in detecting phleboliths, which are present in approximately 30 % of cavernous hemangiomas. Surgical excision would be treatment of choice. In this case, the site of the lesion was in the breast clinically mimicking that of a fibroadenoma which warrants hemangioma as a differential diagnosis.

  18. Congenital tri-cavernous hemangiomas of the right buccal region, right accessory parotid gland, and masseter muscle region.

    PubMed

    Yang, Tao; Gu, Yongchun; Zhang, Li; Hua, Zequan

    2014-03-01

    We report a rare case of congenital tri-cavernous hemangiomas of the right buccal region, right accessory parotid gland, and masseter muscle region in an adult. The patient, a 25-year-old woman, complained of 3 masses in her right midcheek. Ultrasonographic and computed tomographic findings showed an irregular-shaped mass (multiple calcifications) with a well-defined margin in the masseter muscle region, an ellipse-shaped mass (multiple calcifications) with a well-defined margin in the right buccal region, and a comma-shaped mass (no calcifications) with a well-defined margin separate from the parotid gland in the right accessory parotid gland region. These iconographic findings suggested that the masses were all hemangiomas separately originating from the parotid gland, accessory parotid gland, and masseter muscle. The masses were completely removed through a standard parotid incision without postoperative facial palsy, skin deformity, and difficulty in secreting saliva. Findings from histologic examination of the tumor revealed multiple, thin-walled, and dilated blood vessels, confirming the diagnosis of cavernous hemangiomas. Ultrasonographic and computed tomographic findings were extremely useful in diagnosing the mass/masses as hemangioma before surgery, clarifying relationships between the mass and adjacent structures, and determining the surgical approach to the mass/masses.

  19. Feasibility of Using Intravascular Ultrasonography for Assessment of Giant Cavernous Aneurysm after Endovascular Treatment: A Technical Report

    PubMed Central

    Majidi, Shahram; Grigoryan, Mikayel; Tekle, Wondwossen G; Watanabe, Masaki; Qureshi, Adnan I

    2012-01-01

    Introduction Intravascular ultrasonography (IVUS) has been shown as a valuable adjunct imaging tool during endovascular procedures but its value in detection of any recurrence during follow up after endovascular coil embolization of large and giant intracranial aneurysms is not reported. Methods A 41 years old man who had been treated using stent assisted coil embolization for cavernous segment aneurysm of the left internal carotid artery underwent 60 month angiographic follow up. Concurrently, IVUS catheter was advanced under fluoroscopic guidance inside the cavernous portion of the left internal carotid artery. Then IVUS images were used to visualize the stent, coil loops, and aneurysm neck. Results The angiographic images were limited because of superimposition of the aneurysm on the parent vessel in all projections. IVUS images demonstrated that the stent was patent along its whole length and there was no sign of stent deformity or in-stent thrombosis. Loops of the coil were visualized as hyperechoic signals inside the aneurysm and there was no sign of herniated loops of coil inside the stent. Conclusion In this case report, we observed that adjunct use of IVUS can provide valuable information not ascertained by angiography during follow up assessment of coil embolized aneurysm. PMID:22737259

  20. Japan's exploration of vertical holes and subsurface caverns on the Moon and Mars

    NASA Astrophysics Data System (ADS)

    Haruyama, J.; Kawano, I.; Kubota, T.; Yoshida, K.; Kawakatsu, Y.; Kato, H.; Otsuki, M.; Watanabe, K.; Nishibori, T.; Yamamoto, Y.; Iwata, T.; Ishigami, G.; Yamada, T. T.

    2013-12-01

    Recently, gigantic vertical holes exceeding several tens of meters in diameter and depth were discovered on the Moon and Mars. Based on high-resolution image data, lunar holes and some Martian pits (called 'holes' hereafter) are probably skylights of subsurface caverns such as lava tubes or magma chambers. We are starting preparations for exploring the caverns through the vertical holes. The holes and subsurface caverns have high potential as resources for scientific studies. Various important geological and mineralogical processes could be uniquely and effectively observed inside these holes and subsurface caverns. The exposed fresh lava layers on the vertical walls of the lunar and Martian holes would provide information on volcanic eruption histories. The lava layers may also provide information on past magnetic fields of the celestial bodies. The regolith layers may be sandwiched between lava layers and may preserve volatile elements including solar wind protons that could be a clue to understanding past solar activities. Water molecules from solar winds or cometary/meteorite impacts may be stored inside the caverns because of mild temperatures there. The fresh lava materials forming the walls and floors of caverns might trap endogenic volatiles from magma eruptions that will be key materials for revealing the formation and early evolution of the Moon and Mars. Furthermore, the Martian subsurface caverns are highly expected to be life cradles where the temperatures are probably stable and that are free from ultra-violet and other cosmic rays that break chemical bonds, thus avoiding polymerization of molecules. Discovering extraterrestrial life and its varieties is one of our ultimate scientific purposes for exploring the lunar and Martian subsurface caverns. In addition to scientific interests, lunar and Martian subsurface caverns are excellent candidates for future lunar bases. We expect such caverns to have high potential due to stable temperatures; absence of ultra-violet rays, cosmic rays, and meteorite impacts; spacious volumes based on analogues of terrestrial lava tubes; tight walls and floors possibly glass-coated by rapid cooling inside the caverns; and so on. Exploration of subsurface caverns of the Moon and Mars would provide answers to various basic and applied scientific questions fundamental to understanding the nature of the Moon, Mars, and life. Furthermore, it could provide knowledge to enable constructing lunar and Martian bases for robotic and/or manned activities there. However, Japan does not have the technology for soft-landing on gravitational celestial bodies. First, we should acquire that technology. Next, we should acquire the technology for approaching and descending into holes that could be skylights of caverns. We should also develop the technology to move on the floors where there are many boulders and/or a mound of dusts. We should also consider how to investigate the dark inside of the caverns. There are many engineering challenges for exploring the lunar and Martian subsurface caverns, but our team is prepared to meet them.

  1. Cerebral Cavernous Malformation

    MedlinePlus

    ... and individuals frequently have multiple CCMs found via magnetic resonance imaging. Individuals with CCM are faced with a diagnosis ... and individuals frequently have multiple CCMs found via magnetic resonance imaging. Individuals with CCM are faced with a diagnosis ...

  2. CNS cavernous haemangioma: "popcorn" in the brain and spinal cord.

    PubMed

    Hegde, A N; Mohan, S; Lim, C C T

    2012-04-01

    Cavernous haemangiomas (CH) are relatively uncommon non-shunting vascular malformations of the central nervous system and can present with seizures or with neurological deficits due to haemorrhage. Radiologists can often suggest the diagnosis of CH based on characteristic magnetic resonance imaging (MRI) features, thus avoiding further invasive procedures such as digital subtraction angiography or surgical biopsy. Although typical MRI appearance combined with the presence of multiple focal low signal lesions on T2*-weighted images or the presence of one or more developmental venous anomaly within the brain can improve the diagnostic confidence, serial imaging studies are often required if a solitary CH presents at a time when the imaging appearances had not yet matured to the typical "popcorn" appearance. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  3. Prevalence of extracranial carotid artery aneurysms in patients with an intracranial aneurysm.

    PubMed

    Pourier, V E C; van Laarhoven, C J H C M; Vergouwen, M D I; Rinkel, G J E; de Borst, Gert J

    2017-01-01

    Aneurysms in various arterial beds have common risk- and genetic factors. Data on the correlation of extracranial carotid artery aneurysms (ECAA) with aneurysms in other vascular territories are lacking. We aimed to investigate the prevalence of ECAA in patients with an intracranial aneurysm (IA). We used prospectively collected databases of consecutive patients registered at the University Medical Center Utrecht with an unruptured intracranial aneurysm (UIA) or aneurysmal Subarachnoid hemorrhage (SAH). The medical files of patients included in both databases were screened for availability of radiological reports, imaging of the brain and of the cervical carotid arteries. All available radiological images were then reviewed primarily for the presence of an ECAA and secondarily for an extradural/cavernous carotid or vertebral artery aneurysm. An ECAA was defined as a fusiform dilation ≥150% of the normal internal or common carotid artery or a saccular distention of any size. We screened 4465 patient records (SAH database n = 3416, UIA database n = 1049), of which 2931 had radiological images of the carotid arteries available. An ECAA was identified in 12/638 patients (1.9%; 95% CI 1.1-3.3) with completely imaged carotid arteries and in 15/2293 patients (0.7%; 95% CI 0.4-1.1) with partially depicted carotid arteries. Seven out of 27 patients had an additional extradural (cavernous or vertebral artery) aneurysm. This comprehensive study suggests a prevalence for ECAA of approximately 2% of patients with an IA. The rarity of the disease makes screening unnecessary so far. Future registry studies should study the factors associated with IA and ECAA to estimate the prevalence of ECAA in these young patients more accurately.

  4. Computed tomographic diagnosis of unilateral cavernous sinus syndrome caused by a chondrosarcoma in a dog: a case report.

    PubMed

    Hernández-Guerra, Angel María; Del Mar López-Murcia, María; Planells, Alicia; Corpa, Juan Manuel; Liste, Fernando

    2007-07-01

    An eight-year old Rottweiler dog was presented with signs of enophthalmia, ptosis, anisocoria and mydriasis of the right eye, which showed visual disturbance, reduced or absent reflexes, and ophthalmoplegia. Consensual pupillary light reflex was also absent in the left eye. These neurological deficits were compatible with cavernous sinus syndrome. Computed tomography images of the cavernous sinus and the optical fissure revealed a mildly calcified mass arising from the right presphenoid bone extending further caudally into the orbital foramina. This extension of the mass affected the normal function of several cranial nerves. The dog was euthanased within one year of the initial presentation following development of forebrain signs. A chondrosarcoma was diagnosed histologically after necropsy.

  5. Indocyanine Green Fluorescence Endoscopy at Endonasal Transsphenoidal Surgery for an Intracavernous Sinus Dermoid Cyst: Case Report

    PubMed Central

    HIDE, Takuichiro; YANO, Shigetoshi; KURATSU, Jun-ichi

    2014-01-01

    The complete resection of intracavernous sinus dermoid cysts is very difficult due to tumor tissue adherence to important anatomical structures such as the internal carotid artery (ICA), cavernous sinus, and cranial nerves. As residual dermoid cyst tissue sometimes induces symptoms and repeat surgery may be required after cyst recurrence, minimal invasiveness is an important consideration when selecting the surgical approach to the lesion. We addressed a recurrent intracavernous sinus dermoid cyst by the endoscopic endonasal transsphenoidal approach assisted by neuronavigation and indocyanine green (ICG) endoscopy to confirm the ICA and patency of the cavernous sinus. The ICG endoscope detected the fluorescence signal from the ICA and cavernous sinus; its intensity changed with the passage of time. The ICG endoscope was very useful for real-time imaging, and its high spatial resolution facilitated the detection of the ICA and the patent cavernous sinus. We found it to be of great value for successful endonasal transsphenoidal surgery. PMID:25446381

  6. Transient pituitary enlargement with central hypogonadism secondary to bilateral cavernous sinus thrombosis: pituitary oedema?

    PubMed

    Joubert, Michael; Verdon, Renaud; Reznik, Yves

    2009-05-01

    Design We report the case of an incidental pituitary mass discovered in the context of bilateral cavernous sinus thrombosis due to a bacterial pansinusitis. Conclusions Magnetic resonance imaging features of the pituitary lesion, together with transient central hypogonadism and total regression of the mass after anticoagulation and antimicrobial therapy, suggest that this lesion is a pituitary oedema of vascular mechanism. Other possible causes of pituitary mass in such a situation are also discussed.

  7. Brain stem venous congestion due to dural arteriovenous fistulas of the cavernous sinus.

    PubMed

    Kai, Y; Hamada, J I; Morioka, M; Yano, S; Ushio, Y

    2004-10-01

    Venous congestion of the brain stem due to dural arteriovenous fistulas (DAVFs) in the cavernous sinus is rare and presents therapeutic challenges. To assess the prognosis of patients with symptomatic DAVFs and brain stem dysfunction, we evaluated the degree of venous ischemia by examining pre- and post-treatment magnetic resonance images (MRI) in 2 patients presenting with venous congestion of the brain stem. A 56-year-old woman with left hemiparesis and a 70-year-old woman with gait disturbance attributable to right cavernous sinus DAVFs were referred to our hospital. In both cases, T2-weighted magnetic resonance imaging (MRI) disclosed a hyperintensity lesion in the brainstem due to venous congestion. Both patients underwent open surgery for direct embolization of the cavernous sinus because there were no approach routes for transvenous embolization. The patient whose pretreatment MRI demonstrated Gd enhancement continued to manifest neurological deficits and persistence of the abnormal hyperintensity on post-treatment T2-weighted MRI. In the other patient whose pretreatment MRI showed no Gd enhancement, treatment produced a complete response of her neurological deficit and disappearance of the abnormal hyperintensity area. We tentatively conclude that lesions corresponding to hyperintensity areas on non-Gd-enhanced, T2-weighted MRI may reflect a reversible condition whereas lesions identified as hyperintense areas on GD-enhanced T2-weighted MRI may be indicative of irreversibility.

  8. Geomechanical Model Calibration Using Field Measurements for a Petroleum Reserve

    NASA Astrophysics Data System (ADS)

    Park, Byoung Yoon; Sobolik, Steven R.; Herrick, Courtney G.

    2018-03-01

    A finite element numerical analysis model has been constructed that consists of a mesh that effectively captures the geometries of Bayou Choctaw (BC) Strategic Petroleum Reserve (SPR) site and multimechanism deformation (M-D) salt constitutive model using the daily data of actual wellhead pressure and oil-brine interface location. The salt creep rate is not uniform in the salt dome, and the creep test data for BC salt are limited. Therefore, the model calibration is necessary to simulate the geomechanical behavior of the salt dome. The cavern volumetric closures of SPR caverns calculated from CAVEMAN are used as the field baseline measurement. The structure factor, A 2, and transient strain limit factor, K 0, in the M-D constitutive model are used for the calibration. The value of A 2, obtained experimentally from BC salt, and the value of K 0, obtained from Waste Isolation Pilot Plant salt, are used for the baseline values. To adjust the magnitude of A 2 and K 0, multiplication factors A 2 F and K 0 F are defined, respectively. The A 2 F and K 0 F values of the salt dome and salt drawdown skins surrounding each SPR cavern have been determined through a number of back analyses. The cavern volumetric closures calculated from this model correspond to the predictions from CAVEMAN for six SPR caverns. Therefore, this model is able to predict behaviors of the salt dome, caverns, caprock, and interbed layers. The geotechnical concerns associated with the BC site from this analysis will be explained in a follow-up paper.

  9. Geomechanical Model Calibration Using Field Measurements for a Petroleum Reserve

    DOE PAGES

    Park, Byoung Yoon; Sobolik, Steven R.; Herrick, Courtney G.

    2018-01-19

    A finite element numerical analysis model has been constructed that consists of a mesh that effectively captures the geometries of Bayou Choctaw (BC) Strategic Petroleum Reserve (SPR) site and multimechanism deformation (M-D) salt constitutive model using the daily data of actual wellhead pressure and oil–brine interface location. The salt creep rate is not uniform in the salt dome, and the creep test data for BC salt are limited. Therefore, the model calibration is necessary to simulate the geomechanical behavior of the salt dome. The cavern volumetric closures of SPR caverns calculated from CAVEMAN are used as the field baseline measurement.more » The structure factor, A 2, and transient strain limit factor, K o, in the M-D constitutive model are used for the calibration. The value of A 2, obtained experimentally from BC salt, and the value of K o, obtained from Waste Isolation Pilot Plant salt, are used for the baseline values. To adjust the magnitude of A 2 and K0, multiplication factors A 2 F and K o F are defined, respectively. The A 2 F and K0F values of the salt dome and salt drawdown skins surrounding each SPR cavern have been determined through a number of back analyses. The cavern volumetric closures calculated from this model correspond to the predictions from CAVEMAN for six SPR caverns. Therefore, this model is able to predict behaviors of the salt dome, caverns, caprock, and interbed layers. In conclusion, the geotechnical concerns associated with the BC site from this analysis will be explained in a follow-up paper.« less

  10. Geomechanical Model Calibration Using Field Measurements for a Petroleum Reserve

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Park, Byoung Yoon; Sobolik, Steven R.; Herrick, Courtney G.

    A finite element numerical analysis model has been constructed that consists of a mesh that effectively captures the geometries of Bayou Choctaw (BC) Strategic Petroleum Reserve (SPR) site and multimechanism deformation (M-D) salt constitutive model using the daily data of actual wellhead pressure and oil–brine interface location. The salt creep rate is not uniform in the salt dome, and the creep test data for BC salt are limited. Therefore, the model calibration is necessary to simulate the geomechanical behavior of the salt dome. The cavern volumetric closures of SPR caverns calculated from CAVEMAN are used as the field baseline measurement.more » The structure factor, A 2, and transient strain limit factor, K o, in the M-D constitutive model are used for the calibration. The value of A 2, obtained experimentally from BC salt, and the value of K o, obtained from Waste Isolation Pilot Plant salt, are used for the baseline values. To adjust the magnitude of A 2 and K0, multiplication factors A 2 F and K o F are defined, respectively. The A 2 F and K0F values of the salt dome and salt drawdown skins surrounding each SPR cavern have been determined through a number of back analyses. The cavern volumetric closures calculated from this model correspond to the predictions from CAVEMAN for six SPR caverns. Therefore, this model is able to predict behaviors of the salt dome, caverns, caprock, and interbed layers. In conclusion, the geotechnical concerns associated with the BC site from this analysis will be explained in a follow-up paper.« less

  11. Geomechanical Simulation of Bayou Choctaw Strategic Petroleum Reserve - Model Calibration.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Park, Byoung

    2017-02-01

    A finite element numerical analysis model has been constructed that consists of a realistic mesh capturing the geometries of Bayou Choctaw (BC) Strategic Petroleum Reserve (SPR) site and multi - mechanism deformation ( M - D ) salt constitutive model using the daily data of actual wellhead pressure and oil - brine interface. The salt creep rate is not uniform in the salt dome, and the creep test data for BC salt is limited. Therefore, the model calibration is necessary to simulate the geomechanical behavior of the salt dome. The cavern volumetric closures of SPR caverns calculated from CAVEMAN aremore » used for the field baseline measurement. The structure factor, A 2 , and transient strain limit factor, K 0 , in the M - D constitutive model are used for the calibration. The A 2 value obtained experimentally from the BC salt and K 0 value of Waste Isolation Pilot Plant (WIPP) salt are used for the baseline values. T o adjust the magnitude of A 2 and K 0 , multiplication factors A2F and K0F are defined, respectively. The A2F and K0F values of the salt dome and salt drawdown skins surrounding each SPR cavern have been determined through a number of back fitting analyses. The cavern volumetric closures calculated from this model correspond to the predictions from CAVEMAN for six SPR caverns. Therefore, this model is able to predict past and future geomechanical behaviors of the salt dome, caverns, caprock , and interbed layers. The geological concerns issued in the BC site will be explained from this model in a follow - up report .« less

  12. [Septic thrombosis of the cavernous sinus due to folliculitis].

    PubMed

    Tuettenberg, A; Tuettenberg, J; Knop, J; Enk, A

    2003-04-01

    Sinus thrombosis is an acute life-threatening disease. While cavernous sinus thrombosis secondary to facial infections is described in the literature, it is uncommon. The key clinical characteristics are a facial infection, headache, chemosis and edema of the eyelid. The main differential diagnostic consideration is meningoencephalitis. Early diagnosis by angiography, magnetic resonance imaging and examination of CSF is important as treatment should be initiated as soon as possible in order to decrease morbidity and mortality. The mainstays of therapy are heparinization and appropriate intravenous antibiotic therapy.

  13. Pure Spinal Epidural Cavernous Hemangioma with Intralesional Hemorrhage: A Rare Cause of Thoracic Myelopathy

    PubMed Central

    Jang, Donghwan; Kim, Choonghyo; Lee, Seung Jin; Ryu, Young-Joon

    2014-01-01

    Although cavernous hemangiomas occur frequently in the intracranial structures, they are rare in the spine. Most of spinal hemangiomas are vertebral origin and "pure" epidural hemangiomas not originating from the vertebral bone are very rare. Our spinal hemangioma case is extremely rare because of its "pure" epidural involvement and intralesional hemorrhage. A 64-year-old man presented with progressive paraparesis from two months ago. His motor weakness was rated as grade 4/5 in bilateral lower extremities. He also complained of decreased sensation below the T4 sensory dermatome, which continuously progressed to the higher dermatome level. Magnetic resonance imaging demonstrated thoracic spinal tumor at T3-T4 level. The tumor was located epidural space compressing thoracic spinal cord ventrally. The tumor was not involved with the thoracic vertebral bone. We performed T3-5 laminectomy and removed the tumor completely. The tumor was not infiltrating into intradural space or vertebral bone. The histopathologic study confirmed the epidural tumor as cavernous hemangioma. Postoperatively, his weakness improved gradually. Four months later, his paraparesis recovered completely. Here, we present a case of pure spinal epidural cavernous hemangioma, which has intralesional hemorrhage. We believe cavernous hemangioma should be included in the differential diagnosis of the spinal epidural tumors. PMID:25110490

  14. Transarterial Onyx Embolization for Patients with Cavernous Sinus Dural Arteriovenous Fistulas Who Have Failed Transvenous Embolization.

    PubMed

    Wen, Jun; Duan, Chuan-Zhi; Huang, Li-Jing; Zhang, Xin; He, Xu-Ying; Li, Xi-Feng

    2015-09-01

    Transvenous embolization is the treatment of choice for cavernous sinus dural arteriovenous fistulas (csDAVFs) despite occasional difficulty in transvenous catheterization. We reported our experience in the treatment of csDAVFs by transarterial Onyx embolization in patients who had failed transvenous catheterization. We reviewed the clinical and radiographic records of csDAVFs patients receiving transarterial Onyx embolization after failed transvenous Onyx embolization at our institution over a period of 31 months. Success was defined as complete or near complete occlusion upon angiographic examination. In seven cases, the microcatheter failed to reach the cavernous sinus; in the remaining case, the internal jugular vein was occlusive. Eight sessions of the embolization and catheterization procedures via the arterial routes were conducted. Among them, five cases via the middle meningeal artery and the other three via the accessory meningeal artery. Angiography, immediately after embolization, revealed complete occlusion in seven cases (87.5 %) and partial occlusion in the remaining case. Angiographic follow-up (range, 6-10 months) showed that all patients achieved complete embolization. In cases where transvenous embolization of the cavernous sinus is difficult, transarterial embolization of the fistulas offers a safe and effective alternative.

  15. Artificial embolization of carotid-cavernous fistula with post-operative patency of internal carotid artery

    PubMed Central

    Isamat, Fabian; Salleras, V.; Miranda, A. M.

    1970-01-01

    This report deals with a patient of 86 who developed a carotid-cavernous fistula. Artificial embolization alone was considered the safest treatment for this patient and proved to be adequate. Post-operative preservation of the patency of the internal carotid artery was demonstrated by angiography. We believe this method is particularly appropriate for carotid-cavernous fistulas if it is demonstrated by angiography that the major blood flow of the carotid artery pours into the fistula. A soft-iron clip attached to the muscle can be used for external and forceful guidance of the embolus into the fistula with the help of an electromagnet, hence the patency of the internal carotid artery can be preserved. The embolus should be introduced through the external carotid artery. This is the only case known to us in which patency of the internal carotid artery was post-operatively maintained. We have reviewed 545 reported cases of surgically treated carotid-cavernous fistulas and analysed the results from simple cervical carotid ligation to the more sophisticated methods of artificial embolizations. The results obtained by artificial embolization have been consistently good, while the other techniques have failed in large percentages. Artificial embolization should be used as the primary treatment for carotid-cavernous fistula, since ligation of the internal carotid artery precludes its embolization at a later date. Images PMID:5478949

  16. A creative therapy in treating cavernous hemangioma of penis with copper wire.

    PubMed

    Zhang, Dong; Zhang, Haiyang; Sun, Peng; Li, Peng; Xue, Aibing; Jin, Xunbo

    2014-10-01

    Cavernous hemangiomas of penis are rare benign lesions infrequently described in the literature. No completely satisfactory treatment has been found to correct the cosmetic deformities especially the extensive hemangiomas of corpus penis. In light of the promising application of copper wire/needle in vascular malformations, we began a clinical study to investigate the safety, feasibility, and cosmetic effect of copper wire therapy in treating cavernous hemangioma of penis. Seven patients ranging in age from 12 to 32 years with penile cavernous hemangiomas entered our study from 2005 to 2011. All patients received treatments with percutaneous copper wires. Perioperative data including mean operation time, estimated blood loss, length of copper wire retention, and length of hospital stay were analyzed. All possible complications were noted, and cosmetic result was evaluated. Patients were followed up after discharge from the hospital. All operations were successful, and no obvious complications were observed. The patients were satisfied with the aesthetic results. Follow-up time ranged from 1 to 5 years. Recurrence was discovered in a patient with the largest lesion of corpus penis 2 months after the treatment. Secondary procedure was carried out with the same technique, and no lesions were found later. The shortage of studies on this topic prevented us from defining a therapeutic reference standard. The results of our study confirmed that copper wire therapy was a simple, safe, and useful option for penile cavernous hemangioma. © 2013 International Society for Sexual Medicine.

  17. Hepatocellular carcinoma metastasizing to the skull base involving multiple cranial nerves.

    PubMed

    Kim, Soo Ryang; Kanda, Fumio; Kobessho, Hiroshi; Sugimoto, Koji; Matsuoka, Toshiyuki; Kudo, Masatoshi; Hayashi, Yoshitake

    2006-11-07

    We describe a rare case of HCV-related recurrent multiple hepatocellular carcinoma (HCC) metastasizing to the skull base involving multiple cranial nerves in a 50-year-old woman. The patient presented with symptoms of ptosis, fixation of the right eyeball, and left abducens palsy, indicating disturbances of the right oculomotor and trochlear nerves and bilateral abducens nerves. Brain contrast-enhanced computed tomography (CT) revealed an ill-defined mass with abnormal enhancement around the sella turcica. Brain magnetic resonance imaging (MRI) disclosed that the mass involved the clivus, cavernous sinus, and petrous apex. On contrast-enhanced MRI with gadolinium-chelated contrast medium, the mass showed inhomogeneous intermediate enhancement. The diagnosis of metastatic HCC to the skull base was made on the basis of neurological findings and imaging studies including CT and MRI, without histological examinations. Further studies may provide insights into various methods for diagnosing HCC metastasizing to the craniospinal area.

  18. [Orbito-palpebral vascular pathology].

    PubMed

    Heran Dreyfus, F; Galatoire, O; Koskas, P; Lafitte, F; Nau, E; Bergès, O

    2016-11-01

    Orbito-palpebral vascular pathology represents 10% of all the diseases of this area. The lesion may be discovered during a brain CT scan or MRI, or because it causes clinical symptoms such as orbital mass, visual or oculomotor alteration, pain, proptosis, or acute bleeding due to a complication of the lesion (hemorrhage, thrombosis). We present these lesions using an anatomical, clinical, imaging and therapeutic approach. We distinguish four different entities. Vascular tumors have common imaging characteristics (hypersignal on T2 sequence, contrast enhancement, abnormal vascularization well depicted with ultrasound and Doppler, and possible bleeding). The main lesions are cavernous hemangiomas, the most frequent lesion of that type during adulthood; infantile hemangiomas, the most frequent vascular tumor in children; and more seldomly, hemangioperitcytomas. True vascular malformations are divided according to their flow. Low flow lesions are venous (orbital varix), capillarovenous or lymphatic (lymphangioma). High flow malformations, more rare, are either arteriovenous or arterial malformations (aneurisms). Complex malformations include both low and high flow elements. Lesions leading to modifications of the orbito-palpebral blood flow are mainly due to cavernous sinus abnormalities, either direct carotid-cavernous fistula affecting young adults after severe head trauma, or dural fistula, more insidious, found in older adults. The last section is devoted to congenital syndromic vascular malformations (Sturge-Weber, Rendu-Olser…). This classification allows for a better understanding of these pathologies and their specific imaging features. Copyright © 2016. Published by Elsevier Masson SAS.

  19. Intralesional hemorrhage and thrombosis without rupture in a pure spinal epidural cavernous angioma: a rare cause of acute lumbal radiculopathy

    PubMed Central

    Riemenschneider, Markus; Herdmann, Jörg

    2010-01-01

    Pure spinal epidural cavernous angiomas are extremely rare lesions, and their normal shape is that of a fusiform mass in the dorsal aspects of the spinal canal. We report a case of a lumbo-sacral epidural cavernous vascular malformation presenting with acute onset of right-sided S1 radiculopathy. Clinical aspects, imaging, intraoperative findings, and histology are demonstrated. The patient, a 27-year-old man presented with acute onset of pain, paraesthesia, and numbness within the right leg corresponding to the S1 segment. An acute lumbosacral disc herniation was suspected, but MRI revealed a cystic lesion with the shape of a balloon, a fluid level and a thickened contrast-enhancing wall. Intraoperatively, a purple-blue tumor with fibrous adhesions was located between the right S1 and S2 nerve roots. Macroscopically, no signs of epidural bleedings could be denoted. After coagulation of a reticular venous feeder network and dissection of the adhesions the rubber ball-like lesion was resected in total. Histology revealed a prominent venous vessel with a pathologically thickened, amuscular wall surrounded by smaller, hyalinized, venous vessels arranged in a back-to-back position typical for the diagnosis of a cavernous angioma. Lumina were partially occluded by thrombi. The surrounding fibrotic tissue showed signs of recurrent bleedings. There was no obvious mass hemorrhage into the surrounding tissue. In this unique case, the pathologic mechanism was not the usual rupture of the cavernous angioma with subsequent intraspinal hemorrhage, but acute mass effect by intralesional bleedings and thrombosis with subsequent increase of volume leading to nerve root compression. Thus, even without a sudden intraspinal hemorrhage a spinal cavernous malformation can cause acute symptoms identical to the clinical features of a soft disc herniation. PMID:20213297

  20. [A case of multiple cavernous angioma with dementia].

    PubMed

    Kariya, S; Kawahara, M; Suzumura, A

    2000-10-01

    We reported a 65-year-old man who developed dementia since 50 years of age. His consciousness was clear but he was indifferent to his illness. Also, the luck of attention was recognized when we underwent examinations and the result of intellectual test varied every time we performed. His memory function was almost normal on the examination which was performed when he was cooperative. Magnetic resonance imaging (MRI) disclosed multiple tiny lesions (more than 130 in all) in cerebrum, brainstem, cerebellum and spinal cord. These lesions were compatible with multiple cavernous angioma. Most of lesions manifested high-density area on cranial CT. Though the multiplicity of foci indicated the possibility of familial occurrence, he was considered to be a sporadic case on his lineage investigation and the brain MRI of his only son. In this case, neither headache nor seizures which were known as the major clinical features of intracerebral cavernous angioma was observed. He was diagnosed as having white matter dementia characterized by attentional dysfunction, decrement of volition and less memory disturbance. We speculated that he developed symptomatic dementia by the sum of multiple minor degeneration, especially in frontal lobe white matter, caused by repeated minor bleeding from cavernous angiomas.

  1. Analysis of cavern and well stability at the West Hackberry SPR site using a full-dome model.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sobolik, Steven R.

    2015-08-01

    This report presents computational analyses that simulate the structural response of caverns at the Strategic Petroleum Reserve (SPR) West Hackberry site. The cavern field comprises 22 caverns. Five caverns (6, 7, 8, 9, 11) were acquired from industry and have unusual shapes and a history dating back to 1946. The other 17 caverns (101-117) were leached according to SPR standards in the mid-1980s and have tall cylindrical shapes. The history of the caverns and their shapes are simulated in a three-dimensional geomechanics model of the site that predicts deformations, strains, and stresses. Future leaching scenarios corresponding to oil drawdowns usingmore » fresh water are also simulated by increasing the volume of the caverns. Cavern pressures are varied in the model to capture operational practices in the field. The results of the finite element model are interpreted to provide information on the current and future status of subsidence, well integrity, and cavern stability. The most significant results in this report are relevant to Cavern 6. The cavern is shaped like a bowl with a large ceiling span and is in close proximity to Cavern 9. The analyses predict tensile stresses at the edge of the ceiling during repressurization of Cavern 6 following workover conditions. During a workover the cavern is at low pressure to service a well. The wellhead pressures are atmospheric. When the workover is complete, the cavern is repressurized. The resulting elastic stresses are sufficient to cause tension around the edge of the large ceiling span. With time, these stresses relax to a compressive state because of salt creep. However, the potential for salt fracture and propagation exists, particularly towards Cavern 9. With only 200 feet of salt between the caverns, the operational consequences must be examined if the two caverns become connected. A critical time may be during a workover of Cavern 9 in part because of the operational vulnerabilities, but also because dilatant damage is predicted under the ledge that forms the lower lobe in the cavern. The remaining caverns have no significant issues regarding cavern stability and may be safely enlarged during subsequent oil drawdowns. Predicted well strains and subsidence are significant and consequently future remedial actions may be necessary. These predicted well strains certainly suggest appropriate monitoring through a well-logging program. Subsidence is currently being monitored.« less

  2. The “Endothelialized Muscularis Mucosae”: A Case Report Describing a Large Cavernous Hemangioma at the Terminal Ileum and a New Histologic Clue for Preoperative Diagnosis from Endoscopic Biopsy

    PubMed Central

    Purdy-Payne, Erin K.; Miner, Jean F.; Foles, Brandon; Tran, Tien-Anh N.

    2015-01-01

    Cavernous hemangiomas of the gastrointestinal tract are quite rare and, until now, have been difficult to diagnose preoperatively due their nonspecific presentations and imaging features, as well as a lack of histologic description pertaining to small superficial biopsies such as those obtained endoscopically. We report a unique case of a 4 cm transmural cavernous hemangioma in the terminal ileum with literature review and describe a new histologic finding—the “endothelialized muscularis mucosae,” which was discovered upon review of the endoscopic biopsy and could potentially facilitate preoperative diagnosis of these lesions from endoscopic biopsies in the future. These lesions have classically required surgical resection in order to make a definitive diagnosis and rule out malignancy, with which they share many historical and radiographic features. Due to their potential to cause bowel obstruction, intussusception, perforation, and hemorrhage, these lesions may ultimately require surgical resection to relieve symptoms or prevent or treat complications—however, surgical planning and patient counseling could be greatly improved by a preoperative diagnosis. Therefore, gastroenterologists, pathologists, and surgeons should be aware of the “endothelialized muscularis mucosae” which can be very helpful in diagnosing GI cavernous hemangiomas from endoscopic biopsies. PMID:26442160

  3. Pythium Keratitis Leading to Fatal Cavernous Sinus Thrombophlebitis.

    PubMed

    Rathi, Anubha; Chakrabarti, Arunaloke; Agarwal, Tushar; Pushker, Neelam; Patil, Mukesh; Kamble, Hemant; Titiyal, Jeewan S; Mohan, Rishi; Kashyap, Seema; Sharma, Sanjay; Sen, Seema; Satpathy, Gita; Sharma, Namrata

    2018-04-01

    To report a case of Pythium insidiosum keratitis leading to fatal cavernous sinus thrombophlebitis. Case report. A 70-year-old man presented with excruciating pain, redness, and diminution of vision in his left eye for 2 weeks after washing his hair with tap water. A total corneal ulcer with surrounding infiltrates and associated corneal thinning was present. Corneal scraping revealed the presence of Gram-positive cocci. KOH wet mount and in vivo confocal microscopy revealed branching hyphae. Combined antibacterial and antifungal treatment was started, but 4 days later, the ulcer showed signs of worsening with perforation for which a large therapeutic penetrating keratoplasty was done. The host cornea showed branching septate hyphae on Sabarouds Dextrose Agar. Two weeks later, the patient developed left eye proptosis with associated extraocular movement restriction. Magnetic resonance imaging of the head and orbit revealed cavernous sinus thrombophlebitis. Lid sparing partial exenteration was performed. Polymerase chain reaction revealed P. insidiosum. The patient subsequently developed a cerebrovascular attack and died of its complications. Ocular pythiosis may lead to cavernous sinus thrombophlebitis and can even be life threatening. Timely diagnosis and early radical surgery are of value. A high index of suspicion must be kept for P. insidiosum in cases with suspected fungal etiology not responding to conventional treatment.

  4. Ten Triangles around Cavernous Sinus for Surgical Approach, Described by Schematic Diagram and Three Dimensional Models with the Sectioned Images.

    PubMed

    Chung, Beom Sun; Ahn, Young Hwan; Park, Jin Seo

    2016-09-01

    For the surgical approach to lesions around the cavernous sinus (CS), triangular spaces around CS have been devised. However, educational materials for learning the triangles were insufficient. The purpose of this study is to present educational materials about the triangles, consisting of a schematic diagram and 3-dimensional (3D) models with sectioned images. To achieve the purposes, other studies were analyzed to establish new definitions and names of the triangular spaces. Learning materials including schematic diagrams and 3D models with cadaver's sectioned images were manufactured. Our new definition was attested by observing the sectioned images and 3D models. The triangles and the four representative surgical approaches were stereoscopically indicated on the 3D models. All materials of this study were put into Portable Document Format file and were distributed freely at our homepage (anatomy.dongguk.ac.kr/triangles). By using our schematic diagram and the 3D models with sectioned images, ten triangles and the related structures could be understood and observed accurately. We expect that our data will contribute to anatomy education, surgery training, and radiologic understanding of the triangles and related structures.

  5. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ehgartner, Brian L.; Sobolik, Steven Ronald

    This report presents computational analyses that simulate the structural response of caverns at the Strategic Petroleum Reserve Bryan Mound site. The cavern field comprises 20 caverns. Five caverns (1, 2, 4, and 5; 3 was later plugged and abandoned) were acquired from industry and have unusual shapes and a history dating back to 1946. The other 16 caverns (101-116) were leached according to SPR standards in the mid-1980s and have tall cylindrical shapes. The history of the caverns and their shapes are simulated in a 3-D geomechanics model of the site that predicts deformations, strains, and stresses. Future leaching scenariosmore » due to oil drawdowns using fresh water are also simulated by increasing the volume of the caverns. Cavern pressures are varied in the model to capture operational practices in the field. The results of the finite element model are interpreted to provide information on the current and future status of subsidence, well integrity, and cavern stability. The most significant result in this report is relevant to caverns 1, 2, and 5. The caverns have non-cylindrical shapes and have potential regions where the surrounding salt may be damaged during workover procedures. During a workover the normal cavern operating pressure is lowered to service a well. At this point the wellhead pressures are atmospheric. When the workover is complete, the cavern is repressurized. The resulting elastic stresses are sufficient to cause tension and large deviatoric stresses at several locations. With time, these stresses relax to a compressive state due to salt creep. However, the potential for salt damage and fracturing exists. The analyses predict tensile stresses at locations with sharp-edges in the wall geometry, or in the case of cavern 5, in the neck region between the upper and lower lobes of the cavern. The effects do not appear to be large-scale, however, so the only major impact is the potential for stress-induced salt falls in cavern 5, potentially leading to hanging string damage. Caverns 1 and 2 have no significant issues regarding leachings due to drawdowns; cavern 5 may require a targeted leaching of the neck region to improve cavern stability and lessen hanging string failure potential. The remaining caverns have no significant issues regarding cavern stability and may be safely enlarged during subsequent oil drawdowns. Well strains are significant and consequently future remedial actions may be necessary. Well strains certainly suggest the need for appropriate monitoring through a well-logging program. Subsidence is currently being monitored; there are no issues identified regarding damage from surface subsidence or horizontal strain to surface facilities.« less

  6. Electromagnetic navigation-guided neuroendoscopic removal of radiation-induced intraforniceal cavernoma as a late complication of medulloblastoma treatment.

    PubMed

    Liby, Petr; Zamecnik, J; Kyncl, M; Zackova, J; Tichy, M

    2017-11-01

    Medulloblastoma is the most frequent malignant brain tumour in children. Radiation-induced cavernous haemangiomas (RICHs) are a known late complication of radiation exposure, especially in young children. We present a patient who underwent subtotal resection of posterior fossa medulloblastoma with subsequent chemotherapy and radiotherapy at the age of 10 years. A new lesion in the region of the left foramen of Monro appeared 16 years later. Based on the imaging results, metastasis or radiation-induced cavernoma was considered. The lesion had the same appearance on imaging as a rarely published intraventricular cavernoma of the foramen of Monro. Unlike the cavernoma of the foramen of Monro, this lesion was subependymal and intraforniceal. Using electromagnetic navigation and neuroendoscopy, the lesion was completely removed. Histopathological examination revealed a cavernous haemangioma. This is a unique case of intraforniceal paraforaminal cavernoma that was successfully removed endoscopically using electromagnetic neuronavigation and without neurological sequelae.

  7. Threat of a sinkhole: A reevaluation of Cavern 4, Bayou Choctaw salt dome, Louisiana

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Neal, J.T.; Todd, J.L.; Linn, J.K.

    1993-09-01

    Cavern Lake at Bayou Choctaw salt dome resulted from the failure of Cavern 7 in 1954. Uncontrolled solutioning of this cavern through the thin caprock had set the stage for overburden to collapse into the cavern below. A similar situation developed with nearby Cavern 4, but with less dissolutioning of the caprock. Because pressure loss was already a problem and because another 800 ft diameter lake would have endangered surface operations, solutioning of Cavern 4 was stopped and the cavern abandoned in 1957 in order to protect the already-small site. In 1978 the Strategic Petroleum Reserve (SPR) acquired a numbermore » of caverns at Bayou Choctaw, including Cavern 4, and the possible repeat of the Cavern 7 failure and formation of another lake thus became an issue. The cavern dimensions were re-sonared in 1980 for comparison with 1963 and 1977 surveys. Annual surface leveling between 1982--1992 showed less subsidence occurring than the site average, and a cavern monitoring system, installed in 1984, has revealed no anomalous motion. Repeat sonar surveys in 1992 showed very little, if any, change occurred since 1980 although a small amount of uncertainty exists as a result of changing sonar techniques. We conclude that significant additional solutioning or erosion of the caprock has not occurred and that there is no increased threat to SPR operations.« less

  8. Instability risk analysis and risk assessment system establishment of underground storage caverns in bedded salt rock

    NASA Astrophysics Data System (ADS)

    Jing, Wenjun; Zhao, Yan

    2018-02-01

    Stability is an important part of geotechnical engineering research. The operating experiences of underground storage caverns in salt rock all around the world show that the stability of the caverns is the key problem of safe operation. Currently, the combination of theoretical analysis and numerical simulation are the mainly adopts method of reserve stability analysis. This paper introduces the concept of risk into the stability analysis of underground geotechnical structure, and studies the instability of underground storage cavern in salt rock from the perspective of risk analysis. Firstly, the definition and classification of cavern instability risk is proposed, and the damage mechanism is analyzed from the mechanical angle. Then the main stability evaluating indicators of cavern instability risk are proposed, and an evaluation method of cavern instability risk is put forward. Finally, the established cavern instability risk assessment system is applied to the analysis and prediction of cavern instability risk after 30 years of operation in a proposed storage cavern group in the Huai’an salt mine. This research can provide a useful theoretical base for the safe operation and management of underground storage caverns in salt rock.

  9. Severe progressive scoliosis due to huge subcutaneous cavernous hemangioma: A case report

    PubMed Central

    2011-01-01

    Cavernous hemangioma consists mainly of congenital vascular malformations present before birth and gradually increasing in size with skeletal growth. A small number of patients with cavernous hemangioma develop scoliosis, and surgical treatment for the scoliosis in such cases has not been reported to date. Here we report a 12-year-old male patient with severe progressive scoliosis due to a huge subcutaneous cavernous hemangioma, who underwent posterior correction and fusion surgery. Upon referral to our department, radiographs revealed a scoliosis of 85° at T6-L1 and a kyphosis of 58° at T4-T10. CT and MR images revealed a huge hemangioma extending from the subcutaneous region to the paraspinal muscles and the retroperitoneal space and invading the spinal canal. Posterior correction and fusion surgery using pedicle screws between T2 and L3 were performed. Massive hemorrhage from the hemangioma occurred during the surgery, with intraoperative blood loss reaching 2800 ml. The scoliosis was corrected to 59°, and the kyphosis to 45° after surgery. Seven hours after surgery, the patient suffered from hypovolemic shock and disseminated intravascular coagulation due to postoperative hemorrhage from the hemangioma. The patient developed sensory and conduction aphasia caused by cerebral hypoxia during the shock on the day of the surgery. At present, two years after the surgery, although the patient has completely recovered from the aphasia. This case illustrates that, in correction surgery for scoliosis due to huge subcutaneous cavernous hemangioma, intraoperative and postoperative intensive care for hemodynamics should be performed, since massive hemorrhage can occur during the postoperative period as well as the intraoperative period. PMID:21414205

  10. Posttraumatic carotid cavernous fistula that presented as seizure and focal neurological deficits with symptom resolution after therapeutic coil embolization.

    PubMed

    Klevtsova, Ekaterina; Nguyen-Min, Caroline; Lalani, Tania; Carlan, Stephen James; Madruga, Mario

    2015-02-01

    A posttraumatic carotid cavernous fistula can remain unrecognized and ultimately present with symptoms characteristic for a middle cerebral artery stroke. Progressive neurologic deterioration can occur until the condition is diagnosed and treated. If unrecognized and untreated, permanent damage may result. A 46-year-old white man with the history of a motor vehicle crash 6 months prior presented with complaints of acute onset of expressive aphasia and seizure-like activity for 3 days. On presentation, the patient was noted to have moderate proptosis and chemosis of the left eye. Magnetic resonance imaging of the brain showed an arteriovenous fistula arising from the anterolateral precavernous left internal carotid artery. This was directly communicating with the adjacent cortical veins along the medial aspect of the left temporal lobe, resulting in venous congestion in the left frontal opercular region, the left insula, and subinsular tracks. The patient underwent an intracranial coil embolization of a left carotid cavernous fistula. No complications were encountered, and the patient had near-complete resolution of neurologic deficits and left eye proptosis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although posttraumatic carotid cavernous fistula is a rare condition, it is important to be aware of this entity because immediate diagnosis and treatment may improve outcome. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Crater Formation Above Salt Caverns: Piston vs Hour-glass

    NASA Astrophysics Data System (ADS)

    Berest, P.

    2016-12-01

    Conditions leading to crater formation above salt caverns are discussed. In most cases, at the end of leaching, the cavern roof had reached the top of the salt formation, allowing direct contact between brine and marl (or argillite) layers that compose the overburden of the salt formation. These layers are prone to weathering when in contact with saturated brine. Stoping takes place, and the cavern roof rises through the overburden. This process may be several years or dozens of years long. In Lorraine salt formations, stoping stops when the rising cavern top reaches a competent layer, the Beaumont Dolomite. Operators then lower cavern-brine pressure to trigger collapse. A rigid cylinder of rock (a "piston") drops into the cavern, and a crater whose initial edges are vertical is created. Cavern drop is more abrupt when the cavern top is filled partly with air. The contour of the piston is circular, as a circle is the shape such that the ratio between perimeter and area is minimal. In other cases, for instance in Kansas, the cavern rises until the uppermost keystone in the bedrock at shallow depth is breached, permitting loose materials to flow into the cavern through a relatively narrow hole at the bottom of the sink hole, as in an hour glass.

  12. The Measurement of Spectral Characteristics and Composition of Radiation in Atlas with MEDIPIX2-USB Devices

    NASA Astrophysics Data System (ADS)

    Campbell, M.; Doležal, Z.; Greiffenberg, D.; Heijne, E.; Holy, T.; Idárraga, J.; Jakůbek, J.; Král, V.; Králík, M.; Lebel, C.; Leroy, C.; Llopart, X.; Lord, G.; Maneuski, D.; Ouellette, O.; Sochor, V.; Pospíšil, S.; Suk, M.; Tlustos, L.; Vykydal, Z.; Wilhelm, I.

    2008-06-01

    A network of devices to perform real-time measurements of the spectral characteristics and composition of radiation in the ATLAS detector and cavern during its operation is being built. This system of detectors will be a stand alone system fully capable of delivering real-time images of fluxes and spectral composition of different particle species including slow and fast neutrons. The devices are based on MEDIPIX2 pixel silicon detectors that will be operated via active USB cables and USB-Ethernet extenders through an Ethernet network by a PC located in the USA15 ATLAS control room. The installation of 14 devices inside ATLAS (detector and cavern) is in progress.

  13. Limestone Caverns

    ERIC Educational Resources Information Center

    Powell, Richard L.

    1970-01-01

    Describes the origin of limestone caverns, using Mammoth Cave as an example, with particular reference to the importance of groundwater information of caverns, the present condition of groundwater, and how caverns develop within fluctuating groundwater zones. (BR)

  14. Historical Cavern Floor Rise for All SPR Sites

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Moriarty, Dylan Michael

    2016-09-01

    The Strategic Petroleum Reserve (SPR) contains the largest supply is the largest stockpile of government-owned emergency crude oil in the world. The oil is stored in multiple salt caverns spread over four sites in Louisiana and Texas. Cavern infrastructure near the bottom of the cavern can be damaged from vertical floor movement. This report presents a comprehensive history of floor movements in each cavern. Most of the cavern floor rise rates ranged from 0.5-3.5 ft/yr, however, there were several caverns with much higher rise rates. BH103, BM106, and BH105 had the three highest rise rates. Information from this report willmore » be used to better predict future vertical floor movements and optimally place cavern infrastructure. The reasons for floor rise are not entirely understood and should be investigated.« less

  15. Manufactured caverns in carbonate rock

    DOEpatents

    Bruce, David A.; Falta, Ronald W.; Castle, James W.; Murdoch, Lawrence C.

    2007-01-02

    Disclosed is a process for manufacturing underground caverns suitable in one embodiment for storage of large volumes of gaseous or liquid materials. The method is an acid dissolution process that can be utilized to form caverns in carbonate rock formations. The caverns can be used to store large quantities of materials near transportation facilities or destination markets. The caverns can be used for storage of materials including fossil fuels, such as natural gas, refined products formed from fossil fuels, or waste materials, such as hazardous waste materials. The caverns can also be utilized for applications involving human access such as recreation or research. The method can also be utilized to form calcium chloride as a by-product of the cavern formation process.

  16. Use of processed resistivity borehole imaging to assess the insoluble content of the massively bedded Preesall Halite NW England

    NASA Astrophysics Data System (ADS)

    Kingdon, Andrew; Evans, David J.

    2013-04-01

    With the decline of the UK's remaining conventional reserves of natural gas and associated growth of imports, the lack of adequate storage capacity is a matter of concern for ensuring energy security year-round. In a number of countries, subsurface caverns for gas storage have been created by solution mining of massive halite deposits and similar storage facilities are likely to become an important part of the UK's energy infrastructure. Crucial to the economic viability of such facilities is the percentage of insoluble material within the halite intervals, which influences strongly the relationship between cavern sump and working volumes: successful development of these caverns is dependent upon maximising the efficiency of cavern design and construction. The purity of a massive halite sequence can only be assessed either by direct means (i.e. coring) or indirectly by downhole geophysical logs The use of conventional geophysical logs in subsurface exploration is well established but literature generally relies on a very low resolution tools with a typical vertical logging sample interval of 15 centimetres. This means that such tools provide, at best, a "blurred" view of the sedimentary successions penetrated by the borehole and that discrete narrow bands of insoluble material will not be identifiable or distinguishable from zones of "dirtier" halite with disseminated mud materials. In 2008, Halite-Energy Group (formerly Canatxx Gas Storage Ltd) drilled the Burrows Marsh #1 borehole and acquired resistivity borehole imaging (FMI) logs through the Triassic Preesall Halite in the Preesall Saltfield, NW England. In addition to near full circumferal imaging capability, rather than a single measurement per increment, FMI logs allows millimetre to centimetre scale imaging of sedimentary features, that is one to two orders of magnitude higher vertical resolution. After binary segmentation of the FMI images to achieve a simple halite-insoluble ("mud") separation these were subject to a filtering process to develop a detailed understanding of the halite sequence's insoluble content. The results were then calibrated, post-normalisation, by new laboratory determinations of the insoluble content of laterally equivalent samples of core from the nearby Arm Hill #1 borehole. The FMI logs provide a greater degree of resolution when compared to conventional geophysical logs. With the statistical analysis provided by this process, it further enhances the correlation between the logs and core and ultimately, the assessment of insoluble content. Despite the obvious increase in resolution, precise statistical quantification of the success of the borehole imaging technique is somewhat obfuscated by the absence of both FMI logs and continuous core in a single borehole. The acquisition parameters for these images are at the limits for the tools and therefore more noisy than those acquired in other lithologies or logging environments. The optimum acquisition parameters (in particular gain settings and logging speed), the nature of the filtering required to quantify the insoluble content and the effects of image noise on those calculations are discussed.

  17. Expansion analyses of strategic petroleum reserve in Bayou Choctaw : revised locations.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ehgartner, Brian L.; Park, Byoung Yoon

    2010-11-01

    This report summarizes a series of three-dimensional simulations for the Bayou Choctaw Strategic Petroleum Reserve. The U.S. Department of Energy plans to leach two new caverns and convert one of the existing caverns within the Bayou Choctaw salt dome to expand its petroleum reserve storage capacity. An existing finite element mesh from previous analyses is modified by changing the locations of two caverns. The structural integrity of the three expansion caverns and the interaction between all the caverns in the dome are investigated. The impacts of the expansion on underground creep closure, surface subsidence, infrastructure, and well integrity are quantified.more » Two scenarios were used for the duration and timing of workover conditions where wellhead pressures are temporarily reduced to atmospheric pressure. The three expansion caverns are predicted to be structurally stable against tensile failure for both scenarios. Dilatant failure is not expected within the vicinity of the expansion caverns. Damage to surface structures is not predicted and there is not a marked increase in surface strains due to the presence of the three expansion caverns. The wells into the caverns should not undergo yield. The results show that from a structural viewpoint, the locations of the two newly proposed expansion caverns are acceptable, and all three expansion caverns can be safely constructed and operated.« less

  18. Cavernous antioxidant effect of green tea, epigallocatechin-3-gallate with/without sildenafil citrate intake in aged diabetic rats.

    PubMed

    Mostafa, T; Sabry, D; Abdelaal, A M; Mostafa, I; Taymour, M

    2013-08-01

    This study aimed to assess the cavernous antioxidant effect of green tea (GT), epigallocatechin-3-gallate (EGCG) with/without sildenafil citrate intake in aged diabetic rats. One hundred and four aged male white albino rat were divided into controls that received ordinary chow, streptozotocin (STZ)-induced aged diabetic rats, STZ-induced diabetic rats on infused green tea, induced diabetic rats on epigallocatechin-3-gallate and STZ-induced diabetic rats on sildenafil citrate added to EGCG. After 8 weeks, dissected cavernous tissues were assessed for gene expression of eNOS, cavernous malondialdehyde (MDA), glutathione peroxidase (GPx), cyclic guanosine monophosphate (cGMP), and serum testosterone (T). STZ-induced diabetic rats on GT demonstrated significant increase in cavernous eNOS, cGMP, GPx and significant decrease in cavernous MDA compared with diabetic rats. Diabetic rats on EGCG demonstrated significant increase in cavernous eNOS, cGMP, GPx and significant decrease in cavernous MDA compared with diabetic rats or diabetic rats on GT. Diabetic rats on EGCG added to sildenafil showed significant increase in cavernous eNOS, cGMP and significant decrease in cavernous MDA compared with other groups. Serum T demonstrated nonsignificant difference between the investigated groups. It is concluded that GT and EGCG have significant cavernous antioxidant effects that are increased if sildenafil is added. © 2012 Blackwell Verlag GmbH.

  19. Dural cavernous sinus fistula: an unusual presentation.

    PubMed Central

    Procope, J. A.; Kidwell, E. D.; Copeland, R. A.; Perry, A. F.

    1994-01-01

    This article describes a 22-year-old man who presented to the Howard University Hospital emergency room with acute onset of swelling, proptosis, and decreased vision in the right eye preceded by 24 hours of nausea and vomiting. The patient's visual acuity was count fingers in the involved eye with marked proptosis and limitation of ocular motility. There was no history given of any ocular or head trauma. A computed tomography scan of the orbits showed diffuse symmetric enlargement of the extraocular muscles of the right eye, felt to be consistent with an orbital inflammatory pseudotumor. The patient was treated with intravenous steroids initially, then placed on oral prednisone. After minimal improvement on the steroids, a selective external carotid angiogram showed a moderate-sized dural cavernous sinus fistula. The patient underwent selective embolization of the fistula with rapid resolution of periorbital edema and proptosis. Visual acuity was stabilized at 20/200 in the right eye. The differential diagnosis and pathogenesis of carotid cavernous sinus fistulas and the likely pathogenesis of the fistula in this case are discussed. Images Figure 1 Figure 2 Figure 3 PMID:8046763

  20. Directable weathering of concave rock using curvature estimation.

    PubMed

    Jones, Michael D; Farley, McKay; Butler, Joseph; Beardall, Matthew

    2010-01-01

    We address the problem of directable weathering of exposed concave rock for use in computer-generated animation or games. Previous weathering models that admit concave surfaces are computationally inefficient and difficult to control. In nature, the spheroidal and cavernous weathering rates depend on the surface curvature. Spheroidal weathering is fastest in areas with large positive mean curvature and cavernous weathering is fastest in areas with large negative mean curvature. We simulate both processes using an approximation of mean curvature on a voxel grid. Both weathering rates are also influenced by rock durability. The user controls rock durability by editing a durability graph before and during weathering simulation. Simulations of rockfall and colluvium deposition further improve realism. The profile of the final weathered rock matches the shape of the durability graph up to the effects of weathering and colluvium deposition. We demonstrate the top-down directability and visual plausibility of the resulting model through a series of screenshots and rendered images. The results include the weathering of a cube into a sphere and of a sheltered inside corner into a cavern as predicted by the underlying geomorphological models.

  1. Sonar surveys used in gas-storage cavern analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Crossley, N.G.

    1998-05-04

    Natural-gas storage cavern internal configuration, inspection information, and cavern integrity data can be obtained during high-pressure operations with specialized gas-sonar survey logging techniques. TransGas Ltd., Regina, Sask., has successfully performed these operations on several of its deepest and highest pressurized caverns. The data can determine gas-in-place inventory and assess changes in spatial volumes. These changes can result from cavern creep, shrinkage, or closure or from various downhole abnormalities such as fluid infill or collapse of the sidewall or roof. The paper discusses conventional surveys with sonar, running surveys in pressurized caverns, accuracy of the sonar survey, initial development of Cavernmore » 5, a roof fall, Cavern 4 development, and a damaged string.« less

  2. High-flow bypass with radial artery graft followed by internal carotid artery ligation for large or giant aneurysms of cavernous or cervical portion: clinical results and cognitive performance.

    PubMed

    Ono, Hideaki; Inoue, Tomohiro; Tanishima, Takeo; Tamura, Akira; Saito, Isamu; Saito, Nobuhito

    2018-04-01

    High-flow bypass followed by ligation of the internal carotid artery (ICA) is an effective treatment, but the impact of abrupt occlusion of the ICA is unpredictable, especially on postoperative cognitive function. The present study evaluated the clinical results as well as cognitive performances after high-flow bypass using radial artery graft (RAG) with supportive superficial temporal artery (STA)-middle cerebral artery (MCA) bypass, followed by ICA ligation. Ten consecutive patients underwent high-flow bypass surgery for large or giant ICA aneurysms of cavernous or cervical portion. Demographics, clinical information, magnetic resonance (MR) imaging, computed tomography, digital subtraction angiography (DSA), intraoperative somatosensory evoked potentials, neuropsychological examinations including the Wechsler Adult Intelligence Scale-Third Edition and the Wechsler Memory Scale-Revised (WMS-R), and follow-up data were analyzed. The aneurysm was located on the cavernous segment in eight cases and cervical segment in two cases, and mean aneurysm size was 27.9 mm. Postoperative DSA demonstrated robust bypass flow from the external carotid artery to MCA via the RAG, and no anterograde flow into the aneurysm. No patient showed new symptoms after the operation. Follow-up clinical study and MR imaging were performed in nine patients and showed no additional ischemic lesion compared with preoperative imaging. Seven patients completed neuropsychological examinations before and after surgery. All postoperative scores except WMS-R composite memory score slightly improved. High-flow bypass followed by ICA ligation can achieve good clinical outcomes. Successful high-flow bypass using RAG with supportive STA-MCA bypass and ICA ligation does not adversely affect postoperative cognitive function.

  3. Defining the Cubature Changes of Historic St. Kinga Chamber in Bochnia Salt Mine, Using Laser Scanning Technology

    NASA Astrophysics Data System (ADS)

    Szafarczyk, Anna; Gawałkiewicz, Rafał

    2018-03-01

    In Poland, there are many mining enterprises, of historic character registered in the UNESCO World Heritage List. One of the oldest mining enterprises in Poland is the Salt Mine in Bochnia. The processes inside the rock mass require that surveying services carry out regular geometric control of the cavities. A particular attention should be paid (due to its sacral function) on St. Kinga Chamber, located 195 metres below the surface, on the mine level "August". So far measurement technologies have been connected with the studies on changes in the geometry of cavities and based on linear bases used to measure convergence. This only provides discrete information (in a point) and not always presents a real state of deformation. In the scanning method, in practice a three dimension image of changes (structural deformations) is obtained, impossible to determine with the application of measurement methods, applied to measure the value of linear convergence (the method with a limited number of bases). Laser scanning, apart from determining the value of volume convergence, gives also the possibility of the visualization of 3D cavern. Moreover, it provides direct information to update mining numerical maps and make it possible to generate various cross-sections through the cavern. The authors analysed the possibility of the application of laser scanning (scanner Faro Focus 3D), as a modern tool allowing the measuring of the value of volume convergence.

  4. The association of carotid cavernous fistula with Graves’ ophthalmopathy

    PubMed Central

    Celik, Ozlem; Buyuktas, Deram; Islak, Civan; Sarici, A Murat; Gundogdu, A Sadi

    2013-01-01

    Graves’ ophthalmopathy (GO) is one of the frequent manifestations of the disorder which is an inflammatory process due to fibroblast infiltration, fibroblast proliferation and accumulation of glycosaminoglycans. Eye irritation, dryness, excessive tearing, visual blurring, diplopia, pain, visual loss, retroorbital discomfort are the symptoms and they can mimic carotid cavernous fistulas. Carotid cavernous fistulas are abnormal communications between the carotid arterial system and the cavernous sinus. The clinical manifestations of GO can mimic the signs of carotid cavernous fistulas. Carotid cavernous fistulas should be considered in the differential diagnosis of the GO patients especially who are not responding to the standard treatment and when there is a unilateral or asymmetric eye involvement. Here we report the second case report with concurrent occurrence of GO and carotid cavernous fistula in the literature. PMID:23571267

  5. Hydatid liver cyst causing portal vein thrombosis and cavernous transformation: a case report and literature review

    PubMed Central

    Kirmizi, Serdar; Kayaalp, Cuneyt; Yilmaz, Sezai

    2016-01-01

    A 33-year-old male with abdominal distention after meals was admitted to the hospital. He had a history of surgery for hydatid liver cyst. The cyst was located at the liver hilum and there were portal venous thrombosis and cavernous transformation. It had been treated with partial cystectomy, omentoplasty and albendazole. Two years later at the admission to our center, his laboratory tests were in normal ranges. Abdominal imaging methods revealed splenomegaly, portal vein thrombosis, cavernous transformation and the previously operated hydatid liver cyst. Upper gastrointestinal endoscopy demonstrated esophageal and gastric fundal varices. Due to his young age and low risk for surgery, the patient was planned for surgical treatment of both pathologies at the same time. At laparotomy, hydatid liver cyst was obliterated with omentum and there was no sign of active viable hydatid disease. A meso-caval shunt with an 8 mm in-diameter graft was created. In the postoperative period, his symptoms and endoscopic varices were regressed. There were four similar cases reported in the literature. This one was the youngest and the only one treated by a surgical shunt. Hydatid liver cysts that located around the hilum can lead to portal vein thrombosis and cavernous thrombosis. Treatment should consist of both hydatid liver cyst and portal hypertension. To the best of our knowledge, this was the first case of surgically treated portal vein thrombosis that was originated from a hydatid liver cyst. PMID:27895860

  6. Factors predicting language lateralization in patients with perisylvian vascular malformations

    PubMed Central

    Lee, Darrin J.; Pouratian, Nader; Bookheimer, Susan Y.; Martin, Neil A.

    2017-01-01

    Object The authors conducted a study to determine the factors associated with right-sided language dominance in patients with cerebrovascular malformations. Methods Twenty-two patients with either arteriovenous malformations (AVMs [15 cases]) or cavernous malformations (7 cases) underwent functional MR (fMR) imaging studies of language function; a 3.0-T head-only unit was used. Lateralization indices were calculated separately for Broca and Wernicke areas. Lesion size, Spetzler-Martin grade, and the distance between the lesion and anatomically defined language cortex were calculated for each patient. Results Right-sided language dominance occurred in 5 patients, all of whom had AVMs within 10 mm of canonical language areas. Three patients had right-sided language dominance in the Wernicke area alone whereas 2 had right-sided language dominance in both Broca and Wernicke areas. Wada testing and intraoperative electrocortical stimulation were performed as clinically indicated to corroborate fMR imaging findings. Conclusions The primary factor associated with right-sided language dominance was the AVM being within 10 mm of anatomically defined language areas. The lesion size and the Spetzler-Martin grade were not significant factors. Anomalous fMR imaging laterality was typically confined to the language area proximate to the lesion, with the distal language area remaining in the left hemisphere dominant. This study emphasizes the need to map each case individually in patients with left perisylvian AVMs. Assumptions about eloquent cortex based on anatomical landmarks (a key component of Spetzler-Martin grading) may have to be reconsidered. PMID:20302390

  7. Gamma Knife surgery in patients harboring orbital cavernous hemangiomas that were diagnosed on the basis of imaging findings.

    PubMed

    Liu, Xiaomin; Xu, Desheng; Zhang, Yipei; Liu, Dong; Song, Guoxiang

    2010-12-01

    This study was undertaken to evaluate clinical outcomes and tumor control in patients harboring orbital cavernous hemangiomas (OCHs) that had been diagnosed based on findings of imaging studies and treated by Gamma Knife surgery (GKS). Between 1995 and 2008, 23 patients harboring OCHs that had been diagnosed on the basis of imaging findings were treated using GKS; complete follow-up data are available in all cases. The median treatment volume was 1.5 cm³ (range 0.15-10.10 cm³), the median tumor margin dose was 15 Gy (range 12-20 Gy), and the median follow-up period was 12 months (range 6-120 months). A decrease in tumor size was found in 20 patients, and no tumor progression was observed after GKS. Eleven of 14 patients whose visual function had been adversely affected prior to treatment had improved visual acuity at the last assessment. Side effects of the procedure included orbital pain in 3 patients and chemosis in 2 patients. In this preliminary experience, GKS proved to be an effective treatment for OCHs diagnosed on the basis of imaging findings. Additional follow-up is necessary, and the long-term side effects of the procedure still need to be determined.

  8. [Fracture of the penis].

    PubMed

    Kogan, M I; Obeĭd, M T; Siziakin, D V

    2007-01-01

    Rupture of the cavernous bodies is a serious penile trauma which may result in severe long-term consequences. Standard suturing of the cavernous body is accompanied with posttraumatic complications: erectile dysfunction and distortion of the penis. The results of examination and treatment of 38 patients with rupture of the tunica albuginea of the penile cavernous bodies are presented. The technique of the cavernous body wound suturing was perfected. Long-term sequences of fracture of the penis in conservative policy and different methods of cavernous body wound suturing are compared.

  9. Beta electron fluxes inside a magnetic plasma cavern: Calculation and comparison with experiment

    NASA Astrophysics Data System (ADS)

    Stupitskii, E. L.; Smirnov, E. V.; Kulikova, N. A.

    2010-12-01

    We study the possibility of electrostatic blanking of beta electrons in the expanding spherical blob of a radioactive plasma in a rarefied ionosphere. From numerical studies on the dynamics of beta electrons departing a cavern, we obtain the form of a function that determines the portion of departing electrons and calculate the flux density of beta electrons inside the cavern in relation to the Starfish Prime nuclear blast. We show that the flux density of electrons in geomagnetic flux tubes and inside the cavern depend on a correct allowance for the quantity of beta electrons returning to the cavern. On the basis of a physical analysis, we determine the approximate criterion for the return of electrons from a geomagnetic flux tube to the cavern. We compare calculation results in terms of the flux density of beta electrons inside the cavern with the recently published experimental results from operation Starfish Prime.

  10. Cavernous sinus thrombosis caused by contralateral sphenoid sinusitis: a case report

    PubMed Central

    2013-01-01

    Objective To report a rare case of unilateral cavernous sinus thrombosis caused by contralateral sphenoid sinusitis. Case report A 33-year-old female visited our hospital for severe, right-sided, temporal headache, chemosis, periorbital edema, and proptosis. These signs were associated with congested erythematous nasal mucosa with purulent discharge from the right superior nasal meatus. Contrast enhanced CT showed dilated left superior ophthalmic vein, suggestive of thrombosis, contrast enhancement of the left cavernous sinuses, and dilation of cavernous sinus, indicating cavernous sinus inflammation. The right maxillary, ethmoid and sphenoid sinuses showed mucosal thickening and retention of purulent material. She was diagnosed with cavernous sinus thrombosis caused by contralateral sphenoid sinusitis. All clinical symptoms and signs improved after endoscopic sphenoidotomy and appropriate medical treatment. Conclusions Sphenoiditis can cause contralateral cavernous sinus thrombosis. Early surgical sphenoidotomy and aggressive medical treatment are the cornerstones of successful management of this life-threatening complication. PMID:23497466

  11. Sensitivity of storage field performance to geologic and cavern design parameters in salt domes.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ehgartner, Brian L.; Park, Byoung Yoon

    2009-03-01

    A sensitivity study was performed utilizing a three dimensional finite element model to assess allowable cavern field sizes for strategic petroleum reserve salt domes. A potential exists for tensile fracturing and dilatancy damage to salt that can compromise the integrity of a cavern field in situations where high extraction ratios exist. The effects of salt creep rate, depth of salt dome top, dome size, caprock thickness, elastic moduli of caprock and surrounding rock, lateral stress ratio of surrounding rock, cavern size, depth of cavern, and number of caverns are examined numerically. As a result, a correlation table between the parametersmore » and the impact on the performance of storage field was established. In general, slower salt creep rates, deeper depth of salt dome top, larger elastic moduli of caprock and surrounding rock, and a smaller radius of cavern are better for structural performance of the salt dome.« less

  12. [Endovascular treatment of carotid-cavernous fistula type A with platinium coils].

    PubMed

    Culafić, Slobodan; Juszkat, Robert; Rusović, Sinisa; Stefanović, Dara; Minić, Ljubodrag; Spaić, Milan

    2008-12-01

    Carotid-cavernous fistulas are abnormal communications between carotid arteries or their branches and the cavernous system caused mostly by trauma. Posttraumatic fistulas represent 70% of all carotid-cavernous fistulas and they are mostly high-flow shunts (type A). This type gives characteristic eye symptoms. This paper presents a 44-year old male patient with carotid-cavernous fistula as a result of penetrating head injury. In clinical presentation the patient had exophthalmos, conjunctival chemosis and weakening of vision on the right eye, headache and diplopia. Digital subtracted angiography showed high-flow carotid-cavernous fistula, which was vascularised from the left carotid artery and from vertebrobasilar artery. Endovascular embolization with platinum coils was performed through the transarterial route (endoarterial approach). Check angiogram confirmed that the fistula was closed and that no new communications developed. Embolization of complex carotid-cavernous fistula type A was successfully performed with platinum coils by endovascular approach.

  13. Numerical study on criteria for design and operation of water curtain system in underground oil storage cavern using site descriptive fracture networks

    NASA Astrophysics Data System (ADS)

    Moon, Jiwon; Yeo, In Wook

    2013-04-01

    Underground unlined caverns have been constructed in fractured rocks to stockpile oil and petroleum products, where they are hydraulically contained by natural groundwater pressure. However, for the case that natural groundwater pressure is not maintained at the required level, water curtain boreholes, through which water is injected, are often constructed above the cavern as engineering barrier to secure water pressure enough to overwhelm the operational pressure of the cavern. For secure containment of oil and petroleum products inside the cavern, it is essential to keep water pressure around the cavern higher than operational pressure of the cavern using either natural groundwater pressure or engineering barrier. In the Republic of Korea, a number of underground stockpile bases are being operated by Korea National Oil Corporation (KNOC) and private companies, most of which have water curtain system. The criterion that KNOC adopts for water curtain system design and operation such as the vertical distance from the cavern and operational injection rate is based on the Åberg hypothesis that the vertical hydraulic gradient should be larger than one. The criterion has been used for maintaining oil storage cavern without its thorough review. In this study, systematic numerical works have been done for reviewing the Åberg criterion. As groundwater predominantly takes places through fractures in underground caverns, discrete fracture modeling approach is essential for this study. Fracture data, obtained from boreholes drilled at the stage of site investigation at the Yeosu stockpile base in Korea, were statistically analyzed in terms of orientation and intensity, which were used to generate the site descriptive three dimensional fracture networks. Then, groundwater flow modeling has been carried out for the fracture networks. Constant head boundaries were applied along the circumference of the cavern and water curtain boreholes. Main flow channel and hydraulic connectivity between water curtain boreholes and the caverns have been identified, along which hydraulic heads are monitored to find out whether the required hydraulic pressure is maintained around the cavern. The flow modeling has been repeatedly carried out at different constant head boundary conditions to create the criterion for the optimal operation of water curtain system.

  14. Assessment of normal perisellar anatomy in 1.5 T T2-weighted MRI and comparison with the anatomic criteria defining cavernous sinus invasion of pituitary adenomas.

    PubMed

    Knappe, U J; Jaursch-Hancke, C; Schönmayr, R; Lörcher, U

    2009-08-01

    The study aimed to evaluate the anatomical relations of sellar and perisellar structures with T2-weighted MRI and to apply criteria for cavernous sinus (CS) invasion by pituitary adenomas to normal sellar anatomy. Thin slice (3 mm) coronal T2-weighted MR-images (1.5 Tesla) were obtained in 117 individuals (234 CS) without pituitary disorders (58 females, 59 males; age 17 months to 87 years). In 99 cases data indicating the presence of arterial hypertension (AH) were available, 25 with AH, 74 without AH. The medial wall of the cavernous sinus was detectable in 33% of cases. The inferior rim of the horizontal part of the ICA was located at the level of the sellar floor in 33%, below in 47%, and above in 20%. The mean distance between the both ICAs was 17.8 mm (range, 7-38 mm). The mean distance between the pituitary and the ICA in AH was significantly shorter than in patients without AH (Chi-square, p=0.01). There was contact between the gland and the ICA in 41.5% of the cases. In 16.7% (39 sides) of all 234 SCs investigated, the area of contact between the ICA and the gland was at least 25% of the vessel's circumference. The medial intercarotid line (ICL) was crossed by the pituitary gland in 9% (21 of 234 CS), the central ICL was touched in another 5% (11 of 234 CS), lateral ICL was never reached. There was a weak correlation with age: a more extensive lateral extension of the gland was seen in individuals older than 40 years compared to younger individuals (Chi-square, p=0.03). There was a marked difference in the anatomical findings between both sides in 41.9% of cases. Inter- and intra-individual variations of the perisellar anatomy and its relation to the pituitary gland exist, which are partly related to age and AH. This must be remembered when the invasiveness of pituitary adenomas is assessed in MRI. Georg Thieme Verlag KG Stuttgart New York.

  15. Normal flow signal of the pterygoid plexus on 3T MRA in patients without DAVF of the cavernous sinus.

    PubMed

    Watanabe, K; Kakeda, S; Watanabe, R; Ohnari, N; Korogi, Y

    2013-01-01

    Cavernous sinuses and draining dural sinuses or veins are often visualized on 3D TOF MRA images in patients with dural arteriovenous fistulas involving the CS. Flow signals may be seen in the jugular vein and dural sinuses at the skull base on MRA images in healthy participants, however, because of reverse flow. Our purpose was to investigate the prevalence of flow signals in the pterygoid plexus and CS on 3T MRA images in a cohort of participants without DAVFs. Two radiologists evaluated the flow signals of the PP and CS on 3T MRA images obtained from 406 consecutive participants by using a 5-point scale. In addition, the findings on 3T MRA images were compared with those on digital subtraction angiography images in an additional 171 participants who underwent both examinations. The radiologists identified 110 participants (27.1%; 108 left, 10 right, 8 bilateral) with evidence of flow signals in the PP alone (n = 67) or in both the PP and CS (n = 43). Flow signals were significantly more common in the left PP than in the right PP. In 171 patients who underwent both MRA and DSA, the MRA images showed flow signals in the PP with or without CS in 60 patients; no DAVFs were identified on DSA in any of these patients. Flow signals are frequently seen in the left PP on 3T MRA images in healthy participants. This finding may be the result of flow reversal and should not be considered to indicate occult DAVF.

  16. Stroke-Related Translational Research

    PubMed Central

    Caplan, Louis R.; Arenillas, Juan; Cramer, Steven C.; Joutel, Anne; Lo, Eng H.; Meschia, James; Savitz, Sean; Tournier-Lasserve, Elizabeth

    2013-01-01

    Stroke-related translational research is multifaceted. Herein, we highlight genome-wide association studies and genetic studies of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, COL4A1 mutations, and cerebral cavernous malformations; advances in molecular biology and biomarkers; newer brain imaging research; and recovery from stroke emphasizing cell-based and other rehabilitative modalities. PMID:21555605

  17. Interesting case of base of skull mass infiltrating cavernous sinuses.

    PubMed

    Singh, Achintya Dinesh; Soneja, Manish; Memon, Saba Samad; Vyas, Surabhi

    2016-11-16

    A man aged 35 years presented with chronic headache and earache of 1-year duration. He had progressive vision loss and diplopia since last 9 months. He also had pain over the face and episodic profuse epistaxis. On examination, perception of light was absent in the right eye and hand movements were detected at 4 m distance in the left eye. Imaging revealed a lobulated mass in the nasopharynx extending into the bilateral cavernous sinuses and sphenoid sinus with bony erosions. Biopsy of the nasopharyngeal mass revealed pathological features which are characteristic of IgG4 disease. His serum IgG4 levels and acute inflammatory markers were also elevated. The patient was started on oral corticosteroid therapy. Fever, headache and earache resolved early and there was gradual improvement in the vision of the left eye. After 6 months, visual acuity in the left eye was 6/9, but right eye visual acuity had no change. Follow-up imaging revealed a significant reduction in the size of the mass. 2016 BMJ Publishing Group Ltd.

  18. "Tepid" Geysers above salt caverns

    NASA Astrophysics Data System (ADS)

    Bérest, Pierre; Brouard, Benoît; Zakharov, Vassily

    2018-06-01

    The formation of a brine geyser erupting from the wellhead of a large underground salt cavern is described. In most cases, the brine outflow from an opened cavern is slow; it results from the cavern creep closure and the thermal expansion of the cavern brine. These two processes are smooth; however, the brine outflow often is bumpy, as it is modulated by atmospheric pressure variations that generate an elastic increase (or decrease) of both cavern and brine volumes. In addition, when the flow is fast enough, the brine thermodynamic behavior in the wellbore is adiabatic. The cold brine expelled from the cavern wellhead is substituted with warm brine entering the borehole bottom, resulting in a lighter brine column. The brine outflow increases. In some cases, the flow becomes so fast that inertia terms must be taken into account. A geyser forms, coming to an end when the pressure in the cavern has dropped sufficiently. A better picture is obtained when head losses are considered. A closed-form solution can be reached. This proves that two cases must be distinguished, depending on whether the cold brine initially contained in the wellbore is expelled fully or not. It can also be shown that geyser formation is a rare event, as it requires both that the wellbore be narrow and that the cavern be very compressible. This study stemmed from an actual example in which a geyser was observed. However, scarce information is available, making any definite interpretation difficult. xml:lang="fr"

  19. Image-guided removal of supratentorial cavernomas in critical brain areas: application of neuronavigation and intraoperative magnetic resonance imaging.

    PubMed

    Gralla, J; Ganslandt, O; Kober, H; Buchfelder, M; Fahlbusch, R; Nimsky, C

    2003-04-01

    In a retrospective study the postoperative results of 26 patients operated on for supratentorial cavernous hemangiomas either deep-seated or near eloquent brain areas are summarized. An exact surgical approach to these lesions is essential to prevent neurological deterioration. Three different navigation systems were used and compared according to their clinical applicability. Complete removal of the lesion was obtained in all patients of this series. In six cases (23 %) functional data from magnetoencephalography or functional magnetic resonance imaging were integrated into the navigational setup. In 14 cases (54 %) intraoperative magnetic resonance imaging was performed. The follow-up time was 3 - 26 months (mean: 10 months). In the postoperative course one patient (3.8 %) developed a hemiparesis, another one developed quadrantopia. Nineteen patients presented with preoperative seizure history, 16 of these (84 %) had no further or rare seizures after surgery. The better results in seizure control were achieved in those patients with shorter duration of seizure history before surgery. The study indicates that the application of neuronavigation allows surgery on supratentorial cavernous hemangiomas in critical brain areas with low morbidity. The intraoperative visualization of eloquent cortex areas by integration of functional data allows a fast identification and exemption of eloquent brain areas, preventing neurological deterioration. Furthermore, the intraoperative MR resection control ensures a complete resection and illustrates the minimal invasive approach.

  20. Mathematical model of salt cavern leaching for gas storage in high-insoluble salt formations.

    PubMed

    Li, Jinlong; Shi, Xilin; Yang, Chunhe; Li, Yinping; Wang, Tongtao; Ma, Hongling

    2018-01-10

    A mathematical model is established to predict the salt cavern development during leaching in high-insoluble salt formations. The salt-brine mass transfer rate is introduced, and the effects of the insoluble sediments on the development of the cavern are included. Considering the salt mass conservation in the cavern, the couple equations of the cavern shape, brine concentration and brine velocity are derived. According to the falling and accumulating rules of the insoluble particles, the governing equations of the insoluble sediments are deduced. A computer program using VC++ language is developed to obtain the numerical solution of these equations. To verify the proposed model, the leaching processes of two salt caverns of Jintan underground gas storage are simulated by the program, using the actual geological and technological parameters. The same simulation is performed by the current mainstream leaching software in China. The simulation results of the two programs are compared with the available field data. It shows that the proposed software is more accurate on the shape prediction of the cavern bottom and roof, which demonstrates the reliability and applicability of the model.

  1. Magnetic Resonance Thermometry-Guided Stereotactic Laser Ablation of Cavernous Malformations in Drug-Resistant Epilepsy: Imaging and Clinical Results

    PubMed Central

    McCracken, D. Jay; Willie, Jon T.; Fernald, Brad; Saindane, Amit M.; Drane, Daniel L.; Barrow, Daniel L.; Gross, Robert E.

    2016-01-01

    BACKGROUND Surgery is indicated for cerebral cavernous malformations (CCM) that cause medically refractory epilepsy. Real-time magnetic resonance thermography (MRT)-guided stereotactic laser ablation (SLA) is a minimally invasive approach to treating focal brain lesions. SLA of CCM has not previously been described. OBJECTIVE To describe MRT-guided SLA, a novel approach to treating CCM-related epilepsy, with respect to feasibility, safety, imaging, and seizure control in 5 consecutive patients. METHODS Five patients with medically refractory epilepsy undergoing standard presurgical evaluation were found to have corresponding lesions fulfilling imaging characteristics of CCM and were prospectively enrolled. Each underwent stereotactic placement of a saline-cooled cannula containing an optical fiber to deliver 980-nm diode laser energy via twist drill craniostomy. MR anatomic imaging was used to evaluate targeting prior to ablation. MR imaging provided evaluation of targeting and near real-time feedback regarding extent of tissue thermocoagulation. Patients maintained seizure diaries, and remote imaging (6–21 months post-ablation) was obtained in all patients. RESULTS Imaging revealed no evidence of acute hemorrhage following fiber placement within presumed CCM. MRT during treatment and immediate post-procedure imaging confirmed desired extent of ablation. We identified no adverse events or neurological deficits. Four of 5 (80%) patients achieved freedom from disabling seizures after SLA alone (Engel class 1 outcome), with follow-up ranging 12–28 months. Reimaging of all subjects (6–21 months) indicated lesion diminution with surrounding liquefactive necrosis, consistent with the surgical goal of extended lesionotomy. CONCLUSION Minimally invasive MRT-guided SLA of epileptogenic CCM is a potentially safe and effective alternative to open resection. Additional experience and longer follow-up are needed. PMID:27959970

  2. Deep Fracturing of the Hard Rock Surrounding a Large Underground Cavern Subjected to High Geostress: In Situ Observation and Mechanism Analysis

    NASA Astrophysics Data System (ADS)

    Feng, Xia-Ting; Pei, Shu-Feng; Jiang, Quan; Zhou, Yang-Yi; Li, Shao-Jun; Yao, Zhi-Bin

    2017-08-01

    Rocks that are far removed from caverns or tunnels peripheries and subjected to high geostress may undergo `deep fracturing'. Deep fracturing of hard rock can cause serious hazards that cause delays and increase the cost of construction of underground caverns with high sidewalls and large spans (especially when subjected to high geostress). To extensively investigate the mechanism responsible for deep fracturing, and the relationship between fracturing and the excavation & support of caverns, this paper presents a basic procedure for making in situ observations on the deep fracturing process in hard rock. The basic procedure involves predicting the stress concentration zones in the surrounding rocks of caverns induced by excavation using geomechanical techniques. Boreholes are then drilled through these stress concentration zones from pre-existing tunnels (such as auxiliary galleries) toward the caverns before its excavation. Continuous observations of the fracturing of the surrounding rocks are performed during excavation using a borehole camera in the boreholes in order to analyze the evolution of the fracturing process. The deep fracturing observed in a large underground cavern (high sidewalls and large span) in southwest China excavated in basalt under high geostress is also discussed. By continuously observing the hard rock surrounding the arch on the upstream side of the cavern during the excavation of the first three layers, it was observed that the fracturing developed into the surrounding rocks with downward excavation of the cavern. Fracturing was found at distances up to 8-9 m from the cavern periphery during the excavation of Layer III. Also, the cracks propagated along pre-existing joints or at the interfaces between quartz porphyry and the rock matrix. The relationship between deep fracturing of the surrounding rocks and the advance of the cavern working faces was analyzed during excavation of Layer Ib. The results indicate that the extent of the stress relief zone is about 7 m if footage of 3 m is adopted for the rate of advance of the cavern faces. An analysis of the effects of the initial geostress and evolving stress concentration on deep fracturing was also made. It could be concluded that the deep fracturing of the rocks in the upstream side of the cavern is caused by the combined effect of the high initial geostress, the transfer of the stress concentration zone toward the deep surrounding rocks, and the occurrence of discontinuities.

  3. Hexahedral Finite Element Mesh Capturing Realistic Geometries of Bayou Choctaw Strategic Petroleum Reserve

    NASA Astrophysics Data System (ADS)

    Park, B. Y.; Roberts, B. L.; Sobolik, S. R.

    2016-12-01

    The U.S. Strategic Petroleum Reserve (SPR) stores crude oil in 60 caverns located at four sites located along the Gulf Coast. As a matter of normal operation of caverns in a salt dome, the continuous mechanical creep of salt, along with the change in internal cavern and casing pressure due to cavern closure and fluid exchanges, impose several mechanical conditions on the skin, well, and casing of a cavern that could potentially create damage. Sandia, on behalf of DOE, is evaluating the structural integrity of the salt surrounding existing caverns in the Bayou Choctaw (BC) salt dome in Louisiana. In reality, the geometry, spacing, and depths of the caverns are irregular. It is not easy to realize the naturally and artificially formed cavern and salt dome for numerical analysis. It is harder to convert the geometries into the meshed mass consisting of only hexahedral finite elements. A three-dimensional (3D) finite element mesh capturing realistic geometries of the Bayou Choctaw site has been constructed using the seismic and sonar survey data obtained from the field (see Figures below). The mesh consists of hexahedral elements because the salt constitutive model is coded using hexahedral elements. Techniques to reduce the number of elements as much as possible to save on computer run time while maintaining computational accuracy are also developed. These methodologies could also be applied to construct computational meshes for the Big Hill, Bryan Mound, and West Hackberry SPR sites. The methodology could be applied to the complicated shape masses for not only various civil and geological structures but also biological applications such as artificial limbs. The newly developed mesh is expected to provide more accurate solutions of geotechnical concerns that arise due to the close proximity of the caverns to each other or to the edge of salt. Also, there are nine abandoned caverns, one of which is believed to be in a quasi-stable condition. Stability issues for these abandoned caverns must be evaluated and, if necessary, addressed to prevent potential cavern collapse. The integrity of wellbores at the interbed between the caprock and salt is another concern because oil leaks could occur due to the horizontal and downward movements of the salt top relative to the caprock.

  4. Pathological Evaluation of Radiation-Induced Vascular Lesions of the Brain: Distinct from De Novo Cavernous Hemangioma

    PubMed Central

    Cha, Yoon Jin; Nahm, Ji Hae; Ko, Ji Eun; Shin, Hyun Joo; Chang, Jong-Hee; Cho, Nam Hoon

    2015-01-01

    Purpose We aimed to evaluate the histologic and radiologic findings of vascular lesions after stereotactic radiosurgery (SRS) categorized as radiation-induced cavernous hemangioma (RICH). Materials and Methods Among 89 patients who underwent neurosurgery for cavernous hemangioma, eight RICHs from 7 patients and 10 de novo CHs from 10 patients were selected for histopathological and radiological comparison. Results Histologically, RICHs showed hematoma-like gross appearance. Microscopically, RICH exhibited a hematoma-like area accompanied by proliferation of thin-walled vasculature with fibrin deposits and infiltrating foamy macrophages. In contrast, CHs demonstrated localized malformed vasculature containing fresh and old clotted blood on gross examination. Typically, CHs consisted of thick, ectatic hyalinized vessels lined by endothelium under a light microscope. Magnetic resonance imaging of RICHs revealed some overlapping but distinct features with CHs, including enhancing cystic and solid components with absence or incomplete popcorn-like appearance and partial hemosiderin rims. Conclusion Together with histologic and radiologic findings, RICH may result from blood-filled space after tissue destruction by SRS, accompanied with radiation-induced reactive changes rather than vascular malformation. Thus, the term "RICH" would be inappropriate, because it is more likely to be an inactive organizing hematoma rather than proliferation of malformed vasculature. PMID:26446658

  5. Art Rocks with Rock Art!

    ERIC Educational Resources Information Center

    Bickett, Marianne

    2011-01-01

    This article discusses rock art which was the very first "art." Rock art, such as the images created on the stone surfaces of the caves of Lascaux and Altimira, is the true origin of the canvas, paintbrush, and painting media. For there, within caverns deep in the earth, the first artists mixed animal fat, urine, and saliva with powdered minerals…

  6. Novel Optical Methods for Identification, Imaging, and Preservation of the Cavernous Nerves Responsible for Penile Erections during Prostate Cancer Surgery

    DTIC Science & Technology

    2011-03-01

    epartment of Physics and Optical Science harlotte, North Carolina 28223 homas P. Weldon niversity of North Carolina at Charlotte epartment of...Lens Glass Ferrule Visible Diode Laser IR Diode Laser 90% 10% Fiber Coupler 10/90 (SMF-28) Butterfly Diode Laser Mount 1420 1430 147014501440

  7. A NOVEL PROCESS TO USE SALT CAVERNS TO RECEIVE SHIP BORNE LNG

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Michael M. McCall; William M. Bishop; Marcus Krekel

    2005-05-31

    This cooperative research project validates use of man made salt caverns to receive and store the cargoes of LNG ships in lieu of large liquid LNG tanks. Salt caverns will not tolerate direct injection of LNG because it is a cryogenic liquid, too cold for contact with salt. This research confirmed the technical processes and the economic benefits of pressuring the LNG up to dense phase, warming it to salt compatible temperatures and then directly injecting the dense phase gas into salt caverns for storage. The use of salt caverns to store natural gas sourced from LNG imports, particularly whenmore » located offshore, provides a highly secure, large scale and lower cost import facility as an alternative to tank based LNG import terminals. This design can unload a ship in the same time as unloading at a tank based terminal. The Strategic Petroleum Reserve uses man made salt caverns to securely store large quantities of crude oil. Similarly, this project describes a novel application of salt cavern gas storage technologies used for the first time in conjunction with LNG receiving. The energy industry uses man made salt caverns to store an array of gases and liquids but has never used man made salt caverns directly in the importation of LNG. This project has adapted and expanded the field of salt cavern storage technology and combined it with novel equipment and processes to accommodate LNG importation. The salt cavern based LNG receiving terminal described in the project can be located onshore or offshore, but the focus of the design and cost estimates has been on an offshore location, away from congested channels and ports. The salt cavern based terminal can provide large volumes of gas storage, high deliverability from storage, and is simplified in operation compared to tank based LNG terminals. Phase I of this project included mathematical modeling that proved a salt cavern based receiving terminal could be built at lower capital cost, and would have significantly higher delivery capacity, shorter construction time, and be much more secure than a conventional liquid tank based terminal. Operating costs of a salt cavern terminal are lower than tank based terminals because ''boil off'' is eliminated and maintenance costs of caverns are lower than LNG tanks. Phase II included the development of offshore mooring designs, wave tank tests, high pressure LNG pump field tests, heat exchanger field tests, and development of a model offshore LNG facility and cavern design. Engineers designed a model facility, prepared equipment lists, and confirmed capital and operating costs. In addition, vendors quoted fabrication and installation costs, confirming that an offshore salt cavern based LNG terminal would have lower capital and operating costs than a similarly sized offshore tank based terminal. Salt cavern storage is infinitely more secure than surface storage tanks, far less susceptible to accidents or purposeful damage, and much more acceptable to the community. More than thirty industry participants provided cost sharing, technical expertise, and guidance in the conduct and evaluation of the field tests, facility design and operating and cost estimates. Their close participation has accelerated the industry's acceptance of the conclusions of this research. The industry participants also developed and submitted several alternative designs for offshore mooring and for high pressure LNG heat exchangers in addition to those that were field tested in this project. HNG Storage, a developer, owner, and operator of natural gas storage facilities, and a participant in the DOE research has announced they will lead the development of the first offshore salt cavern based LNG import facility. Which will be called the Freedom LNG Terminal. It will be located offshore Louisiana, and is expected to be jointly developed with other members of the research group yet to be named. An offshore port license application is scheduled to be filed by fourth quarter 2005 and the terminal could be operational by 2009. This terminal allows the large volume importation of LNG without disrupting coastal port operations by being offshore, out of sight of land.« less

  8. Successful Transarterial Embolization of a Posttraumatic Fistula Between a Posterior Communicating Artery Aneurysm and the Cavernous Sinus: A Case Report.

    PubMed

    Jinbo, Yin; Jun, Liu; Kejie, Mou; Zheng, Zhou

    2015-01-01

    Posterior communicating artery (PCoA) aneurysm-cavernous sinus fistulae are an extremely rare complication of head injury . The treatment of PCoA aneurysm-cavernous sinus fistulae has not been well described. A 27-year-old man was admitted with a retroocular bruit and blurred vision of the left eye seven months after a severe head injury. We report the angiographic appearance of a posterior communicating artery (PCoA) aneurysm with a fistula to the cavernous sinus. This injury had been previously misinterpreted to be a PCoA aneurysm by computerized tomographic angiography (CTA). The patient was successfully treated with coils and Onyx of a fistula between the PCoA aneurysm and cavernous sinus.

  9. Limited endoscopic transsphenoidal approach for cavernous sinus biopsy: illustration of 3 cases and discussion.

    PubMed

    Graillon, T; Fuentes, S; Metellus, P; Adetchessi, T; Gras, R; Dufour, H

    2014-01-01

    Advances in transsphenoidal surgery and endoscopic techniques have opened new perspectives for cavernous sinus (CS) approaches. The aim of this study was to assess the advantages and disadvantages of limited endoscopic transsphenoidal approach, as performed in pituitary adenoma surgery, for CS tumor biopsy illustrated with three clinical cases. The first case was a 46-year-old woman with a prior medical history of parotid adenocarcinoma successfully treated 10 years previously. The cavernous sinus tumor was revealed by right third and sixth nerve palsy and increased over the past three years. A tumor biopsy using a limited endoscopic transsphenoidal approach revealed an adenocarcinoma metastasis. Complementary radiosurgery was performed. The second case was a 36-year-old woman who consulted for diplopia with right sixth nerve palsy and amenorrhea with hyperprolactinemia. Dopamine agonist treatment was used to restore the patient's menstrual cycle. Cerebral magnetic resonance imaging (MRI) revealed a right sided CS tumor. CS biopsy, via a limited endoscopic transsphenoidal approach, confirmed a meningothelial grade 1 meningioma. Complementary radiosurgery was performed. The third case was a 63-year-old woman with progressive installation of left third nerve palsy and visual acuity loss, revealing a left cavernous sinus tumor invading the optic canal. Surgical biopsy was performed using an enlarged endoscopic transsphenoidal approach to the decompress optic nerve. Biopsy results revealed a meningothelial grade 1 meningioma. Complementary radiotherapy was performed. In these three cases, no complications were observed. Mean hospitalization duration was 4 days. Reported anatomical studies and clinical series have shown the feasibility of reaching the cavernous sinus using an endoscopic endonasal approach. Trans-foramen ovale CS percutaneous biopsy is an interesting procedure but only provides cell analysis results, and not tissue analysis. However, radiotherapy and radiosurgery have proven effective for SC meningiomas. When histological diagnosis is required, limited endoscopic transsphenoidal approach appears as a safe, fast, and useful alternative to the classical endocranial approach. Also, a tailored enlargement of the approach could be performed if optic nerve decompression is required. The feasibility of CS endoscopic transsphenoidal biopsy has prompted us to consider CS biopsy when the diagnosis of CS meningioma is uncertain. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Derivation and application of an analytical rock displacement solution on rectangular cavern wall using the inverse mapping method.

    PubMed

    Gao, Mingzhong; Yu, Bin; Qiu, Zhiqiang; Yin, Xiangang; Li, Shengwei; Liu, Qiang

    2017-01-01

    Rectangular caverns are increasingly used in underground engineering projects, the failure mechanism of rectangular cavern wall rock is significantly different as a result of the cross-sectional shape and variations in wall stress distributions. However, the conventional computational method always results in a long-winded computational process and multiple displacement solutions of internal rectangular wall rock. This paper uses a Laurent series complex method to obtain a mapping function expression based on complex variable function theory and conformal transformation. This method is combined with the Schwarz-Christoffel method to calculate the mapping function coefficient and to determine the rectangular cavern wall rock deformation. With regard to the inverse mapping concept, the mapping relation between the polar coordinate system within plane ς and a corresponding unique plane coordinate point inside the cavern wall rock is discussed. The disadvantage of multiple solutions when mapping from the plane to the polar coordinate system is addressed. This theoretical formula is used to calculate wall rock boundary deformation and displacement field nephograms inside the wall rock for a given cavern height and width. A comparison with ANSYS numerical software results suggests that the theoretical solution and numerical solution exhibit identical trends, thereby demonstrating the method's validity. This method greatly improves the computing accuracy and reduces the difficulty in solving for cavern boundary and internal wall rock displacements. The proposed method provides a theoretical guide for controlling cavern wall rock deformation failure.

  11. Derivation and application of an analytical rock displacement solution on rectangular cavern wall using the inverse mapping method

    PubMed Central

    Gao, Mingzhong; Qiu, Zhiqiang; Yin, Xiangang; Li, Shengwei; Liu, Qiang

    2017-01-01

    Rectangular caverns are increasingly used in underground engineering projects, the failure mechanism of rectangular cavern wall rock is significantly different as a result of the cross-sectional shape and variations in wall stress distributions. However, the conventional computational method always results in a long-winded computational process and multiple displacement solutions of internal rectangular wall rock. This paper uses a Laurent series complex method to obtain a mapping function expression based on complex variable function theory and conformal transformation. This method is combined with the Schwarz-Christoffel method to calculate the mapping function coefficient and to determine the rectangular cavern wall rock deformation. With regard to the inverse mapping concept, the mapping relation between the polar coordinate system within plane ς and a corresponding unique plane coordinate point inside the cavern wall rock is discussed. The disadvantage of multiple solutions when mapping from the plane to the polar coordinate system is addressed. This theoretical formula is used to calculate wall rock boundary deformation and displacement field nephograms inside the wall rock for a given cavern height and width. A comparison with ANSYS numerical software results suggests that the theoretical solution and numerical solution exhibit identical trends, thereby demonstrating the method’s validity. This method greatly improves the computing accuracy and reduces the difficulty in solving for cavern boundary and internal wall rock displacements. The proposed method provides a theoretical guide for controlling cavern wall rock deformation failure. PMID:29155892

  12. Assessment of the Available Drawdowns for Oil Storage Caverns at the West Hackberry SPR Site

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sobolik, Steven R.

    The Department of Energy, in response to requests from the U.S. Congress, wishes to maintain an up-to-date table documenting the number of available full drawdowns of each of the caverns owned by the Strategic Petroleum Reserve. This information is important for assessing the SPR’s ability to deliver oil to domestic oil companies expeditiously if national or world events dictate a rapid sale and deployment of the oil reserves. What factors go into assessing available drawdowns? The evaluation of drawdown risks require the consideration of several factors regarding cavern and wellbore integrity and stability, including stress states caused by cavern geometrymore » and operations, salt damage caused by dilatant and tensile stresses, the effect on enhanced creep on wellbore integrity, the sympathetic stress effect of operations on neighboring caverns. Based on the work over the past several months, a consensus has been built regarding the assessment of drawdown capabilities and risks for the SPR caverns. This paper draws upon the recently West Hackberry model upgrade and analyses to reevaluate and update the available drawdowns for each of those caverns. Similar papers for the Bryan Mound, Big Hill, and Bayou Choctaw papers will be developed as the upgrades to those analyses are completed. The rationale and documentation of the methodology is described in the remainder of this report, as are the updated estimates of available drawdowns for the West Hackberry caverns.« less

  13. Rates and characteristics of radiographically detected intracerebral cavernous malformations after cranial radiation therapy in pediatric cancer patients

    PubMed Central

    Hills, Nancy; Roddy, Erika; Randazzo, Dominica; Chettout, Nassim; Hess, Christopher; Cotter, Jennifer; Haas-Kogan, Daphne A.; Fullerton, Heather; Mueller, Sabine

    2014-01-01

    Rates and characteristics of intracerebral cavernous malformations (ICMs) after cranial radiation therapy (CRT) remain poorly understood. Herein we report on ICMs detected on follow+up imaging in pediatric cancer patients who received CRT at age ≤ 18 years from 1980 to 2009. Through chart reviews (n=362) and phone interviews (n=104) of a retrospective cohort we identified 10 patients with ICMs. The median latency time for detection of ICMs after CRT was 12 years (range 1+24 years) at a median age of 21.4 years (IQR 15+28). The cumulative incidence was 3% (95% CI 1+8%) at 10 years post CRT and 14% (95% CI 7+26%) at 15 years. Three patients underwent surgical resection. Two surgical specimens were pathologically similar to sporadically occurring ICMs; one was consistent with capillary telangiectasia. ICMs are common after CRT and can show a spectrum of histological features. PMID:25122111

  14. Cavernous sinus syndrome due to osteochondromatosis in a cat.

    PubMed

    Perazzi, Anna; Bernardini, Marco; Mandara, Maria T; De Benedictis, Giulia M; De Strobel, Francesca; Zotti, Alessandro

    2013-12-01

    A 1-year-old sexually intact male Korat cat was referred for ophthalmological consultation due to anisocoria. Mydriasis with external ophthalmoplegia and absence of pupillary light responses in the right eye and nasofacial hypalgesia were seen. Cavernous sinus syndrome (CSS) was suspected. Bilateral deformities of the jaw and phalangeal bones, severe spinal pain and abnormal conformation of the lumbar spine were also present. Radiographic examination revealed several mineralised masses in the appendicular and axial skeleton, indicative of multiple cartilaginous exostoses. For further investigation of the CSS-related neurological deficits, the cat underwent computed tomography (CT) examination of the skull. CT images revealed a non-vascularised, calcified, amorphous mass originating from the right lateral skull base and superimposing on the sella turcica. Based on the severity of diffuse lesions and owing to the clinical signs of extreme pain, the cat was euthanased. A diffuse skeletal and intracranial osteochondromatosis was diagnosed histologically.

  15. Clival osteomyelitis and hypoglossal nerve palsy--rare complications of Lemierre's syndrome.

    PubMed

    He, Jingzhou; Lam, Jonathan Chun Leuk; Adlan, Tarig

    2015-08-30

    An increasingly reported entity, Lemierre's syndrome classically presents with a recent oropharyngeal infection, internal jugular vein thrombosis and the presence of anaerobic organisms such as Fusobacterium necrophorum. The authors report a normally fit and well 17-year-old boy who presented with severe sepsis following a 5-day history of a sore throat, myalgia and neck stiffness requiring intensive care admission. Blood cultures grew F. necrophorum and radiological investigations demonstrated left internal jugular vein, cavernous sinus and sigmoid sinus thrombus, left vertebral artery dissection and thrombus within the left internal carotid artery. Imaging also revealed two areas of acute ischaemia in the brain, consistent with septic emboli, skull base (clival) osteomyelitis and an extensive epidural abscess. The patient improved on meropenem and metronidazole and was warfarinised for his cavernous sinus thrombosis. He has an on-going left-sided hypoglossal (XIIth) nerve palsy. 2015 BMJ Publishing Group Ltd.

  16. Multiphoton Microscopy of Prostate and Periprostatic Neural Tissue: A Promising Imaging Technique for Improving Nerve-Sparing Prostatectomy

    PubMed Central

    Yadav, Rajiv; Mukherjee, Sushmita; Hermen, Michael; Tan, Gerald; Maxfield, Frederick R.; Webb, Watt W.

    2009-01-01

    Abstract Background and Purpose Various imaging modalities are under investigation for real-time tissue imaging of periprostatic nerves with the idea of improving the results of nerve-sparing radical prostatectomy. We explored multiphoton microscopy (MPM) for real-time tissue imaging of the prostate and periprostatic neural tissue in a male Sprague-Dawley rat model. The unique advantage of this technique is the acquisition of high-resolution images without necessitating any extrinsic labeling agent and with minimal phototoxic effect on tissue. Materials and Methods The prostate and cavernous nerves were surgically excised from male Sprague-Dawley rats. The imaging was carried out using intrinsic fluorescence and scattering properties of the tissues without any exogenous dye or contrast agent. A custom-built MPM, consisting of an Olympus BX61WI upright frame and a modified MRC 1024 scanhead, was used. A femtosecond pulsed titanium/sapphire laser at 780-nm wavelength was used to excite the tissue; laser power under the objective was modulated via a Pockels cell. Second harmonic generation (SHG) signals were collected at 390 (±35 nm), and broadband autofluorescence was collected at 380 to 530 nm. The images obtained from SHG and from tissue fluorescence were then merged and color coded during postprocessing for better appreciation of details. The corresponding tissues were subjected to hematoxylin and eosin staining for histologic confirmation of the structures. Results High-resolution images of the prostate capsule, underlying acini, and individual cells outlining the glands were obtained at varying magnifications. MPM images of adipose tissue and the neural tissues were also obtained. Histologic confirmation and correlation of the prostate gland, fat, cavernous nerve, and major pelvic ganglion validated the findings of MPM. Conclusion Real-time imaging and microscopic resolution of prostate and periprostatic neural tissue using MPM is feasible without the need for any extrinsic labeling agents. Integration of this imaging modality with operative technique has the potential to improve the precision of nerve-sparing prostatectomy. PMID:19425823

  17. 36 CFR 7.47 - Carlsbad Caverns National Park.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Carlsbad Caverns National Park. 7.47 Section 7.47 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.47 Carlsbad Caverns National Park. (a...

  18. 36 CFR 7.47 - Carlsbad Caverns National Park.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Carlsbad Caverns National Park. 7.47 Section 7.47 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.47 Carlsbad Caverns National Park. (a...

  19. 36 CFR 7.47 - Carlsbad Caverns National Park.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Carlsbad Caverns National Park. 7.47 Section 7.47 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.47 Carlsbad Caverns National Park. (a...

  20. 36 CFR 7.47 - Carlsbad Caverns National Park.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Carlsbad Caverns National Park. 7.47 Section 7.47 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.47 Carlsbad Caverns National Park. (a...

  1. 36 CFR 7.47 - Carlsbad Caverns National Park.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Carlsbad Caverns National Park. 7.47 Section 7.47 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.47 Carlsbad Caverns National Park. (a...

  2. Direct carotid cavernous fistula after submucous resection of the nasal septum.

    PubMed

    Bizri, A R; al-Ajam, M; Zaytoun, G; al-Kutoubi, A

    2000-01-01

    A carotid cavernous fistula (CCF) is an abnormal arteriovenous anastomosis between the carotid artery and the cavernous sinus. Etiologies of this condition reported in the literature so far include facial trauma, rupture of an intracavernous aneurysm of the carotid artery, Ehler-Danlos syndrome and fibromuscular dysplasia of the cerebral arteries. Such fistulae were reported as complications of rhinoplasty, transsphenoidal surgery, embolization of cavernous sinus meningioma, and rhinocerebral mucormycosis. CCF may also occur spontaneously in children or as a congenital malformation. However, to our knowledge, submucous resection of the nasal septum has not been reported before to cause direct carotid-cavernous fistula. CT and angiographic findings are presented and a review of the literature for reported causes of CCF is made as well as a brief discussion of the possible pathophysiology.

  3. Construction of the bridge in the cavern in the Vrata tunnel (Croatia)

    NASA Astrophysics Data System (ADS)

    Garasic, Mladen; Sasa Kovacevic, Meho; Juric-Kacunic, Danijela

    2010-05-01

    In the Dinaric karst system in Croatia some 11500 speleological objects have been explored so far, more than 1000 of which were discovered during construction works. Such speleological objects without natural entrance on the terrain surface (which are called "caverns") have been discovered on the construction sites of the highways. Over the past twenty years they have been systematically investigated and treated. A special kind of remediation was conducted in the cavern's large hall of the "Vrata" tunnel on the Zagreb - Rijeka highway. Due to size, shape, cavern's position and hydrogeological parameters (fissured and karstified aquifers) within the karst system it was necessary to design and construct a 58 m bridge over the cavern. In addition, the cavern's vault had to be reinforced and stabilized, as the overburden was very thin. The beam-and -stringer grid with special anchors was used. The cavern's rehabilitation in the "Vrata" tunnel was a unique undertaking, and the bridge (without piers) is the cavern's longest bridge in the world. A speleological object of large dimensions was discovered in the "Vrata"tunnel's right tube on the Rijeka-Zagreb highway. Speleological, geotechnical, engineering geological and hydrogeological investigation works were carried out for the purpose of preservation the speleological object (cavern). On the basis of classification results of rock masses and conducted numerical analyses the support system for the cavern's vault stabilization was selected. The support system's elements include the beam-and-stringer grid constructed on the terrain's surface above the cavern, tendons and geotechnical anchors. To ensure stability of the speleological object, and to conduct the backward numerical analyses the measurement of vertical deformations from the terrain's surface along the rock's mass by means of sliding micrometers was undertaken. Backward numerical analyses combined with geotechnical measurements enable safer and more rational approach to design and construction of underground structures. They contribute to the knowledge on rock mass performance and to determination of its physical and mechanical parameters connecting them with rock classification results. The analyses are a great help in verification or modification of elements' features of primary support system. Tunnel and bridge in tunnel "Vrata" were opened for traffic in November 2008. Keywords: speleology, cave, Dinaric karst, Croatia, tunnel, karst phenomena, geotechnical engineering.

  4. Computer-aided diagnosis of cavernous malformations in brain MR images.

    PubMed

    Wang, Huiquan; Ahmed, S Nizam; Mandal, Mrinal

    2018-06-01

    Cavernous malformation or cavernoma is one of the most common epileptogenic lesions. It is a type of brain vessel abnormality that can cause serious symptoms such as seizures, intracerebral hemorrhage, and various neurological disorders. Manual detection of cavernomas by physicians in a large set of brain MRI slices is a time-consuming and labor-intensive task and often delays diagnosis. In this paper, we propose a computer-aided diagnosis (CAD) system for cavernomas based on T2-weighted axial plane MRI image analysis. The proposed technique first extracts the brain area based on atlas registration and active contour model, and then performs template matching to obtain candidate cavernoma regions. Texture, the histogram of oriented gradients and local binary pattern features of each candidate region are calculated, and principal component analysis is applied to reduce the feature dimensionality. Support vector machines (SVMs) are finally used to classify each region into cavernoma or non-cavernoma so that most of the false positives (obtained by template matching) are eliminated. The performance of the proposed CAD system is evaluated and experimental results show that it provides superior performance in cavernoma detection compared to existing techniques. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Thermo-mechanical modelling of salt caverns due to fluctuating loading conditions.

    NASA Astrophysics Data System (ADS)

    Böttcher, N.

    2015-12-01

    This work summarizes the development and application of a numerical model for the thermo-mechanical behaviour of salt caverns during cyclic gas storage. Artificial salt caverns are used for short term energy storage, such as power-to-gas or compressed air energy storage. Those applications are characterized by highly fluctuating operation pressures due to the unsteady power levels of power plants based on renewable energy. Compression and expansion of the storage gases during loading and unloading stages lead to rapidly changing temperatures in the host rock of the caverns. This affects the material behaviour of the host rock within a zone that extends several meters into the rock mass adjacent to the cavern wall, and induces thermo-mechanical stresses and alters the creep response.The proposed model features the thermodynamic behaviour of the storage medium, conductive heat transport in the host rock, as well as temperature dependent material properties of rock salt using different thermo-viscoplastic material models. The utilized constitutive models are well known and state-of-the-art in various salt mechanics applications. The model has been implemented into the open-source software platform OpenGeoSys. Thermal and mechanical processes are solved using a finite element approach, coupled via a staggered coupling scheme. The simulation results allow the conclusion, that the cavern convergence rate (and thus the efficiency of the cavern) is highly influenced by the loading cycle frequency and the resulting gas temperatures. The model therefore allows to analyse the influence of operation modes on the cavern host rock or on neighbouring facilities.

  6. Spontaneous subarachnoid hemorrhage due to ruptured cavernous internal carotid artery aneurysm after medical prolactinoma treatment.

    PubMed

    Khalsa, Siri Sahib; Hollon, Todd C; Shastri, Ravi; Trobe, Jonathan D; Gemmete, Joseph J; Pandey, Aditya S

    2017-03-01

    Aneurysms of the cavernous segment of the internal carotid artery (ICA) are believed to have a low risk of subarachnoid haemorrhage (SAH), given the confines of the dural rings and the anterior clinoid process. The risk may be greater when the bony and dural protection has been eroded. We report a case of spontaneous SAH from rupture of a cavernous ICA aneurysm in a patient whose large prolactinoma had markedly decreased in size as the result of cabergoline treatment. After passing a balloon test occlusion, the patient underwent successful endovascular vessel deconstruction. This case suggests that an eroding skull base lesion may distort normal anterior cranial base anatomy and allow communication between the cavernous ICA and subarachnoid space. The potential for SAH due to cavernous ICA aneurysm rupture should be recognised in patients with previous pituitary or other skull base lesions adjacent to the cavernous sinus. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Frontal Lobe Cavernous Malformations in Pediatric Patients: Clinical Features and Surgical Outcomes.

    PubMed

    Wang, Chengjun; Zhao, Meng; Wang, Jia; Wang, Shuo; Jiang, Zhongli; Zhao, Jizong

    2018-01-01

    The purpose of this study is to investigate the clinical manifestations, surgical treatment, and neurologic outcomes of frontal lobe cavernous malformations in children. A retrospective analysis of 23 pediatric frontal lobe cavernous malformation patients who underwent surgical treatment in Beijing Tiantan Hospital was performed. The case series included 16 boys and 7 girls. Gross total removal without surgical mortality was achieved in all patients. The mean follow-up period after surgery was 33.1 months. Two patients who left hospital with motor deficits gradually recovered after rehabilitative treatment, and other patients were considered to be in excellent clinical condition. For symptomatic frontal lobe cavernous malformations, neurosurgical management should be the treatment of choice. Conservative treatment may be warranted in asymptomatic frontal lobe cavernous malformations, especially the deep-seated or eloquently located cases.

  8. Analysis of the evolution of the instability process of a coastal cavern

    NASA Astrophysics Data System (ADS)

    Lollino, P.; Reina, A.

    2012-04-01

    This work concerns the study performed for the interpretation of the potential failure mechanism of a large natural cavern, which is located along the rocky cliffs of Polignano a Mare town (Apulia, Southern Italy) under an intensely urbanised area. This cavern, which is located at the sea level, was formed due to an intense process of salt and wave erosion, mainly acting during sea storms, within a rock mass formed of a lower stratified limestone mass and an upper soft calcarenite mass. Therefore, the influence of the climatic factors and of the upward erosion process within the cavern has been specifically investigated. At present, the thickness of the cave roof, which has a dome shape, is less than 10 metres in the centre and several buildings are founded on the ground surface above. In 2006 a large calcarenite block, of about 1.5 m diameter, fell down from the roof of the cavern and afterwards field and laboratory investigations as well as both simple analytical methods and elasto-plastic numerical modelling were carried out in order to assess the current state of the roof and to interpret the effects of the potential evolution of the inner erosion and of the local failure processes of the cave. As such, a detailed geo-structural survey has firstly been carried out, together with laboratory and in-situ testing for the geomechanical characterisation of the rock materials and of the corresponding joints. An analysis of the sea storms occurred within the observation period has also been performed by considering daily rainfall and wind data. The rate of erosion has been measured by means of special nets installed at the sea level to collect the material falling down from the roof and the corresponding measurements, which lasted for about one year, indicate an erosion rate of at least 0.005 m3/month. A structural monitoring system, including extensometers and joint-meters, was also installed in several points of the cave in order to measure eventual block displacements within the cavern and the results show some correlations of the logged data with the occurrence of sea storms and in general with the weather factors. The results of both simplified analytical methods and numerical analysis show that the cave is at present stable. Also, numerical modelling was aimed at defining the conditions under which general failure of the cave might occur. In particular, sensitivity analyses have been carried out to assess the influence of specific factors, as the progressive reduction of the roof thickness due to erosion or the gradual reduction of the strength properties of the calcarenite due to weathering processes.

  9. Hazard assessment of the stability of a cavern roof along the coastline

    NASA Astrophysics Data System (ADS)

    Reina, A.; Lollino, P.

    2009-04-01

    This work concerns the hazard assessment about the stability of a large shallow depth cavern, located along the coastline rocky sector of Polignano town (Apulia, Southern Italy) under an intensely urbanised area. This cavern, which lies at the sea level, has been created by a prolonged process of sea erosion within a rock mass formed of a lower stratified limestone mass and an upper Gravina Calcarenite mass. The thickness of the cavern roof, which has a dome shape, is less than 10 metres in the centre. Important buildings, as hotels and private houses, are located just above the top of the roof. Erosion processes have been observed to be still active along the whole cavern due to climate factors and, in particular, to sea salt weathering and sea spray effects. In 2007 a large calcarenite block, 3 m large, fell down from the cavern roof and consequently a field investigation campaign was carried out for a rational stabilization plan in order to understand the current stability conditions of the roof and the potential failure mechanism. Therefore, a thorough geo-structural survey has firstly been carried out, together with laboratory and in-situ testing for measuring the physical and mechanical properties of the calcarenite rock and of the corresponding joints. A monitoring system has also been planned and installed in order to measure the erosional rate and the block displacements in the cavern.

  10. Cavernous carotid aneurysms in the era of flow diversion: a need to revisit treatment paradigms.

    PubMed

    Tanweer, O; Raz, E; Brunswick, A; Zumofen, D; Shapiro, M; Riina, H A; Fouladvand, M; Becske, T; Nelson, P K

    2014-12-01

    Recent techniques of endoluminal reconstruction with flow-diverting stents have not been incorporated into treatment algorithms for cavernous carotid aneurysms. This study examines the authors' institutional experience and a systematic review of the literature for outcomes and complications using the Pipeline Embolization Device in unruptured cavernous carotid aneurysms. A retrospective search for cavernous carotid aneurysms from a prospectively collected data base of aneurysms treated with the Pipeline Embolization Device at our institution was performed. Baseline demographic, clinical, and laboratory values; intrainterventional data; and data at all follow-up visits were collected. A systematic review of the literature for complication data was performed with inquiries sent when clarification of data was needed. Forty-three cavernous carotid aneurysms were included in the study. Our mean radiographic follow-up was 2.05 years. On last follow-up, 88.4% of the aneurysms treated had complete or near-complete occlusion. Aneurysm complete or near-complete occlusion rates at 6 months, 12 months, and 36 months were 81.4%, 89.7%, and 100%, respectively. Of patients with neuro-ophthalmologic deficits on presentation, 84.2% had improvement in their visual symptoms. Overall, we had a 0% mortality rate and a 2.3% major neurologic complication rate. Our systematic review of the literature yielded 227 cavernous carotid aneurysms treated with the Pipeline Embolization Device with mortality and morbidity rates of 0.4% and 3.1%, respectively. Endoluminal reconstruction with flow diversion for large unruptured cavernous carotid aneurysms can yield high efficacy with low complications. Further long-term data will be helpful in assessing the durability of the cure; however, we advocate a revisiting of current management paradigms for cavernous carotid aneurysms. © 2014 by American Journal of Neuroradiology.

  11. Orbital cellulitis demands early recognition, urgent admission and aggressive management.

    PubMed Central

    Tole, D M; Anderton, L C; Hayward, J M

    1995-01-01

    Orbital cellulitis is an emergency. Confusion still exists between the diagnosis of this serious condition and that of preseptal cellulitis. Delay in treatment may cause blindness and progression to life-threatening sequelae such as brain abscess, meningitis or cavernous sinus thrombosis. We report a case in which, despite late referral, emergency surgical intervention was sight saving. Images Fig. 1 Fig. 2 PMID:7582417

  12. A rare case of important and recurrent abnormal uterine bleeding in a post partum woman caused by cavernous hemangioma: a case report and review of literature.

    PubMed

    Aka, Kacou Edele; Apollinaire Horo, Gninlgninrin; Fomba, Minata; Kouyate, Salif; Koffi, Abdoul Koffi; Konan, Seni; Fanny, Mohamed; Effi, Benjamin; Kone, Mamourou

    2017-01-01

    The cavernous hemangioma is a rare benign vascular tumor. About 50 cases of this disease were found in the literature over the last century and only 9 cases of cavernous hemangioma on the pregnant uterus were published it comes into cavernous or capillary form. The symptomatology is not unequivocal and when it occurs during pregnancy or postpartum, it causes life-threatening cataclysmic hemorrhage. Antenatal diagnosis is difficult and requires a multidisciplinary approach with pathologists, radiologists and gynecologists to avoid these complications or unnecessary hysterectomies. The diagnosis is histological. Hysterectomy is possible after failure of conservative treatment means. We report a rare case, a novel mixed cavernous hemangioma of the body associated with a capillary hemangioma of the cervix in a patient of 28 years 5th visors with recurrent genital bleeding in the postpartum period leading to a hysterectomy.

  13. Building the 3D Geological Model of Wall Rock of Salt Caverns Based on Integration Method of Multi-source data

    NASA Astrophysics Data System (ADS)

    Yongzhi, WANG; hui, WANG; Lixia, LIAO; Dongsen, LI

    2017-02-01

    In order to analyse the geological characteristics of salt rock and stability of salt caverns, rough three-dimensional (3D) models of salt rock stratum and the 3D models of salt caverns on study areas are built by 3D GIS spatial modeling technique. During implementing, multi-source data, such as basic geographic data, DEM, geological plane map, geological section map, engineering geological data, and sonar data are used. In this study, the 3D spatial analyzing and calculation methods, such as 3D GIS intersection detection method in three-dimensional space, Boolean operations between three-dimensional space entities, three-dimensional space grid discretization, are used to build 3D models on wall rock of salt caverns. Our methods can provide effective calculation models for numerical simulation and analysis of the creep characteristics of wall rock in salt caverns.

  14. A singular case of cavernous internal carotid artery aneurysm in patient with cavernous sinus syndrome and bacterial meningitis.

    PubMed

    Sacchetti, Federico; Stagni, Silvia; Spinardi, Luca; Raumer, Luigi; Dentale, Nicola; Cirillo, Luigi

    2016-09-01

    We report the uncommon case of an acute cavernous sinus syndrome in a patient who was consequently discovered to have both a cavernous internal carotid artery aneurysm and bacterial meningitis. Which came first, the chicken or the egg? Which of the two, the aneurysm or the meningitis, gave rise to the patient's symptoms? We briefly reviewed the literature of similar cases and tried to analyze the possible pathophysiological relationship between these findings. Moreover, this case highlights the importance of a multidisciplinary management of these patients to better decide between a medical and a surgical and/or endovascular treatment.

  15. Designed angiopoietin-1 variant, COMP-angiopoietin-1, rescues erectile function through healthy cavernous angiogenesis in a hypercholesterolemic mouse

    PubMed Central

    Ryu, Ji-Kan; Kim, Woo Jean; Koh, Young Jun; Piao, Shuguang; Jin, Hai-Rong; Lee, Sae-Won; Choi, Min Ji; Shin, Hwa-Yean; Kwon, Mi-Hye; Jung, Keehoon; Koh, Gou Young; Suh, Jun-Kyu

    2015-01-01

    Despite the advent of oral phosphodiesterase-5 inhibitors, curative treatment for erectile dysfunction (ED) remains unavailable. Recently, the link between ED and cardiovascular disease was unveiled and the main etiology of ED was found to be vasculogenic. Therefore, neovascularization is a promising strategy for curing ED. Angiopoietin-1 (Ang1) is an angiogenic growth factor that promotes the generation of stable and functional vasculature. Here, we demonstrate that local delivery of the soluble, stable, and potent Ang1 variant, COMP-Ang1 gene or protein, into the penises of hypercholesterolemic mice increases cavernous angiogenesis, eNOS phosphorylation, and cGMP expression, resulting in full recovery of erectile function and cavernous blood flow up to 8 weeks after treatment. COMP-Ang1-induced promotion of cavernous angiogenesis and erectile function was abolished in Nos3-/- mice and in the presence of the NOS inhibitor, L-NAME. COMP-Ang1 also restored the integrity of endothelial cell-cell junction by down-regulating the expression of histone deacetylase 2 in the penis of hypercholesterolemic mice and in primary cultured mouse cavernous endothelial cells. These findings constitute a new paradigm toward curative treatment of both cavernous angiopathy and ED. PMID:25783805

  16. Induced Seismicity Monitoring of an Underground Salt Cavern Prone to Collapse

    NASA Astrophysics Data System (ADS)

    Mercerat, E. D.; Driad-Lebeau, L.; Bernard, P.

    2010-02-01

    Within the framework of a large research project launched to assess the feasibility of microseismic monitoring of growing underground caverns, this specific work focuses on the analysis of the induced seismicity recorded in a salt mine environment. A local seismic network has been installed over an underground salt cavern located in the Lorraine basin (Northeast of France). The microseismic network includes four 3-components and three single component geophones deployed at depths between 30 and 125 m in cemented boreholes drilled in the vicinity of the study area. The underground cavern under monitoring is located within a salt layer at 180 m depth and it presents a rather irregular shape that can be approximated by a cylindrical volume of 50 m height and 180 m diameter. Presently, the cavern is full of saturated brine inducing a significant pressure on its walls (~2.0 MPa) to keep the overburden mechanically stable. Nevertheless some small microseismic events were recorded by the network and analyzed (approximately 2,000 events in 2 years of recording). In October 2005 and April 2007, two controlled pressure transient experiments were carried out in the cavern, in order to analyze the mechanical response of the overburden by tracking the induced microseismicity. The recorded events were mainly grouped in clusters of 3-30 s of signal duration with emergent first arrivals and rather low frequency content (between 20 and 120 Hz). Some of these events have been spatially located by travel-time picking close to the actual cavern and its immediate roof. Preliminary spectral analysis of isolated microearthquakes suggests sources with non-negligible tensile components possibly related to fluid-filled cracks. Rock-debris falling into the cavern from delamination of clay marls in the immediate roof is probably another source of seismic excitation. This was later confirmed when the most important seismic swarms occurred at the site during May 2007, accompanied by the detachment of more than 8 × 104 m3 of marly material on top of the cavern roof. In any case, no clear evidence of classical brittle ruptures in the most competent layers of the overburden has been observed during the analyzed period. Current work is focused on the discrimination of all these possible mechanisms to better understand the damage processes in the cavern overburden and to assess its final collapse hazard.

  17. Submarine groundwater discharge into the coast revealed by water chemistry of man-made undersea liquefied petroleum gas cavern

    NASA Astrophysics Data System (ADS)

    Lee, Jin-Yong; Cho, Byung Wook

    2008-10-01

    SummaryThe occurrence of submarine groundwater discharge (SGD) as well as its supply of many nutrients and metals to coastal seawaters is now generally known. However, previous studies have focused on the chemical and radiological analysis of groundwater, surface seawater, shallow marine sediments and their pore waters, as well as the measurement of upward flow through the marine sediments, as end members of the discharge process. In this study, chemical and isotopic analysis results of marine subsurface waters are reported. These were obtained from deep boreholes of an undersea liquefied petroleum gas (LPG) storage cavern, located about 8 km off the western coast of Korea. The cavern is about 130-150 m below the sea bottom, which is covered by a 4.8-19.5 m silty clay stratum. An isotopic composition (δ 2H and δ 18O) of the marine subsurface waters falls on a mixing line between terrestrial groundwater and seawater. Vertical EC profiling at the cavern boreholes revealed the existence of a fresh water zone. An increase in the contents of ferrous iron and manganese and a decrease in levels of nitrate, bicarbonate and cavern seepage were recorded in August 2006, indicating a decreased submarine groundwater flux originating from land, mainly caused by an elevated cavern gas pressure. It is suggested in this study that the main source of fresh waters in the man-made undersea cavern is the submarine groundwater discharge mainly originating from the land.

  18. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Weber, Paula D.; Flores, Karen A.; Lord, David L.

    Bryan Mound 5 ( BM5 ) and West Hackberry 9 ( WH9 ) have the potential to create a significant amount of new storage space should the caverns be deemed "leach - ready". This study discusses the original drilling history of the caverns, surrounding geology, current stability, and, based on this culmination of data, makes a preliminary assessment of the leach potential for the cavern. The risks associated with leaching BM5 present substantial problems for the SPR . The odd shape and large amount of insoluble material make it difficult to de termine whether a targeted leach would have themore » desired effect and create useable ullage or further distort the shape with preferential leaching . T he likelihood of salt falls and damaged or severed casing string is significant . In addition, a targeted le ach would require the relocation of approximately 27 MMB of oil . Due to the abundance of unknown factors associated with this cavern, a targeted leach of BM5 is not recommended. A targeted leaching of the neck of WH 9 could potentially eliminate or diminis h the mid - cavern ledge result ing in a more stable cavern with a more favorable shape. A better understanding of the composition of the surrounding salt and a less complicated leaching history yields more confidence in the ability to successfully leach this region. A targeted leach of WH9 can be recommended upon the completion of a full leach plan with consideration of the impacts upon nearby caverns .« less

  19. Extraosseous, epidural cavernous hemangioma with back pain.

    PubMed

    Ozkal, Birol; Yaldiz, Can; Yaman, Onur; Ozdemır, Nail; Dalbayrak, Sedat

    2015-01-01

    Cavernous malformations are characterized by enlarged vascular structures located in benign neural tissues within the cerebellum and spinal cord of the central nervous system. Cavernous hemangiomas (CHs) account for 5% to 12% of all spinal vascular malformations. We removed a hemorrhagic thoracic mass in a 40-year-old male patient who presented with progressive neurological deficits. We found it appropriate to present this case due to its rarity.

  20. Simulation of Mechanical Processes in Gas Storage Caverns for Short-Term Energy Storage

    NASA Astrophysics Data System (ADS)

    Böttcher, Norbert; Nagel, Thomas; Kolditz, Olaf

    2015-04-01

    In recent years, Germany's energy management has started to be transferred from fossil fuels to renewable and sustainable energy carriers. Renewable energy sources such as solar and wind power are subjected by fluctuations, thus the development and extension of energy storage capacities is a priority in German R&D programs. This work is a part of the ANGUS+ Project, funded by the federal ministry of education and research, which investigates the influence of subsurface energy storage on the underground. The utilization of subsurface salt caverns as a long-term storage reservoir for fossil fuels is a common method, since the construction of caverns in salt rock is inexpensive in comparison to solid rock formations due to solution mining. Another advantage of evaporate as host material is the self-healing behaviour of salt rock, thus the cavity can be assumed to be impermeable. In the framework of short-term energy storage (hours to days), caverns can be used as gas storage reservoirs for natural or artificial fuel gases, such as hydrogen, methane, or compressed air, where the operation pressures inside the caverns will fluctuate more frequently. This work investigates the influence of changing operation pressures at high frequencies on the stability of the host rock of gas storage caverns utilizing numerical models. Therefore, we developed a coupled Thermo-Hydro-Mechanical (THM) model based on the finite element method utilizing the open-source software platform OpenGeoSys. The salt behaviour is described by well-known constitutive material models which are capable of predicting creep, self-healing, and dilatancy processes. Our simulations include the thermodynamic behaviour of gas storage process, temperature development and distribution on the cavern boundary, the deformation of the cavern geometry, and the prediction of the dilatancy zone. Based on the numerical results, optimal operation modes can be found for individual caverns, so the risk of host rock damage can be minimized. Furthermore, the model can be used to design efficient monitoring programs to detect possible variations of the host rock due construction and operation of the storage facility. The developed model will be used by public authorities for land use planning issues.

  1. Failure Analysis of Overhanging Blocks in the Walls of a Gas Storage Salt Cavern: A Case Study

    NASA Astrophysics Data System (ADS)

    Wang, Tongtao; Yang, Chunhe; Li, Jianjun; Li, Jinlong; Shi, Xilin; Ma, Hongling

    2017-01-01

    Most of the rock salt of China is bedded, in which non-salt layers and rock salt layers alternate. Due to the poor solubility of the non-salt layers, many blocks overhang on the walls of the caverns used for gas storage, constructed by water leaching. These overhanging blocks may collapse at any time, which may damage the tubing and casing string, and even cause instability of the cavern. They are one of the main factors threatening the safety of caverns excavated in bedded rock salt formations. In this paper, a geomechanical model of the JJKK-D salt cavern, located in Jintan salt district, Jintan city, Jiangsu province, China, is established to evaluate the stability of the overhanging blocks on its walls. The characters of the target formation, property parameters of the rock mass, and actual working conditions are considered in the geomechanical model. An index system composed of stress, displacement, plastic zone, safety factor, and equivalent strain is used to predict the collapse length of the overhanging blocks, the moment the collapse will take place, and the main factors causing the collapse. The sonar survey data of the JJKK-D salt cavern are used to verify the reliability and accuracy of the proposed geomechanical model. The results show that the proposed geomechanical model has a good reliability and accuracy, and can be used for the collapse prediction of the overhanging blocks on the wall of the JJKK-D salt cavern. The collapse length of the overhanging block is about 8 m. We conclude that the collapse takes place during the debrining. The reason behind the collapse is the sudden decrease of the fluid density, leading to the increase of the self-weight of the overhanging blocks. This study provides a basis for the collapse prediction method of the overhanging blocks of Jintan salt cavern gas storage, and can also serve as a reference for salt cavern gas storage with similar conditions to deal with overhanging blocks.

  2. Coupled thermal-hydrological-mechanical behavior of rock mass surrounding a high-temperature thermal energy storage cavern at shallow depth

    DOE PAGES

    Park, Jung-Wook; Rutqvist, Jonny; Ryu, Dongwoo; ...

    2016-01-15

    The present study is aimed at numerically examining the thermal-hydrological-mechanical (THM) processes within the rock mass surrounding a cavern used for thermal energy storage (TES). We considered a cylindrical rock cavern with a height of 50 m and a radius of 10 m storing thermal energy of 350ºC as a conceptual TES model and simulated its operation for 30 years using THM coupled numerical modeling. At first, the insulator performance was not considered for the purpose of investigating the possible coupled THM behavior of the surrounding rock mass; then, the effects of an insulator were examined for different insulator thicknesses.more » The key concerns were focused on the hydro-thermal multiphase flow and heat transport in the rock mass around the thermal storage cavern, the effect of evaporation of rock mass, thermal impact on near the ground surface and the mechanical behavior of the surrounding rock mass. It is shown that the rock temperature around the cavern rapidly increased in the early stage and, consequently, evaporation of groundwater occurred, raising the fluid pressure. However, evaporation and multiphase flow did not have a significant effect on the heat transfer and mechanical behavior in spite of the high-temperature (350ºC) heat source. The simulations showed that large-scale heat flow around a cavern was expected to be conductiondominated for a reasonable value of rock mass permeability. Thermal expansion as a result of the heating of the rock mass from the storage cavern led to a ground surface uplift on the order of a few centimeters and to the development of tensile stress above the storage cavern, increasing the potentials for shear and tensile failures after a few years of the operation. Finally, the analysis showed that high tangential stress in proximity of the storage cavern can some shear failure and local damage, although large rock wall failure could likely be controlled with appropriate insulators and reinforcement.« less

  3. Modeling deformation processes of salt caverns for gas storage due to fluctuating operation pressures

    NASA Astrophysics Data System (ADS)

    Böttcher, N.; Nagel, T.; Goerke, U.; Khaledi, K.; Lins, Y.; König, D.; Schanz, T.; Köhn, D.; Attia, S.; Rabbel, W.; Bauer, S.; Kolditz, O.

    2013-12-01

    In the course of the Energy Transition in Germany, the focus of the country's energy sources is shifting from fossil to renewable and sustainable energy carriers. Since renewable energy sources, such as wind and solar power, are subjected to annual, seasonal, and diurnal fluctuations, the development and extension of energy storage capacities is a priority in German R&D programs. Common methods of energy storage are the utilization of subsurface caverns as a reservoir for natural or artificial fuel gases, such as hydrogen, methane, or the storage of compressed air. The construction of caverns in salt rock is inexpensive in comparison to solid rock formations due to the possibility of solution mining. Another advantage of evaporite as a host material is the self-healing capacity of salt rock. Gas caverns are capable of short-term energy storage (hours to days), so the operating pressures inside the caverns are fluctuating periodically with a high number of cycles. This work investigates the influence of fluctuating operation pressures on the stability of the host rock of gas storage caverns utilizing numerical models. Therefore, we developed a coupled Thermo-Hydro-Mechanical (THM) model based on the finite element method utilizing the open-source software platform OpenGeoSys. Our simulations include the thermodynamic behaviour of the gas during the loading/ unloading of the cavern. This provides information on the transient pressure and temperature distribution on the cavern boundary to calculate the deformation of its geometry. Non-linear material models are used for the mechanical analysis, which describe the creep and self-healing behavior of the salt rock under fluctuating loading pressures. In order to identify the necessary material parameters, we perform experimental studies on the mechanical behaviour of salt rock under varying pressure and temperature conditions. Based on the numerical results, we further derive concepts for monitoring THM quantities in the vicinity of the cavern. These programs will allow detecting changes of the host rock properties during the construction and operation of the storage facility. The developed model will be used by public authorities for land use planning issues.

  4. Familial Cerebral Cavernous Malformations Are Associated with Adrenal Calcifications on CT Scans: An Imaging Biomarker for a Hereditary Cerebrovascular Condition.

    PubMed

    Strickland, Corinne D; Eberhardt, Steven C; Bartlett, Mary R; Nelson, Jeffrey; Kim, Helen; Morrison, Leslie A; Hart, Blaine L

    2017-08-01

    Purpose To determine if adrenal calcifications seen at computed tomography (CT) are associated with familial cerebral cavernous malformations (fCCMs) in carriers of the CCM1 Common Hispanic Mutation. Materials and Methods This study was approved by the institutional review board. The authors retrospectively reviewed abdominal CT scans in 38 patients with fCCM, 38 unaffected age- and sex-matched control subjects, and 13 patients with sporadic, nonfamilial cerebral cavernous malformation (CCM). The size, number, and laterality of calcifications and the morphologic characteristics of the adrenal gland were recorded. Brain lesion count was recorded from brain magnetic resonance (MR) imaging in patients with fCCM. The prevalence of adrenal calcifications in patients with fCCM was compared with that in unaffected control subjects and those with sporadic CCM by using the Fisher exact test. Additional analyses were performed to determine whether age and brain lesion count were associated with adrenal findings in patients with fCCM. Results Small focal calcifications (SFCs) (≤5 mm) were seen in one or both adrenal glands in 19 of the 38 patients with fCCM (50%), compared with 0 of the 38 unaffected control subjects (P < .001) and 0 of the 13 subjects with sporadic CCM (P = .001). Adrenal calcifications in patients with fCCM were more frequently left sided, with 17 of 19 patients having more SFCs in the left adrenal gland than the right adrenal gland and 50 of the 61 observed SFCs (82%) found in the left adrenal gland. No subjects had SFCs on the right side only. In patients with fCCM, the presence of SFCs showed a positive correlation with age (P < .001) and number of brain lesions (P < .001). Conclusion Adrenal calcifications identified on CT scans are common in patients with fCCM and may be a clinically silent manifestation of disease. © RSNA, 2017.

  5. Carotid-cavernous fistula after functional endoscopic sinus surgery.

    PubMed

    Karaman, Emin; Isildak, Huseyin; Haciyev, Yusuf; Kaytaz, Asim; Enver, Ozgun

    2009-03-01

    Carotid-cavernous fistulas (CCFs) are anomalous communications between the carotid arterial system and the venous cavernous sinus. They can arise because of spontaneous or trauma causes. Most caroticocavernous fistulas are of spontaneous origin and unknown etiology. Spontaneous CCF may also be associated with cavernous sinus pathology such as arteriosclerotic changes of the arterial wall, fibromuscular dysplasia, or Ehler-Danlos syndrome. Traumatic CCFs may occur after either blunt or penetrating head trauma. Their clinical presentation is related to their size and to the type of venous drainage, which can lead to a variety of symptoms, such as visual loss, proptosis, bruit, chemosis, cranial nerve impairment, intracranial hemorrhage (rare), and so on. Treatment by endovascular transarterial embolization with electrolytically detachable coils is a very effective method for CCF with good outcomes. Carotid-cavernous fistulas have been rarely reported after craniofacial surgery and are uncommon pathologies in otolaryngology practice. In this study, we report a 40-year-old woman with CCF secondary to blunt trauma of functional endoscopic sinus surgery.

  6. Analysis of SPR salt cavern remedial leach program 2013.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Weber, Paula D.; Gutierrez, Karen A.; Lord, David L.

    The storage caverns of the US Strategic Petroleum Reserve (SPR) exhibit creep behavior resulting in reduction of storage capacity over time. Maintenance of oil storage capacity requires periodic controlled leaching named remedial leach. The 30 MMB sale in summer 2011 provided space available to facilitate leaching operations. The objective of this report is to present the results and analyses of remedial leach activity at the SPR following the 2011 sale until mid-January 2013. This report focuses on caverns BH101, BH104, WH105 and WH106. Three of the four hanging strings were damaged resulting in deviations from normal leach patterns; however, themore » deviations did not affect the immediate geomechanical stability of the caverns. Significant leaching occurred in the toes of the caverns likely decreasing the number of available drawdowns until P/D ratio criteria are met. SANSMIC shows good agreement with sonar data and reasonably predicted the location and size of the enhanced leaching region resulting from string breakage.« less

  7. Borehole geophysical and flowmeter data for eight boreholes in the vicinity of Jim Woodruff Lock and Dam, Lake Seminole, Jackson County, Florida

    USGS Publications Warehouse

    Clarke, John S.; Hamrick, Michael D.; Holloway, O. Gary

    2011-01-01

    Borehole geophysical logs and flowmeter data were collected in April 2011 from eight boreholes to identify the depth and orientation of cavernous zones within the Miocene Tampa Limestone in the vicinity of Jim Woodruff Lock and Dam in Jackson County, Florida. These data are used to assess leakage near the dam. Each of the eight boreholes was terminated in limestone at depths ranging from 84 to 104 feet. Large cavernous zones were encountered in most of the borings, with several exceeding 20-inches in diameter. The cavernous zones generally were between 1 and 5 feet in height, but a cavern in one of the borings reached a height of about 6 feet. The resistivity of limestone layers penetrated by the boreholes generally was less than 1,000 ohm-meters. Formation resistivity near the cavernous zones did not show an appreciable contrast from surrounding bedrock, probably because the bedrock is saturated, owing to its primary permeability. Measured flow rates in the eight boreholes determined using an electromagnetic flowmeter were all less than ±0.1 liter per second. These low flow rates suggest that vertical hydraulic gradients in the boreholes are negligible and that hydraulic head in the various cavernous zones shows only minor, if any, variation.

  8. Short Hairpin Ribonucleic Acid Constructs Targeting Insulin-like Growth Factor Binding Protein-3 Reversed Decreased Testosterone Concentrations in Diabetic Rats

    PubMed Central

    Zhou, Zhang-Yan; Fei-Li; Cheng, Shao-Ping; Huang, Hui; Peng, Bi-Wen; Wang, Jing; Liu, Chang-Mao; Xing, Cheng; Sun, Ya-Ling; Bsoul, Najeeb; Pan, Hui; Yi, Cun-Jian; Liu, Rong-Hua; Zhong, Guang-Jun

    2015-01-01

    Background The aim of this study was to determine if shRNA constructs targeting insulin-like growth factor binding protein-3 can rehabilitate decreased serum testosterone concentrations in streptozotocin-induced diabetic rats. Material/Methods After 12 weeks of intracavernous administration of IGFBP-3 shRNA, intracavernous pressure responses to electrical stimulation of cavernous nerves were evaluated. The expression of IGFBP-3 at mRNA and protein levels was detected by quantitative real-time PCR analysis and Western blot, respectively. The concentrations of serum testosterone and cavernous cyclic guanosine monophosphate were detected by enzyme-linked immunosorbent assay. Results After 12 weeks of intracavernous administration of IGFBP-3 shRNA, the cavernosal pressure was significantly increased in response to the cavernous nerves stimulation compared to the diabetic control group (p<0.01). Cavernous IGFBP-3 expression at both mRNA and protein levels was significantly inhibited. Both serum testosterone and cavernous cyclic guanosine monophosphate concentrations were significantly increased in the IGFBP-3 shRNA treatment group compared to the diabetic control group (p<0.01). Conclusions These results suggest that IGFBP-3 shRNA may rehabilitate erectile function via increases of concentrations of serum testosterone and cavernous cyclic guanosine monophosphate in streptozotocin-induced diabetic rats. PMID:25582342

  9. Hypertrophic olivary degeneration following surgical resection or gamma knife radiosurgery of brainstem cavernous malformations: an 11-case series and a review of literature.

    PubMed

    Yun, Jung-Ho; Ahn, Jae Sung; Park, Jung Cheol; Kwon, Do Hoon; Kwun, Byung Duk; Kim, Chang Jin

    2013-03-01

    We describe 11 patients with hypertrophic olivary degeneration (HOD) after surgical resection or gamma knife radiosurgery for brainstem cavernous malformations. In addition, we statistically analyzed the predicting factors associated with the development of HOD. From January 2001 to May 2011, a total of 73 patients (30 in the surgical group and 43 in the radiosurgery group) with brainstem cavernous malformations were treated in our institute. Of them, 11 patients (incidence: 15 %) developed HOD with high signal intensity on T2-weighted MRI during follow-up. The predicting factors (location, size, age, and treatment method) associated with the development of HOD were statistically analyzed. Among the 11 HOD patients, seven patients received surgical resection and four patients received gamma knife radiosurgery. Six patients had bilateral HOD and the remaining five patients had unilateral HOD. Overall HOD-associated symptoms presented in four patients, including three palatal tremors and one ataxia. In all four patients with symptoms, these symptoms disappeared incompletely within the clinical follow-up period. The size of the cavernous malformation, age of patient, and treatment methods were not significantly correlated with the development of HOD. A significantly higher incidence of HOD was associated with midbrain cavernous malformations than with pontine or medulla cavernous malformations. HOD should be recognized as a non-infrequent complication of surgical resection or gamma knife radiosurgery within the brainstem, especially for midbrain cavernous malformations. In addition, to the best of our knowledge, this is the first report on HOD development after radiosurgery.

  10. Novel Evidence-Based Classification of Cavernous Venous Occlusive Disease.

    PubMed

    Pathak, Ram A; Rawal, Bhupendra; Li, Zhuo; Broderick, Gregory A

    2016-10-01

    The primary aim of our study was to determine whether an evidence-based rationale could categorize cavernous venous occlusive disease into mild, moderate and severe erectile dysfunction. A total of 863 patients underwent color duplex Doppler ultrasound from January 2010 to June 2013 performed by a single urologist. We identified a cohort of 75 patients (8.7%) with a diagnosis of cavernous venous occlusive disease based on a unilateral resistive index less than 0.9, and right and left peak systolic velocity 35 cm per second or less after visual sexual stimulation. At a median followup of 13 months patients were evaluated for treatment efficacy. A total of 75 patients with a median age of 60 years (range 19 to 83) and a mean body mass index of 26.3 kg/m(2) (range 19.0 to 39.3) satisfied the criteria of cavernous venous occlusive disease. When substratified into tertiles, resistive index cutoffs were obtained, including mild cavernous venous occlusive disease-81.6 to 94.0, moderate disease-72.6 to 81.5 and severe disease-59.5 to 72.5. Using these 3 groups the phosphodiesterase type 5-inhibitor failure rate (p = 0.017) and SHIM (Sexual Health Inventory for Men) score categories (1 to 10 vs 11 to 20, p = 0.030) were statistically significantly different for mild, moderate and severe cavernous venous occlusive disease. Treatment satisfaction was also statistically significantly different. Penile prosthetic placement was a more common outcome among patients with erectile dysfunction and more severe cavernous venous occlusive disease. Our retrospective analysis supports a correlation between the phosphodiesterase type 5 inhibitor failure rate, SHIM score and the rate of surgical intervention using resistive index values. Our data further suggest that an evidence-based classification of cavernous venous occlusive disease by color Doppler ultrasound is possible and can triage patients to penile prosthetic placement. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Park, Jung-Wook; Rutqvist, Jonny; Ryu, Dongwoo

    The present study is aimed at numerically examining the thermal-hydrological-mechanical (THM) processes within the rock mass surrounding a cavern used for thermal energy storage (TES). We considered a cylindrical rock cavern with a height of 50 m and a radius of 10 m storing thermal energy of 350ºC as a conceptual TES model and simulated its operation for 30 years using THM coupled numerical modeling. At first, the insulator performance was not considered for the purpose of investigating the possible coupled THM behavior of the surrounding rock mass; then, the effects of an insulator were examined for different insulator thicknesses.more » The key concerns were focused on the hydro-thermal multiphase flow and heat transport in the rock mass around the thermal storage cavern, the effect of evaporation of rock mass, thermal impact on near the ground surface and the mechanical behavior of the surrounding rock mass. It is shown that the rock temperature around the cavern rapidly increased in the early stage and, consequently, evaporation of groundwater occurred, raising the fluid pressure. However, evaporation and multiphase flow did not have a significant effect on the heat transfer and mechanical behavior in spite of the high-temperature (350ºC) heat source. The simulations showed that large-scale heat flow around a cavern was expected to be conductiondominated for a reasonable value of rock mass permeability. Thermal expansion as a result of the heating of the rock mass from the storage cavern led to a ground surface uplift on the order of a few centimeters and to the development of tensile stress above the storage cavern, increasing the potentials for shear and tensile failures after a few years of the operation. Finally, the analysis showed that high tangential stress in proximity of the storage cavern can some shear failure and local damage, although large rock wall failure could likely be controlled with appropriate insulators and reinforcement.« less

  12. Visualization of hydraulic connections using Borehole Array around LPG Underground Storage Cavern

    NASA Astrophysics Data System (ADS)

    Shimo, M.; Mashimo, H.; Maejima, T.; Aoki, K.

    2006-12-01

    This paper presents a systematic approach to visualize the hydraulic connections within the fractured rock mass around the underground LPG storage caverns using array of water injection boreholes. By taking advantage that water injection boreholes are located so as to cover the storage caverns, a complete sketch of hydraulic conditions around the caverns, such as locations of water conducting fractures, hydraulic conductivity and groundwater pressure can be obtained. Applicability of the proposed techniques have been tested in an on-going construction project operated by JOGMEC, Japan Oil, Gas and Metals National Corporation, at Namikata, Western part of Japan. Three 26m x 30m x 485m caverns, located at 150 - 200 m below the ground surface in a granitic rock, are under construction. By systematically monitoring the pressure responses between the neighboring boreholes during drilling of total 387 boreholes around the two propane caverns, a spatial profile of the hydraulic connections and hydraulic conductivity around the caverns has been successfully obtained. Locations of localized depressurized zones created during an arch excavation have been detected by monitoring pressure in each borehole after stopping water supply to that borehole temporarily. Measurement has been conducted using each one of the 302 boreholes, one at a time. Observation shows that there is a clear correlation between total pressure drop and pressure gradient versus time curve on semi-logarithmic plot, dH/log10t, as expected by the numerical prediction. Regions where dH/log10t is larger than a certain criteria, determined by a numerical simulation for flow around a cavern in a rock with uniform hydraulic conductivity, have been evaluated as a depressurized zone caused by insufficient water supply, possibly due to existence of the high permeable zones. Separate pore pressure measurement around the caverns also supports this interpretation that a low pressure is prevailing near the borehole where a large value of dH/log10t is obtained. As a countermeasure to avoid further depressurization, installation of additional water injection hole was conducted. The same observation was then repeated. It is recognized that dH/log10t has recovered above the criteria, showing that the local water balance has been improved. Finally it is concluded that the proposed rather simple but space encompassing observation is applicable to groundwater management during construction and also provides useful information for creating a hydrogeological model, considering a fracture network system, that will be used for the evaluation of the cavern performance as a storage tank.

  13. Flow diversion in the treatment of carotid injury and carotid-cavernous fistula after transsphenoidal surgery

    PubMed Central

    Lum, Cheemum; Ahmed, Muhammad E; Glikstein, Rafael; dos Santos, Marlise P; Lesiuk, Howard; Labib, Mohamed; Kassam, Amin B

    2015-01-01

    We describe a case of iatrogenic carotid injury with secondary carotid-cavernous fistula (CCF) treated with a silk flow diverter stent placed within the injured internal carotid artery and coils placed within the cavernous sinus. Flow diverters may offer a simple and potentially safe vessel-sparing option in this rare complication of transsphenoidal surgery. The management options are discussed and the relevant literature is reviewed. PMID:26015526

  14. Transvenous embolization in spontaneous direct carotid-cavernous fistula in childhood

    PubMed Central

    Mercado, Glenna B.; Irie, Keiko; Negoro, Makoto; Moriya, Shigeta; Tanaka, Teppei; Ohmura, Masahiro; Sadato, Akiyo; Hayakawa, Motuharu; Sano, Hirotoshi

    2011-01-01

    Carotid cavernous fistula (CCF) is an abnormal arteriovenous communication in the cavernous sinus. Direct CCF results from a tear in the intracavernous carotid artery. Typically, it has a high flow and usually presents with oculo-orbital venous congestive features such as exophthalmos, chemosis, and sometimes oculomotor or abducens cranial nerve palsy. Indirect CCF generally occurs spontaneously with subtle signs. We report a rare case of spontaneous direct CCF in childhood who did not have the usual history of craniofacial trauma or connective tissue disorder but presented with progressive chemosis and exophthalmos of the right eye. This report aims also to describe the safety and success of transvenous embolization with coils of the superior ophthalmic vein and cavernous sinus through the inferior petrosal sinus. PMID:22059104

  15. Use of antithrombotic agents in patients with intracerebral cavernous malformations.

    PubMed

    Flemming, Kelly D; Link, Michael J; Christianson, Teresa J H; Brown, Robert D

    2013-01-01

    The goal of this study was to determine the risk of using antithrombotic agents in patients with established intracerebral cavernous malformations (ICMs). From a previously described cohort of 292 patients with radiographically defined ICMs, 40 required an antithrombotic after the ICM was diagnosed. Patients underwent follow-up to determine the incidence of hemorrhage. The mean age of these 40 patients was 62.4 years; there were 21 male and 19 female patients. Five (12.5%) of the 40 patients initially presented with hemorrhage and 4 (10%) had multiple ICMs. Of these patients, 32 were placed on an antiplatelet agent alone, 6 on an anticoagulant alone, and 2 were placed on both. In patients necessitating any antithrombotic agent, 1 patient developed a prospective hemorrhage over the 258 person-years of follow-up (prospective hemorrhage rate 0.41% per person-year). Antithrombotics likely do not precipitate hemorrhage in patients with known ICMs. However, caution should be exercised in the use of antithrombotics in patients with ICMs at high risk for hemorrhage. The risks and benefits of antithrombotics in each situation should be carefully weighed against the natural history of ICM.

  16. A Review of Vascular Abnormalities of the Spine.

    PubMed

    Singh, Rahul; Lucke-Wold, Brandon; Gyure, Kymberly; Boo, Sohyun

    2016-01-01

    Patients with spinal vascular lesions present with unique symptoms and have important anatomical and physiologic changes that must be considered prior to treatment. In this mini-review, we provide an overview of normal spinal vascular anatomy and discuss several key spinal vascular lesions. We provide an overview of cavernous malformations, intradural arteriovenous malformations, perimedullary arteriovenous fistulas, and dural arteriovenous fistulas. Important considerations are addressed in terms of pathologic characterization, specific imaging findings, and treatment approaches.

  17. Losartan, an Angiotensin type I receptor, restores erectile function by downregulation of cavernous renin-angiotensin system in streptozocin-induced diabetic rats.

    PubMed

    Yang, Rong; Yang, Bin; Wen, Yanting; Fang, Feng; Cui, Souxi; Lin, Guiting; Sun, Zeyu; Wang, Run; Dai, Yutian

    2009-03-01

    The high incidence of erectile dysfunction (ED) in diabetes highlights the need for good treatment strategies. Recent evidence indicates that blockade of the angiotensin type I receptor (AT1) may reverse ED from various diseases. To explore the role of cavernous renin-angiotensin system (RAS) in the pathogenesis of diabetic ED and the role of losartan in the treatment of diabetic ED. The AT1 blocker (ARB) losartan (30 mg/kg/d) was administered to rats with streptozocin (65 mg/kg)-induced diabetes. Erectile function, cavernous structure, and tissue gene and protein expression of RAS in the corpora cavernosa were studied. We sought to determine the changes of cavernous RAS in the condition of diabetes and after treatment with losartan. RAS components (angiotensinogen, [pro]renin receptor, angiotensin-converting enzyme [ACE], and AT1) were expressed in cavernosal tissue. In diabetic rats, RAS components were upregulated, resulting in the increased concentration of angiotensin II (Ang II) in the corpora. A positive feedback loop for Ang II formation in cavernosum was also identified, which could contribute to overactivity of cavernous RAS in diabetic rats. Administration of losartan blocked the effect of Ang II, downregulated the expression of AT1 and Ang II generated locally, and partially restored erectile function (losartan-treated group revealed an improved intracavernous pressure/mean systemic arterial pressure ratio as compared with the diabetic group (0.480 +/- 0.031 vs. 0.329 +/- 0.020, P < 0.01). However, losartan could not elevate the reduced smooth muscle/collagen ratio in diabetic rats. The cavernous RAS plays a role in modulating erectile function in corpora cavernosa and is involved in the pathogenesis of diabetic ED. ARB can restore diabetic ED through downregulating cavernous RAS.

  18. Efficacy of transsphenoidal surgery in achieving biochemical cure of growth hormone-secreting pituitary adenomas among patients with cavernous sinus invasion: a systematic review and meta-analysis.

    PubMed

    Briceno, Vanessa; Zaidi, Hasan A; Doucette, Joanne A; Onomichi, Kaho B; Alreshidi, Amer; Mekary, Rania A; Smith, Timothy R

    2017-05-01

    Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature. We conducted a meta-analysis to examine the prevalence of biochemical remission after TSS among patients with growth hormone-secreting pituitary adenomas with and without cavernous sinus invasion. Embase, PubMed, and Cochrane Library databases were searched for relevant publications. Fourteen studies with 972 patients with biochemically confirmed growth hormone-secreting pituitary adenomas were included in the meta-analysis. The overall remission prevalence under a fixed-effect model was 47.6% (95% CI = 40.8-54.4%) for patients with invasive macroadenomas (I 2  = 74.6%, p < 0.01); 76.4% (95% CI = 72.2-80.1%) for patients with non-invasive macroadenomas (I 2  = 59.6%, p = 0.03); and 74.2% (95% CI = 66.3-80.7%) for patients with non-invasive microadenomas (I 2  = 36.4, p = 0.10). The significant difference among the three groups resulted from the difference between patients with or without cavernous sinus invasion (p = 0.01) and not from the size of adenomas among those without cavernous sinus invasion (p = 0.66). The prevalence of biochemical remission in patients with cavernous sinus invasion was lower than in patients without cavernous sinus invasion after TSS for acromegaly.

  19. Brainstem cavernous malformations: anatomical, clinical, and surgical considerations.

    PubMed

    Giliberto, Giuliano; Lanzino, Desiree J; Diehn, Felix E; Factor, David; Flemming, Kelly D; Lanzino, Giuseppe

    2010-09-01

    Symptomatic brainstem cavernous malformations carry a high risk of permanent neurological deficit related to recurrent hemorrhage, which justifies aggressive management. Detailed knowledge of the microscopic and surface anatomy is important for understanding the clinical presentation, predicting possible surgical complications, and formulating an adequate surgical plan. In this article the authors review and illustrate the surgical and microscopic anatomy of the brainstem, provide anatomoclinical correlations, and illustrate a few clinical cases of cavernous malformations in the most common brainstem areas.

  20. Spinal Epidural Haemangioma Associated with Extensive Gastrointestinal Haemangiomas

    PubMed Central

    Cheng, L.T.E.; Lim, W.E.H.

    2005-01-01

    Summary A case of spinal epidural cavernous haemangioma associated with gastrointestinal haemangiomas is discussed. The patient was a young Chinese female presenting with chronic lower back pain. She had a history of extensive gastric and small bowel haemangiomas. Lumbar spine MRI showed a heterogeneously enhancing epidural mass infiltrating the paravertebral muscles. Open biopsy confirmed an epidural cavernous haemangioma. To our knowledge, an association between spinal epidural cavernous haemangiomas and gastrointestinal haemangiomas has not been reported. PMID:20584496

  1. Calvarial bone cavernous hemangioma with intradural invasion: An unusual aggressive course-Case report and literature review.

    PubMed

    Nasi, Davide; Somma, Lucia di; Iacoangeli, Maurizio; Liverotti, Valentina; Zizzi, Antonio; Dobran, Mauro; Gladi, Maurizio; Scerrati, Massimo

    2016-01-01

    Cavernous hemangioma of the skull is a rare pathological diagnosis, accounting for 0.2% of bone tumors and 7% of skull tumors. Usually calvarial bone cavernous hemangioma are associated with a benign clinical course and, despite their enlargement and subsequent erosion of the surrounding bone, the inner table of the skull remains intact and the lesion is completely extracranial. The authors present the unique case of a huge left frontal bone cavernous malformation with intradural extension and brain compression determining a right hemiparesis. Calvarial cavernous hemangiomas are benign tumors. They arise from vessels in the diploic space and tend to involve the outer table of the skull with relative sparing of the inner table. More extensive involvement of the inner table and extradural space is very unusual and few cases are reported in literature. To the best of our knowledge, intradural invasion of calvarial hemangioma has not been previously reported. Our case highlights the possibility of an aggressive course of this rare benign pathology. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Calvarial bone cavernous hemangioma with intradural invasion: An unusual aggressive course—Case report and literature review

    PubMed Central

    Nasi, Davide; Somma, Lucia di; Iacoangeli, Maurizio; Liverotti, Valentina; Zizzi, Antonio; Dobran, Mauro; Gladi, Maurizio; Scerrati, Massimo

    2016-01-01

    Introduction Cavernous hemangioma of the skull is a rare pathological diagnosis, accounting for 0.2% of bone tumors and 7% of skull tumors. Usually calvarial bone cavernous hemangioma are associated with a benign clinical course and, despite their enlargement and subsequent erosion of the surrounding bone, the inner table of the skull remains intact and the lesion is completely extracranial. Presentation of a case The authors present the unique case of a huge left frontal bone cavernous malformation with intradural extension and brain compression determining a right hemiparesis. Discussion Calvarial cavernous hemangiomas are benign tumors. They arise from vessels in the diploic space and tend to involve the outer table of the skull with relative sparing of the inner table. More extensive involvement of the inner table and extradural space is very unusual and few cases are reported in literature. To the best of our knowledge, intradural invasion of calvarial hemangioma has not been previously reported. Conclusion Our case highlights the possibility of an aggressive course of this rare benign pathology. PMID:27061482

  3. Strains and stresses in the rock around and unlined hot water cavern

    NASA Astrophysics Data System (ADS)

    Rehbinder, Göran

    1984-07-01

    Hot water stored in an unlined rock cavern is an efficient energy storage. A research program has been carried out with a test plant at the city of Avesta, Sweden. The plant consists of a rock cavern, the volume of which is 15000 m3, which serves as an energy buffer in the district heating system of the city. The water is heated from a garbage incinerator located close to the cavern. During the first test period the temperature of the stored water has varied between 40°C and 95°C. The heating of the rock causes strains and stresses in the rock. The measurements show that the state in the rock does mainly respond to the average temperature and not to the fluctuations. The maximum thermal stress is 9 MPa occurring at the wall of the cavern. The heave of the ground is less than 5 mm. The development of stress and strain will continue after the first test period since thermal equilibrium was not reached during this period.

  4. Hypophysopexy technique for radiosurgical treatment of cavernous sinus pituitary adenoma.

    PubMed

    Couldwell, William T; Rosenow, Joshua M; Rovit, Richard L; Benzil, Deborah L

    2002-01-01

    Stereotactic radiosurgery is being used with increased frequency in the treatment of residual or recurrent pituitary adenomas. The major risk associated with radiosurgical treatment of residual or recurrent pituitary tumor adjacent to normal functional pituitary gland is radiation of the pituitary, which frequently leads to the development of hypopituitarism. The authors describe a technique of pituitary transposition to reduce the radiation dose to the normal pituitary gland in cases of planned radiosurgical treatment of residual pituitary adenoma within the cavernous sinus. A sellar exploration for tumor resection is performed, the pituitary gland is transposed from the region of the cavernous sinus, and a fat and fascia graft is interposed between the normal pituitary gland and the residual tumor in the cavernous sinus. The residual tumor may then be treated with stereotactic radiosurgery. The increased distance between the normal pituitary gland and the residual tumor facilitates treatment of the tumor with radiosurgery and reduces the radiation to the normal pituitary gland. An illustrative case of a young female with recurrent acromegaly and a pituitary adenoma invading the cavernous sinus is described.

  5. Spontaneous dural cavernous fistula in infancy.

    PubMed

    Johnson, Paul B; Lelli, Gary J; Khorsandi, Azita; Dellarocca, David A

    2010-01-01

    A 4-month-old boy presented with the sudden onset of proptosis and dilated episcleral veins. CT revealed an enlarged superior ophthalmic vein and diffusely thickened extraocular muscles. MRI and angiography confirmed a dural middle meningeal--cavernous sinus fistula. Embolization was performed leading to successful resolution of the patient's signs and symptoms. Spontaneous atraumatic arteriovenous cavernous fistulae in infancy are extremely rare, but should be included in the differential diagnosis of infants with orbital congestion. Appropriate treatment leads to prevention of amblyopia, glaucoma, and anisometropia.

  6. Analogue of Caldera Dynamics: the Controlled Salt Cavern Collapse

    NASA Astrophysics Data System (ADS)

    Jousset, P. G.; Rohmer, J.

    2012-12-01

    Caldera collapse (or pit-crater) dynamics are inferred from geological observations and laboratory experiments. Here, we present an analogue of caldera collapse at field scale and possible analogy with large scale caldera dynamics. Through an original exploitation technique in sedimentary environment, a salt layer is emptied, leaving a brine-filled cavern, which eventually collapses after overburden falls into the cavern. Such a collapse was monitored in East France by many instruments (including GPS, extensometers, geophones, broadband seismological sensors, tiltmeter, gravity meter, … ), which allowed us to describe mechanisms of the collapse. Micro-seismicity is a good indicator of spatio-temporal evolution of physical properties of rocks prior to catastrophic events like volcanic eruptions or landslides and may be triggered by a number of causes including dynamic characteristics of processes in play or/and external forces. We show evidence of triggered micro-seismicity observed in the vicinity of this underground salt cavern prone to collapse by a remote M~7.2 earthquake, which occurred ~12000 kilometres away. High-dynamic broadband records reveal the strong time-correlation between a dramatic change in the rate of local high-frequency micro-seismicity and the passage of low-frequency seismic waves, including body, Love and Rayleigh surface waves. Pressure was lowered in the cavern by pumping operations of brine out of the cavern. We demonstrate the near critical state of the cavern before the collapse by means of 2D axisymmetric elastic finite-element simulations. Stress oscillations due to the seismic waves may have exceeded the strength required for the rupture of the complex media made of brine and rock triggering micro-earthquakes and leading to damage of the overburden and eventually collapse of the salt cavern. The increment of stress necessary for the failure of a Dolomite layer is of the same order or magnitude as the maximum dynamic stress magnitude observed during the passage of the earthquakes waves. On this basis, we discuss the possible contribution of the Love and Rayleigh low-frequency surfaces waves. This experiment may help us understand mechanisms of caldera formation.

  7. A Review of Vascular Abnormalities of the Spine

    PubMed Central

    Singh, Rahul; Lucke-Wold, Brandon; Gyure, Kymberly; Boo, Sohyun

    2017-01-01

    Patients with spinal vascular lesions present with unique symptoms and have important anatomical and physiologic changes that must be considered prior to treatment. In this mini-review, we provide an overview of normal spinal vascular anatomy and discuss several key spinal vascular lesions. We provide an overview of cavernous malformations, intradural arteriovenous malformations, perimedullary arteriovenous fistulas, and dural arteriovenous fistulas. Important considerations are addressed in terms of pathologic characterization, specific imaging findings, and treatment approaches. PMID:28191502

  8. Devils Hole, Nevada—A photographic story of a restricted subaqueous environment

    USGS Publications Warehouse

    Hoffman, Ray J.

    2017-07-24

    This report presents selected photographic images taken by the author during U.S. Geological Survey (USGS) research into paleoclimatology and geochemistry in Devils Hole cavern during 1984 to 1993 in cooperation with the National Park Service. The unaltered suite of photographs was prepared by the USGS dive team as an aid to assist nondiving scientists with a visual perspective of the environment where earth-science samples were collected and subsequently analyzed for chemical and isotopic composition.

  9. Monitoring and/or Detection of Wellbore Leakage In Energy Storage Wells

    NASA Astrophysics Data System (ADS)

    Ratigan, J.

    2017-12-01

    Energy (compressed natural gas, crude oil, NGL, and LPG) storage wells in solution-mined caverns in salt formations are required to be tested for integrity every five years. Rules promulgated for such testing typically assume the cavern interval in the salt formation is inherently impermeable, even though some experience demonstrates that this is not always the case. A protocol for testing the cavern impermeable hypothesis should be developed. The description for the integrity test of the "well" component of the well and cavern storage system was developed more than 30 years ago. However, some of the implicit assumptions inherent to the decades-old well test protocol are no longer applicable to the large diameter, high flow rate wells commonly constructed today. More detailed test protocols are necessary for the more contemporary energy storage wells.

  10. Effects of hyperglycemia on rat cavernous nerve axons: a functional and ultrastructural study.

    PubMed

    Zotova, Elena G; Schaumburg, Herbert H; Raine, Cedric S; Cannella, Barbara; Tar, Moses; Melman, Arnold; Arezzo, Joseph C

    2008-10-01

    The present study explored parallel changes in the physiology and structure of myelinated (Adelta) and unmyelinated (C) small diameter axons in the cavernous nerve of rats associated with streptozotocin-induced hyperglycemia. Damage to these axons is thought to play a key role in diabetic autonomic neuropathy and erectile dysfunction, but their pathophysiology has been poorly studied. Velocities in slow conducting fibers were measured by applying multiple unit procedures; histopathology was evaluated with both light and electron microscopy. To our knowledge, these are the initial studies of slow nerve conduction velocities in the distal segments of the cavernous nerve. We report that hyperglycemia is associated with a substantial reduction in the amplitude of the slow conducting response, as well as a slowing of velocities within this very slow range (< 2.5 m/s). Even with prolonged hyperglycemia (> 4 months), histopathological abnormalities were mild and limited to the distal segments of the cavernous nerve. Structural findings included dystrophic changes in nerve terminals, abnormal accumulations of glycogen granules in unmyelinated and preterminal axons, and necrosis of scattered smooth muscle fibers. The onset of slowing of velocity in the distal cavernous nerve occurred subsequent to slowing in somatic nerves in the same rats. The functional changes in the cavernous nerve anticipated and exceeded the axonal degeneration detected by morphology. The physiologic techniques outlined in these studies are feasible in most electrophysiologic laboratories and could substantially enhance our sensitivity to the onset and progression of small fiber diabetic neuropathy.

  11. EFFECTS OF HYPERGLYCEMIA ON RAT CAVERNOUS NERVE AXONS: A FUNCTIONAL AND ULTRASTRUCTURAL STUDY

    PubMed Central

    Zotova, Elena G.; Schaumburg, Herbert H.; Raine, Cedric S.; Cannella, Barbara; Tar, Moses; Melman, Arnold; Arezzo, Joseph C.

    2008-01-01

    The present study explored parallel changes in the physiology and structure of myelinated (Aδ) and unmyelinated (C) small diameter axons in the cavernous nerve of rats associated with streptozotocin-induced hyperglycemia. Damage to these axons is thought to play a key role in diabetic autonomic neuropathy and erectile dysfunction, but their pathophysiology has been poorly studied. Velocities in slow conducting fibers were measured by applying multiple unit procedures; histopathology was evaluated with both light and electron microscopy. To our knowledge, these are the initial studies of slow nerve conduction velocities in the distal segments of the cavernous nerve. We report that hyperglycemia is associated with a substantial reduction in the amplitude of the slow conducting response, as well as a slowing of velocities within this very slow range (<2.5 m/sec). Even with prolonged hyperglycemia (> 4 months), histopathological abnormalities were mild and limited to the distal segments of the cavernous nerve. Structural findings included dystrophic changes in nerve terminals, abnormal accumulations of glycogen granules in unmyelinated and preterminal axons, and necrosis of scattered smooth muscle fibers. The onset of slowing of velocity in the distal cavernous nerve occurred subsequent to slowing in somatic nerves in the same rats. The functional changes in the cavernous nerve anticipated and exceeded the axonal degeneration detected by morphology. The physiologic techniques outlined in these studies are feasible in most electrophysiologic laboratories and could substantially enhance our sensitivity to the onset and progression of small fiber diabetic neuropathy. PMID:18687329

  12. Multiple cavernous malformations presenting in a patient with Poland syndrome: A case report

    PubMed Central

    2011-01-01

    Introduction Poland syndrome is a congenital disorder related to chest and hand anomalies on one side of the body. Its etiology remains unclear, with an ipsilateral vascular alteration (of unknown origin) to the subclavian artery in early embryogenesis being the currently accepted theory. Cavernous malformations are vascular hamartomas, which have been linked to a genetic etiology, particularly in familial cases, which commonly present with multiple lesions. Our case report is the first to describe multiple cavernous malformations associated with Poland syndrome, further supporting the vascular etiology theory, but pointing to a genetic rather than a mechanistic factor disrupting blood flow in the corresponding vessels. Case presentation A 41-year-old Caucasian man with Poland syndrome on the right side of his body presented to our hospital with a secondary generalized seizure and was found to have multiple cavernous malformations distributed in his brain, cerebellum, and brain stem, with a predominance of lesions in the left hemisphere. Conclusion The distribution of cavernous malformations in the left hemisphere and the right-sided Poland syndrome in our patient could not be explained by a mechanistic disruption of one of the subclavian arteries. A genetic alteration, as in familial cavernous malformations, would be a more appropriate etiologic diagnosis of Poland syndrome in our patient. Further genetic and pathological studies of the involved blood vessels in patients with Poland syndrome could lead to a better understanding of the disease. PMID:21933407

  13. Endovascular Treatment of Dural Arteriovenous Fistulas: Single Center Experience

    PubMed Central

    Oh, Jae-Sang; Oh, Hyuk-Jin; Shim, Jai-Joon; Bae, Hack-Gun; Lee, Kyeong-Seok

    2016-01-01

    Objective Treatment of intracranial dural arteriovenous fistulas (dAVFs) remains a challenge. However, after introduction of Onyx, transarterial approach is the preferred treatment option in many centers. We report our experience of dAVFs embolization with special emphasis on transarterial approach. Methods Seventeen embolization procedures were performed in 13 patients with dAVFs between Jan 2009 and Oct 2014. Clinical symptoms, location and type of fistulas, embolization methods, complications, radiological and clinical outcomes were evaluated using charts and PACS images. Results All 13 patients had symptomatic lesions. The locations of fistulas were transverse-sigmoid sinus in 6, middle fossa dura in 4, cavernous sinus in 2, and superior sagittal sinus in 1 patient. Cognard types were as follows : I in 4, IIa in 2, IIa+IIb in 5, and IV in 2. Embolization procedures were performed ≥2 times in 3 patients. Nine patients were treated with transarterial Onyx embolization alone. One of these required direct surgical puncture of middle meningeal artery. Complete obliteration of fistulas was achieved in 11/13 (85%) patients. There were no complications except for 1 case of Onyx migration in cavernous dAVF. Modified Rankin scale score at post-operative 3 months were 0 in 11, and 3 in 2 patients. Conclusion Transarterial Onyx embolization can be a first line therapeutic option in patients with dAVFs. However, transvenous approach should be tried first in cavernous sinus dAVF because of the risk of intracranial migration of liquid embolic materials. Furthermore, combined surgical endovascular approach can be considered as a useful option in inaccessible route. PMID:26885282

  14. Intracranial cavernous angioma: a practical review of clinical and biological aspects.

    PubMed

    Raychaudhuri, Ratul; Batjer, H Huntington; Awad, Issam A

    2005-04-01

    Cavernomas are an uncommon lesion seen in neurosurgical practice that can occasionally rupture. Recent developments in neurosurgical technique and microbiology have brought greater insight into the treatment and molecular pathogenesis of cavernoma. In this review, a historical overview of cavernous angioma, a current paradigm for treatment, promising new molecular biological developments, and suggestions for future directions in neurosurgical research are presented, with emphasis on practical clinical applications. A survey of the literature on cavernous angioma and consultation with the Department of Neurosurgery at Northwestern Memorial Hospital was conducted by the authors to gain greater insight regarding this lesion. Papers and consultation revealed the importance of careful evaluation of this lesion, new techniques such as functional magnetic resonance imaging and frameless stereotaxy that simplify clinical management of cavernomas, and potential mechanisms by which to tackle this lesion in the future. New basic knowledge on disease biology is summarized with practical applications in the clinical arena. There appear to be a number of controversies regarding management of this lesion. These include risk factors faced by the patient, controversy over the importance of resection, and modality through which the treatment should occur. An algorithm is presented to aid the neurosurgeon in management of these lesions. Exciting developments in neurosurgery and molecular biology will continue to have a major impact on clinical treatment of this disease. Unresolved issues regarding the importance of certain risk factors, the role for radiotherapy in treatments, and the underlying molecular abnormalities must be tackled to gain greater clarity in treatment of this lesion.

  15. Horizontal natural gas storage caverns and methods for producing same

    DOEpatents

    Russo, Anthony

    1995-01-01

    The invention provides caverns and methods for producing caverns in bedded salt deposits for the storage of materials that are not solvents for salt. The contemplated salt deposits are of the bedded, non-domed variety, more particularly salt found in layered formations that are sufficiently thick to enable the production of commercially usefully sized caverns completely encompassed by walls of salt of the formation. In a preferred method, a first bore hole is drilled into the salt formation and a cavity for receiving insolubles is leached from the salt formation. Thereafter, at a predetermined distance away from the first bore hole, a second bore hole is drilled towards the salt formation. As this drill approaches the salt, the drill assumes a slant approach and enters the salt and drills through it in a horizontal direction until it intersects the cavity for receiving insolubles. This produces a substantially horizontal conduit from which solvent is controlledly supplied to the surrounding salt formation, leaching the salt and producing a concentrated brine which is removed through the first bore hole. Insolubles are collected in the cavity for receiving insolubles. By controlledly supplying solvent, a horizontal cavern is produced with two bore holes extending therefrom.

  16. [The use of intraoperative Doppler ultrasound in endoscopic transsphenoidal surgery].

    PubMed

    Sharipov, O I; Kutin, M A; Kalinin, P L; Fomichev, D V; Lukshin, V A; Kurnosov, A B

    2016-01-01

    Doppler ultrasound (DUS) has been widely used in neurosurgical practice to diagnose various cerebrovascular diseases. This technique is used in transsphenoidal surgery to identify the localization of intracranial arteries when making an approach or during tumor resection. To identify the cavernous segment of the internal carotid artery (ICA) and/or basilar artery during endoscopic transsphenoidal surgery, we used a combined device on the basis of a click line curette («Karl Storz») and a 16 MHz Doppler probe (Lassamed). The technique was used in 51 patients during both standard transsphenoidal surgery (23 cases) and transsphenoidal tumor resection through an extended approach (28 cases). Doppler ultrasound was used in different situations: to determine a trajectory of the endonasal transsphenoidal approach in the absence of the normal anatomical landmarks (16 cases), to define the limits of safe resection of a tumor located in the laterosellar region (7), and to implement an extended transsphenoidal endoscopic approach (28). Intraoperative Doppler ultrasound enabled identification of the cavernous segment of the internal carotid artery in 45 cases and the basilar artery in 2 cases; a blood vessel was not found in 4 cases. Injury to the cavernous segment of the internal carotid artery was observed only in 1 case. The use of the described combined device in transsphenoidal surgery turned Doppler ultrasound into an important and useful technique for visualization of the ICA within the tumor stroma as well as in the case of the changed skull base anatomy. Its use facilitates manipulations in a deep and narrow wound and enables inspection of the entire surface of the operative field in various planes, thereby surgery becomes safer due to the possibility of maximum investigation of the operative field.

  17. Occipital Neuralgia from C2 Cavernous Malformation

    PubMed Central

    Ha, Sang-woo; Choi, Jin-gyu; Son, Byung-chul

    2018-01-01

    A unique case is presented of chronic occipital neuralgia (ON) caused by cavernous malformation (CM) in the intramedullary C2 spinal cord and subsequent pain relief and remodeling of allodynic pain following dorsal root rhizotomy. A 53-year-old male presented with a 30-year history of chronic allodynic, paroxysmal lancinating pain in the greater and lesser occipital nerves. Typically, the pain was aggravated with neck extension and head movement. Magnetic resonance imaging showed a CM in the right posterolateral side of the intramedullary C2 cord. Considering potential risks associated with removal of the lesion, intradural C1-3 dorsal root rhizotomy with dentate ligament resection was performed. The paroxysmal lancinating pain of ON was significantly alleviated, and the remodeling of the extent of allodynic pain was noted after C1-3 dorsal root rhizotomy. These changes gradually occurred during the second postoperative month, and this effect was maintained for 24 months postoperatively. Significant reduction in chronic allodynic pain of secondary ON caused by cervicomedullary CM involving central sensitization in the trigeminocervical complex was observed with reduction of irritating, afferent input with C1-C3 dorsal root rhizotomy. PMID:29682056

  18. Intramedullary cavernous angioma of the spinal cord in a pediatric patient, with multiple cavernomas, familial occurrence and partial spontaneous regression: case report and review of the literature.

    PubMed

    Santoro, Antonio; Piccirilli, Manolo; Brunetto, Giacoma Maria Floriana; Delfini, Roberto; Cantore, Giampaolo

    2007-11-01

    The authors present their experience with the 17th pediatric intramedullary cavernoma reported in English literature. The patient firstly underwent surgery for a left frontal cavernoma when he was 2 years old. Also the child's mother was operated for a C2-C3 intramedullary cavernoma. He grew up normally and the radiological follow-up was negative for other brainstem cavernous malformations. When he was 11 years old he complained a worsening tetraparesis. A cerebral and spinal magnetic resonance (MR) imaging revealed the presence of a C1 intramedullary cavernoma and a pontine cavernoma. He underwent surgery for the cervical lesion, which was completely removed. The postoperative course was regular with a total recovery from the neurological deficit. The boy underwent a radiological follow-up, monitoring the pontine lesion, which spontaneously regressed when he was 19 years old. The rarity of the pediatric intramedullary cavernoma, the familial occurrence, and the spontaneous regression of the pontine cavernoma make this case very peculiar.

  19. Occipital Neuralgia from C2 Cavernous Malformation.

    PubMed

    Ha, Sang-Woo; Choi, Jin-Gyu; Son, Byung-Chul

    2018-01-01

    A unique case is presented of chronic occipital neuralgia (ON) caused by cavernous malformation (CM) in the intramedullary C2 spinal cord and subsequent pain relief and remodeling of allodynic pain following dorsal root rhizotomy. A 53-year-old male presented with a 30-year history of chronic allodynic, paroxysmal lancinating pain in the greater and lesser occipital nerves. Typically, the pain was aggravated with neck extension and head movement. Magnetic resonance imaging showed a CM in the right posterolateral side of the intramedullary C2 cord. Considering potential risks associated with removal of the lesion, intradural C1-3 dorsal root rhizotomy with dentate ligament resection was performed. The paroxysmal lancinating pain of ON was significantly alleviated, and the remodeling of the extent of allodynic pain was noted after C1-3 dorsal root rhizotomy. These changes gradually occurred during the second postoperative month, and this effect was maintained for 24 months postoperatively. Significant reduction in chronic allodynic pain of secondary ON caused by cervicomedullary CM involving central sensitization in the trigeminocervical complex was observed with reduction of irritating, afferent input with C1-C3 dorsal root rhizotomy.

  20. SU-G-IeP4-10: Microimaging for Different Degrees of Human Cavernous Hemangioma of Liver by Using In-Line Phase-Contrast Imaging CT

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Duan, J

    2016-06-15

    Purpose: Cavernous hemangioma of the liver (CHL) is the most common benign solid tumor of the liver. In this study, we quantitative assessment the different degrees of CHL from microscopic viewpoint by using in-line phase-contrast imaging CT (ILPCI-CT). Methods: The experiments were performed at x-ray imaging and biomedical application beamline (BL13W1) of Shanghai Synchrotron Radiation Facility (SSRF) in China. Three typical specimens at different stages, i.e., mild, moderate and severe human CHL were imaged using ILPCI-CT at 16keV without contrast agents. The 3D visualization of different degrees of CHL samples were presented using ILPCI-CT. Additionally, quantitative evaluation of the CHLmore » features, such as the range of hepatic sinusoid equivalent diameters in different degrees of CHL samples, the ratio of the hepatic sinusoid to the CHL tissue, were measured. Results: The planar image clearly displayed the dilated hepatic sinusoids in microns. There was no normal hepatic vascular found in the all CHL samples. Different stages of CHL samples were presented with vivid shapes and stereoscopic effects by using 3D visualization. The equivalent diameters of hepatic sinusoids in three degrees CHL were different. The equivalent diameters of the hepatic sinusoids in mild CHL, range from 60 to 120 µm. The equivalent diameters of the hepatic sinusoids in moderate CHL, range from 65 to 190 µm. The equivalent diameters of the hepatic sinusoids in severe CHL, range from 95 to 215 µm. The ratio of the hepatic sinusoid to the mild, moderate and severe CHL tissue were 3%, 16% and 21%, respectively. Conclusion: The results show that the high degree of sensitivity of the ILPCI-CT technique and demonstrate the feasibility of accurate visualization of different stage human CHL. ILPCI-CT may offers a potential use in non-invasive study and analysis of CHL.« less

  1. Tolerance of cranial nerves of the cavernous sinus to radiosurgery

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tishler, R.B.; Loeffler, J.S.; Alexander, E. III

    1993-09-20

    Stereotactic radiosurgery is becoming a more accepted treatment option for benign, deep seated intracranial lesions. However, little is known about the effects of large single fractions of radiation on cranial nerves. This study was undertaken to assess the effect of radiosurgery on the cranial nerves of the cavernous sinus. The authors examined the tolerance of cranial nerves (II-VI) following radiosurgery for 62 patients (42/62 with meningiomas) treated for lesions within or near the cavernous sinus. Twenty-nine patients were treated with a modified 6 MV linear accelerator (Joint Center for Radiation Therapy) and 33 were treated with the Gamma Knife (Universitymore » of Pittsburgh). Three-dimensional treatment plans were retrospectively reviewed and maximum doses were calculated for the cavernous sinus and the optic nerve and chiasm. Median follow-up was 19 months (range 3-49). New cranial neuropathies developed in 12 patients from 3-41 months following radiosurgery. Four of these complications involved injury to the optic system and 8 (3/8 transient) were the result of injury to the sensory or motor nerves of the cavernous sinus. There was no clear relationship between the maximum dose to the cavernous sinus and the development of complications for cranial nerves III-VI over the dose range used (1000-4000 cGy). For the optic apparatus, there was a significantly increased incidence of complications with dose. Four of 17 patients (24%) receiving greater than 800 cGy to any part of the optic apparatus developed visual complications compared with 0/35 who received less than 800 cGy (p = 0.009). Radiosurgery using tumor-controlling doses of up to 4000 cGy appears to be a relatively safe technique in treating lesions within or near the sensory and motor nerves (III-VI) of the cavernous sinus. The dose to the optic apparatus should be limited to under 800 cGy. 21 refs., 4 tabs.« less

  2. Systematic Evaluation of Salt Cavern Well Integrity

    NASA Astrophysics Data System (ADS)

    Roberts, B. L.; Lord, D. L.; Lord, A. S.; Bettin, G.; Sobolik, S. R.; Park, B. Y.

    2017-12-01

    The U.S. Strategic Petroleum Reserve (SPR) holds a reserve of crude oil ( 700 million barrels) to help ease any interruptions in oil import to the United States. The oil is stored in a set of 63 underground caverns distributed across four sites along the U.S. Gulf Coast. The caverns were solution mined into salt domes at each of the four sites. The plastic nature of the salt is beneficial for the storage of crude oil as it heals any fractures that may occur in the salt. The SPR is responsible for operating and maintaining the nearly 120 wells used to access the storage caverns over operational lifetimes spanning decades. Salt creep can induce deformation of the well casing which must be remediated to insure cavern and well integrity. This is particularly true at the interface between the plastic salt and the rigid caprock. The Department of Energy, the SPR Management and Operations contractor, and Sandia National Laboratories has developed a multidimensional well-grading system for the salt cavern access wells. This system is designed to assign numeric grades to each well indicating its risk of losing integrity and remediation priority. The system consists of several main components which themselves may consist of sub-components. The main components consider such things as salt cavern pressure history, results from geomechanical simulations modeling salt deformation, and measurements of well casing deformation due to salt creep. In addition, the geology of the salt domes and their overlying caprock is also included in the grading. These multiple factors are combined into summary values giving the monitoring and remediation priority for each well. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology and Engineering Solutions of Sandia LLC, a wholly owned subsidiary of Honeywell International Inc. for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

  3. Cavernous sinus involvement is not a risk factor for the primary tumor site treatment outcome of Sinonasal adenoid cystic carcinoma.

    PubMed

    Lee, Yi-Chan; Lee, Ta-Jen; Tsang, Ngan-Ming; Huang, Yenlin; Hsu, Cheng-Lung; Hsin, Li-Jen; Lee, Yi-Hsuan; Chang, Kai-Ping

    2018-02-05

    Sinonasal adenoid cystic carcinoma is a rare malignancy of the head and neck. Cavernous sinus invasion from sinonasal adenoid cystic carcinoma and its related management have rarely been investigated. This study evaluated the relationship between treatment outcome and cavernous sinus involvement in addition to other parameters. A retrospective case series study was conducted at a tertiary referral center. The medical records of 47 patients diagnosed with primary sinonasal adenoid cystic carcinoma between 1984 and 2015 were retrospectively reviewed. The survival impact of the primary treatment modalities and the anatomic sites of tumor involvement were analyzed. Cavernous sinus invasion was observed in 8 patients (17%), of whom 7 had ACC tumors originating from the maxillary sinus. The results of univariate analysis revealed that tumor stage, primary surgery, and the absence of skull-base and infratemporal fossa invasion were associated with better overall survival (P = 0.033, P = 0.012, P = 0.011, and P = 0.040, respectively) and better disease-free survival (P = 0.019, P = 0.001, P = 0.017, and P = 0.029, respectively). Multivariate analysis identified primary surgery as the only independent prognostic factor for disease-free survival (P = 0.026). Cavernous sinus invasion by sinonasal adenoid cystic carcinoma was not associated with worse overall survival or disease-free survival (P = 0.200 and P = 0.198, respectively). Because maxillary adenoid cystic carcinoma is associated with a higher rate of cavernous sinus invasion, such cases warrant caution during preoperative planning. Primary surgery as the initial therapy provides better locoregional control and survival for patients with sinonasal adenoid cystic carcinoma. Cavernous sinus invasion did not significantly impact survival; thus, it should not be regarded as a contraindication for curative treatment.

  4. Salinization of groundwater around underground LPG storage caverns, Korea : statistical interpretation

    NASA Astrophysics Data System (ADS)

    Lee, J.; Chang, H.

    2001-12-01

    In this research, we investigate the reciprocal influence between groundwater flow and its salinization occurred in two underground cavern sites, using major ion chemistry, PCA for chemical analysis data, and cross-correlation for various hydraulic data. The study areas are two underground LPG storage facilities constructed in South Sea coast, Yosu, and West Sea coastal regions, Pyeongtaek, Korea. Considerably high concentration of major cations and anions of groundwaters at both sites showed brackish or saline water types. In Yosu site, some great chemical difference of groundwater samples between rainy and dry season was caused by temporal intrusion of high-saline water into propane and butane cavern zone, but not in Pyeongtaek site. Cl/Br ratios and δ 18O- δ D distribution for tracing of salinization source water in both sites revealed that two kind of saline water (seawater and halite-dissolved solution) could influence the groundwater salinization in Yosu site, whereas only seawater intrusion could affect the groundwater chemistry of the observation wells in Pyeongtaek site. PCA performed by 8 and 10 chemical ions as statistical variables in both sites showed that intensive intrusion of seawater through butane cavern was occurred at Yosu site while seawater-groundwater mixing was observed at some observation wells located in the marginal part of Pyeongtaek site. Cross-correlation results revealed that the positive relationship between hydraulic head and cavern operating pressure was far more conspicuous at propane cavern zone in both sites (65 ~90% of correlation coefficients). According to the cross-correlation results of Yosu site, small change of head could provoke massive influx of halite-dissolved solution from surface through vertically developed fracture networks. However in Pyeongtaek site, the pressure-sensitive observation wells are not completely consistent with seawater-mixed wells, and the hydraulic change of heads at these wells related to the operating pressure is highly associated with horizontal fault developed along the east-west line of propane cavern zone.

  5. Navigated transcranial magnetic stimulation in preoperative planning for the treatment of motor area cavernous angiomas

    PubMed Central

    Paiva, Wellingson Silva; Fonoff, Erich Talamoni; Marcolin, Marco Antonio; Bor-Seng-Shu, Edson; Figueiredo, Eberval Gadelha; Teixeira, Manoel Jacobsen

    2013-01-01

    Since the introduction of microscopic techniques, radical surgery for cavernous angiomas has become a recommended treatment option. However, the treatment of motor area cavernous angioma represents a great challenge for the surgical team. Here, we describe an approach guided by frameless neuronavigation and preoperative functional mapping with transcranial magnetic stimulation (TMS), for surgical planning. We used TMS to map the motor cortex and its relationship with the angioma. We achieved complete resection of the lesions in the surgeries, while avoiding areas of motor response identified during the preoperative mapping. We verified the complete control of seizures (Engel class 1A) in the patients with previous refractory epilepsy. Postsurgery, one patient was seizure-free without medication, and two patients required only one medication for seizure control. Thus, navigated TMS appears to be a useful tool, in preoperative planning for cavernous angiomas of the motor area. PMID:24353424

  6. Combination of low-energy shock-wave therapy and bone marrow mesenchymal stem cell transplantation to improve the erectile function of diabetic rats

    PubMed Central

    Shan, Hai-Tao; Zhang, Hai-Bo; Chen, Wen-Tao; Chen, Feng-Zhi; Wang, Tao; Luo, Jin-Tai; Yue, Min; Lin, Ji-Hong; Wei, An-Yang

    2017-01-01

    Stem cell transplantation and low-energy shock-wave therapy (LESWT) have emerged as potential and effective treatment protocols for diabetic erectile dysfunction. During the tracking of transplanted stem cells in diabetic erectile dysfunction models, the number of visible stem cells was rather low and decreased quickly. LESWT could recruit endogenous stem cells to the cavernous body and improve the microenvironment in diabetic cavernous tissue. Thus, we deduced that LESWT might benefit transplanted stem cell survival and improve the effects of stem cell transplantation. In this research, 42 streptozotocin-induced diabetic rats were randomized into four groups: the diabetic group (n = 6), the LESWT group (n = 6), the bone marrow-derived mesenchymal stem cell (BMSC) transplantation group (n = 15), and the combination of LESWT and BMSC transplantation group (n = 15). One and three days after BMSC transplantation, three rats were randomly chosen to observe the survival numbers of BMSCs in the cavernous body. Four weeks after BMSC transplantation, the following parameters were assessed: the surviving number of transplanted BMSCs in the cavernous tissue, erectile function, real-time polymerase chain reaction, and penile immunohistochemical assessment. Our research found that LESWT favored the survival of transplanted BMSCs in the cavernous body, which might be related to increased stromal cell-derived factor-1 expression and the enhancement of angiogenesis in the diabetic cavernous tissue. The combination of LESWT and BMSC transplantation could improve the erectile function of diabetic erectile function rats more effectively than LESWT or BMSC transplantation performed alone. PMID:27427555

  7. Combination of low-energy shock-wave therapy and bone marrow mesenchymal stem cell transplantation to improve the erectile function of diabetic rats.

    PubMed

    Shan, Hai-Tao; Zhang, Hai-Bo; Chen, Wen-Tao; Chen, Feng-Zhi; Wang, Tao; Luo, Jin-Tai; Yue, Min; Lin, Ji-Hong; Wei, An-Yang

    2017-01-01

    Stem cell transplantation and low-energy shock-wave therapy (LESWT) have emerged as potential and effective treatment protocols for diabetic erectile dysfunction. During the tracking of transplanted stem cells in diabetic erectile dysfunction models, the number of visible stem cells was rather low and decreased quickly. LESWT could recruit endogenous stem cells to the cavernous body and improve the microenvironment in diabetic cavernous tissue. Thus, we deduced that LESWT might benefit transplanted stem cell survival and improve the effects of stem cell transplantation. In this research, 42 streptozotocin-induced diabetic rats were randomized into four groups: the diabetic group (n = 6), the LESWT group (n = 6), the bone marrow-derived mesenchymal stem cell (BMSC) transplantation group (n = 15), and the combination of LESWT and BMSC transplantation group (n = 15). One and three days after BMSC transplantation, three rats were randomly chosen to observe the survival numbers of BMSCs in the cavernous body. Four weeks after BMSC transplantation, the following parameters were assessed: the surviving number of transplanted BMSCs in the cavernous tissue, erectile function, real-time polymerase chain reaction, and penile immunohistochemical assessment. Our research found that LESWT favored the survival of transplanted BMSCs in the cavernous body, which might be related to increased stromal cell-derived factor-1 expression and the enhancement of angiogenesis in the diabetic cavernous tissue. The combination of LESWT and BMSC transplantation could improve the erectile function of diabetic erectile function rats more effectively than LESWT or BMSC transplantation performed alone.

  8. Novel Optical Methods for Identification, Imaging, and Preservation of the Cavernous Nerves Responsible for Penile Erections during Prostate Cancer Surgery

    DTIC Science & Technology

    2009-03-01

    wavelength, pulse energy, and pulse rate) to produce strongest and most rapid erectile response as measured by intracavernosal pressure in the penis ...PC Fiber Rod Housing Optics 5-mm-ID Port Probe Handle Probe Stem Enlarged View of Probe Tip Oscilloscope FunctionGenerator Thulium Fiber Laser Shutter...rapid erectile response as measured by intracavernosal pressure (ICP) in the penis . ICP values were increased from an initial range of 30-40 mmHg

  9. Novel Optical Methods for Identification, Imaging, and Preservation of the Cavernous Nerves Responsible for Penile Erections during Prostate Cancer Surgery

    DTIC Science & Technology

    2010-03-01

    of near- IR l ight as a f unction of source-detector distance. The effective attenuation coefficient (μeff) and optical penetration depth (OPD...were then calculated for near- IR wavelengths of 1064, 1307, and 1555 nm (Table 1). A total of ten canine samples were used for this study. At...Diego, CA, 2009). Chitchian S, Fried NM. Near- IR optical properties of canine prostate tissue using oblique incidence reflectometry. Proc. SPIE

  10. Myometrial cavernous hemangioma with pulmonary thromboembolism in a post-partum woman: a case report and review of the literature.

    PubMed

    Bhavsar, Tapan; Wurzel, John; Duker, Nahum

    2012-11-23

    Cavernous hemangiomas of the uterus are rare benign vascular lesions. Nine cases of diffuse cavernous hemangioma of the gravid uterus have been reported, most of which diffusely involved the myometrium. These vascular malformations are clinically significant, and may cause pronounced bleeding resulting in maternal or fetal demise. Thrombosis of cavernous hemangiomas of the uterus has been previously reported. We here report the first case in which a thrombosed cavernous hemangioma of the myometrium resulted in a fatal pulmonary embolism in a post-partum woman. A 25-year-old obese African-American woman who had one pregnancy and was delivered of twins by cesarean section was admitted 1 week after the successful delivery. The 12-day clinical course included ventilator-dependent respiratory failure, systemic hypertension, methicillin-resistant Staphylococcus aureus in the sputum, leukocytosis and asystole. A transabdominal ultrasound examination showed heterogeneous thickened and irregular products in the endometrial canal. The laboratory values were relevant for an increased prothrombin time, activated partial thromboplastin time, ferritin and a decrease in hemoglobin. The clinical cause of death was cited as acute respiratory distress syndrome. At autopsy, a 400g spongy, hemorrhagic uterus with multiple cystic spaces measuring approximately 0.5 × 0.4cm filled with thrombi within the myometrium was identified. Immunohistological examination with a CD31 stain for vascular endothelium associated antigen confirmed several endothelium-lined vessels, some of which contained thrombi. These histological features were consistent with cavernous hemangioma of the myometrium. A histological examination of the lungs revealed multiple fresh thromboemboli in small- and medium-sized pulmonary arteries in the right upper and lower lobes without organization, but with adjacent areas of fresh hemorrhagic infarction. This case underscores the importance of a high index of suspicion in a pregnant or post-partum woman presenting with respiratory symptoms. Thrombosis of the cavernous hemangiomas of the gravid or post-partum uterus is a rare entity. This case is of interest because it indicates that this condition can be fatally complicated by embolization of the thrombi in the cavernous myometrial hemangiomas. Although delivery by conservative methods, as well as cesarean section, is possible without resorting to hysterectomy, occasionally, the consequences could be fatal as in this case.

  11. Unprecedented Zipangu Underworld of the Moon Exploration (UZUME)

    NASA Astrophysics Data System (ADS)

    Haruyama, J.; Kawano, I.; Kubota, T.; Otsuki, M.; Kato, H.; Nishibori, T.; Iwata, T.; Yamamoto, Y.; Nagamatsu, A.; Shimada, K.; Ishihara, Y.; Hasenaka, T.; Morota, T.; Nishino, M. N.; Hashizume, K.; Saiki, K.; Shirao, M.; Komatsu, G.; Hasebe, N.; Shimizu, H.; Miyamoto, H.; Kobayashi, K.; Yokobori, S.; Michikami, T.; Yamamoto, S.; Yokota, Y.; Arisumi, H.; Ishigami, G.; Furutani, K.; Michikawa, Y.

    2014-04-01

    On the Moon, three huge vertical holes (several tens to a hundred meters in diameter and depth) were discovered in SELENE (nicknamed Kaguya) Terrain Camera data of 10 m pixel resolution. These holes are probably skylights of underground large caverns such as lava tubes, or magma chambers. The huge holes and their associated subsurface caverns are among the most important future exploration targets from the viewpoint of constructing lunar bases and many scientific aspects. We are now planning to explore the caverns through the skylight holes. We name the project as UZUME (Unprecedented Zipangu (Japan) Underworld of the Moon Exploration).

  12. Bayou Choctaw Well Integrity Grading Component Based on Geomechanical Simulation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Park, Byoung

    2016-09-08

    This letter report provides a Bayou Choctaw (BC) Strategic Petroleum Reserve (SPR) well grading system based on the geomechanical simulation. The analyses described in this letter were used to evaluate the caverns’ geomechanical effect on wellbore integrity, which is an important component in the well integrity grading system recently developed by Roberts et al. [2015]. Using these analyses, the wellbores for caverns BC-17 and 20 are expected to be significantly impacted by cavern geomechanics, BC-18 and 19 are expected to be medium impacted; and the other caverns are expected to be less impacted.

  13. Pure Epidural Cavernous Hemangioma of the Cervical Spine that Presented with an Acute Sensory Deficit Caused by Hemorrhage

    PubMed Central

    Lee, Sang-Ho; Chung, Seung-Eun; Paeng, Sung-Suk; Kim, Hye-Sung; Yoon, Sang-Wook; Yu, Jeong-Sik

    2006-01-01

    Pure epidural cavernous hemangioma of the spine without vertebral involvement is rare. Due to the slow growth of this lesion, the most common symptoms are chronic pain, myelopathy, and radiculopathy. In our case, the patient complained of an acute onset sensory deficit of the C4 dermatome. An MRI revealed an epidural mass with an acute hematoma. Here, we report a case of a pure epidural cavernous hemangioma that presented with acute neurologic symptoms caused by intralesional hemorrhage and an acute epidural hematoma, which were demonstrated on the patient's MRI. PMID:17191320

  14. Pure epidural cavernous hemangioma of the cervical spine that presented with an acute sensory deficit caused by hemorrhage.

    PubMed

    Jo, Byung-June; Lee, Sang-Ho; Chung, Seung-Eun; Paeng, Sung-Suk; Kim, Hye-Sung; Yoon, Sang-Wook; Yu, Jeong-Sik

    2006-12-31

    Pure epidural cavernous hemangioma of the spine without vertebral involvement is rare. Due to the slow growth of this lesion, the most common symptoms are chronic pain, myelopathy, and radiculopathy. In our case, the patient complained of an acute onset sensory deficit of the C4 dermatome. An MRI revealed an epidural mass with an acute hematoma. Here, we report a case of a pure epidural cavernous hemangioma that presented with acute neurologic symptoms caused by intralesional hemorrhage and an acute epidural hematoma, which were demonstrated on the patient's MRI.

  15. A cavernous sinus lesion clinically responsive to steroids.

    PubMed

    Ruff, M W; Carabenciov, I D; Johnson, D R; Pollock, B E; Parisi, J E; Klaas, J P

    2018-04-20

    Tolosa Hunt syndrome (THS) is characterized by painful ophthalmoplegia secondary to idiopathic granulomatous inflammation of the cavernous sinus. The characteristic finding on MRI is an enhancing T1 isointense and T2 hypo- or hyperintense cavernous sinus mass lesion, which may result in focal narrowing of the ipsilateral internal carotid artery. Although the incidence is quite rare, it is a common diagnostic consideration in cases that present with multiple cranial neuropathies. However, the differential diagnosis for a unilateral cavernous sinus lesion in adults is broad and includes neoplastic, inflammatory (such as sarcoidosis and immunoglobulin G4-related disease [IgG4-RD]), infectious etiologies (such as syphilis and leprosy), as well as vascular lesions. We describe a patient presenting with neurologic symptoms referable to a persistent unilateral cavernous sinus MRI abnormality, initially thought to be consistent with Tolosa-Hunt syndrome, that was clinically but not radiographically responsive to steroids. Following reevaluation due to the presence of new symptoms, pathology revealed that the abnormality was most consistent with chordoma, a rare skull based tumor. In patients with a presumed diagnosis of Tolosa-Hunt syndrome, close clinical and radiographic follow-up is imperative, with early consideration for biopsy in patients that fail to respond to treatment both clinically and radiographically. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Cavernous Transformation of Portal Vein Secondary to Portal Vein Thrombosis: A Case Report

    PubMed Central

    Ramos, Radhames; Park, Yoojin; Shazad, Ghulamullah; A.Garcia, Christine; Cohen, Ronny

    2012-01-01

    There are few reported cases of cavernous transformation of the portal vein (CTPV) in adults. We present a case of a 58 year-old male who was found to have this complication due to portal vein thrombosis (PVT). A 58-year old African American male with chronic alcohol and tobacco use presented with a 25-day history of weakness, generalized malaise, nausea and vomiting associated with progressively worsening anorexia and weight loss. The patient was admitted for severe anemia in conjunction with abnormal liver function tests and electrolyte abnormalities, and to rule out end stage liver disease or hepatic malignancy. The work-up for anemia showed no significant colon abnormalities, cholecystitis, liver cirrhosis, or liver abnormalities but could not rule out malignancy. An esophageogastroduodenoscopy (EGD) was suspicious for a mass compressing the stomach and small bowel. After further work-up, the hepatic mass has been diagnosed as a cavernous transformation of the portal vein (CTPV), a very rare complication of portal vein thrombosis (PVT). Cavernous Transformation of the Portal Vein (CTPV) is a rare and incurable complication of portal vein thrombosis (PVT) that should be considered as one of the differential diagnoses of a hepatic mass. Keywords Cavernous transformation of the portal vein; Portal vein thrombosis; Portal hypertension; Hyperbilirubinemia; Hepatic mass PMID:22383935

  17. Cavernous sinus tuberculoma mimicking a neoplasm: Case report, literature review, and diagnostic and treatment suggestions for tuberculomas in rare locations

    PubMed Central

    Jaimovich, Sebastián G.; Thea, Victor Castillo; Guevara, Martin; Gardella, Javier L.

    2013-01-01

    Background: Cavernous sinus tuberculomas are extremely rare, but the increasing incidence worldwide of central nervous system (CNS) tuberculosis, mostly due to human immunodeficiency virus and poor sanitary conditions, and the ability of tuberculomas to mimic a brain neoplasm makes cavernous sinus tuberculomas a suspicious pathologic finding in the differential diagnosis of a brain space-occupying lesion. Case Description: We present an immunocompetent patient with no signs of systemic tuberculosis and an isolated right cavernous sinus space-occupying lesion. A skull base approach was performed and tumor resection achieved. The postoperative course was uneventful. Pathologic findings consisted of a tuberculoma and antituberculous treatment was immediately begun with total tumor regression after a 12-month regimen. After reviewing the literature, we propose suggestions to orient the diagnosis and a treatment algorithm for tuberculomas in rare locations. Conclusion: Tuberculomas in rare locations, as the cavernous sinus, are a challenging pathology as they have the ability to mimic a brain neoplasm. Although first line treatment are antituberculous therapy (4 drugs for at least 12 months) and adjuvant steroids, in inconclusive cases, surgical biopsy or excision is recommended for histopathologic confirmation and to reduce the mass effect, always following with antituberculous therapy and adjuvant steroids. PMID:24381801

  18. Urethral cavernous hemangioma in a female patient: a rare entity

    PubMed Central

    Bolat, Mustafa Suat; Yüzüncü, Kubilay; Akdeniz, Ekrem; Demirdoven, Ayse Nurten

    2015-01-01

    Genitourinary hemangiomas are rare entities of the urinary system. We reported a female patient who suffered dyspareunia and intermitant hematuria that was proved as urethral cavernous hemangioma. Despite its benign nature, hemangiomas may recur due to incomplet excision. PMID:26985270

  19. Susceptibility-weighted imaging at 7 T: Improved diagnosis of cerebral cavernous malformations and associated developmental venous anomalies☆☆☆

    PubMed Central

    Frischer, Josa M.; Göd, Sabine; Gruber, Andreas; Saringer, Walter; Grabner, Günther; Gatterbauer, Brigitte; Kitz, Klaus; Holzer, Sabrina; Kronnerwetter, Claudia; Hainfellner, Johannes A.; Knosp, Engelbert; Trattnig, Siegfried

    2012-01-01

    Background and aim In the diagnosis of cerebral cavernous malformations (CCMs) magnetic resonance imaging is established as the gold standard. Conventional MRI techniques have their drawbacks in the diagnosis of CCMs and associated venous malformations (DVAs). The aim of our study was to evaluate susceptibility weighted imaging SWI for the detection of CCM and associated DVAs at 7 T in comparison with 3 T. Patients and methods 24 patients (14 female, 10 male; median age: 38.3 y (21.1 y–69.1 y) were included in the study. Patients enrolled in the study received a 3 T and a 7 T MRI on the same day. The following sequences were applied on both field strengths: a T1 weighted 3D GRE sequence (MP-RAGE) and a SWI sequence. After obtaining the study MRIs, eleven patients underwent surgery and 13 patients were followed conservatively or were treated radio-surgically. Results Patients initially presented with haemorrhage (n = 4, 16.7%), seizures (n = 2, 8.3%) or other neurology (n = 18, 75.0%). For surgical resected lesions histopathological findings verified the diagnosis of CCMs. A significantly higher number of CCMs was diagnosed at 7 T SWI sequences compared with 3 T SWI (p < 0.05). Additionally diagnosed lesions on 7 T MRI were significantly smaller compared to the initial lesions on 3 T MRIs (p < 0.001). Further, more associated DVAs were diagnosed at 7 T MRI compared to 3 T MRI. Conclusion SWI sequences at ultra-high-field MRI improve the diagnosis of CCMs and associated DVAs and therefore add important pre-operative information. PMID:24179744

  20. Sensory function after cavernous haemangioma: a case report of thermal hypersensitivity at and below an incomplete spinal cord injury.

    PubMed

    Gómez-Soriano, J; Goiriena, E; Florensa-Vila, J; Gómez-Arguelles, J M; Mauderli, A; Vierck, C J; Albu, S; Simón-Martinez, C; Taylor, J

    2012-09-01

    Case report of a 42-year-old woman with non-evoked pain diagnosed with a cavernous C7-Th6 spinal haemangioma. To assess the effect of intramedullary haemorrhage (IH) on nociception and neuropathic pain (NP) at and below an incomplete spinal cord injury (SCI). Sensorimotor Function Group, Hospital Nacional de Parapléjicos de Toledo (HNPT). T2*-susceptibility weighted image (SWI) magnetic resonance imaging (MRI) of spinal haemosiderin and a complete pain history were performed 8 months following initial dysaesthesia complaint. Thermal pain thresholds were assessed with short 1 s stimuli, while evidence for central sensitization was obtained with psychophysical electronic Visual Analogue Scale rating of tonic 10 s 3 °C and 48 °C stimuli, applied at and below the IH. Control data were obtained from 10 healthy volunteers recruited from the HNPT. Non-evoked pain was present within the Th6 dermatome and lower legs. T2*-SWI MRI imaging detected extensive haemosiderin-rich IH (C7-Th5/6 spinal level). Cold allodynia was detected below the IH (left L5 dermatome) with short thermal stimuli. Tonic thermal stimuli applied to the Th6, Th10 and C7 dermatomes revealed widespread heat and cold allodynia. NP was diagnosed following IH, corroborated by an increase in below-level cold pain threshold with at- and below-level cold and heat allodynia. Psychophysical evidence for at- and below-level SCI central sensitization was obtained with tonic thermal stimuli. Early detection of IH could lead to better management of specific NP symptoms, an appreciation of the role of haemorrhage as an aggravating SCI physical factor, and the identification of specific spinal pathophysiological pain mechanisms.

  1. The Role of Palliative Radiosurgery When Cancer Invades the Cavernous Sinus

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kano, Hideyuki; Niranjan, Ajay; Kondziolka, Douglas

    2009-03-01

    Purpose: Involvement of the cavernous sinus by direct invasion from skull base cancer or from metastatic spread of cancers is a challenging problem. We evaluated the role of stereotactic radiosurgery (SRS) in the treatment of patients who developed cavernous sinus metastases or direct invasion. Methods and Materials: We retrospectively reviewed the data from 37 patients who had cavernous sinus metastases or had cavernous sinus invasion from adjacent skull base cancers and who underwent SRS between 1992 and 2006 at University of Pittsburgh Medical Center. The median patient age was 57.8 years. Previous adjuvant management included fractionated radiotherapy in 8, chemotherapymore » in 16, and both radiotherapy and chemotherapy in 5. The primary sites of metastases or invasion were nasopharyngeal carcinoma (n = 7), parotid gland carcinoma (n = 7), and metastases from systemic cancer (n = 23). The median target volume was 6.3 cm{sup 3} (range, 0.3-33.6), and the median margin dose was 14 Gy (range, 12-20). Results: At a mean of 12.9 months (range, 0.8-63.9), 32 patients had died and 5 were living. The overall survival rate after SRS was 36.6% and 19.4% at 1 and 2 years, respectively. Progression-free survival was related to a greater marginal dose. After SRS, 12 (35.3%) of 34 patients with neurologic symptoms exhibited improvement. SRS early after diagnosis was significantly associated with improvement of cranial nerve dysfunction. Conclusion: SRS is a minimally invasive palliative option for patients whose cancer has invaded the cavernous sinus. The benefits for cranial nerve deficits are best when SRS is performed early.« less

  2. Trans-zygomatic middle cranial fossa approach to access lesions around the cavernous sinus and anterior parahippocampus: a minimally invasive skull base approach.

    PubMed

    Melamed, Itay; Tubbs, R Shane; Payner, Troy D; Cohen-Gadol, Aaron A

    2009-08-01

    Exposure of the cavernous sinus or anterior parahippocampus often involves a wide exposure of the temporal lobe and mobilization of the temporalis muscle associated with temporal lobe retraction. The authors present a cadaveric study to illustrate the feasibility, advantages and landmarks necessary to perform a trans-zygomatic middle fossa approach to lesions around the cavernous sinus and anterior parahippocampus. The authors performed bilateral trans-zygomatic middle fossae exposures to reach the cavernous sinus and parahippocampus in five cadavers (10 sides). We assessed the morbidity associated with this procedure and compared the indications, advantages, and disadvantages of this method versus more extensive skull base approaches. A vertical linear incision along the middle portion of the zygomatic arch was extended one finger breadth inferior to the inferior edge of the zygomatic arch. Careful dissection inferior to the arch allowed preservation of facial nerve branches. A zygomatic osteotomy was followed via a linear incision through the temporalis muscle and exposure of the middle cranial fossa floor. A craniotomy along the inferolateral temporal bone and middle fossa floor allowed extradural dissection along the middle fossa floor and exposure of the cavernous sinus including all three divisions of the trigeminal nerve. Intradural inspection demonstrated adequate exposure of the parahippocampus. Exposure of the latter required minimal or no retraction of the temporal lobe. The trans-zygomatic middle fossa approach is a simplified skull base exposure using a linear incision, which may avoid the invasivity of more extensive skull base approaches while providing an adequate corridor for resection of cavernous sinus and parahippocampus lesions. The advantages of this approach include its efficiency, ease, minimalism, preservation of the temporalis muscle, and minimal retraction of the temporal lobe.

  3. Effect of chronic low-dose tadalafil on penile cavernous tissues in diabetic rats.

    PubMed

    Mostafa, Mohamed E; Senbel, Amira M; Mostafa, Taymour

    2013-06-01

    To assess the effect of chronic low-dose administration of tadalafil (Td) on penile cavernous tissue in induced diabetic rats. The study investigaged 48 adult male albino rats, comprising a control group, sham controls, streptozotocin-induced diabetic rats, and induced diabetic rats that received Td low-dose daily (0.09 mg/200 g weight) for 2 months. The rats were euthanized 1 day after the last dose. Cavernous tissues were subjected to histologic, immunohistochemical, morphometric studies, and measurement of intracavernosal pressure and mean arterial pressure in anesthetized rats. Diabetic rats demonstrated dilated cavernous spaces, smooth muscles with heterochromatic nuclei, degenerated mitochondria, vacuolated cytoplasm, and negative smooth muscle immunoreactivity. Nerve fibers demonstrated a thick myelin sheath and intra-axonal edema, where blood capillaries exhibited thick basement membrane. Diabetic rats on Td showed improved cavernous organization with significant morphometric increases in the area percentage of smooth muscles and elastic tissue and a significant decrease of fibrous tissue. The Td-treated group showed enhanced erectile function (intracavernosal pressure/mean arterial pressure) at 0.3, 0.5, 1, 3, and 5 Hz compared with diabetic group values at the respective frequencies (P <.05) that approached control values. Chronic low-dose administration of Td in diabetic rats is associated with substantial improvement of the structure of penile cavernous tissue, with increased smooth muscles and elastic tissue, decreased fibrous tissue, and functional enhancement of the erectile function. This raises the idea that the change in penile architecture with Td treatment improves erectile function beyond its half-life and its direct pharmacologic action on phosphodiesterase type 5. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Characterizing Excavation Damaged Zone and Stability of Pressurized Lined Rock Caverns for Underground Compressed Air Energy Storage

    NASA Astrophysics Data System (ADS)

    Kim, Hyung-Mok; Rutqvist, Jonny; Jeong, Ju-Hwan; Choi, Byung-Hee; Ryu, Dong-Woo; Song, Won-Kyong

    2013-09-01

    In this paper, we investigate the influence of the excavation damaged zone (EDZ) on the geomechanical performance of compressed air energy storage (CAES) in lined rock caverns. We conducted a detailed characterization of the EDZ in rock caverns that have been excavated for a Korean pilot test program on CAES in (concrete) lined rock caverns at shallow depth. The EDZ was characterized by measurements of P- and S-wave velocities and permeability across the EDZ and into undisturbed host rock. Moreover, we constructed an in situ concrete lining model and conducted permeability measurements in boreholes penetrating the concrete, through the EDZ and into the undisturbed host rock. Using the site-specific conditions and the results of the EDZ characterization, we carried out a model simulation to investigate the influence of the EDZ on the CAES performance, in particular related to geomechanical responses and stability. We used a modeling approach including coupled thermodynamic multiphase flow and geomechanics, which was proven to be useful in previous generic CAES studies. Our modeling results showed that the potential for inducing tensile fractures and air leakage through the concrete lining could be substantially reduced if the EDZ around the cavern could be minimized. Moreover, the results showed that the most favorable design for reducing the potential for tensile failure in the lining would be a relatively compliant concrete lining with a tight inner seal, and a relatively stiff (uncompliant) host rock with a minimized EDZ. Because EDZ compliance depends on its compressibility (or modulus) and thickness, care should be taken during drill and blast operations to minimize the damage to the cavern walls.

  5. Evidence for remotely triggered micro-earthquakes during salt cavern collapse

    NASA Astrophysics Data System (ADS)

    Jousset, P.; Rohmer, J.

    2012-04-01

    Micro-seismicity is a good indicator of spatio-temporal evolution of physical properties of rocks prior to catastrophic events like volcanic eruptions or landslides and may be triggered by a number of causes including dynamic characteristics of processes in play or/and external forces. Micro-earthquake triggering has been in the recent years the subject of intense research and our work contribute to showing further evidence of possible triggering of micro-earthquakes by remote large earthquakes. We show evidence of triggered micro-seismicity in the vicinity of an underground salt cavern prone to collapse by a remote M~7.2 earthquake, which occurred ~12000 kilometres away. We demonstrate the near critical state of the cavern before the collapse by means of 2D axisymmetric elastic finite-element simulations. Pressure was lowered in the cavern by pumping operations of brine out of the cavern. We demonstrate that a very small stress increase would be sufficient to break the overburden. High-dynamic broadband records reveal a remarkable time-correlation between a dramatic increase of the local high-frequency micro-seismicity rate associated with the break of the stiffest layer stabilizing the overburden and the passage of low-frequency remote seismic waves, including body, Love and Rayleigh surface waves. Stress oscillations due to the seismic waves exceeded the strength required for the rupture of the complex media made of brine and rock triggering micro-earthquakes and leading to damage of the overburden and eventually collapse of the salt cavern. The increment of stress necessary for the failure of a Dolomite layer is of the same order or magnitude as the maximum dynamic stress magnitude observed during the passage of the earthquakes waves. On this basis, we discuss the possible contribution of the Love and Rayleigh low-frequency surfaces waves.

  6. In Situ Observation of Failure Mechanisms Controlled by Rock Masses with Weak Interlayer Zones in Large Underground Cavern Excavations Under High Geostress

    NASA Astrophysics Data System (ADS)

    Duan, Shu-Qian; Feng, Xia-Ting; Jiang, Quan; Liu, Guo-Feng; Pei, Shu-Feng; Fan, Yi-Lin

    2017-09-01

    A weak interlayer zone (WIZ) is a poor rock mass system with loose structure, weak mechanical properties, variable thickness, random distribution, strong extension, and high risk due to the shear motion of rock masses under the action of tectonism, bringing many stability problems and geological hazards, especially representing a potential threat to the overall stability of rock masses with WIZs in large underground cavern excavations. Focusing on the deformation and failure problems encountered in the process of excavation unloading, this research proposes comprehensive in situ observation schemes for rock masses with WIZs in large underground cavern on the basis of the collection of geological, construction, monitoring, and testing data. The schemes have been fully applied in two valuable project cases of an underground cavern group under construction in the southwest of China, including the plastic squeezing-out tensile failure and the structural stress-induced collapse of rock masses with WIZs. In this way, the development of rock mass failure, affected by the step-by-step excavations along the cavern's axis and the subsequent excavation downward, could be observed thoroughly. Furthermore, this paper reveals the preliminary analyses of failure mechanism of rock masses with WIZs from several aspects, including rock mass structure, strength, high stress, ground water effects, and microfracture mechanisms. Finally, the failure particularities of rock masses with WIZs and rethink on prevention and control of failures are discussed. The research results could provide important guiding reference value for stability analysis, as well as for rethinking the excavation and support optimization of rock masses with WIZs in similar large underground cavern under high geostress.

  7. Preoperative Lateralization Modalities for Cushing Disease: Is Dynamic Magnetic Resonance Imaging or Cavernous Sinus Sampling More Predictive of Intraoperative Findings?

    PubMed

    Sun, Hai; Yedinak, Chris; Ozpinar, Alp; Anderson, Jim; Dogan, Aclan; Delashaw, Johnny; Fleseriu, Maria

    2015-06-01

    Objective To analyze whether cavernous sinus sampling (CSS) and dynamic magnetic resonance imaging (dMRI) are consistent with intraoperative findings in Cushing disease (CD) patients. Design Retrospective outcomes study. Setting Oregon Health & Science University; 2006 and 2013. Participants A total of 37 CD patients with preoperative dMRI and CSS to confirm central adrenocorticotropic hormone (ACTH) hypersecretion. Patients were 78% female; mean age was 41 years (at diagnosis), and all had a minimum of 6 months of follow-up. Main Outcome Measures Correlations among patient characteristics, dMRI measurements, CSS results, and intraoperative findings. Results All CSS indicated presence of CD. Eight of 37 patients had no identifiable tumor on dMRI. Three of 37 patients had no tumor at surgery. dMRI tumor size was inversely correlated with age (rs = - 0.4; p = 0.01) and directly correlated to intraoperative lateralization (rs = 0.3; p < 0.05). Preoperative dMRI was directly correlated to intraoperative lateralization (rs = 0.5; p < 0.002). CSS lateralization showed no correlation with intraoperative findings (rs = 0.145; p = 0.40) or lateralization observed on preoperative dMRI (rs = 0.17; p = 0.29). Postoperative remission rate was 68%. Conclusion dMRI localization was most consistent with intraoperative findings; CSS results were less reliable. Results suggest that small ACTH-secreting tumors continue to pose a challenge to reliable preoperative localization.

  8. Micro-computed tomography in murine models of cerebral cavernous malformations as a paradigm for brain disease.

    PubMed

    Girard, Romuald; Zeineddine, Hussein A; Orsbon, Courtney; Tan, Huan; Moore, Thomas; Hobson, Nick; Shenkar, Robert; Lightle, Rhonda; Shi, Changbin; Fam, Maged D; Cao, Ying; Shen, Le; Neander, April I; Rorrer, Autumn; Gallione, Carol; Tang, Alan T; Kahn, Mark L; Marchuk, Douglas A; Luo, Zhe-Xi; Awad, Issam A

    2016-09-15

    Cerebral cavernous malformations (CCMs) are hemorrhagic brain lesions, where murine models allow major mechanistic discoveries, ushering genetic manipulations and preclinical assessment of therapies. Histology for lesion counting and morphometry is essential yet tedious and time consuming. We herein describe the application and validations of X-ray micro-computed tomography (micro-CT), a non-destructive technique allowing three-dimensional CCM lesion count and volumetric measurements, in transgenic murine brains. We hereby describe a new contrast soaking technique not previously applied to murine models of CCM disease. Volumetric segmentation and image processing paradigm allowed for histologic correlations and quantitative validations not previously reported with the micro-CT technique in brain vascular disease. Twenty-two hyper-dense areas on micro-CT images, identified as CCM lesions, were matched by histology. The inter-rater reliability analysis showed strong consistency in the CCM lesion identification and staging (K=0.89, p<0.0001) between the two techniques. Micro-CT revealed a 29% greater CCM lesion detection efficiency, and 80% improved time efficiency. Serial integrated lesional area by histology showed a strong positive correlation with micro-CT estimated volume (r(2)=0.84, p<0.0001). Micro-CT allows high throughput assessment of lesion count and volume in pre-clinical murine models of CCM. This approach complements histology with improved accuracy and efficiency, and can be applied for lesion burden assessment in other brain diseases. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Cerebral Cavernous Malformation and Hemorrhage

    MedlinePlus

    ... of the bleeding can be divided into three groups: “Slow ooze”: blood slowly seeps through the cavern “walls” inside the ... after a bleed. This allows time for excess blood absorption, unmasking the ... were recorded in the group over this period. A 2015 Mayo study determined ...

  10. Brainstem cavernous malformations: Natural history versus surgical management.

    PubMed

    Walcott, Brian P; Choudhri, Omar; Lawton, Michael T

    2016-10-01

    While brainstem cavernous malformations were once considered inoperable, improvements in patient selection, surgical exposures, intraoperative MRI-guidance, MR tractography, and neurophysiologic monitoring have resulted in good outcomes in the majority of operated patients. In a consecutive series of 104 patients with brainstem cavernous malformations, only 14% of patients experienced cranial nerve or motor dysfunction that was worse at late follow-up, relative to their preoperative condition. Outcomes were predicted by several factors, including larger lesion size, lesions that crossed the midline, the presence of a developmental venous anomaly, older age, and greater time interval from lesion hemorrhage to surgery. The 14% of patients who experienced a persistent neurological deficit as a result of surgery, while substantial from any perspective, compares favorably with the risks of observation based on a recent meta-analysis. Curative resection is a safe and effective treatment for brainstem cavernous malformations that will prevent re-hemorrhage in symptomatic patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. November 2016 West Hackberry Subsidence Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Moriarty, Dylan Michael; Lord, Anna C. Snider

    Subsidence monitoring is a critical component to understanding the cavern integrity of salt storage caverns. This report looks at historical and recent data from two of the three West Hackberry dome cavern operators. DOE SPR and LA Storage are coordinating subsidence surveys to create a comprehensive understanding of ground movement above the dome. Data from annual level and rod surveys, GPS, and tiltmeter data show the sites are experiencing typical ground movement. The highest subsidence rate is seen in the middle of the DOE SPR site at just under one inch per year with less ground movement around the edgemore » of the site. A GPS and tiltmeter instrument in the northeast areas of the DOE SPR site has not seen any trend change since the devices were installed in 2013. Comparison between recent ground movement data and historical trends suggest that there is no reason to believe that any DOE SPR or LA Storage caverns have been structurally compromised.« less

  12. U.S. strategic petroleum reserve Big Hill 114 leak analysis 2012.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lord, David L.; Roberts, Barry L.; Lord, Anna C. Snider

    2013-06-01

    This report addresses recent well integrity issues related to cavern 114 at the Big Hill Strategic Petroleum Reserve site. DM Petroleum Operations, M&O contractor for the U.S. Strategic Petroleum Reserve, recognized an apparent leak in Big Hill cavern well 114A in late summer, 2012, and provided written notice to the State of Texas as required by law. DM has since isolated the leak in well A with a temporary plug, and is planning on remediating both 114 A- and B-wells with liners. In this report Sandia provides an analysis of the apparent leak that includes: (i) estimated leak volume, (ii)more » recommendation for operating pressure to maintain in the cavern between temporary and permanent fixes for the well integrity issues, and (iii) identification of other caverns or wells at Big Hill that should be monitored closely in light of the sequence of failures there in the last several years.« less

  13. Transsphenoidal pituitary resection with intraoperative MR guidance: preliminary results

    NASA Astrophysics Data System (ADS)

    Pergolizzi, Richard S., Jr.; Schwartz, Richard B.; Hsu, Liangge; Wong, Terence Z.; Black, Peter M.; Martin, Claudia; Jolesz, Ferenc A.

    1999-05-01

    The use of intraoperative MR image guidance has the potential to improve the precision, extent and safety of transsphenoidal pituitary resections. At Brigham and Women's Hospital, an open-bore configuration 0.5T MR system (SIGNA SP, GE Medical Systems, Milwaukee, WI) has been used to provide image guidance for nine transsphenoidal pituitary adenoma resections. The intraoperative MR system allowed the radiologist to direct the surgeon toward the sella turcica successfully while avoiding the cavernous sinus, optic chiasm and other sensitive structures. Imaging performed during the surgery monitored the extent of resection and allowed for removal of tumor beyond the surgeon's view in five cases. Dynamic MR imaging was used to distinguish residual tumor from normal gland and postoperative changes permitting more precise tumor localization. A heme-sensitive long TE gradient echo sequence was used to evaluate for the presence of hemorrhagic debris. All patients tolerated the procedure well without significant complications.

  14. [Clinical picture and complex treatment of septic thromboses of the cavernous sinuses].

    PubMed

    Mozhaev, S V; Zubkov, Iu N; Ponomarev, A M; Shimchenko, P Ia

    1980-07-01

    Under analysis are etiology, clinical picture and diagnosis of a septic thrombosis of cavernous sinuses in 28 patients. The authors have shown the interrelationship between local manifestations of the disease, injuries of the brain and its sheaths and septic complications (abscessing pneumonia as the most severe of them). A scheme of the complex treatment of patients with thrombosis of the cavernous sinus is proposed. The leading role in this treatment is played by intracarotid infusion of antibiotics in combination with anticoagulant drugs, vasodilatatory agents and novocaine as well as the therapy of septic complications (abscesses of the face and hairy part of the head, meningoencephalitis, pneumonia).

  15. 78 FR 38704 - Mississippi Hub, LLC; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-27

    ... finished drilling the injection and withdrawal wells for Cavern 3 and is presently leaching the underground salt formation. The proposed increase in capacity will entail continued leaching of Cavern 3 to reach the proposed new capacity levels. The activity will be completed using the existing leaching...

  16. Subgaleal Retention Sutures: Internal Pressure Dressing Technique for Dolenc Approach.

    PubMed

    Burrows, Anthony M; Rayan, Tarek; Van Gompel, Jamie J

    2017-08-01

    Extradural approach to the cavernous sinus, the "Dolenc" approach recognizing its developing Dr. Vinko Dolenc, is a critically important skull base approach. However, resection of the lateral wall of the cavernous sinus, most commonly for cavernous sinus meningiomas, results commonly in a defect that often cannot be reconstructed in a water-tight fashion. This may result in troublesome pseudomeningocele postoperatively. To describe a technique designed to mitigate the development of pseudomeningocele. We found the Dolenc approach critical for resection of cavernous lesions. However, a number of pseudomeningoceles were managed with prolonged external pressure wrapping in the early cohort. Therefore, we incorporated subgaleal to muscular sutures, which were designed to close this potential space and retrospectively analyzed our results. Twenty-one patients treated with a Dolenc approach and resection of the lateral wall of the cavernous sinus over a 2-year period were included. Prior to incorporation of this technique, 12 patients were treated and 3 (25%) experienced postoperative pseudomeningoceles requiring multiple clinic visits and frequent dressing. After incorporation of subgaleal retention sutures, no patient (0%) experienced this complication. Although basic, subgaleal to temporalis muscle retention sutures likely aid in eliminating this potential dead space, thereby preventing patient distress postoperatively. This technique is simple and further emphasizes the importance of dead space elimination in complex closures. Copyright © 2017 by the Congress of Neurological Surgeons

  17. Vascular tumors of the iris in 45 patients: the 2009 Helen Keller Lecture.

    PubMed

    Shields, Jerry A; Bianciotto, Carlos; Kligman, Brad E; Shields, Carol L

    2010-09-01

    To report on a series of vascular tumors of the iris. Noncomparative case series. A retrospective medical record review of all patients with an iris vascular tumor was performed to identify the clinical features and develop a simple classification of these lesions. Included were demographics, clinical features, systemic associations, complications, management, and histopathology. There were 54 eyes in 45 patients with an iris vascular tumor. These were categorized as racemose hemangioma (41 eyes: 29 simple and 12 complex), cavernous hemangioma (3 eyes: 2 localized and 1 systemic), capillary hemangioma (1 eye, localized), varix (3 eyes, localized), and microhemangiomatosis (6 eyes, localized). The hemangiomas occurred in adults at a median age of 55 years, whereas capillary hemangioma occurred in infancy and cavernous hemangioma with systemic involvement occurred in a child. Of the 41 eyes with iris racemose hemangioma, none showed systemic involvement. Of all 54 eyes, transient hyphema was the main complication, found at some point in 30% or more of each affected eye except for iris capillary and racemose hemangioma. Surgical resection was necessary in 1 cavernous hemangioma and 1 varix. The remainder were managed with observation. There are now well-documented examples of iris racemose hemangioma, cavernous hemangioma, capillary hemangioma, varix, and microhemangiomatosis. Transient hyphema is the main complication. Observation is usually advised. Most are solitary lesions confined to the iris and some (cavernous hemangioma and microhemangiomatosis) can have important systemic associations.

  18. Simulation of Cavern Formation and Karst Development Using Salt

    ERIC Educational Resources Information Center

    Kent, Douglas C.; Ross, Alex R.

    1975-01-01

    A salt model was developed as a teaching tool to demonstrate the development of caverns and karst topography. Salt slabs are placed in a watertight box to represent fractured limestone. Erosion resulting from water flow can be photographed in time-lapse sequence or demonstrated in the laboratory. (Author/CP)

  19. 77 FR 74838 - Perryville Gas Storage LLC; Notice of Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP13-23-000] Perryville Gas Storage LLC; Notice of Amendment Take notice that on December 3, 2012, Perryville Gas Storage LLC... the approved storage cavern wells (Cavern Well PGS- 2) approximately 400 feet, all as more fully set...

  20. Microbial megacities fueled by methane oxidation in a mineral spring cave

    PubMed Central

    Karwautz, Clemens; Kus, Günter; Stöckl, Michael; Neu, Thomas R; Lueders, Tillmann

    2018-01-01

    Massive biofilms have been discovered in the cave of an iodine-rich former medicinal spring in southern Germany. The biofilms completely cover the walls and ceilings of the cave, giving rise to speculations about their metabolism. Here we report on first insights into the structure and function of the biofilm microbiota, combining geochemical, imaging and molecular analytics. Stable isotope analysis indicated that thermogenic methane emerging into the cave served as an important driver of biofilm formation. The undisturbed cavern atmosphere contained up to 3000 p.p.m. methane and was microoxic. A high abundance and diversity of aerobic methanotrophs primarily within the Methylococcales (Gammaproteobacteria) and methylotrophic Methylophilaceae (Betaproteobacteria) were found in the biofilms, along with a surprising diversity of associated heterotrophic bacteria. The highest methane oxidation potentials were measured for submerged biofilms on the cavern wall. Highly organized globular structures of the biofilm matrix were revealed by fluorescent lectin staining. We propose that the extracellular matrix served not only as an electron sink for nutrient-limited biofilm methylotrophs but potentially also as a diffusive barrier against volatilized iodine species. Possible links between carbon and iodine cycling in this peculiar habitat are discussed. PMID:28949325

  1. Tumors masquerading in patients with thyroid eye disease.

    PubMed

    Griepentrog, Gregory J; Burkat, Cat N; Kikkawa, Don O; Lucarelli, Mark J

    2013-08-01

    Thyroid eye disease (TED) is the most common cause of proptosis in adults. The external manifestations of TED are characteristic and the diagnosis is typically made without imaging. Although there are multiple descriptions of primary and secondary orbital tumors initially mistaken for TED in the literature, there are limited reports detailing the findings of patients with long-standing TED whom developed an orbital tumor at a later date. Herein, we present a 6-year retrospective multi-center report of three patients with long-standing TED who developed an initially unsuspected orbital or cavernous sinus tumor.

  2. 76 FR 63916 - Transcontinental Gas Pipe Line Company, LLC; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-14

    ... associated storage deliverability and capacity at the Eminence Storage Field (Eminence) in Covington County... Caverns 1, 2, 3, and 4, and reduce deliverability and capacity from 20.5 Bcf to 15.025 Bcf in Caverns 5, 6, and 7. Transco also seeks to partially abandon the total storage capacity and deliverability...

  3. 75 FR 57747 - Tres Palacios Gas Storage LLC; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-22

    ... Gas Storage LLC; Notice of Application September 15, 2010. Take notice that on September 3, 2010, Tres Palacios Gas Storage LLC (Tres Palacios), 53 Riverside Avenue, Westport, Connecticut 06880, filed in Docket... natural gas storage caverns to the actual capacities available in each cavern as established by the most...

  4. Challenges of constructing salt cavern gas storage in China

    NASA Astrophysics Data System (ADS)

    Xia, Yan; Yuan, Guangjie; Ban, Fansheng; Zhuang, Xiaoqian; Li, Jingcui

    2017-11-01

    After more than ten years of research and engineering practice in salt cavern gas storage, the engineering technology of geology, drilling, leaching, completion, operation and monitoring system has been established. With the rapid growth of domestic consumption of natural gas, the requirement of underground gas storage is increasing. Because high-quality rock salt resources about 1000m depth are relatively scarce, the salt cavern gas storages will be built in deep rock salt. According to the current domestic conventional construction technical scheme, construction in deep salt formations will face many problems such as circulating pressure increasing, tubing blockage, deformation failure, higher completion risk and so on, caused by depth and the complex geological conditions. Considering these difficulties, the differences between current technical scheme and the construction scheme of twin well and big hole are analyzed, and the results show that the technical scheme of twin well and big hole have obvious advantages in reducing the circulating pressure loss, tubing blockage and failure risk, and they can be the alternative schemes to solve the technical difficulties of constructing salt cavern gas storages in the deep rock salt.

  5. Electrical stimulation vs. pulsed and continuous-wave optical stimulation of the rat prostate cavernous nerves, in vivo

    NASA Astrophysics Data System (ADS)

    Perkins, William C.; Lagoda, Gwen A.; Burnett, Arthur; Fried, Nathaniel M.

    2015-07-01

    Identification and preservation of the cavernous nerves (CNs) during prostate cancer surgery is critical for post-operative sexual function. Electrical nerve stimulation (ENS) mapping has previously been tested as an intraoperative tool for CN identification, but was found to be unreliable. ENS is limited by the need for electrode-tissue contact, poor spatial precision from electrical current spreading, and stimulation artifacts interfering with detection. Alternatively, optical nerve stimulation (ONS) provides noncontact stimulation, improved spatial selectivity, and elimination of stimulation artifacts. This study compares ENS to pulsed/CW ONS to explore the ONS mechanism. A total of eighty stimulations were performed in 5 rats, in vivo. ENS (4 V, 5 ms, 10 Hz) was compared to ONS using a pulsed diode laser nerve stimulator (1873 nm, 5 ms, 10 Hz) or CW diode laser nerve stimulator (1455 nm). Intracavernous pressure (ICP) response and nerve compound action potentials (nCAPs) were measured. All three stimulation modes (ENS, ONS-CW, ONS-P) produced comparable ICP magnitudes. However, ENS demonstrated more rapid ICP response times and well defined nCAPs compared to unmeasurable nCAPs for ONS. Further experiments measuring single action potentials during ENS and ONS are warranted to further understand differences in the ENS and ONS mechanisms.

  6. Intracavernous Delivery of a Designed Angiopoietin-1 Variant Rescues Erectile Function by Enhancing Endothelial Regeneration in the Streptozotocin-Induced Diabetic Mouse

    PubMed Central

    Jin, Hai-Rong; Kim, Woo Jean; Song, Jae Sook; Piao, Shuguang; Choi, Min Ji; Tumurbaatar, Munkhbayar; Shin, Sun Hwa; Yin, Guo Nan; Koh, Gou Young; Ryu, Ji-Kan; Suh, Jun-Kyu

    2011-01-01

    OBJECTIVE Patients with diabetic erectile dysfunction often have severe endothelial dysfunction and respond poorly to oral phosphodiesterase-5 inhibitors. We examined the effectiveness of the potent angiopoietin-1 (Ang1) variant, cartilage oligomeric matrix protein (COMP)-Ang1, in promoting cavernous endothelial regeneration and restoring erectile function in diabetic animals. RESEARCH DESIGN AND METHODS Four groups of mice were used: controls; streptozotocin (STZ)-induced diabetic mice; STZ-induced diabetic mice treated with repeated intracavernous injections of PBS; and STZ-induced diabetic mice treated with COMP-Ang1 protein (days −3 and 0). Two and 4 weeks after treatment, we measured erectile function by electrical stimulation of the cavernous nerve. The penis was harvested for histologic examinations, Western blot analysis, and cGMP quantification. We also performed a vascular permeability test. RESULTS Local delivery of the COMP-Ang1 protein significantly increased cavernous endothelial proliferation, endothelial nitric oxide (NO) synthase (NOS) phosphorylation, and cGMP expression compared with that in the untreated or PBS-treated STZ-induced diabetic group. The changes in the group that received COMP-Ang1 restored erectile function up to 4 weeks after treatment. Endothelial protective effects, such as marked decreases in the expression of p47phox and inducible NOS, in the generation of superoxide anion and nitrotyrosine, and in the number of apoptotic cells in the corpus cavernosum tissue, were noted in COMP-Ang1–treated STZ-induced diabetic mice. An intracavernous injection of COMP-Ang1 completely restored endothelial cell-cell junction proteins and decreased cavernous endothelial permeability. COMP-Ang1–induced promotion of cavernous angiogenesis and erectile function was abolished by the NOS inhibitor, N-nitro-L-arginine methyl ester, but not by the NADPH oxidase inhibitor, apocynin. CONCLUSIONS These findings support the concept of cavernous endothelial regeneration by use of the recombinant Ang1 protein as a curative therapy for diabetic erectile dysfunction. PMID:21270241

  7. [Morphological signs of inflammatory activity in different clinical forms of drug-resistant pulmonary tuberculosis].

    PubMed

    Elipashev, A A; Nikolsky, V O; Shprykov, A S

    to determine whether the activity of tuberculous inflammation is associated with different clinical forms of drug-resistant pulmonary tuberculosis. The material taken from 310 patients operated on in 2010-2015 were retrospectively examined. The patients underwent economical lung resections of limited extent (typical and atypical ones of up to 3 segments) for circumscribed forms of tuberculosis with bacterial excretion. A study group consisted of 161 (51.9%) patients with drug-resistant variants of pulmonary tuberculosis. A control group included 149 (48.1%) patients with preserved susceptibility of Mycobacterium tuberculosis to anti-TB drugs. The activity of specific changes in tuberculosis was morphologically evaluated in accordance with the classification proposed by B.M. Ariel in 1998. The highest activity of fourth-to-fifth degree specific inflammation, including that outside the primary involvement focus, was obtained in the drug-resistant pulmonary tuberculosis group due to the predominance of patients with cavernous and fibrous-cavernous tuberculosis versus those in whom the susceptibility to chemotherapeutic agents was preserved. A macroscopic study showed that the primary lesion focus had a median size in one-half of the all the examinees; but large tuberculomas, caverns, and fibrous caverns over 4 cm in diameter were multiple and detected in the drug-resistant pulmonary tuberculosis group. Multidrug resistance was observed in more than 60% of the patients with fibrous-cavernous pulmonary tuberculosis, extensive drug resistance was seen in those with cavernous tuberculosis, which is an aggravating factor. The data obtained from the morphological study of the intraoperative material can specify the clinical form of tuberculosis and evaluate the efficiency of preoperative specific therapy. The highest activity of specific inflammation was observed in patients with multiple drug-resistant pulmonary tuberculosis, the prevalence of third-to-fourth degree specific changes was seen in those with multiple and extensively drug-resistant tuberculosis. The findings suggest that the activity of tuberculous inflammation is associated with different clinical forms of drug-resistant tuberculosis and with a spectrum of drug resistance.

  8. OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN CYTOMEGALOVIRUS RETINITIS: A Longitudinal Study.

    PubMed

    Invernizzi, Alessandro; Agarwal, Aniruddha; Ravera, Vittoria; Oldani, Marta; Staurenghi, Giovanni; Viola, Francesco

    2018-01-01

    To evaluate the vitreal, retinal, and choroidal features using spectral domain optical coherence tomography (SD-OCT) in eyes affected by cytomegalovirus (CMV) retinitis. Patients diagnosed with either active or inactive CMV retinitis were included in the study. Complete ophthalmic examination, serial color fundus photography, and SD-OCT (with and without enhanced depth imaging function) were performed for all the subjects at baseline and follow-up visits. The SD-OCT images were analyzed by two independent graders to evaluate the structural changes in areas of CMV retinitis. Prevalence data for vitreal, retinal, and choroidal SD-OCT features were collected. Twelve eyes from 9 patients (6 males, mean age: 52.7 ± 10.3 years) were enrolled. Nine eyes were diagnosed with active CMV retinitis at baseline. Active disease SD-OCT characteristic findings included nebulous vitritis (100%), posterior hyaloid thickening (83.3%), epiretinal membrane (100%), and retinal swelling (100%). Two distinct patterns of chorioretinal involvement were observed in active retinitis: 1) full-thickness retinitis (Full thickness retinitis) (n = 7 eyes) with choriocapillaris alterations and retinal pigment epithelial thickening and 2) cavernous retinitis (n = 3 eyes) characterized by inner retinal hyperreflectivity, large empty spaces in outer nuclear layer, and bridges of retinal tissue but retinal pigment epithelium and choriocapillaris sparing. Patients with cavernous retinitis develop retinal detachment during follow-up. Eyes with Full thickness retinitis developed choriocapillaris atrophy and choroidal thinning and retinal scars as the lesions healed. There are two distinct patterns of chorioretinal involvement in CMV retinitis. SD-OCT is a useful tool in the diagnosis, management, and prediction of the outcome of CMV retinitis.

  9. Operative management of brainstem cavernous malformations.

    PubMed

    Asaad, Wael F; Walcott, Brian P; Nahed, Brian V; Ogilvy, Christopher S

    2010-09-01

    Brainstem cavernous malformations (CMs) are complex lesions associated with hemorrhage and neurological deficit. In this review, the authors describe the anatomical nuances relating to the operative techniques for these challenging lesions. The resection of brainstem CMs in properly selected patients has been demonstrated to reduce the risk of rehemorrhage and can be achieved relatively safely in experienced hands.

  10. The Effect of Audio Tours on Learning and Social Interaction: An Evaluation at Carlsbad Caverns National Park

    ERIC Educational Resources Information Center

    Novey, Levi T.; Hall, Troy E.

    2007-01-01

    Auditory forms of nonpersonal communication have rarely been evaluated in informal settings like parks and museums. This study evaluated the effect of an interpretive audio tour on visitor knowledge and social behavior at Carlsbad Caverns National Park. A cross-sectional pretest/posttest quasi-experimental design compared the responses of audio…

  11. Nasopharyngeal carcinoma presented as cavernous sinus tumour.

    PubMed

    Moona, Mohammad Shafi; Mehdi, Itrat

    2011-12-01

    A 32 year Libyan male presented with the complaints of headache and diplopia. He was diagnosed with a cavernous sinus meningioma on the basis of MRI findings but no initial biopsy was taken. Depending on the radiologic diagnosis the patient was treated with gamma knife surgery twice, abroad. During follow up he developed left ear deafness and left cervical lymph adenopathy. An ENT evaluation with biopsy from the nasopharynx and cervical lymph node was taken. The histopathologic diagnosis of the resected tumour showed a nasopharyngeal carcinoma with cervical lymph node metastasis (poorly differentiated lympho-epithelial carcinoma). The cavernous sinus tumour which was initially treated as a meningioma was in fact metastasis from the nasopharyngeal carcinoma, making this an interesting and rare occurrence.

  12. Different effect of losartan and amlodipine on penile structures in male spontaneously hypertensive rats.

    PubMed

    Toblli, Jorge Eduardo; Stella, Inés; Mazza, Osvaldo Néstor; Ferder, León; Inserra, Felipe

    2004-01-01

    Erectile dysfunction is highly prevalent in hypertensive patients. Since both angiotensin II receptor type-1 blockers (ARBs) and calcium antagonists are current and effective antihypertensive drugs, the aim of this study was to determine possible differences between ARBs and calcium antagonists concerning the protection of penile structures from the deleterious effects of arterial hypertension. During 6 months, 3 groups of male spontaneously hypertensive rats (SHR) and 1 of Wistar-Kyoto (WKY) rats, as a control group, were studied: SHR without treatment; SHR with losartan (L) 30 mg/kg/day; SHR with amlodipine (A) 3 mg/kg/day, and WKY without treatment. Cavernous smooth muscle (CSM) and vascular smooth muscle (VSM) from cavernous arteries, cavernous tissue fibrosis and collagen type III (COL III) were evaluated. After 6 months, SHR+L and SHR+A showed a similar reduction in blood pressure compared with untreated SHR. However, only SHR+L and control WKY presented significantly lower values of: CSM (p < 0.01), VSM (p < 0.01), and COL III (p < 0.01) when compared with either untreated SHR or SHR+A. There was also a positive correlation between left ventricular mass and proteinuria with VSM from cavernous arteries, CSM and COL III in untreated SHR and SHR+A. These relations were not present in SHR+L and WKY. Although losartan and amlodipine achieved similar blood pressure control, losartan but not amlodipine showed a significant protective role against structural changes in the vessels and cavernous spaces of the erectile tissue caused by arterial hypertension. Copyright 2004 S. Karger AG, Basel

  13. Phenotypic modulation of corpus cavernosum smooth muscle cells in a rat model of cavernous neurectomy.

    PubMed

    Yang, Fan; Zhao, Jian F; Shou, Qi Y; Huang, Xiao J; Chen, Gang; Yang, Ke B; Zhang, Shi G; Lv, Bo D; Fu, Hui Y

    2014-01-01

    Patients undergoing radical prostatectomy (RP) are at high risk for erectile dysfunction (ED) due to potential cavernous nerve (CN) damage during surgery. Penile hypoxia after RP is thought to significantly contribute to ED pathogenesis. We previously showed that corpora cavernosum smooth muscle cells (CCSMCs) undergo phenotypic modulation under hypoxic conditions in vitro. Here, we studied such changes in an in vivo post-RP ED model by investigating CCSMCs in bilateral cavernous neurectomy (BCN) rats. Sprague-Dawley rats underwent sham (n = 12) or BCN (n = 12) surgery. After 12 weeks, they were injected with apomorphine to determine erectile function. The penile tissues were harvested and assessed for fibrosis using Masson trichrome staining and for molecular markers of phenotypic modulation using immunohistochemistry and western blotting. CCSMC morphological structure was evaluated by hematoxylin-eosin (H&E) staining and transmission electron microscopy (TEM). Erectile function was significantly lower in BCN rats than in sham rats. BCN increased hypoxia-inducible factor-1α and collagen protein expression in corpora cavernous tissue. H&E staining and TEM showed that CCSMCs in BCN rats underwent hypertrophy and showed rough endoplasmic reticulum formation. The expression of CCSMC phenotypic markers, such as smooth muscle α-actin, smooth muscle myosin heavy chain, and desmin, was markedly lower, whereas vimentin protein expression was significantly higher in BCN rats than in control rats. CCSMCs undergo phenotype modulation in rats with cavernous neurectomy. The results have unveiled physiological transformations that occur at the cellular and molecular levels and have helped characterize CN injury-induced ED.

  14. Relative Evaluation of the Independent Volume Measures of Caverns

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    MUNSON,DARRELL E.

    2000-08-01

    Throughout the construction and operation of the caverns of the Strategic Petroleum Reserve (SPR), three types of cavern volume measurements have been maintained. These are: (1) the calculated solution volume determined during initial construction by solution mining and any subsequent solutioning during oil transfers, (2) the calculated sonar volume determined through sonar surveys of the cavern dimensions, and (3) the direct metering of oil to determine the volume of the cavern occupied by the oil. The objective of this study is to compare these measurements to each other and determine, if possible, the uncertainties associated with a given type ofmore » measurement. Over time, each type of measurement has acquired a customary, or an industry accepted, stated uncertainty. This uncertainty is not necessarily the result of a technical analysis. Ultimately there is one definitive quantity, the oil volume measure by the oil custody transfer meters, taken by all parties to the transfer as the correct ledger amount and for which the SPR Project is accountable. However, subsequent transfers within a site may not be with meters of the same accuracy. In this study, a very simple theory of the perfect relationship is used to evaluate the correlation (deviation) of the various measures. This theory permits separation of uncertainty and bias. Each of the four SPR sites are examined, first with comparisons between the calculated solution volumes and the sonar volumes determined during construction, then with comparisons of the oil inventories and the sonar volumes obtained either by surveying through brine prior to oil filling or through the oil directly.« less

  15. Long-term high-fat consumption leads to downregulation of Akt phosphorylation of eNOS at Ser1177 and upregulation of Sirtuin-1 expression in rat cavernous tissue.

    PubMed

    Tomada, I; Negrão, R; Almeida, H; Neves, D

    2014-04-01

    Long-term consumption of high-fat diets negatively interferes with metabolic status and promotes endothelial dysfunction and inflammation. In the cavernous tissue, these outcomes become conspicuous in the elderly and strongly affect penile erection, a vascular process highly dependent on local nitric oxide bioavailability. Although epidemiological data links erectile dysfunction to nutritional patterns, the underlying molecular mechanisms remain unclear. Therefore, we investigated the effects of long-term high-fat diet on endothelial nitric oxide synthase (eNOS)-Sirtuin-1 axis and Akt/eNOS phosphorylation in the cavernous tissue of Sprague-Dawley rats, and compared with energy-restricted animals. We demonstrated that high-fat diet intake led to a noteworthy decrease in eNOS phosphorylation at Ser1177 residue through the Akt pathway, which seems to be compensated by upregulation of phosphorylation at Ser615, but without an increment in nitric oxide production. These results are accompanied by an increase of systemic inflammatory markers and upregulation of the inducible NOS and of the deacetylase Sirtuin-1 in the cavernous tissue to levels apparently detrimental to cells and to metabolic homeostasis. Conversely, in long-term energy-restricted animals, the rate of phosphorylation of eNOS at Ser1177 diminished, but the activation of the enzyme increased through phosphorylation of eNOS at Ser615, resulting in an enhancement in nitric oxide bioavailability. Taken together, our results demonstrate that long-term nutritional conditions override the influence of age on the eNOS expression and activation in rat cavernous tissue.

  16. SANSMIC design document.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Weber, Paula D.; Rudeen, David Keith

    2015-07-01

    The United States Strategic Petroleum Reserve (SPR) maintains an underground storage system consisting of caverns that were leached or solution mined in four salt domes located near the Gulf of Mexico in Texas and Louisiana. The SPR comprises more than 60 active caverns containing approximately 700 million barrels of crude oil. Sandia National Labo- ratories (SNL) is the geotechnical advisor to the SPR. As the most pressing need at the inception of the SPR was to create and fill storage volume with oil, the decision was made to leach the caverns and fill them simultaneously (leach-fill). Therefore, A.J. Russo developedmore » SANSMIC in the early 1980s which allows for a transient oil-brine interface (OBI) making it possible to model leach-fill and withdrawal operations. As the majority of caverns are currently filled to storage capacity, the primary uses of SANSMIC at this time are related to the effects of small and large withdrawals, expansion of existing caverns, and projecting future pillar to diameter ratios. SANSMIC was identified by SNL as a priority candidate for qualification. This report continues the quality assurance (QA) process by documenting the "as built" mathematical and numerical models that comprise this document. The pro- gram flow is outlined and the models are discussed in detail. Code features that were added later or were not documented previously have been expounded. No changes in the code's physics have occurred since the original documentation (Russo, 1981, 1983) although recent experiments may yield improvements to the temperature and plume methods in the future.« less

  17. Environmental change at Kartchner Caverns: trying to separate natural and anthropogenic changes

    Treesearch

    Rickard S. Toomey; Ginger Nolan

    2005-01-01

    Cave temperature and moisture levels are important factors in the environmental health of Kartchner Caverns. Monitoring indicates the cave has warmed and moisture levels have fallen over the past 14 years. Timing and patterns of change within the cave suggest that changes are due to development as a show cave. However, changes in other caves, surface temperature and...

  18. Performance Study of Salt Cavern Air Storage Based Non-Supplementary Fired Compressed Air Energy Storage System

    NASA Astrophysics Data System (ADS)

    Chen, Xiaotao; Song, Jie; Liang, Lixiao; Si, Yang; Wang, Le; Xue, Xiaodai

    2017-10-01

    Large-scale energy storage system (ESS) plays an important role in the planning and operation of smart grid and energy internet. Compressed air energy storage (CAES) is one of promising large-scale energy storage techniques. However, the high cost of the storage of compressed air and the low capacity remain to be solved. This paper proposes a novel non-supplementary fired compressed air energy storage system (NSF-CAES) based on salt cavern air storage to address the issues of air storage and the efficiency of CAES. Operating mechanisms of the proposed NSF-CAES are analysed based on thermodynamics principle. Key factors which has impact on the system storage efficiency are thoroughly explored. The energy storage efficiency of the proposed NSF-CAES system can be improved by reducing the maximum working pressure of the salt cavern and improving inlet air pressure of the turbine. Simulation results show that the electric-to-electric conversion efficiency of the proposed NSF-CAES can reach 63.29% with a maximum salt cavern working pressure of 9.5 MPa and 9 MPa inlet air pressure of the turbine, which is higher than the current commercial CAES plants.

  19. Genetically diagnosed Birt-Hogg-Dubé syndrome and familial cerebral cavernous malformations in the same individual: a case report.

    PubMed

    Whitworth, James; Stausbøl-Grøn, Brian; Skytte, Anne-Bine

    2017-01-01

    When faced with an unusual clinical feature in a patient with a Mendelian disorder, the clinician may entertain the possibilities of either the feature representing a novel manifestation of that disorder or the co-existence of a different inherited condition. Here we describe an individual with a submandibular oncocytoma, pulmonary bullae and renal cysts as well as multiple cerebral cavernous malformations and haemangiomas. Genetic investigations revealed constitutional mutations in FLCN, associated with Birt-Hogg-Dubé syndrome (BHD) and CCM2, associated with familial cerebral cavernous malformation. Intracranial vascular pathologies (but not cerebral cavernous malformation) have recently been described in a number of individuals with BHD (Kapoor et al. in Fam Cancer 14:595-597, 10.1007/s10689-015-9807-y , 2015) but it is not yet clear whether they represent a genuine part of that conditions' phenotypic spectrum. We suggest that in such instances of potentially novel clinical features, more extensive genetic testing to consider co-existing conditions should be considered where available. The increased use of next generation sequencing applications in diagnostic settings is likely to lead more cases such as this being revealed.

  20. Opportunities for Multidisciplinary Research in Partnership with Rock Engineers at the Deep Underground Science and Engineering Laboratory

    NASA Astrophysics Data System (ADS)

    Laughton, C.

    2008-12-01

    For the last half century the physics community has increasingly turned to the use of underground space to conduct basic research. The community is currently planning to conduct a new generation of underground experiments at the Deep Underground Science and Engineering Laboratory (DUSEL). DUSEL will be constructed within the footprint of the defunct Homestake Gold Mine, located in Lead, South Dakota. Physics proposals call for the construction of new caverns in which to conduct major new experiments. Some of the proposed laboratory facilities will be significantly larger and deeper than any previously constructed. The talk will highlight possible opportunities for integrating multi-disciplinary research in to the cavern construction program, and will stress the need to work closely with design and construction contractors to ensure that research goals can be achieve with minimal impact on project work. The constructors of large caverns should be particularly receptive to, and encouraging of geoscience research that could improve the engineering characterization of the rock mass. An improved understanding of the rock mass, as the host construction material, would result in a more reliable cavern design and construction process, and a reduced construction risk to the Project.

  1. Continuous-wave vs. pulsed infrared laser stimulation of the rat prostate cavernous nerves

    NASA Astrophysics Data System (ADS)

    Tozburun, Serhat; Cilip, Christopher M.; Lagoda, Gwen A.; Burnett, Arthur L.; Fried, Nathaniel M.

    2011-03-01

    Optical nerve stimulation has recently been developed as an alternative to electrical nerve stimulation. However, recent studies have focused primarily on pulsed delivery of the laser radiation and at relatively low pulse rates. The objective of this study is to demonstrate faster optical stimulation of the prostate cavernous nerves using continuouswave (CW) infrared laser radiation, for potential diagnostic applications. A Thulium fiber laser (λ = 1870 nm) was used for non-contact optical stimulation of the rat prostate cavernous nerves, in vivo. Optical nerve stimulation, as measured by an intracavernous pressure (ICP) response in the penis, was achieved with the laser operating in either CW mode, or with a 5-ms pulse duration at 10, 20, 30, 40, 50, and 100 Hz. Successful optical stimulation was observed to be primarily dependent on a threshold nerve temperature (42-45 °C), not an incident fluence, as previously reported. CW optical nerve stimulation provides a significantly faster ICP response time using a laser with lower power output than pulsed stimulation. CW optical nerve stimulation may therefore represent an alternative mode of stimulation for intra-operative diagnostic applications where a rapid response is critical, such as identification of the cavernous nerves during prostate cancer surgery.

  2. Pain outcomes after surgery in patients with intramedullary spinal cord cavernous malformations.

    PubMed

    Deutsch, Harel

    2010-09-01

    The objective of the study was to quantify the improvement in pain levels for patients who have undergone surgery for intramedullary spinal cord cavernous malformations (SCCMs). The author reviewed medical records of patients who underwent surgery for an intramedullary SCCM between 2003 and 2010. Numerical pain scores (range 0-10) were recorded preoperatively and at follow-up. The follow-up period exceeded 1 year. Neurological status and subjective outcomes were assessed. Each patient underwent follow-up MR imaging. Five patients were identified with SCCMs who underwent surgery: 4 with thoracic and 1 with cervical lesions. Patients had been conservatively managed for an average of 5 years prior to surgery, and none had a history of acute hemorrhage or neurological deterioration during the observation period. The primary indication for surgery in each patient was pain, although 4 of 5 patients had some evidence of myelopathy on examination. Pain improved from a mean preoperative score of 8.6 to mean score of 2.0 (p < 0.01) at 1 month. Pain scores then increased to 3.7 (p < 0.01) at 1 year. All patients had some improvement in pain. No new motor weakness was noted, but all patients had increased symptoms of posterior-column dysfunction and numbness after surgery. Spinal cord intramedullary cavernous malformations are increasingly being diagnosed early with patients presenting with mostly pain symptoms. Removal of the lesion is reliably associated with improvement in pain scores but often the pain improvement is transient. While long-term worsening of pain scores occurs, at 1-year follow-up, patients reported pain scores were improved over preoperative scores. In all patients some degree of postoperative posterior-column dysfunction was present. Some of the immediate pain relief may be due to analgesia related to the myelotomy of newly described posterior column pain pathways. In patients with severe pain, surgery to remove SCCMs reduced the overall pain level at 1 year.

  3. Surgical Management and Long-Term Seizure Outcome After Surgery for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations.

    PubMed

    Yang, Peng-Fan; Pei, Jia-Sheng; Jia, Yan-Zeng; Lin, Qiao; Xiao, Hui; Zhang, Ting-Ting; Zhong, Zhong-Hui

    2018-02-01

    Operative strategies for cerebral cavernous malformation (CCM)-associated temporal lobe epilepsy and timing of surgical intervention continue to be debated. This study aimed to establish an algorithm to evaluate the efficacy of surgical intervention strategies, to maximize positive surgical outcomes and minimize postsurgical neurologic deficits. 47 patients having undergone operation for CCM-associated temporal lobe epilepsy were retrospectively reviewed. They had received a diagnostic series for seizure localization, including long-term video electroencephalography (vEEG), high-resolution magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT). In patients with mesial temporal lobe CCMs, the involved structures (amygdala, hippocampus, or parahippocampal gyrus) were resected in addition to the lesions. Patients with neocortical epileptogenic CCM underwent extended lesionectomy guided by intraoperative electrocorticography; further performance of amygdalohippocampectomy depended on the extent of hippocampal epileptogenicity. The study cohort contained 28 patients with drug-resistant epilepsy (DRE), 12 with chronic epilepsy (CE), and 7 with sporadic seizure (SS). Normal temporal lobe metabolism was seen in 7/7 patients of the SS group. Hypometabolism was found in all patients with chronic disease except for those with posterior inferior and middle temporal gyrus cavernous malformations (CMs). Of the 31 patients with superficial neocortical CCM, 7 had normal PET without hippocampal sclerosis, 14 had ipsilateral temporal lobe hypometabolism without hippocampal sclerosis, and 10 had obvious hippocampal sclerosis and hypometabolism. Seizure freedom in DRE, CE, and SS was 82.1%, 75%, and 100%, respectively. A significant difference was found between lesion laterality and postoperative seizure control; the rate was lower in left-sided cases because of less aggressive resection. Our study demonstrates that the data from the presurgical evaluation, particularly regarding CM location, responsiveness to antiepileptic drugs, and temporal lobe metabolism, are crucial parameters for choosing surgical approaches to CCM-associated temporal lobe epilepsy. By this operative strategy, patients may receive maximized seizure control and minimized postsurgical neurologic sequelae. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Cavernous malformations of the brainstem: three-dimensional-constructive interference in steady-state magnetic resonance imaging for improvement of surgical approach and clinical results.

    PubMed

    Zausinger, Stefan; Yousry, Indra; Brueckmann, Hartmut; Schmid-Elsaesser, Robert; Tonn, Joerg-Christian

    2006-02-01

    The indications for resection of cavernous malformations (CMs) of the brainstem include neurological deficits, (recurrent) hemorrhage, and surgically accessible location. In particular, knowledge of the thickness of the parenchymal layer and of the CM's spatial relation to nuclei, tracts, cranial nerves, and vessels is critical for planning the surgical approach. We reviewed the operative treatment of 13 patients with 14 brainstem CMs, with special regard to refined three-dimensional (3D)-constructive interference in steady-state (CISS) magnetic resonance imaging (MRI). Patients were evaluated neurologically and by conventional spin-echo/fast spin-echo and 3D-CISS MRI. Surgery was performed with the use of microsurgical techniques and neurophysiological monitoring. Eleven CMs were located in the pons/pontomedullary region; 10 of the 11 were operated on via the lateral suboccipital approach. Three CMs were located near the floor of the fourth ventricle and operated on via the median suboccipital approach, with total removal of all CMs. Results were excellent or good in 10 patients; one patient transiently required tracheostomy, and two patients developed new hemipareses/ataxia with subsequent improvement. Not only did 3D-CISS sequences allow improved judgment of the thickness of the parenchymal layer over the lesion compared with spin-echo/fast spin-echo MRI, but 3D-CISS imaging also proved particularly superior in demonstrating the spatial relation of the lesion to fairly "safe" entry zones (e.g., between the trigeminal nerve and the VIIth and VIIIth nerve groups) by displaying the cranial nerves and vessels within the cerebellopontine cistern more precisely. Surgical treatment of brainstem CMs is recommended in symptomatic patients. Especially in patients with lesions situated ventrolaterally, the 3D-CISS sequence seems to be a valuable method for identifying the CM's relation to safe entry zones, thereby facilitating the surgical approach.

  5. The Medial Extra-Sellar Corridor to the Cavernous Sinus: Anatomic Description and Clinical Correlation.

    PubMed

    Theodosopoulos, Philip V; Cebula, Helene; Kurbanov, Almaz; Cabero, Arnau Benet; Osorio, Joseph A; Zimmer, Lee A; Froelich, Sebastien C; Keller, Jeffrey T

    2016-12-01

    The zenith of surgical interest in the cavernous sinus peaked in the 1980s, as evidenced by reports of 10 surgical triangles that could access the contents of the lateral sellar compartment (LSC). However, these transcranial approaches later became marginalized, first by radiosurgery's popularity and lower morbidity, and then by clinical potential of endoscopic corridors noted in several qualitative studies. Our anatomic study, taking a contemporary look at the medial extra-sellar corridor, gives a detailed qualitative-quantitative analysis for its use with increasingly popular endoscopic endonasal approaches to the cavernous sinus. In 20 cadaveric specimens, we re-examined the anatomic landmarks of the medial corridor into the LSC with qualitative descriptions and measurements. An illustrative case highlights a recurrent symptomatic pituitary adenoma that invaded the cavernous sinus approached through the medial corridor. The corridor's shape varied from tetrahedron to hexahedron. Comparing right and left sides, width averaged 3.6 ± 4.5 mm and 4.0 ± 4.4 mm, and height averaged 2.3 mm and 2.1 mm, respectively. About 35% of sides showed ample space for access into the cavernous sinus. Our case report of successful outcome lends support for the safety and efficacy of this endoscopic approach. Our re-examination of this particular surgical access into the LSC refines the understanding of the medial extra-sellar corridor as a main endoscopic access route to this compartment. Achieving safe access to the contents of the LSC, this 11th triangle is clinically relevant and potentially superior for select lesions in this region. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Decrease in neuronal nicotinic acetylcholine receptor subunit and PSD-93 transcript levels in the male mouse MPG after cavernous nerve injury or explant culture.

    PubMed

    Girard, Beatrice M; Merriam, Laura A; Tompkins, John D; Vizzard, Margaret A; Parsons, Rodney L

    2013-11-15

    Quantitative real-time PCR was used to test whether cavernous nerve injury leads to a decrease in major pelvic ganglia (MPG) neuronal nicotinic ACh receptor (nAChR) subunit and postsynaptic density (PSD)-93 transcript levels. Subunits α3, β4, and α7, commonly expressed in the MPG, were selected for analysis. After 72 h in explant culture, MPG transcript levels for α3, β4, α7, and PSD-93 were significantly depressed. Three days after cavernous nerve axotomy or crush in vivo, transcript levels for α3, β4, and PSD-93, but not for α7, were significantly depressed. Three days after dissection of the cavernous nerve free of underlying tissue and application of a 5-mm lateral stretch (manipulation), transcript levels for α3 and PSD-93 were also significantly decreased. Seven days after all three surgical procedures, α3 transcript levels remained depressed, but PSD-93 transcript levels were still decreased only after axotomy or nerve crush. At 30 days postsurgery, transcript levels for the nAChR subunits and PSD-93 had recovered. ACh-induced currents were significantly smaller in MPG neurons dissociated from 3-day explant cultured ganglia than from those recorded in neurons dissociated from acutely isolated ganglia; this observation provides direct evidence showing that a decrease in nAChR function was coincident with a decrease in nAChR subunit transcript levels. We conclude that a downregulation of nAChR subunit and PSD-93 expression after cavernous nerve injury, or even manipulation, could interrupt synaptic transmission within the MPG and thus contribute to the loss of neural control of urogenital organs after pelvic surgeries.

  7. Surgical cannulation of the superior ophthalmic vein for the treatment of previously embolized cavernous sinus dural arteriovenous fistulas: serial studies and angiographic follow-up.

    PubMed

    Luo, Bin; Zhang, Xin; Duan, Chuan-Zhi; He, Xu-Ying; Li, Xi-Feng; Karuna, Tamrakar; Gu, Da-Qun; Long, Xiao-Ao; Li, Tie-Lin; Zhang, Shi-Zhong; Ke, Yi-Quan; Jiang, Xiao-Dan

    2013-04-01

    The purpose of this study was to evaluate the safety and efficacy of transorbital puncture for the retreatment of previously embolized cavernous sinus dural arteriovenous fistulas (DAVFs) via a superior ophthalmic vein (SOV) approach. During a 12-year period, 9 consecutive patients with previously embolized cavernous sinus DAVFs underwent retreatment via the transorbital SOV approach. All of the nine cases of previously embolized cavernous sinus DAVFs were successfully embolized. Clinical follow-ups were conducted in all nine cases at the duration of 17-141 months (61.22 ± 39.13 months). No recanalization occurred during the follow-up period. A subtle ptosis appeared in two patients and disappeared in one of the two cases after a 4-year follow-up. One patient suffered from paroxysmal positional vertigo and bruit for nearly 2 years after the treatment, but the follow-up angiography demonstrated no recurrence. One patient had persistent visual impairment caused by the initial venous stasis retinopathy. One patient with a history of a procedure-related transient decrease in visual acuity had it return to the normal level. The remaining four cases had clear improvement in the ocular symptoms and became completely asymptomatic during the follow-up period. No patient worsened or developed new symptoms. The approach of surgical cannulation of the SOV for the retreatment of previously embolized cavernous sinus DAVFs was proved feasible and efficient, especially when the transarterial and transfemoral venous approaches were inaccessible. However, if the SOV is not dilated enough or is located deeply in the orbit, transorbital venous puncture access may not be possible.

  8. What is the origin of the arterial vascularization of the corpora cavernosa? A computer-assisted anatomic dissection study

    PubMed Central

    Diallo, Djibril; Zaitouna, Mazen; Alsaid, Bayan; Quillard, Jeannine; Droupy, Stéphane; Benoit, Gérard; Bessede, Thomas

    2013-01-01

    The purpose of this study was to identify the microscopic arterial vascularization of the corpora cavernosa (CC) of the penis using computer-assisted anatomic dissection (CAAD), determine the contribution of the different penile arteries towards this vascularization, detail the nature of cavernospongiosum shunts, and locate the anastomoses between these different arteries. Tissue specimens were taken from five donors who donated their bodies to science. The specimens were fixed in 10% formalin and sliced into a series of five 5-μm sections at intervals of 200 μm. The first section was stained with hematoxylin-eosin or Masson's trichrome and the second with anti-protein S100. The cavernous artery of the penis is not the only source of arterial vascularization of the CC. In four of the five cases studied, we found two to four perforating branches arising from the dorsal arteries of the penis that join up with the cavernous artery of the penis or that are solely responsible for the vascularization of the distal third of the penis. The bulbo-urethral and urethral arteries are situated outside of the tunica albuginea of the corpus spongiosum on their lateral and dorsal sides. The anastomoses do not occur between the cavernous artery of the penis and the corpus spongiosum but between the cavernous artery of the penis and the urethral artery on the surface of the tunica albuginea. All of these arteries are accompanied by nerve branches. The CC were found to be vascularized by both cavernous and dorsal arteries of the penis. Intrapenile vascularization is organized around four arterial axes, which are anastomosed by multiple neurovascular shunts. PMID:23981086

  9. Potential effects of recurrent low oxygen conditions on the Illinois Cave amphipod

    USGS Publications Warehouse

    Panno, S.V.; Hackley, Keith C.; Kelly, W.R.; Hwang, H.-H.; Wilhelm, F.M.; Taylor, S.J.; Stiff, B.J.

    2006-01-01

    The caves of Illinois' sinkhole plain are the sole habitat of the Illinois Cave amphipod (Gammarus acherondytes), a federally endangered species. The sinkhole plain is a hydrologically-connected sequence of karstified limestone that constitutes an extensive karst aquifer which serves as an important source of potable water for area residents. During this investigation, we examined the ground-water quality in caves within two ground-water basins: 1) Illinois Caverns, where the amphipod is now present after previously reported to have been extirpated from the lower reaches, and 2) Stemler Cave, where the amphipod is reported to have been extirpated. The chemical composition of cave streams in Illinois Caverns and Stemler Cave were compared to determine which parameters, if any, could have contributed to the loss of G. acherondytes from Stemler Cave. Stream water in Stemler Cave contained higher concentrations of organic carbon, potassium, silica, chloride, fluoride, sulfate, iron and manganese than Illinois Caverns. Perhaps most importantly, dissolved oxygen (DO) concentrations in Stemler Cave were, during periods of low flow, substantially lower than in Illinois Caverns. Based on land use, there are probably at least eight times more private septic systems in the Stemler Cave ground-water basin than in the Illinois Caverns ground-water basin. Low DO concentrations were likely the result of microbial breakdown of soil organic matter and wastewater treatment system effluent, and the oxidation of pyrite in bedrock. The near-hypoxic DO in Stemler Cave that occurred during low-flow conditions, and, we speculate, a limited range of G. acherondytes within the Stemler Cave ground-water basin due to a metabolic advantage of the stygophilic aquatic invertebrates over the stygobitic G. acherodytes, resulted in the apparent loss of G. acherondytes from Stemler Cave.

  10. Natural gas storage in bedded salt formations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Macha, G.

    1996-09-01

    In 1990 Western Resources Inc. (WRI) identified the need for additional natural gas storage capacity for its intrastate natural gas system operated in the state of Kansas. Western Resources primary need was identified as peak day deliverability with annual storage balancing a secondary objective. Consequently, an underground bedded salt storage facility, Yaggy Storage Field, was developed and placed in operation in November 1993. The current working capacity of the new field is 2.1 BCF. Seventy individual caverns are in service on the 300 acre site. The caverns vary in size from 310,000 CF to 2,600,000 CF. Additional capacity can bemore » added on the existing acreage by increasing the size of some of the smaller existing caverns by further solution mining and by development of an additional 30 potential well sites on the property.« less

  11. Spinal extradural cavernous haemangioma in an elderly man

    PubMed Central

    Rahman, Asifur; Hoque, Saif Ul; Bhandari, Paawan Bahadur; Abu Obaida, Abu Saleh Md

    2012-01-01

    Cavernous haemangiomas are vascular malformations that may affect any part of the central nervous system. Epidural haemangiomas are rare and constitute ∼4% of all epidural tumours and 12% of all intraspinal haemangiomas. These tumours enlarge slowly and produce symptoms of progressive myelopathy or radiculopathy or both. History, clinical examination, routine radiographs, MRI and histopathological studies are the aids for a definitive diagnosis. Surgery can give a very beneficial result with good functional and neurological improvement. Chance of recurrence is less after a good surgical removal. Here we present a case of spinal extradural cavernous haemangioma in a 65- year-old man who had a good functional and neurological recovery after surgery. At 9 months postoperative follow-up, he did well without any new problems with regard to recurrence. We report this case for its rarity. PMID:22878996

  12. Trigemino-cardiac reflex: occurrence of asystole during trans-sphenoidal adenomectomy: a case report.

    PubMed

    Jeon, Dae Geun; Kang, Bong Jin; Hur, Tae Won

    2014-09-01

    The trigemino-cardiac reflex has been reported to occur during various craniofacial surgeries or procedures including manipulation of the trigeminal ganglion, tumor resection in the cerebellopontine angle, various facial reconstructions and trans-sphenoidal adenomectomy. Regarding risk factors during trans-sphenoidal adenomectomy, invasiveness closely related to the size of tumor and the degree of manipulation of cavernous sinus wall have been reported. We report the case of a 40-year-old female patient who had a relatively small-sized (< 10 mm) pituitary adenoma. Repetitive asystoles occurred during microscopic trans-sphenoidal operation of the wall of the cavernous sinus, which strongly suggests the importance of careful manipulation of the cavernous sinus wall. In addition to reporting this rare complication of trans-sphenoidal adenomectomy, we reviewed its clinical management by performing a literature search.

  13. Difference of language cortex reorganization between cerebral arteriovenous malformations, cavernous malformations, and gliomas: a functional MRI study.

    PubMed

    Deng, Xiaofeng; Xu, Long; Zhang, Yan; Wang, Bo; Wang, Shuo; Zhao, Yuanli; Cao, Yong; Zhang, Dong; Wang, Rong; Ye, Xun; Wu, Jun; Zhao, Jizong

    2016-04-01

    The authors attempted to demonstrate the difference in language cortex reorganization between cerebral malformations (AVMs), cavernous malformations (CMs), and gliomas by blood oxygen level-dependent (BOLD) functional magnetic resonance imaging. Clinical and imaging data of 27 AVM patients (AVM-L group), 29 CM patients (CM-L group), and 20 glioma patients (Glioma-L group) were retrospectively reviewed, with lesions overlying the left inferior frontal gyrus (Broca area). As a control, patients with lesions involving the right inferior frontal gyrus were also enrolled, including 14 AVM patients (AVM-R group), 20 CM patients (CM-R group), and 14 glioma patients (Glioma-R group). All patients were right-handed. Lateralization indices (LI) of BOLD signal activations were calculated separately for Broca and Wernicke areas. In AVM-L group, right-sided lateralization of BOLD signals was observed in 10 patients (37.0%), including 6 in the Broca area alone, 1 in the Wernicke area alone, and 3 in both areas. Three patients (10.3%) of CM-L group showed right-sided lateralization in both Broca and Wernicke areas, and 1 patient (5.0%) of Glioma-L group had right-sided lateralization in the Wernicke area alone. A significant difference of right-sided lateralization was observed between the AVM-L group and CM-L group (P = 0.018) and also between the AVM-L group and Glioma-L group (P = 0.027). No patient in AVM-R, CM-R, or Glioma-R groups showed right-sided lateralization. Language cortex reorganization may occur in AVM, CM, and glioma patients when the traditional language cortex was involved by lesions, but the potential of reorganization for CM and glioma patients seems to be insufficient compared with AVM patients.

  14. Primary Endoscopic Transnasal Transsphenoidal Surgery for Magnetic Resonance Image-Positive Cushing Disease: Outcomes of a Series over 14 Years.

    PubMed

    Kuo, Chao-Hung; Yen, Yu-Shu; Wu, Jau-Ching; Chen, Yu-Chun; Huang, Wen-Cheng; Cheng, Henrich

    2015-09-01

    There are scant data of endoscopic transsphenoidal surgery (ETS) with adjuvant therapies of Cushing disease (CD). To report the remission rate, secondary management, and outcomes of a series of CD patients. Patients with CD with magnetic resonance imaging (MRI)-positive adenoma who underwent ETS as the first and primary treatment were included. The diagnostic criteria were a combination of 24-hour urine-free cortisol, elevated serum cortisol levels, or other tests (e.g., inferior petrosal sinus sampling). All clinical and laboratory evaluations and radiological examinations were reviewed. Forty consecutive CD patients, with an average age of 41.0 years, were analyzed with a mean follow-up of 40.2 ± 29.6 months. These included 22 patients with microadenoma and 18 with macroadenoma, including 9 cavernous invasions. The overall remission rate of CD after ETS was 72.5% throughout the entire follow-up. Patients with microadenoma or noninvasive macroadenoma had a higher remission rate than those who had macroadenoma with cavernous sinus invasion (81.8% or 77.8% vs. 44.4%, P = 0.02). After ETS, the patients who had adrenocorticotropic hormone-positive adenoma had a higher remission rate than those who had not (76.5% vs. 50%, P = 0.03). In the 11 patients who had persistent/recurrent CD after the first ETS, 1 underwent secondary ETS, 8 received gamma-knife radiosurgery (GKRS), and 2 underwent both. At the study end point, two (5%) of these CD patients had persistent CD and were under the medication of ketoconazole. For MRI-positive CD patients, primary (i.e., the first) ETS yielded an overall remission rate of 72.5%. Adjuvant therapies, including secondary ETS, GKRS, or both, yielded an ultimate remission rate of 95%. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Dumbbell-Shaped Epidural Cavernous Hemangioma in the Thoracic Spine Mimicking Schwannoma.

    PubMed

    Wang, Shantao; Wang, Mingwei; Wang, Fuchao; Yuan, Xunhui; Xiao, Hang; Bai, Yun'an; Liu, Fucun

    2016-10-01

    Dumbbell-shaped epidural cavernous hemangiomas (CHs) are extremely rare, and they are easily misdiagnosed as spinal schwannomas. Herein, the authors report 1 rare case of dumbbell-shaped epidural CH in the thoracic spine. To the best of our knowledge, only a few cases of dumbbell-shaped epidural CHs in thoracic spine have been reported. Furthermore, the clinical characteristics and treatments for spinal epidural CHs were investigated and reviewed.

  16. Congenital intraosseous cavernous hemangioma of the skull: an unusual case.

    PubMed

    Rumana, Makhdoomi; Khursheed, Nayil; Farhat, Mustafa; Othman, Salim; Masood, Laharwal

    2013-01-01

    Intraosseous hemangiomas are benign vascular malformations mostly seen in the spine. They rarely occur in the skull. The usual age-group involved is the 2nd to 4th decades, and females outnumber males. We hereby report a rare case of congenital intraosseous cavernous hemangioma of the skull bone in a male infant. The patient underwent total excision of the lesion. © 2014 S. Karger AG, Basel.

  17. Fatal Peritoneal Bleeding Following Embolization of a Carotid-Cavernous Fistula in Ehlers-Danlos Syndrome Type IV

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Usinskiene, Jurgita; Mazighi, Mikael; Bisdorff, Annouk

    2006-12-15

    We report the case of a 25-year-old woman treated for a spontaneous carotid-cavernous fistula in a context of Ehlers-Danlos syndrome type IV. Embolization with a transvenous approach was achieved without complications; however, the patient died 72 hr later of massive intraperitoneal bleeding. At autopsy, no lesion of the digestive arteries was identified. Possible causes of this bleeding are discussed.

  18. Evaluation of Computational Method of High Reynolds Number Slurry Flow for Caverns Backfilling

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bettin, Giorgia

    2015-05-01

    The abandonment of salt caverns used for brining or product storage poses a significant environmental and economic risk. Risk mitigation can in part be address ed by the process of backfilling which can improve the cavern geomechanical stability and reduce the risk o f fluid loss to the environment. This study evaluate s a currently available computational tool , Barracuda, to simulate such process es as slurry flow at high Reynolds number with high particle loading . Using Barracuda software, a parametric sequence of simu lations evaluated slurry flow at Re ynolds number up to 15000 and loading up tomore » 25%. Li mitations come into the long time required to run these simulation s due in particular to the mesh size requirement at the jet nozzle. This study has found that slurry - jet width and centerline velocities are functions of Re ynold s number and volume fractio n The solid phase was found to spread less than the water - phase with a spreading rate smaller than 1 , dependent on the volume fraction. Particle size distribution does seem to have a large influence on the jet flow development. This study constitutes a first step to understand the behavior of highly loaded slurries and their ultimate application to cavern backfilling.« less

  19. Coexistence of splenic hemangioma and vascular malformation of the vertebrae.

    PubMed

    Jalaeikhoo, Hasan; Ariana, Mehdi; Kashfi, Seyed Mohammad Hossein; Azimzadeh, Pedram; Narimani, Ahmad; Dadpay, Masoomeh; Keyhani, Manouchehr

    2016-02-09

    Cavernous hemangioma is an encapsulated mass of dilated, endothelial lined vascular channels filled with slowly flowing blood. Cavernous hemangioma of the spleen is a rare condition with less than 100 reports so far. Hemangioma of the vertebral is a benign vascular legion around one or two vertebrae. These are usually asymptomatic and discovered incidentally. In this study we reported an extreme rare case of splenic hemangioma coexistence with vascular malformation of the vertebrae. To our knowledge this is the first report of coexistence of splenic hemangioma and hemangioma of the vertebra. A 20-year-old iranian male with splenomegaly, abdominal pain, diarrhea and pancytopenia who was first highly suspicious for malignancy referred to our center for evaluation of the diagnostic workup. After full examination we detected a very rare case with a giant, solitary cavernous hemangioma of the spleen and multiple hemangiomas in his vertebrae. Histopathology of the spleen showed a large cavernous hemangioma occupying almost the entire spleen with large areas of infarction necrosis with multiple hemangiomas of the vertebrae. It is extremely rare to have a splenic hemangioma concurrent with vertebra hemangioma and this is clinically very important to consider splenic hemangioma in differential diagnosis of splenomegaly for a better therapeutic management in related patients.

  20. PET/CT and MRI of intra-osseous haemangioma of the tibia

    PubMed Central

    Cha, J G; Yoo, J H; Kim, H K; Park, J M; Paik, S H; Park, S J

    2012-01-01

    Intra-osseous haemangioma is a rare, benign neoplasm that usually involves the vertebrae and craniofacial bones. Furthermore, its occurrence in the long bones is extremely rare. We report the findings of fluorine-18-fludeoxyglucose (18F-FDG) positron emission tomography (PET)/CT and MRI in a patient with intra-osseous haemangioma in the proximal tibia, who was initially misdiagnosed as having a malignancy based on 18F-FDG PET/CT. 18F-FDG PET/CT showed a well-marginated osteolytic lesion with abnormal FDG uptake. The mass demonstrated low signal intensity on T1 weighted MRI. On T2 weighted images, the lesion appeared as a cluster of high signal intensity lobules and showed strong enhancement on contrast-enhanced T1 weighted images. Surgical curettage was performed and histopathological examination of the excised tissue confirmed a cavernous haemangioma. PMID:22457416

  1. Refractory seizures due to a dural-based cavernoma masquerading as a meningioma.

    PubMed

    Zeng, Xianwei; Mahta, Ali; Kim, Ryan Y; Saad, Ali G; Kesari, Santosh

    2012-04-01

    A 37-year-old female presented with medically intractable complex partial seizures with secondary generalization. She was found to have a dural-based lesion with radiologic features of meningioma. A gross total resection was performed and pathology confirmed a diagnosis of cavernous angioma and she became seizure free after the surgical resection. Cavernous angioma should be considered in differential diagnosis of a dural-based lesion manifesting with refractory seizures.

  2. Asymptotic solution of the problem for a thin axisymmetric cavern

    NASA Technical Reports Server (NTRS)

    Serebriakov, V. V.

    1973-01-01

    The boundary value problem which describes the axisymmetric separation of the flow around a body by a stationary infinite stream is considered. It is understood that the cavitation number varies over the length of the cavern. Using the asymptotic expansions for the potential of a thin body, the orders of magnitude of terms in the equations of the problem are estimated. Neglecting small quantities, a simplified boundary value problem is obtained.

  3. Study on Excavation of Particular Part of Underground Cavern for Hydropower Station

    NASA Astrophysics Data System (ADS)

    Yang, Yang; Zhang, Feng; Shang, Qin; Zheng, Huakang

    2018-01-01

    In the present study, regarding four particular parts of underground cavern for hydropower station, i.e., crown, high sidewall, the intersection between high sidewall and tunnel and tailrace tunnel, by summarizing the previous construction experience, we have proposed the excavation approach based on “middle first and edge later, soft first and hard later”, “layered construction by excavating the thin layer first and supporting as the layer advances”, “tunnel first and wall later, small tunnels into large ones” and “excavating tunnels supported by separation piers”. In addition, the proposed excavation approach has been analyzed and verified with finite element numerical simulation. The result has indicated that the proposed special approach is reasonable and effective to reduce the turbulence on surrounding rocks, lower the influence of unloading during excavating and enhance the local and global stability of caverns and surrounding rocks.

  4. Cataract surgery in a case of carotid cavernous fistula

    PubMed Central

    Nair, Akshay Gopinathan; Praveen, Smita Vittal; Noronha, Veena Olma

    2014-01-01

    A carotid-cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF. PMID:25370401

  5. History of Hubble Space Telescope (HST)

    NASA Image and Video Library

    1995-01-01

    These eerie, dark, pillar-like structures are actually columns of cool interstellar hydrogen gas and dust that are also incubators for new stars. The pillars protrude from the interior wall of a dark molecular cloud like stalagmites from the floor of a cavern. They are part of the Eagle Nebula (also called M16), a nearby star-forming region 7,000 light-years away, in the constellation Serpens. The ultraviolet light from hot, massive, newborn stars is responsible for illuminating the convoluted surfaces of the columns and the ghostly streamers of gas boiling away from their surfaces, producing the dramatic visual effects that highlight the three-dimensional nature of the clouds. This image was taken on April 1, 1995 with the Hubble Space Telescope Wide Field Planetary Camera 2. The color image is constructed from three separate images taken in the light of emission from different types of atoms. Red shows emissions from singly-ionized sulfur atoms, green shows emissions from hydrogen, and blue shows light emitted by doubly-ionized oxygen atoms.

  6. Combined Dynamic Contrast Enhanced Liver MRI and MRA Using Interleaved Variable Density Sampling

    PubMed Central

    Rahimi, Mahdi Salmani; Korosec, Frank R.; Wang, Kang; Holmes, James H.; Motosugi, Utaroh; Bannas, Peter; Reeder, Scott B.

    2014-01-01

    Purpose To develop and evaluate a method for volumetric contrast-enhanced MR imaging of the liver, with high spatial and temporal resolutions, for combined dynamic imaging and MR angiography using a single injection of contrast. Methods An interleaved variable density (IVD) undersampling pattern was implemented in combination with a real-time-triggered, time-resolved, dual-echo 3D spoiled gradient echo sequence. Parallel imaging autocalibration lines were acquired only once during the first time-frame. Imaging was performed in ten subjects with focal nodular hyperplasia (FNH) and compared with their clinical MRI. The angiographic phase of the proposed method was compared to a dedicated MR angiogram acquired during a second injection of contrast. Results A total of 21 FNH, 3 cavernous hemangiomas, and 109 arterial segments were visualized in 10 subjects. The temporally-resolved images depicted the characteristic arterial enhancement pattern of the lesions with a 4 s update rate. Images were graded as having significantly higher quality compared to the clinical MRI. Angiograms produced from the IVD method provided non-inferior diagnostic assessment compared to the dedicated MRA. Conclusion Using an undersampled IVD imaging method, we have demonstrated the feasibility of obtaining high spatial and temporal resolution dynamic contrast-enhanced imaging and simultaneous MRA of the liver. PMID:24639130

  7. Cavernous hemangioma of the rib: a rare diagnosis.

    PubMed

    Gourgiotis, Stavros; Piyis, Anastasios; Panagiotopoulos, Nikolaos; Panayotopoulos, Panayotis; Salemis, Nikolaos S

    2010-01-01

    Hemangioma of the rib is an uncommon benign vascular tumour. A case of rib hemangioma in a 29-year-old woman is presented. Chest roentgenogram and computed tomography revealed a mass along the inner surface of the 7th left rib with bone destruction. She underwent resection of the 7th rib. The pathologic diagnosis was cavernous hemangioma. Hemangiomas of the rib are rare tumours but should be kept in mind in the differential diagnosis of rib tumours.

  8. [The sequential use of local vacuum magnetotherapy and papaverine electrophoresis with sinusoidal modulated currents in impotence].

    PubMed

    Karpukhin, I V; Bogomol'nyĭ, V A

    1997-01-01

    105 patients with chronic nonspecific prostatitis were examined and treated with papaverin electrophoresis using sinusoidal modulated currents (SMC) and local vacuum magnetotherapy (LVMT). Papaverin SMC electrophoresis and LVMT stimulated cavernous circulation. The highest stimulation was achieved at successive use of LVMT and the electrophoresis. LVMT followed by the electrophoresis maintained good cavernous circulation for 5-6 hours after the procedure in the course of which several spontaneous erections were observed.

  9. Cavernous sinus syndrome in a Holstein bull.

    PubMed

    Jacob, Sarah I; Drees, Randi; Pinkerton, Marie E; Bentley, Ellison M; Peek, Simon F

    2015-03-01

    A 13-month-old Holstein bull was presented for right-sided exophthalmos. Ophthalmologic examination noted that the animal was visual in both eyes, but that the right pupil was persistently dilated and very sluggish to constrict when stimulated with a bright light and that normal ocular motility was absent. Fundic examination of the right eye was normal as was a complete ophthalmologic examination of the left eye. Radiographs at presentation did not reveal the presence of sinusitis or other skull abnormalities. Initial treatment comprised intravenous antibiotics and anti-inflammatories for orbital inflammation over a 14-day period. There was no perceptible change in the appearance or neuro-ophthalmologic examination of the right eye during hospitalization. The animal was discharged to the owner's care, but 3 weeks later was found recumbent with unilateral strabismus of the left eye and a fixed right pupil. Due to the inability to rise and rapid deterioration, humane euthanasia was performed, and a full postmortem examination, preceded by a MRI, was performed that identified abscesses extending bilaterally through the round foramina obliterating the cavernous sinus region, as well as abscessation of the right mandible, right trigeminal neuritis, right-sided sinusitis, and right-sided otitis media. Cavernous sinus syndrome should be considered in cattle with a combination of exophthalmos and neuro-ophthalmologic abnormalities involving cranial nerves III, IV, V, and VI, whose branches are located within the cavernous sinus. © 2013 American College of Veterinary Ophthalmologists.

  10. Micro-CT Imaging Reveals Mekk3 Heterozygosity Prevents Cerebral Cavernous Malformations in Ccm2-Deficient Mice

    PubMed Central

    Choi, Jaesung P.; Foley, Matthew; Zhou, Zinan; Wong, Weng-Yew; Gokoolparsadh, Naveena; Arthur, J. Simon C.; Li, Dean Y.; Zheng, Xiangjian

    2016-01-01

    Mutations in CCM1 (aka KRIT1), CCM2, or CCM3 (aka PDCD10) gene cause cerebral cavernous malformation in humans. Mouse models of CCM disease have been established by deleting Ccm genes in postnatal animals. These mouse models provide invaluable tools to investigate molecular mechanism and therapeutic approaches for CCM disease. However, the full value of these animal models is limited by the lack of an accurate and quantitative method to assess lesion burden and progression. In the present study we have established a refined and detailed contrast enhanced X-ray micro-CT method to measure CCM lesion burden in mouse brains. As this study utilized a voxel dimension of 9.5μm (leading to a minimum feature size of approximately 25μm), it is therefore sufficient to measure CCM lesion volume and number globally and accurately, and provide high-resolution 3-D mapping of CCM lesions in mouse brains. Using this method, we found loss of Ccm1 or Ccm2 in neonatal endothelium confers CCM lesions in the mouse hindbrain with similar total volume and number. This quantitative approach also demonstrated a rescue of CCM lesions with simultaneous deletion of one allele of Mekk3. This method would enhance the value of the established mouse models to study the molecular basis and potential therapies for CCM and other cerebrovascular diseases. PMID:27513872

  11. Pituitary xanthogranulomas: clinical features, radiological appearances and post-operative outcomes.

    PubMed

    Ved, R; Logier, N; Leach, P; Davies, J S; Hayhurst, C

    2018-06-01

    Xanthogranulomas are inflammatory masses most commonly found at peripheral sites such as the skin. Sellar and parasellar xanthogranulomas are rare and present a diagnostic challenge as they are difficult to differentiate from other sellar lesions such as craniopharyngiomas and Rathke's cleft cysts pre-operatively. Their radiological imaging features are yet to be clearly defined, and clinical outcomes after surgery are also uncertain. This study reviews clinical presentation, radiological appearances, and clinical outcomes in a cohort of patients with pituitary xanthogranulomas. A prospectively maintained pituitary surgery database was screened for histologically confirmed pituitary xanthogranulomas between May 2011-December 2016. Retrospective case note assessments were then performed by three independent reviewers. Patient demographics, clinical presentations, imaging, and clinical outcomes were analysed. During the study period 295 endoscopic endonasal pituitary surgeries were performed. Six patients had confirmed pituitary xanthogranulomas (2%). Patients most commonly presented with visual field deficits and/or endocrine dysfunction. Common imaging features included: a cystic consistency, hyperintensity on T1-weighted MR images, and contrast enhancement either peripherally (n = 3) or homogenously (n = 3). The most common pre-operative endocrine deficits were hyperprolactinaemia and hypoadrenalism (at least one of which was identified in 4/6 patients; 66%). Thirty-three percent (2/6) of patients presented with diabetes insipidus. The most common post-operative endocrinological deficits were adrenocortical dysfunction (66%) and gonadotropin deficiency (66%). Visual assessments normalised in all six patients post-operatively. Gross total resection was achieved in all patients, and at median follow up of 33.5 months there were no cases of tumour recurrence. The prevalence of pituitary xanthogranulomas in our series is higher than that suggested in the literature. Surgery restored normal vision to all cases, however four patients (67%) required long-term hormonal replacement post-operatively. Imaging features such peripheral rim enhancement, a suprasellar tumour epicentre, and the absence of both calcification or cavernous sinus invasion were identified as potential indicators that together should alert clinicians to the possibility of pituitary xanthogranuloma when assessing patients with cystic sellar and parasellar tumours.

  12. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Neal, J.T.; Magorian, T.R.; Ahmad, S.

    This report revises the original report that was published in 1980. Some of the topics covered in the earlier report were provisional and it is now practicable to reexamine them using new or revised geotechnical data and that obtained from SPR cavern operations, which involves 16 new caverns. Revised structure maps and sections show interpretative differences as compared with the 1980 report and more definition in the dome shape and caprock structural contours, especially a major southeast-northwest trending anomalous zone. The original interpretation was of westward tilt of the dome, this revision shows a tilt to the southeast, consistent withmore » other gravity and seismic data. This interpretation refines the evaluation of additional cavern space, by adding more salt buffer and allowing several more caverns. Additional storage space is constrained on this nearly full dome because of low-lying peripheral wetlands, but 60 MMBBL or more of additional volume could be gained in six or more new caverns. Subsidence values at Bryan Mound are among the lowest in the SPR system, averaging about 11 mm/yr (0.4 in/yr), but measurement and interpretation issues persist, as observed values are about the same as survey measurement accuracy. Periodic flooding is a continuing threat because of the coastal proximity and because peripheral portions of the site are at elevations less than 15 ft. This threat may increase slightly as future subsidence lowers the surface, but the amount is apt to be small. Caprock integrity may be affected by structural features, especially the faulting associated with anomalous zones. Injection wells have not been used extensively at Bryan Mound, but could be a practicable solution to future brine disposal needs. Environmental issues center on the areas of low elevation that are below 15 feet above mean sea level: the coastal proximity and lowland environment combined with the potential for flooding create conditions that require continuing surveillance.« less

  13. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hinkebein, Thomas E.

    The intrusion of gas into oils stored within the SPR has been examined. When oil is stored in domal salts, gases intrude into the stored oil from the surrounding salt. Aspects of the mechanism of gas intrusion have been examined. In all cases, this gas intrusion results in increases in the oil vapor pressure. Data that have been gathered from 1993 to August 2002 are presented to show the resultant increases in bubble-point pressure on a cavern-by-cavern as well as on a stream basis. The measurement techniques are presented with particular emphasis on the TVP 95. Data analysis methods aremore » presented to show the methods required to obtain recombined cavern oil compositions. Gas-oil ratios are also computed from the data and are presented on a cavern-by-cavern and stream basis. The observed increases in bubble-point pressure and gas-oil ratio are further statistically analyzed to allow data interpretation. Emissions plume modeling is used to determine adherence to state air regulations. Gas intrusion is observed to be variable among the sites and within each dome. Gas intrusions at Bryan Mound and Big Hill have resulted in the largest increases in bubble-point pressure for the Strategic Petroleum Reserve (SPR). The streams at Bayou Choctaw and West Hackberry show minimal bubble-point pressure increases. Emissions plume modeling, using the state mandated ISCST code, of oil storage tanks showed that virtually no gas may be released when H2S standards are considered. DOE plans to scavenge H2S to comply with the very tight standards on this gas. With the assumption of scavenging, benzene releases become the next most controlling factor. Model results show that a GOR of 0.6 SCF/BBL may be emissions that are within standards. Employing the benzene gas release standard will significantly improve oil deliverability. New plume modeling using the computational fluid dynamics code, FLUENT, is addressing limitations of the state mandated ISCST model.« less

  14. The anatomical location and laterality of orbital cavernous haemangiomas.

    PubMed

    McNab, Alan A; Selva, Dinesh; Hardy, Thomas G; O'Donnell, Brett

    2014-10-01

    To determine the anatomical location and laterality of orbital cavernous haemangiomas (OCH). Retrospective case series. The records of 104 patients with OCH were analyzed. The anatomical location of each OCH defined by the location of a point at the centre of the lesion, and its laterality. There were 104 patients included in the study. No patient had more than one lesion. Sixteen (15.4%) were located in the anterior third of the orbit, 74 (71.2%) were in the middle third, and 14 (13.5%) in the posterior third. In the middle third, 10 of 74 (13.5%) were extraconal and 64 intraconal (86.5%), with 30 of 64 (46.9%) middle third intraconal lesions lying lateral to the optic nerve. Of 104 lesions, 56 (53.8%) were left sided, showing a trend towards a predilection for the left side (p = 0.065). If data from other published series which included data on laterality is added to our own data and analysed, 270 of 468 (57.7%) OCH occurred in the left orbit (p < 0.005). OCH may occur at almost any location within the orbit. The commonest location is the middle third of the orbit, in the intraconal space lateral to the optic nerve. This may reflect an origin of these lesions from the arterial side of the circulation, as there are more small arteries in the intraconal space lateral to the optic nerve than in other locations. A predilection for the left orbit remains unexplained.

  15. Cavernous Hemangioma of the Rib: A Rare Diagnosis

    PubMed Central

    Gourgiotis, Stavros; Piyis, Anastasios; Panagiotopoulos, Nikolaos; Panayotopoulos, Panayotis; Salemis, Nikolaos S.

    2010-01-01

    Hemangioma of the rib is an uncommon benign vascular tumour. A case of rib hemangioma in a 29-year-old woman is presented. Chest roentgenogram and computed tomography revealed a mass along the inner surface of the 7th left rib with bone destruction. She underwent resection of the 7th rib. The pathologic diagnosis was cavernous hemangioma. Hemangiomas of the rib are rare tumours but should be kept in mind in the differential diagnosis of rib tumours. PMID:20585365

  16. Hemothorax associated with telangiectatic osteosarcoma in a dog.

    PubMed

    Mahaffey, E A; Greene, C E

    1985-08-01

    Hemothorax in a dog was attributed to bleeding from an intrathoracic mass attached to the sixth through the tenth ribs. The mass contained numerous cavernous, blood-filled spaces as well as bands of osteoid and occasional foci of osseous tissue. The diagnosis was telangiectatic osteosarcoma. Telangiectatic osteosarcoma is an uncommon variant of osteosarcoma. Cavernous, blood-filled spaces and paucity of bone are important histologic features. Metastasis was described in one of the seven telangiectatic osteosarcomas reported in dogs, and none was found in this case.

  17. Benign mass in tonsil- cavernous hemangioma.

    PubMed

    Joseph, Sumitha; Prakash, M; Mohammed, Hafida K; Govar, Aberna

    2013-10-01

    Cavernous hemangioma is also called as 'ANGIOMA CAVERNOSUM' or 'CAVERNOMA' as benign lesion of blood vessels. They are similar to strawberry hemangioma but deeply situated. Although most often associated with skin it is also sometimes found in mucous membrane, brain and the viscera. The diagnosis of hemangiomas is mainly based on clinical evaluation . Isolated hemangiomas in the tonsillar tissue is a rare occurance. In this we report had a case of adult tonsillar hemangioma of left side associated with recurrent tonsillitis . He was effectively managed surgically without any complications.

  18. Expert system for controlling plant growth in a contained environment

    NASA Technical Reports Server (NTRS)

    May, George A. (Inventor); Lanoue, Mark Allen (Inventor); Bethel, Matthew (Inventor); Ryan, Robert E. (Inventor)

    2011-01-01

    In a system for optimizing crop growth, vegetation is cultivated in a contained environment, such as a greenhouse, an underground cavern or other enclosed space. Imaging equipment is positioned within or about the contained environment, to acquire spatially distributed crop growth information, and environmental sensors are provided to acquire data regarding multiple environmental conditions that can affect crop development. Illumination within the contained environment, and the addition of essential nutrients and chemicals are in turn controlled in response to data acquired by the imaging apparatus and environmental sensors, by an "expert system" which is trained to analyze and evaluate crop conditions. The expert system controls the spatial and temporal lighting pattern within the contained area, and the timing and allocation of nutrients and chemicals to achieve optimized crop development. A user can access the "expert system" remotely, to assess activity within the growth chamber, and can override the "expert system".

  19. Expert system for controlling plant growth in a contained environment

    NASA Technical Reports Server (NTRS)

    May, George A. (Inventor); Lanoue, Mark Allen (Inventor); Bethel, Matthew (Inventor); Ryan, Robert E. (Inventor)

    2009-01-01

    In a system for optimizing crop growth, vegetation is cultivated in a contained environment, such as a greenhouse, an underground cavern or other enclosed space. Imaging equipment is positioned within or about the contained environment, to acquire spatially distributed crop growth information, and environmental sensors are provided to acquire data regarding multiple environmental conditions that can affect crop development. Illumination within the contained environment, and the addition of essential nutrients and chemicals are in turn controlled in response to data acquired by the imaging apparatus and environmental sensors, by an ''expert system'' which is trained to analyze and evaluate crop conditions. The expert system controls the spatial and temporal lighting pattern within the contained area, and the timing and allocation of nutrients and chemicals to achieve optimized crop development. A user can access the ''expert system'' remotely, to assess activity within the growth chamber, and can override the ''expert system''.

  20. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pokhrel, D; Sood, S; Badkul, R

    Purpose: To compare dose distributions calculated using PB-hete vs. XVMC algorithms for SRT treatments of cavernous sinus tumors. Methods: Using PB-hete SRT, five patients with cavernous sinus tumors received the prescription dose of 25 Gy in 5 fractions for planning target volume PTV(V100%)=95%. Gross tumor volume (GTV) and organs at risk (OARs) were delineated on T1/T2 MRI-CT-fused images. PTV (range 2.1–84.3cc, mean=21.7cc) was generated using a 5mm uniform-margin around GTV. PB-hete SRT plans included a combination of non-coplanar conformal arcs/static beams delivered by Novalis-TX consisting of HD-MLCs and a 6MV-SRS(1000 MU/min) beam. Plans were re-optimized using XVMC algorithm with identicalmore » beam geometry and MLC positions. Comparison of plan specific PTV(V99%), maximal, mean, isocenter doses, and total monitor units(MUs) were evaluated. Maximal dose to OARs such as brainstem, optic-pathway, spinal cord, and lenses as well as normal tissue volume receiving 12Gy(V12) were compared between two algorithms. All analysis was performed using two-tailed paired t-tests of an upper-bound p-value of <0.05. Results: Using either algorithm, no dosimetrically significant differences in PTV coverage (PTVV99%,maximal, mean, isocenter doses) and total number of MUs were observed (all p-values >0.05, mean ratios within 2%). However, maximal doses to optic-chiasm and nerves were significantly under-predicted using PB-hete (p=0.04). Maximal brainstem, spinal cord, lens dose and V12 were all comparable between two algorithms, with exception of one patient with the largest PTV who exhibited 11% higher V12 with XVMC. Conclusion: Unlike lung tumors, XVMC and PB-hete treatment plans provided similar PTV coverage for cavernous sinus tumors. Majority of OARs doses were comparable between two algorithms, except for small structures such as optic chiasm/nerves which could potentially receive higher doses when using XVMC algorithm. Special attention may need to be paid on a case-by-case basis when planning for sinus SRT based on tumor size and location to OARs particularly the optic apparatus.« less

  1. Surgery for juvenile nasopharyngeal angiofibroma with lateral extension to the infratemporal fossa.

    PubMed

    Yamada, Masato; Tsunoda, Atsunobu; Tokumaru, Takao; Aoyagi, Masaru; Kawano, Yoshihisa; Yano, Tomoyuki; Kishimoto, Seiji

    2014-08-01

    The study aimed to assess the usefulness of skull base surgery for large juvenile nasopharyngeal angiofibroma (JNA) with lateral extension to the infratemporal fossa. Eleven cases were enrolled for this study, and the mean age was 17.7 years old (range: 8-32). Six out of 11 cases underwent surgery as an initial treatment, and the other five underwent secondary surgery after initial surgery or radiotherapy in other institutions. The range of extension of tumor, feeding arteries, surgical approach, and treatment outcome were estimated. All tumors originated from the sphenopalatine foramen. Based on the imaging study, there was extension to the cavernous sinus observed in eight cases, as well as to the middle cranial fossa (8), orbit (4), and anterior cranial fossa (1). These tumors were diagnosed as Andrews' Stage IVa (3) and IVb (8). However, infiltration into the cavernous sinus was observed in one case only during surgery. Ten tumors were separated carefully from the cavernous sinus or dura and were accurately diagnosed as Stage IIIb. In all cases, the main arterial feeders of the JNAs were branches of the external carotid artery, which were embolized prior to surgery. However, 10 cases were also fed by branches of the internal carotid artery (branches of the ophthalmic artery), in which these arteries could not be embolized. Coronal skin incision (1) and a facial dismasking flap (9) were used, and in one case, wide lateral skin incision with temporary incision of the facial nerve was applied. The orbito-zygomatic approach and its modification was applied to all the cases. Fronto-lateral craniotomy was applied in four cases and lateral craniotomy in seven cases. Total resection was achieved in 10 cases and subtotal resection in one case. No mortality was noted in this series. Temporal trismus was observed in all cases which subsided gradually. Cheek numbness and facial palsy were observed in three and two cases, respectively. Coupled with craniotomy, tumor removal was successfully carried out in 11 patients with JNAs, which showed large lateral extension. Our surgical strategy is a safe and effective approach for the removal of JNAs with infratemporal fossa extension. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Trigeminofacial reflex: a means of detecting proximity to ophthalmic and maxillary divisions of the trigeminal nerve during surgery.

    PubMed

    AlMasri, Omar A; Brown, Emma E; Forster, Alan; Kamel, Mahmoud H

    2014-11-01

    The aim in this paper was to localize and detect incipient damage to the ophthalmic and maxillary branches of the trigeminal nerve during tumor surgery. This was an observational study of patients with skull base, retroorbital, or cavernous sinus tumors warranting dissection toward the cavernous sinus at a university hospital. Stimuli were applied as normal during approach to the cavernous sinus to localize cranial nerves (CNs) III, IV, and VI. Recordings were also obtained from the facial muscles to localize CN VII. The trigeminofacial reflex was sought simply by observing a longer time base routinely. Clear facial electromyography responses were reproduced when stimuli were applied to the region of V1, V2, and V3. Response latency was increased compared with direct CN VII stimuli seen in some cases. Responses gave early warning of approach to these sensory trigeminal branches. The authors submit this as a new technique, which may improve the chances of preserving trigeminal sensory branches during surgery in this region.

  3. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rudeen, David Keith; Weber, Paula D.; Lord, David L.

    The U.S. Strategic Petroleum Reserve implemented the first stage of a leach plan in 2011-2012 to expand storage volume in the existing Bryan Mound 113 cavern from a starting volume of 7.4 million barrels (MMB) to its design volume of 11.2 MMB. The first stage was terminated several months earlier than expected in August, 2012, as the upper section of the leach zone expanded outward more quickly than design. The oil-brine interface was then re-positioned with the intent to resume leaching in the second stage configuration. This report evaluates the as-built configuration of the cavern at the end of themore » first stage, and recommends changes to the second stage plan in order to accommodate for the variance between the first stage plan and the as-built cavern. SANSMIC leach code simulations are presented and compared with sonar surveys in order to aid in the analysis and offer projections of likely outcomes from the revised plan for the second stage leach.« less

  4. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dachman, A.H.; Lichtenstein, J.E.; Friedman, A.C.

    Infantile hemangioendothelioma is the most common symptomatic vascular liver tumor of infancy. It is considered a benign tumor; however, aggressive behavior is occasionally seen microscopically, and rarely distant metastases have been reported. The exact incidence of infantile hemangioendothelioma is difficult to determine because often it has been either misdiagnosed or mislabeled as cavernous hemangioma in the literature. Cavernous hemangioma is the most common primary liver tumor in older age groups but is rarely found in infants as a clinically significant tumor. Levick and Rubie were the first to recognize an association between hemangioendothelioma of the liver and congestive heart failure,more » and there were subsequent reports substantiating this association. However, it is our impression and the finding of others that congestive heart failure is distinctly less common than abdominal mass or hepatomegaly as the presenting sign in infantile hemangioendothelioma. Congestive heart failure is rarely a feature of cavernous hemangioma. Because of the errors in terminology and questions regarding clinical presentation, a radiologic-pathologic-clinical correlation study of infantile hemangioendothelioma and review of the literature was undertaken.« less

  5. Characterization of mixing and yield stress of pretreated wheat straw slurries used for the production of biofuels through tomography technique.

    PubMed

    Naghavi-Anaraki, Yasaman; Turcotte, Ginette; Ein-Mozaffari, Farhad

    2018-05-29

    Wheat straw is a low-cost feedstock for the production of biofuel. Pretreatment process is an important stage in producing biofuels since it makes the fibers more accessible to enzymatic hydrolysis which is the final step of producing biofuels. Pretreated wheat straw (PWS) slurries are non-Newtonian fluids with yield stress. Mixing of fluids exhibiting yield stress such as the pretreated wheat straw slurry results in the generation of cavern, which is a fully-mixed zone, around the impeller and the stationary regions elsewhere, which causes difficulties in the production of biofuels. In this study, the non-invasive electrical resistance tomography technique was utilized to determine the cavern dimensions as a function of the impeller type and impeller speed. The cavern sizes were then used to measure the yield stress of PWS slurries as a function of fiber size (≤ 2 and ≤ 6 mm) and fiber concentration (6, 8, and 10 wt%).

  6. Micro-Macro Analysis and Phenomenological Modelling of Salt Viscous Damage and Application to Salt Caverns

    NASA Astrophysics Data System (ADS)

    Zhu, Cheng; Pouya, Ahmad; Arson, Chloé

    2015-11-01

    This paper aims to gain fundamental understanding of the microscopic mechanisms that control the transition between secondary and tertiary creep around salt caverns in typical geological storage conditions. We use a self-consistent inclusion-matrix model to homogenize the viscoplastic deformation of halite polycrystals and predict the number of broken grains in a Representative Elementary Volume of salt. We use this micro-macro modeling framework to simulate creep tests under various axial stresses, which gives us the critical viscoplastic strain at which grain breakage (i.e., tertiary creep) is expected to occur. The comparison of simulation results for short-term and long-term creep indicates that the initiation of tertiary creep depends on the stress and the viscoplastic strain. We use the critical viscoplastic deformation as a yield criterion to control the transition between secondary and tertiary creep in a phenomenological viscoplastic model, which we implement into the Finite Element Method program POROFIS. We model a 850-m-deep salt cavern of irregular shape, in axis-symmetric conditions. Simulations of cavern depressurization indicate that a strain-dependent damage evolution law is more suitable than a stress-dependent damage evolution law, because it avoids high damage concentrations and allows capturing the formation of a damaged zone around the cavity. The modeling framework explained in this paper is expected to provide new insights to link grain breakage to phenomenological damage variables used in Continuum Damage Mechanics.

  7. Fractionated Proton Radiotherapy for Benign Cavernous Sinus Meningiomas

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Slater, Jerry D., E-mail: jdslater@dominion.llumc.edu; Loredo, Lilia N.; Chung, Arthur

    2012-08-01

    Purpose: To evaluate the efficacy of fractionated proton radiotherapy for a population of patients with benign cavernous sinus meningiomas. Methods and Materials: Between 1991 and 2002, 72 patients were treated at Loma Linda University Medical Center with proton therapy for cavernous sinus meningiomas. Fifty-one patients had biopsy or subtotal resection; 47 had World Health Organization grade 1 pathology. Twenty-one patients had no histologic verification. Twenty-two patients received primary proton therapy; 30 had 1 previous surgery; 20 had more than 1 surgery. The mean gross tumor volume was 27.6 cm{sup 3}; mean clinical target volume was 52.9 cm{sup 3}. Median totalmore » doses for patients with and without histologic verification were 59 and 57 Gy, respectively. Mean and median follow-up periods were 74 months. Results: The overall 5-year actuarial control rate was 96%; the control rate was 99% in patients with grade 1 or absent histologic findings and 50% for those with atypical histology. All 21 patients who did not have histologic verification and 46 of 47 patients with histologic confirmation of grade 1 tumor demonstrated disease control at 5 years. Control rates for patients without previous surgery, 1 surgery, and 2 or more surgeries were 95%, 96%, and 95%, respectively. Conclusions: Fractionated proton radiotherapy for grade 1 cavernous sinus meningiomas achieves excellent control rates with minimal toxicities, regardless of surgical intervention or use of histologic diagnosis. Disease control for large lesions can be achieved by primary fractionated proton therapy.« less

  8. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lord, Anna C.

    The U.S. Strategic Petroleum Reserve (SPR) is a stockpile of emergency crude oil to be tapped into if a disruption in the nation's oil supply occurs. The SPR is comprised of four salt dome sites. Subsidence surveys have been conducted either annually or biennially at all four sites over the life of the program. Monitoring of surface behavior is a first line defense to detecting possible subsurface cavern integrity issues. Over the life of the Bryan Mound site, subsidence rates over abandoned Cavern 3 have continuously been the highest at the site. In an effort to try and understand themore » subsurface dynamics, specifically over Bryan Mound Cavern 3, historic interferometric synthetic aperture radar (InSAR) data was acquired and processed by TRE Altamira. InSAR involves the processing of multiple satellite synthetic aperture radar scenes acquired across the same location of the Earth's surface at different times to map surface deformation. The analysis of the data has the ability to detect millimeters of motion spanning days, months, year and decades, across specific sites. The intent in regards to the Bryan Mound site was (1) to confirm the higher subsidence rates recorded over abandoned Cavern 3 indicated by land survey and (2) understand the regional surface behavior. This report describes the InSAR analysis results, how those results compare to the historical collection of land survey data, and what additional information the data has provided towards understanding the response recorded at the surface.« less

  9. Simultaneous cell death in the trigeminal ganglion and in ganglion neurons present in the oculomotor nerve of the bovine fetus.

    PubMed Central

    Bortolami, R; Lucchi, M L; Callegari, E; Barazzoni, A M; Costerbosa, G L; Scapolo, P A

    1990-01-01

    A well-developed ganglion and scattered ganglion cells are present in the intracranial portion of the oculomotor nerve during the first half of fetal life in the ox. In the second half of fetal life a dramatic reduction of the ganglion cells associated with the oculomotor nerve occurs because of spontaneous cell death. Concomitantly, the same phenomenon of cell death is found in the trigeminal ganglion, especially in its rostromedial portion. Free degenerating perikarya can be found in the cavernous sinus. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 PMID:2384329

  10. Fracture Dissolution of Carbonate Rock: An Innovative Process for Gas Storage

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    James W. Castle; Ronald W. Falta; David Bruce

    2006-10-31

    The goal of the project is to develop and assess the feasibility and economic viability of an innovative concept that may lead to commercialization of new gas-storage capacity near major markets. The investigation involves a new approach to developing underground gas storage in carbonate rock, which is present near major markets in many areas of the United States. Because of the lack of conventional gas storage and the projected growth in demand for storage capacity, many of these areas are likely to experience shortfalls in gas deliverability. Since depleted gas reservoirs and salt formations are nearly non-existent in many areas,more » alternatives to conventional methods of gas storage are required. The need for improved methods of gas storage, particularly for ways to meet peak demand, is increasing. Gas-market conditions are driving the need for higher deliverability and more flexibility in injection/withdrawal cycling. In order to meet these needs, the project involves an innovative approach to developing underground storage capacity by creating caverns in carbonate rock formations by acid dissolution. The basic concept of the acid-dissolution method is to drill to depth, fracture the carbonate rock layer as needed, and then create a cavern using an aqueous acid to dissolve the carbonate rock. Assessing feasibility of the acid-dissolution method included a regional geologic investigation. Data were compiled and analyzed from carbonate formations in six states: Indiana, Ohio, Kentucky, West Virginia, Pennsylvania, and New York. To analyze the requirements for creating storage volume, the following aspects of the dissolution process were examined: weight and volume of rock to be dissolved; gas storage pressure, temperature, and volume at depth; rock solubility; and acid costs. Hydrochloric acid was determined to be the best acid to use because of low cost, high acid solubility, fast reaction rates with carbonate rock, and highly soluble products (calcium chloride) that allow for the easy removal of calcium waste from the well. Physical and chemical analysis of core samples taken from prospective geologic formations for the acid dissolution process confirmed that many of the limestone samples readily dissolved in concentrated hydrochloric acid. Further, some samples contained oily residues that may help to seal the walls of the final cavern structure. These results suggest that there exist carbonate rock formations well suited for the dissolution technology and that the presence of inert impurities had no noticeable effect on the dissolution rate for the carbonate rock. A sensitivity analysis was performed for characteristics of hydraulic fractures induced in carbonate formations to enhance the dissolution process. Multiple fracture simulations were conducted using modeling software that has a fully 3-D fracture geometry package. The simulations, which predict the distribution of fracture geometry and fracture conductivity, show that the stress difference between adjacent beds is the physical property of the formations that has the greatest influence on fracture characteristics by restricting vertical growth. The results indicate that by modifying the fracturing fluid, proppant type, or pumping rate, a fracture can be created with characteristics within a predictable range, which contributes to predicting the geometry of storage caverns created by acid dissolution of carbonate formations. A series of three-dimensional simulations of cavern formation were used to investigate three different configurations of the acid-dissolution process: (a) injection into an open borehole with production from that same borehole and no fracture; (b) injection into an open borehole with production from that same borehole, with an open fracture; and (c) injection into an open borehole connected by a fracture to an adjacent borehole from which the fluids are produced. The two-well configuration maximizes the overall mass transfer from the rock to the fluid, but it results in a complex cavern shape. Numerical simulations were performed to evaluate the ability of storage caverns produced by the acid-dissolution method to store natural gas. In addition, analyses were conducted to evaluate cavern stability during gas injection and withdrawal from storage caverns created in carbonate formations by the acid-dissolution method. The stability analyses were conducted using FLAC2D, a commercially available geotechnical analysis and design software. The analyses indicate that a tall cylindrical cavern with a domed roof and floor will be stable under the expected range of in situ and operational conditions. This result suggests that it should be feasible to avoid mechanical instabilities that could potentially diminish the effectiveness of the storage facility. The feasibility of using pressure transients measured at the ground surface was investigated as a means to evaluate (Abstract truncated)« less

  11. Clinical importance of the basal cavernous sinuses and cavernous carotid arteries relative to the pituitary gland and macroadenomas: quantitative analysis of the complete anatomy.

    PubMed

    Yilmazlar, Selcuk; Kocaeli, Hasan; Eyigor, Ozhan; Hakyemez, Bahattin; Korfali, Ender

    2008-08-01

    It is unusual to encounter hemorrhagic complications caused by arterial or venous damage during TSS. Problems with these structures can lead to permanent disability or death. Our aim was to quantitatively analyze anatomical and radiologic relationships among the BCS, the CCA, and the pituitary gland, as these structures are accessed during TSS. Forty-nine formaldehyde-fixed, sellar-parasellar tissue blocks from adult cadavers were used to simulate accessing the BCSs via TSS. In each specimen, size of the pituitary gland and specific characteristics of each BCS and the horizontal segment of each CCA were recorded. Nine other specimens were used for histologic investigation and microanatomical measurements. To attest correlation between clinical data and cadaveric measurements, coronal MRI scans of 22 healthy adults as well as of 28 patients with macroadenomas were analyzed. In cadaveric specimens, distances between both CCAs in the BCS were 17.1 +/- 4.0 mm anteriorly, 20.3 +/- 4.2 mm medially, and 18.8 +/- 4.6 mm posteriorly. In this study, the anterior medial space of the BCS was dominant in 12 specimens on the right side and in 5 specimens on the left; the posterior medial space of the BCS was dominant in 23 specimens on the right side and in 9 specimens on the left side. The right medial BCS was dominant in 35 specimens. On histologic coronal sections, some part of the carotid artery's (CA's) diameter was located below the line passing from the basal dural layer ranging from 5.3% to 65.4%. In normal-sella images, distances between both CCAs were 15.4 +/- 1.8 mm anteriorly, 16.0 +/- 2.8 mm medially, 16.2 +/- 3.4 mm posteriorly. On coronal normal-sella images, some part of the CA's diameter was located below the line passing from the basal dural layer ranging from 16.4% to 66.7%. In macroadenomas, distances between both CCAs were 22.0 +/- 3.6 mm anteriorly, 21.5 +/- 3.8 mm medially, and 20.7.2 +/- 3.7 mm posteriorly . On coronal images, in only 6 of 28 macroadenomas, some part of the CA's diameter was located below the line passing from the basal dural layer ranging from 12.5% to 100%. Our results indicate that a working area of 15.0 +/- 2.6 x 10.3 +/- 2.1 mm is safe during TSS. The position of the CCA posterior segment was notably more caudal than the anterior segment with respect to the basal dura, which should be taken into account during extended exposure. Also, preoperative recognition of the anatomical variations is beneficial for detection of the boundaries of dissection, which is particularly important in the BCS, where variable course of CCAs may transform the anatomical configuration. Slowly growing pituitary adenomas stretch out both CCAs considerably from medial to lateral directions, and they cause widening of intercarotid distances in all segments. Processing of fixation, decalcification, and paraffin embedding for the cadaveric tissue in contrast to physiologically hydrated tissues may change the accuracy of measurements. These measurements are significantly different than those in the radiologic images when arterial blood under pressure is in the CCA as well as when venous blood fills the cavernous sinus as is the case in vivo. In clinical practice, these facts must be taken into consideration in the cadaveric measurements.

  12. Successful Transarterial Guglielmi Detachable Coil Embolization of Post-Traumatic Fistula between a Posterior Communicating Artery Aneurysm and the Cavernous Sinus

    PubMed Central

    Chen, Y.; Jiang, D-Y.; Tan, H-Q.; Wang, L-H.; Chen, X-Y.; Sun, J-H.

    2009-01-01

    Summary We describe a case of a post-traumatic posterior communicating artery (PCoA) aneurysmcavernous sinus fistula, which is an extremely rare complication of craniocerebral trauma, successfully treated with endosaccular coil embolization via transarterial route. Endosaccular embolization with Guglielmi detachable coils via transarterial route appears to be a feasible, effective and minimally invasive option for the treatment of post-traumatic fistula between the PCoA aneurysm with a small ostia and the cavernous sinus in the subacute phase. PMID:20465883

  13. [Pontine cavernous angioma (cavernoma) with initial ENT manifestations].

    PubMed

    Pino Rivero, V; González Palomino, A; Pantoja Hernández, C G; Trinidad Ruíz, G; Marqués Rebollo, L; Blasco Huelva, A

    2006-01-01

    We report the case of a 22 years old female who consulted us for facial parestesias, hearing loss in right ear and sudden tinnitus. Her audiometry showed an unilateral discreet sensorineural hipoacusia and the cranial IRM, a mass of 20 mm diameter in right pontine region and bulbus informed as cavernous angioma with signs of recent bleeding. The patient was sent to Neurosurgery but she refused the intervention. The risk of hemorrhage in the cavernomas is estimated at 0.25% to 1.6% per year and represents the main reason to advise a surgical treatment.

  14. An interesting case of angiogenesis in cavernous hemangioma.

    PubMed

    Das, Dipankar; Bhattacharjee, Kasturi; Deka, Panna; Bhattacharjee, Harsha; Misra, Diva Kant; Koul, Akanksha; Kapoor, Deepika; Deka, Apurba

    2016-10-01

    Cavernous hemangioma is the most common orbital tumor in adult. There is lot of literatures for clinicopathological features of this tumor. These tumors had been studied for the model of angiogenesis in many of the experimental setups. We present a case of 34-year-old male with this tumor in the left eye with computerized tomography evidence. Postsurgical laboratory findings gave interesting evidence of tumor angiogenesis with tumor endothelial cells and sprouting of the small vessels endothelial cells. Podosome rosette could be conceptualized from the characteristic patterns seen in the tumor.

  15. Stent-assisted coil embolization for cavernous carotid artery aneurysms.

    PubMed

    Kono, Kenichi; Shintani, Aki; Okada, Hideo; Tanaka, Yuko; Terada, Tomoaki

    2014-01-01

    Internal carotid artery (ICA) occlusion with or without a bypass surgery is the traditional treatment for cavernous sinus (CS) aneurysms with cranial nerve (CN) dysfunction. Coil embolization without stents frequently requires retreatment because of the large size of CS aneurysms. We report the mid-term results of six unruptured CS aneurysms treated with stent-assisted coil embolization (SACE). The mean age of the patients was 72 years. The mean size of the aneurysms was 19.8 mm (range: 13-26 mm). Before treatment, four patients presented with CN dysfunction and two patients had no symptoms. SACE was performed under local or general anesthesia in three patients each. Mean packing density was 29.1% and tight packing was achieved. There were no neurological complications. CN dysfunction was cured in three patients (75%) and partly resolved in one patient (25%). Transient new CN dysfunction was observed in two patients (33%). Clinical and imaging follow-up ranged from 6 to 26 months (median: 16 months). Recanalization was observed in three patients (50%; neck remnant in two patients and dome filling in one patient), but no retreatment has yet been required. No recurrence of CN dysfunction has occurred yet. In summary, SACE increases packing density and may reduce requirement of retreatment with an acceptable cure rate of CN dysfunction. SACE may be a superior treatment for coiling without stents and be an alternative treatment of ICA occlusion for selected patients, such as older patients and those who require a high-flow bypass surgery or cannot receive general anesthesia.

  16. Very Early Presentation of Extrahepatic Portal Vein Obstruction Causing Portal Hypertension in an Infant: Uncertainties in the Management and Therapeutic Limitations

    PubMed Central

    Khodayar-Pardo, Parisá; Peña Aldea, Andrés; Ramírez González, Ana; Meseguer Carrascosa, Adela; Calabuig Bayo, Cristina

    2016-01-01

    Extrahepatic portal vein obstruction, although rare in children, is a significant cause of portal hypertension (PHT) leading to life-threatening gastrointestinal bleeding in the pediatric age group. PHT may also lead to other complications such as hyperesplenism, cholangyopathy, ascites, and even hepatopulmonary syndrome and portopulmonary hypertension that may require organ transplantation. Herein we report the case of an asymptomatic 11-month-old infant wherein a hepatomegaly and cavernous transformation of the portal vein was detected by liver ultrasound. Neither signs of thrombosis in arteriovenous system, nor affectation of biliary tract were identified in the magnetic resonance imaging study. A significant enlargement of the caudate lobe of the liver was reported. No risk factors were detected. The differential diagnosis performed was extensive. Inherited thrombophilia and storage disorders were especially considered. Liver biopsy was normal. Upper gastrointestinal esophagogastroduodenoscopy detected two small varicose cords on the distal third of the esophagus. Finding a cavernous transformation of the portal vein with evidence of collateral circulation in such an early age is a challenging condition for professionals, since PHT may lead to severe complications during childhood and can compromise growth and development. Evidence-based guidelines for the management of PHT in adults have been published. However, follow-up and treatment of pediatric patients have not yet been standardized. Moreover, management of PHT in infants faces particular difficulties such as technical restrictions that could hinder their treatment. PMID:27504083

  17. Variations of the superficial middle cerebral vein: classification using three-dimensional CT angiography.

    PubMed

    Suzuki, Y; Matsumoto, K

    2000-05-01

    Classification of variations of the superficial middle cerebral vein (SMCV) remains ambiguous. We propose a new classification system based on embryologic development for preoperative examination. Three-dimensional CT angiography was used to evaluate 500 SMCVs (in 250 patients). The outflow vessels from the SMCV were classified into seven types on the basis of embryologic development. The 3D CT angiograms in axial stereoscopic and oblique views and multiple intensity projection images were evaluated by the same neurosurgeon on two occasions. Inconsistent interpretations were regarded as equivocal. Three-dimensional CT angiography clearly depicted the SMCV running along the lesser wing or the middle cranial fossa. However, the outflow vessel could not be confirmed as the sphenoparietal, cavernous, or emissary type in 39 (8%) of the sides. SMCVs running in the middle cranial fossa to join the transverse sinus or superior petrosal sinus were accurately identified. SMCVs were present in 456 sides: 62% entered the sphenoparietal sinus or the cavernous sinus and 12% joined the emissary vein. Nine vessels were the superior petrosal type, 10 the basal type, 12 the squamosal type, and 44 the undeveloped type. Three-dimensional CT angiography can depict the vessels and their anatomic relationship to the bone structure, allowing identification of the SMCV variant in individual patients. Preoperative planning for skull base surgery requires such information to reduce the invasiveness of the procedure. With the use of our classification system, 3D CT angiography can provide exact and practical information concerning the SMCV.

  18. Rational classification of portal vein thrombosis and its clinical significance.

    PubMed

    Ma, Jingqin; Yan, Zhiping; Luo, Jianjun; Liu, Qingxin; Wang, Jianhua; Qiu, Shijing

    2014-01-01

    Portal vein thrombosis (PVT) is commonly classified into acute (symptom duration <60 days and absence of portal carvernoma and portal hypertension) and chronic types. However, the rationality of this classification has received little attention. In this study, 60 patients (40 men and 20 women) with PVT were examined using contrast-enhanced computed tomography (CT). The percentage of vein occlusion, including portal vein (PV) and superior mesenteric vein (SMV), was measured on CT image. Of 60 patients, 17 (28.3%) met the criterion of acute PVT. Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT) compared to those without SMVT (p<0.001). However, there was no significant difference in PV occlusion between patients with and without symptoms. The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001). Complications of portal hypertension were significantly associated with cirrhosis (p<0.001) rather than with the severity of PVT and presence of cavernoma. These results suggest that the severity of PVT is only associated with the formation of portal cavernoma but unrelated to the onset of symptoms and the development of portal hypertension. We classified PVT into complete and partial types, and each was subclassified into with and without portal cavernoma. In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT. The new classification system can determine the pathological alterations of PVT, patency of portal vein and outcome of treatment in a longitudinal study.

  19. 3D spectroscopy of merger Seyfert galaxy Mrk 334: nuclear starburst, superwind and the circumnuclear cavern

    NASA Astrophysics Data System (ADS)

    Smirnova, Aleksandrina; Moiseev, Alexei

    2010-01-01

    We are presenting new results on kinematics and structure of the Mrk 334 Seyfert galaxy. Panoramic (3D) spectroscopy is performed at the 6-m telescope of the Special Astrophysical Observatory of the Russian Academy of Sciences using the integral-field Multi-Pupil Fiber Spectrograph (MPFS) and scanning Fabry-Pérot interferometer. The deep images have revealed that Mrk 334 is observed during the final stage of its merging with a massive companion. A possible mass ratio ranges from 1/5 to 1/3. The merger has triggered mass redistribution in the disc resulting in an intensification of nuclear activity and in a burst of star formation in the inner region of the galaxy. The circumnuclear starburst is so intense that its contribution to the gas ionization exceeds that contribution of the active galactic nuclei (AGN). We interpret the nuclear gas outflow with velocities of ~200kms-1 as a galactic superwind that accompanies the violent star formation. This suggestion is consistent with the asymmetric X-ray brightness distribution in Mrk 334. The trajectory of the fragments of the disrupted satellite in the vicinity of the main galaxy nucleus can be traced. In the galaxy disc, a cavern is found that is filled with a low-density ionized gas. We consider this region to be the place where the remnants of the companion have recently penetrated through the gaseous disc of the main galaxy.

  20. Rational Classification of Portal Vein Thrombosis and Its Clinical Significance

    PubMed Central

    Ma, Jingqin; Yan, Zhiping; Luo, Jianjun; Liu, Qingxin; Wang, Jianhua; Qiu, Shijing

    2014-01-01

    Portal vein thrombosis (PVT) is commonly classified into acute (symptom duration <60 days and absence of portal carvernoma and portal hypertension) and chronic types. However, the rationality of this classification has received little attention. In this study, 60 patients (40 men and 20 women) with PVT were examined using contrast-enhanced computed tomography (CT). The percentage of vein occlusion, including portal vein (PV) and superior mesenteric vein (SMV), was measured on CT image. Of 60 patients, 17 (28.3%) met the criterion of acute PVT. Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT) compared to those without SMVT (p<0.001). However, there was no significant difference in PV occlusion between patients with and without symptoms. The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001). Complications of portal hypertension were significantly associated with cirrhosis (p<0.001) rather than with the severity of PVT and presence of cavernoma. These results suggest that the severity of PVT is only associated with the formation of portal cavernoma but unrelated to the onset of symptoms and the development of portal hypertension. We classified PVT into complete and partial types, and each was subclassified into with and without portal cavernoma. In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT. The new classification system can determine the pathological alterations of PVT, patency of portal vein and outcome of treatment in a longitudinal study. PMID:25393320

  1. Outcome of Microscopic Transsphenoidal Surgery in Cushing Disease: A Case Series of 96 Patients.

    PubMed

    Shirvani, Manochehr; Motiei-Langroudi, Rouzbeh; Sadeghian, Homa

    2016-03-01

    To analyze the results of transsphenoidal surgery in patients with Cushing disease and outcome. Retrospective analysis of the records of 96 patients with Cushing disease from 1997 to 2012. There were 73 females and 23 males, with a mean follow-up of 44 months (range, 3-13 years). The sex ratio was significantly different in children and teenagers versus adults. Magnetic resonance imaging showed microadenoma, macroadenoma, and no adenoma in 66, 18, and 12 patients, respectively. There was no surgical mortality. Early remission (normal 24-hour urinary free cortisol and basal serum cortisol <5 μg/dL) was achieved in 94.8%. Regression analysis showed that only tumor size, cavernous sinus extension, and tumor consistency influenced remission. Recurrence was seen in 21.9%. Regression analysis showed that age, preoperative basal cortisol levels, and follow-up duration influenced recurrence. Correlation analysis showed that there was a significant negative correlation between patient age and the follow-up period. After detection of recurrence, 17 patients underwent repeat transsphenoidal surgery that resulted in remission in 12 patients (70.6%). The other 5 patients were referred for gamma knife radiosurgery or bilateral adrenalectomy. Transsphenoidal surgery is a safe and highly efficient procedure in the treatment of Cushing disease. Macroadenomas, cavernous sinus invasion, and harder tumor consistencies, however, are associated with lower remission rates (higher disease persistence) and younger age, higher preoperative cortisol levels, and longer follow-up periods are associated with higher recurrence. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Radiation-induced erectile dysfunction using prostate-confined modern radiotherapy in a rat model.

    PubMed

    Kimura, Masaki; Yan, Hui; Rabbani, Zahid; Satoh, Takefumi; Baba, Shiro; Yin, Fang-fang; Polascik, Thomas J; Donatucci, Craig F; Vujaskovic, Zeljko; Koontz, Bridget F

    2011-08-01

    The mechanisms of radiation-induced erectile dysfunction (ED) are unclear, as clinical studies are limited, and previous animal models were based on wide-field irradiation, which does not model current radiotherapy (RT) techniques. To perform functional and morphological analyses of erectile function (EF) utilizing image-guided stereotactic prostate-confined RT in a rat model. Sixty young adult male rats aged 10-12 weeks old were divided into age-matched sham and RT groups. A single 20-Gy fraction to the prostate was delivered to RT animals. Penile bulb, shaft, and testes were excluded from treatment fields. Bioassay and intracavernous pressure (ICP) measurements were conducted at 2, 4, and 9 weeks following RT. Perfusion analysis of the corpora cavernosa (CC) was conducted using Hoechst injected prior to sacrifice. Penile shaft and cavernous nerve (CN) were evaluated by immunohistochemistry. Plasma testosterone level was analyzed using a testosterone enzyme-linked immunosorbent assay (ELISA) assay kit. Irradiated animals demonstrated statistically significant time-dependent functional impairment of EF by bioassay and ICP measurement from 4 weeks. Neuronal nitric oxide synthase (NOS) expression was decreased in CN by 4 weeks. In CC, expression levels of anti-alpha smooth muscle actin and endothelial NOS were significantly decreased at 9 weeks. In penile dorsal vessels, smooth muscle/collagen ratio was significantly decreased at 4 and 9 weeks. Additionally, Hoechst perfusion showed time-dependent decrease in CC of RT animals, whereas CD31 expression was not affected. No toxicities were noted; testosterone levels were similar in both groups. We demonstrated time-dependent ED following image-guided stereotactic RT. Our results imply that reduction of neuronal NOS expression in cavernous nerve could trigger consecutive reduction of smooth muscle content as well as blood perfusion in CC that resulted in corporal veno-occlusive dysfunction. Present study could be a cornerstone to future research that may bring comprehensive scientific understanding of radiation-induced ED. © 2011 International Society for Sexual Medicine.

  3. [Magnetic resonance imaging of the penis. Its normal anatomy].

    PubMed

    Banchik, E L; Mineev, N I; Mitusov, V V; Dombrovskiĭ, V I; Kogan, M I

    2012-01-01

    To estimate the capabilities of magnetic resonance imaging (MRI) to identify penile anatomic structures and their topographic relationships. Penile MRI results were analyzed in 52 men of different ages who had no history, clinical, laboratory, and radiological data in favor of diseases of this organ. Penile imaging technology and its algorithm, including patient preparation and posi-tioning and a list of impulse sequences and their parameters, are proposed. Penile MRI and anatomy are described in detail; magnetic resonance signal characteristics of the main structural elements of the organ and its adjacent tissues on T1- and T2-weighted images are specified. The MRI morphometry results of the cavernous and spongy bodies, urethra, and penis as a whole, which agree well with the similar known literature data, are given. The investigation has provided evidence for the high informative value of the technique in recognizing the relatively small anatomic structures of the penis, which is comparable with that of the morphological study of a gross specimen of this organ, which in turn predetermines a further investigation of the capabilities of MRI to diagnose penile diseases and to estimate the quality of their treatment.

  4. Cranio-orbital primary intraosseous haemangioma.

    PubMed

    Gupta, T; Rose, G E; Manisali, M; Minhas, P; Uddin, J M; Verity, D H

    2013-11-01

    Primary intraosseous haemangioma (IOH) is a rare benign neoplasm presenting in the fourth and fifth decades of life. The spine and skull are the most commonly involved, orbital involvement is extremely rare. We describe six patients with cranio-orbital IOH, the largest case series to date. Retrospective review of six patients with histologically confirmed primary IOH involving the orbit. Clinical characteristics, imaging features, approach to management, and histopathological findings are described. Five patients were male with a median age of 56. Pain and diplopia were the most common presenting features. A characteristic 'honeycomb' pattern on CT imaging was demonstrated in three of the cases. Complete surgical excision was performed in all cases with presurgical embolisation carried out in one case. In all the cases, histological studies identified cavernous vascular spaces within the bony tissue. These channels were lined by single layer of cytologically normal endothelial cells. IOCH of the cranio-orbital region is rare; in the absence of typical imaging features, the differential diagnosis includes chondroma, chondrosarcoma, bony metastasis, and lymphoma. Surgical excision may be necessary to exclude more sinister pathology. Intraoperative haemorrhage can be severe and may be reduced by preoperative embolisation.

  5. Systemic mastocytosis: CT and US features of abdominal manifestations.

    PubMed

    Avila, N A; Ling, A; Worobec, A S; Mican, J M; Metcalfe, D D

    1997-02-01

    To study the imaging findings in patients with systemic mastocytosis and to correlate the findings with the severity of disease on the basis of an established classification system. Pathologic findings, when available, were correlated with imaging findings. Computed tomographic (CT) and ultrasound (US) scans and corresponding pathologic findings, when available, were retrospectively reviewed in 27 patients with systemic mastocytosis. Only five (19%) of the patients in our series had normal abdominal CT and/or US examination results. Common abdominal imaging findings associated with systemic mastocytosis were hepatosplenomegaly, retroperitoneal adenopathy, periportal adenopathy, mesenteric adenopathy, thickening of the omentum and the mesentery, and ascites. Less common findings included hepatofugal portal venous flow, Budd-Chiari syndrome, cavernous transformation of the portal vein, ovarian mass, and complications such as chloroma. The findings were more common in patients with category II and those with category III disease. Abdominal findings at CT and US are common in patients with systemic mastocytosis. Although the findings in patients with systemic mastocytosis are not specific to the disease, they are useful in directing further studies for diagnostic confirmation and in estimating the extent of systemic involvement.

  6. Brain Stem Cavernous Malformations: Operative Nuances of a Less-Invasive Resection Technique.

    PubMed

    Singh, Harminder; Elarjani, Turki; da Silva, Harley Brito; Shetty, Rakshith; Kim, Louis; Sekhar, Laligam N

    2017-12-08

    Different operative techniques are reported for the resection of brainstem cavernous malformations (BSCMs). The senior author has previously reported on a less-invasive technique of entering the brain stem with piecemeal removal of BSCMs, especially the deep-seated ones. To present a larger series of these lesions, emphasizing the approach to the brain stem via case selection. We discuss the nuances of the less-invasive operative technique through case illustrations and intraoperative videos. A retrospective review of 46 consecutive cases of BSCMs, with their clinical and radiographic data, was performed. Nine cases were selected to illustrate 7 different operative approaches, and discuss surgical nuances of the less-invasive technique unique to each. Postoperative morbidity, defined as an increase in modified Rankin Scale, was observed in 5 patients (10.9%). A residual BSCM was present in 2 patients (4.3%); both underwent reoperation to remove the remainder. At follow-up of 31.1 ± 27.8 mo, 3 patients experienced recurrence (6.5%). Overall, 65% of our patients improved, 20% stayed the same, and 11% worsened postsurgery. Two patients died, yielding a mortality of 4.3%. Using the less-invasive resection technique for piecemeal BSCM removal, in appropriately selected patients, has yielded comparable to improved patient outcomes over existing large series. In our experience, lateral, anterolateral, and posterolateral approaches are favorable over direct midline (dorsal or ventral) approaches. A thorough understanding of brain-stem safe-entry zones, in conjunction with appropriate approach selection, is key to a good outcome in challenging cases. Copyright © 2017 by the Congress of Neurological Surgeons

  7. The far lateral transpontomedullary sulcus approach to pontine cavernous malformations: technical report and surgical results.

    PubMed

    Abla, Adib A; Benet, Arnau; Lawton, Michael T

    2014-09-01

    Pontine cavernous malformations (CMs) located on a peripheral pontine surface or the fourth ventricular floor are resectable lesions, but those deep within the pons away from a pial surface are typically observed. However, the anterior bulge of the pons formed by the brachium pontis creates a unique entry point for access to deep pontine lesions from below, working upward through the pontomedullary sulcus. We developed a transpontomedullary sulcus (TPMS) approach to these lesions. The TPMS approach used the far lateral craniotomy and upper vagoaccessory triangle to define the surgical corridor. The entry point was above the olive, lateral to the pyramidal tracts and cranial nerve (CN) VI, above the preolivary sulcus and CN XII, and medial to CNs VII and VIII and CNs IX through XI. Four patients underwent this approach. All presented with hemorrhage and CN VI palsies. All pontine CMs were resected completely. Three patients were improved or unchanged, with good outcomes (modified Rankin Scale score ≤2) in all patients. The central pons remains difficult territory to access, and new surgical corridors are needed. The bulging underbelly of the pons allows access to pontine lesions deep to the pial surface from below. The far lateral TPMS approach is a novel and more direct alternative to the retrosigmoid transmiddle cerebellar peduncle approach. Unlike the retrosigmoid approach, the TPMS approach requires minimal parenchymal transgression and uses a brainstem entry point medial to most lower CNs. Favorable results demonstrate the feasibility of resecting pontine CMs that might have been previously deemed unresectable.

  8. CaveMan Enterprise version 1.0 Software Validation and Verification.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hart, David

    The U.S. Department of Energy Strategic Petroleum Reserve stores crude oil in caverns solution-mined in salt domes along the Gulf Coast of Louisiana and Texas. The CaveMan software program has been used since the late 1990s as one tool to analyze pressure mea- surements monitored at each cavern. The purpose of this monitoring is to catch potential cavern integrity issues as soon as possible. The CaveMan software was written in Microsoft Visual Basic, and embedded in a Microsoft Excel workbook; this method of running the CaveMan software is no longer sustainable. As such, a new version called CaveMan Enter- prisemore » has been developed. CaveMan Enterprise version 1.0 does not have any changes to the CaveMan numerical models. CaveMan Enterprise represents, instead, a change from desktop-managed work- books to an enterprise framework, moving data management into coordinated databases and porting the numerical modeling codes into the Python programming language. This document provides a report of the code validation and verification testing.« less

  9. EVOKED CAVERNOUS ACTIVITY: NEUROANATOMIC IMPLICATIONS

    PubMed Central

    Yilmaz, Ugur; Vicars, Brenda; Yang, Claire C.

    2013-01-01

    We investigated the autonomic innervation of the penis by using evoked cavernous activity (ECA). We recruited 7 males with thoracic spinal cord injury (SCI) and sexual dysfunction and 6 males who were scheduled to have pelvic surgery (PS), specifically non-nerve-sparing radical cystoprostatectomy. In the PS subjects, ECA was performed both pre- and postoperatively. The left median nerve was electrically stimulated and ECA was recorded with two concentric electromyography needles placed into the right and left cavernous bodies. We simultaneously recorded hand and foot sympathetic skin responses (SSRs) as controls. In the SCI group, all but one subject had reproducible hand SSRs. None of these subjects had ECA or foot SSRs. All the PS subjects had reproducible ECA and SSRs, both preoperatively and postoperatively. There was no difference in the latency and amplitude measurements of ECA and SSRs in the postoperative compared to the preoperative period (p>0.05). In conclusion, ECA is absent in men with SCI above the sympathetic outflow to the genitalia. In men following radical pelvic surgery, ECA is preserved, indicating the preservation of sympathetic fibers. PMID:19609298

  10. Intraoperative magnetic resonance imaging assessment of non-functioning pituitary adenomas during transsphenoidal surgery.

    PubMed

    Patel, Kunal S; Yao, Yong; Wang, Renzhi; Carter, Bob S; Chen, Clark C

    2016-04-01

    To review the utility of intraoperative imaging in facilitating maximal resection of non-functioning pituitary adenomas (NFAs). We performed an exhaustive MEDLINE search, which yielded 5598 articles. Upon careful review of these studies, 31 were pertinent to the issue of interest. Nine studies examined whether intraoperative MRI (iMRI) findings correlated with the presence of residual tumor on MRI taken 3 months after surgical resection. All studies using iMRI of >0.15T showed a ≥90% concordance between iMRI and 3-month post-operative MRI findings. 24 studies (22 iMRI and 2 intraoperative CT) examined whether intraoperative imaging improved the surgeon's ability to achieve a more complete resection. The resections were carried out under microscopic magnification in 17 studies and under endoscopic visualization in 7 studies. All studies support the value of intraoperative imaging in this regard, with improved resection in 15-83% of patients. Two studies examined whether iMRI (≥0.3T) improved visualization of residual NFA when compared to endoscopic visualization. Both studies demonstrated the value of iMRI in this regard, particularly when the tumor is located lateral of the sella, in the cavernous sinus, and in the suprasellar space. The currently available literature supports the utility of intraoperative imaging in facilitating increased NFA resection, without compromising safety.

  11. Lymphangioma circumscriptum, angiokeratoma, or superficial vascular ectasia with epithelial hyperplasia?

    PubMed

    Katsoulas, Nikolaos; Tosios, Konstantinos I; Argyris, Prokopios; Koutlas, Ioannis G; Sklavounou, Alexandra

    2014-08-01

    We report a case of lymphangioma circumscriptum (cavernous lymphangioma with epithelial hyperplasia) in a 12-year-old girl, presenting as a papillary tumor on the right dorsal side of her tongue. Microscopic examination found cavernous vascular channels lined by a single layer of CD31(+), podoplanin-positive, CD34(-) endothelial cells that occupied the papillary lamina propria and were accompanied by epithelial hyperplasia. A review of the literature on oral vascular tumors with epithelial hyperplasia, namely, lymphangioma circumscriptum and angiokeratoma, provided information that draws into question the use of these terms. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. [Management of penile trauma from compressed air gun in a child].

    PubMed

    Girón-Vallejo, O; Zambudio, G; Ruiz-Pruneda, R; Hernindez, J P; Ruiz-Jiménez, J I

    2011-01-01

    We report on a 6-year old child with a penile injury resulting in the inclusion of a pellet in the cavernous body, by a fortuitous shot. Conservative approach with elective extraction of the bullet and cavernous body repair led to a satisfactory result, in better anatomic conditions. The patient did not have any perioperative complication. Accidents by air weapons are particularly important in children, because these weapons are erroneously considered as toys. Air gun injuries to head, neck and thorax have been often published, but these injuries are rare in the chidren genitourinary area.

  13. Successful treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique.

    PubMed

    Huynh, Thien J; Morton, Ryan P; Levitt, Michael R; Ghodke, Basavaraj V; Wink, Onno; Hallam, Danial K

    2017-08-18

    We report successful transvenous treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd technique allowed for successful treatment using preoperative MR angiography as a three-dimensional overlay roadmap combined with cone beam CT and live fluoroscopy, precluding the need for an arterial puncture. 2017 BMJ Publishing Group Ltd.

  14. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Roberts, Barry L; Lord, David; Lord, Anna C. Snider

    This report summarizes the work performed in the prioritization of cavern access wells for remediation and monitoring at the West Hackberry Strategic Petroleum Reserve site. The grading included consideration of all 31 wells at the West Hackberry site, with each well receiving a separate grade for remediation and monitoring. Numerous factors affecting well integrity were incorporated into the grading including casing survey results, cavern pressure history, results from geomechanical simulations, and site geologic factors. The factors and grading framework used here are the same as those used in developing similar well remediation and monitoring priorities at the Big Hill andmore » Bryan Mound Strategic Petroleum Reserve Sites.« less

  15. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Roberts, Barry L; Lord, David; Lord, Anna C. Snider

    This report summarizes the work performed in the prioritization of cavern access wells for remediation and monitoring at the Bryan Mound Strategic Petroleum Reserve site. The grading included consideration of all 47 wells at the Bryan Mound site, with each well receiving a separate grade for remediation and monitoring. Numerous factors affecting well integrity were incorporated into the grading including casing survey results, cavern pressure history, results from geomechanical simulations, and site geologic factors. The factors and grading framework used here are the same as those used in developing similar well remediation and monitoring priorities at the Big Hill Strategicmore » Petroleum Reserve Site.« less

  16. Involvement of methicillin-susceptible Staphylococcus aureus related to sequence type 25 and harboring pvl genes in a case of carotid cavernous fistula after community-associated sepsis.

    PubMed

    Damasco, Paulo V; Chamon, Raiane C; Barbosa, Angélica T L; da Cunha, Sérgio; Aquino, José H W; Cavalcante, Fernanda S; Dos Santos, Kátia R N

    2012-01-01

    Staphylococcus aureus encoding Panton-Valentine leukocidin (PVL) genes has become the cause of life-threatening infections. We describe a case of carotid cavernous fistula after bacteremia in a 12-year-old male, caused by a methicillin-susceptible S. aureus isolate carrying the pvl, fnbA, and ebpS genes and related to sequence type 25 (ST25). The patient's condition was complicated by pleural empyema and osteomyelitis in the right femur. The patient was discharged in good clinical condition after 160 days of hospitalization.

  17. [Clinical efficacy of the drug enerion in the treatment of patients with psychogenic (functional) erectile dysfunction].

    PubMed

    Dmitriev, D G; Gamidov, S I; Permiakova, O V

    2005-01-01

    Twenty patients with psychogenic erectile dysfunction received the drug enerion (Hungary). After a 30-day course of enerion erectile function improved in 16 of the above patients. A mean value of the international index of erectile function (IIEF) increased in them from 17.5 to 24.8 points. Improvement of cavernous arterial blood flow after the treatment was seen in 3 of 6 patients with arterial disorders. As shown by electromyographic examinations, cavernous electric activity normalized in 8 patients. Thus, psychogenic erectile dysfunction can be effectively treated with enerion.

  18. High temperature underground thermal energy storage system for solar energy

    NASA Technical Reports Server (NTRS)

    Collins, R. E.

    1980-01-01

    The activities feasibility of high temperature underground thermal storage of energy was investigated. Results indicate that salt cavern storage of hot oil is both technically and economically feasible as a method of storing huge quantities of heat at relatively low cost. One particular system identified utilizes a gravel filled cavern leached within a salt dome. Thermal losses are shown to be less than one percent of cyclically transferred heat. A system like this having a 40 MW sub t transfer rate capability and over eight hours of storage capacity is shown to cost about $13.50 per KWh sub t.

  19. 2013 strategic petroleum reserve big hill well integrity grading report.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lord, David L.; Roberts, Barry L.; Lord, Anna C. Snider

    2014-02-01

    This report summarizes the work performed in developing a framework for the prioritization of cavern access wells for remediation and monitoring at the Big Hill Strategic Petroleum Reserve site. This framework was then applied to all 28 wells at the Big Hill site with each well receiving a grade for remediation and monitoring. Numerous factors affecting well integrity were incorporated into the grading framework including casing survey results, cavern pressure history, results from geomechanical simulations, and site geologic factors. The framework was developed in a way as to be applicable to all four of the Strategic Petroleum Reserve sites.

  20. Cryopyrin-associated periodic fever syndrome manifesting as Tolosa-Hunt syndrome.

    PubMed

    Höhne, C; Schuh, E; Kümpfel, T; Straube, A

    2016-12-01

    Tolosa-Hunt syndrome (THS) is characterized by unilateral orbital pain, ipsilateral oculomotor paresis and a prompt response to treatment with corticosteroids. Several reports have demonstrated that the clinical features of THS are not specific to one causal aetiology and can lead to misdiagnosis. We report the case of a patient diagnosed with THS after an episode of unilateral orbital pain and diplopia with demonstration of granulomatous inflammation of both cavernous sinus on cerebral magnetic resonance imaging and an immediate response to treatment with corticosteroids. Progression of the disease over the following years, accompanied by increasing signs of inflammation on cerebral magnetic resonance imaging and cerebrospinal fluid pleocytosis, led to further diagnostic tests. Genetic analyses revealed a heterozygote low-penetrance mutation (Q703K) of the cryopyrin/NLRP3 gene compatible with a cryopyrin-associated periodic fever syndrome. This case report demonstrates that THS can be a central nervous system manifestation of cryopyrin-associated periodic fever syndrome, which therefore represents a differential diagnosis of THS, even in elderly patients. © International Headache Society 2016.

  1. Longitudinal evaluation of corticospinal tract in patients with resected brainstem cavernous malformations using high-definition fiber tractography and diffusion connectometry analysis: preliminary experience.

    PubMed

    Faraji, Amir H; Abhinav, Kumar; Jarbo, Kevin; Yeh, Fang-Cheng; Shin, Samuel S; Pathak, Sudhir; Hirsch, Barry E; Schneider, Walter; Fernandez-Miranda, Juan C; Friedlander, Robert M

    2015-11-01

    Brainstem cavernous malformations (CMs) are challenging due to a higher symptomatic hemorrhage rate and potential morbidity associated with their resection. The authors aimed to preoperatively define the relationship of CMs to the perilesional corticospinal tracts (CSTs) by obtaining qualitative and quantitative data using high-definition fiber tractography. These data were examined postoperatively by using longitudinal scans and in relation to patients' symptomatology. The extent of involvement of the CST was further evaluated longitudinally using the automated "diffusion connectometry" analysis. Fiber tractography was performed with DSI Studio using a quantitative anisotropy (QA)-based generalized deterministic tracking algorithm. Qualitatively, CST was classified as being "disrupted" and/or "displaced." Quantitative analysis involved obtaining mean QA values for the CST and its perilesional and nonperilesional segments. The contralateral CST was used for comparison. Diffusion connectometry analysis included comparison of patients' data with a template from 90 normal subjects. Three patients (mean age 22 years) with symptomatic pontomesencephalic hemorrhagic CMs and varying degrees of hemiparesis were identified. The mean follow-up period was 37.3 months. Qualitatively, CST was partially disrupted and displaced in all. Direction of the displacement was different in each case and progressively improved corresponding with the patient's neurological status. No patient experienced neurological decline related to the resection. The perilesional mean QA percentage decreases supported tract disruption and decreased further over the follow-up period (Case 1, 26%-49%; Case 2, 35%-66%; and Case 3, 63%-78%). Diffusion connectometry demonstrated rostrocaudal involvement of the CST consistent with the quantitative data. Hemorrhagic brainstem CMs can disrupt and displace perilesional white matter tracts with the latter occurring in unpredictable directions. This requires the use of tractography to accurately define their orientation to optimize surgical entry point, minimize morbidity, and enhance neurological outcomes. Observed anisotropy decreases in the perilesional segments are consistent with neural injury following hemorrhagic insults. A model using these values in different CST segments can be used to longitudinally monitor its craniocaudal integrity. Diffusion connectometry is a complementary approach providing longitudinal information on the rostrocaudal involvement of the CST.

  2. The influence of the nasal mucosa and the carotid rete upon hypothalamic temperature in sheep

    PubMed Central

    Baker, Mary Ann; Hayward, James N.

    1968-01-01

    1. In chronically-prepared sheep, intracranial temperatures were measured in the cavernous sinus among the vessels of the carotid rete and at the circle of Willis extravascularly, and in the preoptic area and in other brain stem regions. Extracranial temperatures were measured intravascularly in the carotid or internal maxillary arteries and on the nasal mucosa and the skin of the ear. 2. At 20° C ambient temperature, shifts in temperature of the hypothalamus and of other brain sites paralleled temperature shifts in the cerebral arterial blood which was cooler than central arterial blood. During periods of arousal and of paradoxical sleep, vasoconstriction of the nasal mucosa and the ear skin occurred and temperatures at the cerebral arteries and in the brain rose without a comparable rise in central arterial blood temperature. 3. Anaesthetic doses of barbiturate abolished the temperature oscillations in the cerebral arterial blood and the brain. When air was blown rapidly over the nasal mucosa in anaesthetized animals, temperatures dropped precipitously in the cavernous sinus, at the cerebral arteries, and in the brain, while central arterial temperature fell only slightly. Injections of latex into the facial venous system demonstrated a venous pathway from the nasal mucosa to the cavernous sinus. 4. When sheep were exposed to 45-50° C ambient temperature, respiratory rate increased 5-10 times and the temperature gradient between central and cerebral arterial blood widened. 5. It is concluded that venous blood returning from the nasal mucosa and the skin of the head to the cavernous sinus cools the central arterial blood in the carotid rete. This is an important factor in the maintenance of hypothalamic temperature in the wool-covered, long-nosed, panting sheep and undoubtedly affects hypothalamic thermoreceptors and temperature regulation in artiodactyls. PMID:5685288

  3. May the Inferior Petrosal Sinus Recanalization During Endovascular Treatment for Carotid-Cavernous Fistulas Increase the Risk of Sixth Nerve Palsy?

    PubMed

    Robert, Thomas; Valsecchi, Daniele; Sylvestre, Philippe; Blanc, Raphaël; Ciccio, Gabriele; Smajda, Stanislas; Redjem, Hocine; Piotin, Michel

    2018-05-03

    Sixth nerve palsy is a common complication of endovascular treatment for carotid-cavernous fistulas (CCF). Two hypotheses are evoked: the spontaneous venous congestion into the cavernous sinus and the direct compression of the nerve by the embolic agent into the cavernous sinus. Nevertheless, the evidence is still uncertain. Knowing the vicinity of the sixth nerve with the inferior petrosal sinus (IPS) in the Dorello canal, we hypothesized that the recanalization of the IPS increased the risk of nerve damage. We analyzed a prospective database of patients treated for CCFs from March 2009 to April 2016. We excluded patients who did not need treatment, cases of high-flow CCF, and patients lost to follow-up, obtaining a homogeneous population of 82 patients with indirect CCFs. This population was divided in 2 groups: patients without new-onset/worsening of sixth nerve palsy and patients with this postprocedural complication. Our main endpoints were the potential differences between patients with or without recanalization of IPS and between those who underwent or not an embolization with Onyx-18. We did not find any statistically meaningful difference between the 2 groups concerning the necessity of IPS recanalization (P > 0.999, odds ratio 0.97, 95% confidence interval 0.32-2.96) or with the use of Onyx-18 as an embolic agent (P = 0.56; odds ratio 1.41, 95% confidence interval 0.41-2.45). The recanalization of a thrombosed IPS does not increase the risk of procedural sixth nerve damage. The initial injury seems to relate with development/worsening of a sixth nerve palsy. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Biology of vascular malformations of the brain.

    PubMed

    Leblanc, Gabrielle G; Golanov, Eugene; Awad, Issam A; Young, William L

    2009-12-01

    This review discusses recent research on the genetic, molecular, cellular, and developmental mechanisms underlying the etiology of vascular malformations of the brain (VMBs), including cerebral cavernous malformation, sporadic brain arteriovenous malformation, and the arteriovenous malformations of hereditary hemorrhagic telangiectasia. Summary of Review- The identification of gene mutations and genetic risk factors associated with cerebral cavernous malformation, hereditary hemorrhagic telangiectasia, and sporadic arteriovenous malformation has enabled the development of animal models for these diseases and provided new insights into their etiology. All of the genes associated with VMBs to date have known or plausible roles in angiogenesis and vascular remodeling. Recent work suggests that the angiogenic process most severely disrupted by VMB gene mutation is that of vascular stabilization, the process whereby vascular endothelial cells form capillary tubes, strengthen their intercellular junctions, and recruit smooth muscle cells to the vessel wall. In addition, there is now good evidence that in some cases, cerebral cavernous malformation lesion formation involves a genetic 2-hit mechanism in which a germline mutation in one copy of a cerebral cavernous malformation gene is followed by a somatic mutation in the other copy. There is also increasing evidence that environmental second hits can produce lesions when there is a mutation to a single allele of a VMB gene. Recent findings begin to explain how mutations in VMB genes render vessels vulnerable to rupture when challenged with other inauspicious genetic or environmental factors and have suggested candidate therapeutics. Understanding of the cellular mechanisms of VMB formation and progression in humans has lagged behind that in animal models. New knowledge of lesion biology will spur new translational work. Several well-established clinical and genetic database efforts are already in place, and further progress will be facilitated by collaborative expansion and standardization of these.

  5. Bilateral Cavernous Nerve Crush Injury in the Rat Model: A Comparative Review of Pharmacologic Interventions.

    PubMed

    Haney, Nora M; Nguyen, Hoang M T; Honda, Matthew; Abdel-Mageed, Asim B; Hellstrom, Wayne J G

    2018-04-01

    It is common for men to develop erectile dysfunction after radical prostatectomy. The anatomy of the rat allows the cavernous nerve (CN) to be identified, dissected, and injured in a controlled fashion. Therefore, bilateral CN injury (BCNI) in the rat model is routinely used to study post-prostatectomy erectile dysfunction. To compare and contrast the available literature on pharmacologic intervention after BCNI in the rat. A literature search was performed on PubMed for cavernous nerve and injury and erectile dysfunction and rat. Only articles with BCNI and pharmacologic intervention that could be grouped into categories of immune modulation, growth factor therapy, receptor kinase inhibition, phosphodiesterase type 5 inhibition, and anti-inflammatory and antifibrotic interventions were included. To assess outcomes of pharmaceutical intervention on erectile function recovery after BCNI in the rat model. The ratio of maximum intracavernous pressure to mean arterial pressure was the main outcome measure chosen for this analysis. All interventions improved erectile function recovery after BCNI based on the ratio of maximum intracavernous pressure to mean arterial pressure results. Additional end-point analysis examined the corpus cavernosa and/or the major pelvic ganglion and CN. There was extreme heterogeneity within the literature, making accurate comparisons between crush injury and therapeutic interventions difficult. BCNI in the rat is the accepted animal model used to study nerve-sparing post-prostatectomy erectile dysfunction. However, an important limitation is extreme variability. Efforts should be made to decrease this variability and increase the translational utility toward clinical trials in humans. Haney NM, Nguyen HMT, Honda M, et al. Bilateral Cavernous Nerve Crush Injury in the Rat Model: A Comparative Review of Pharmacologic Interventions. Sex Med Rev 2018;6:234-241. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  6. Improved penile histology by phalloidin stain: circular and longitudinal cavernous smooth muscles, dual-endothelium arteries, and erectile dysfunction-associated changes.

    PubMed

    Lin, Guiting; Qiu, Xuefeng; Fandel, Thomas M; Albersen, Maarten; Wang, Zhong; Lue, Tom F; Lin, Ching-Shwun

    2011-10-01

    To investigate whether fluorochrome-conjugated phalloidin can delineate cavernous smooth muscle (CSM) cells and whether it can be combined with immunofluorescence (IF) staining to quantify erectile dysfunction (ED)-associated changes. ED was induced by cavernous nerve crush in rats. Penile tissues of control and ED rats were stained with Alexa-488-conjugated phalloidin and/or with antibodies against rat endothelial cell antigen (RECA), CD31, neuronal nitric oxide synthase (nNOS), and collagen-IV (Col-IV). Phalloidin was able to delineate CSM as composed of a circular and a longitudinal compartment. When combined with IF stain for CD31 or RECA, it helped the identification of the helicine arteries as covered by endothelial cells on both sides of the smooth muscle layer. When combined with IF stain for nNOS, it helped the identification that nNOS-positive nerves were primarily localized within the dorsal nerves and in the adventitia of dorsal arteries. When combined with IF stain for Col-IV, it helped identify that Col-IV was localized around smooth muscles and beneath the endothelium. Phalloidin also facilitated the quantitative analysis of ED-related changes in the penis. In rats with cavernous nerve injury, RECA or Col-IV expression did not change significantly, but CSM and nNOS nerve contents decreased significantly. Phalloidin stain improved penile histology, enabling the visualization of the circular and longitudinal compartments in the CSM. It also worked synergistically with IF stain, permitting the visualization of the dual endothelial covering in helicine arteries, and facilitating the quantification of ED-related histologic changes. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Roberts, Barry L; Lord, David; Lord, Anna C. Snider

    This report summarizes the work performed in the prioritization of cavern access wells for remediation and monitoring at the Bayou Choctaw Strategic Petroleum Reserve site. The grading included consideration of all 15 wells at the Bayou Choctaw site, with each active well receiving a separate grade for remediation and monitoring. Numerous factors affecting well integrity were incorporated into the grading including casing survey results, cavern pressure history, results from geomechanical simulations, and site geologic factors. The factors and grading framework used here are the same as those used in developing similar well remediation and monitoring priorities at the Big Hill,more » Bryan Mound, and West Hackberry Strategic Petroleum Reserve Sites.« less

  8. Involvement of Methicillin-Susceptible Staphylococcus aureus Related to Sequence Type 25 and Harboring pvl Genes in a Case of Carotid Cavernous Fistula after Community-Associated Sepsis

    PubMed Central

    Damasco, Paulo V.; Chamon, Raiane C.; Barbosa, Angélica T. L.; da Cunha, Sérgio; Aquino, José H. W.; Cavalcante, Fernanda S.

    2012-01-01

    Staphylococcus aureus encoding Panton-Valentine leukocidin (PVL) genes has become the cause of life-threatening infections. We describe a case of carotid cavernous fistula after bacteremia in a 12-year-old male, caused by a methicillin-susceptible S. aureus isolate carrying the pvl, fnbA, and ebpS genes and related to sequence type 25 (ST25). The patient's condition was complicated by pleural empyema and osteomyelitis in the right femur. The patient was discharged in good clinical condition after 160 days of hospitalization. PMID:22090398

  9. Bilateral Cavernous Sinus Thrombosis as First Manifestation of Primary Burkitt Lymphoma of the Thyroid Gland

    PubMed Central

    Moghaddasi, Mehdi; Nabovvati, Mona; Razmeh, Saeed

    2017-01-01

    Cavernous sinus thrombosis (CST) is a rare condition that is usually associated with infections, pregnancy, vasculitis and some types of medication, such as the contraceptive pill and paraneoplastic. Primary Burkitt lymphoma (PBL) of the thyroid gland is very uncommon and the clinical description of such cases has been largely limited to case reports. In this paper, we present a case of CST as the first manifestation of PBL of the thyroid gland. To the best of our knowledge, our patient is the first case report of PBL of the thyroid gland that presents with bilateral CST. PMID:28713532

  10. Lateral sellar compartment O.T. (cavernous sinus): history, anatomy, terminology.

    PubMed

    Parkinson, D

    1998-08-01

    Claudios Galen (119-199 a.d.) dissected lower animals with parasellar carotid retia bathed in venous blood and transposed his findings to human anatomy. Andreas Vesalius (1514-1564) corrected most of Galen's errors but apparently never looked into this small, extradural compartment, nor, apparently, did Winslow (Exposition Anatomique de la Structure du Corps Humain. London: N. Prevast, 1734), who christened it the "cavernous sinus," (CS) presumably thinking that it would resemble the corpora cavernosa of the penis. Multiple surgical explorations, gross dissections, microscopic views, and vascular casts from early fetuses to an 81 year old have been examined and reviewed. The CS is not a dural sinus nor is it cavernous. The compartment is extradural, and the venous structures contained within consist of a greatly variable plexus of extremely thin-walled veins. The name, CS, is a barrier to the understanding of the structure and function of this extradural anatomical jewel box, which contains fat, myelinated and nonmyelinated nerves, arteries, and a plexus of veins. It is proposed that this name be changed, because it is inaccurate and misleading. The replacement should leave no doubt about its meaning. The lateral sellar compartment is descriptive and accurate. The veins within are a parasellar plexus.

  11. External and intralesional photocoagulation of hemangioma in children with infrared diode laser

    NASA Astrophysics Data System (ADS)

    Abushkin, Ivan A.; Privalov, Valery A.; Lappa, Alexander V.; Besshtanko, Evgeny L.

    2005-08-01

    Infra-red diode laser with wavelength 1060 nm was used for combined treatment of 163 children aged from 21 days to 13 years with 221 hemangiomas. For interstitial coagulation a power of 1.8-2 W and a power density of 5-90 J/cm3 were used in continuous mode. For distant coagulation pulse mode was applied with pulse/pause duration 30-50/200-250 ms, average power 1.3-2 W, and power density 65-450 J/cm2. 197 (89.1 %) hemangiomas were capillary, 7 (3.2 %) cavernous, and 17 (7.7 %) combined (combination of capillary and cavernous hemangiomas). The area of hemangiomas ranged from 6 mm2 to 48 cm2. For the majority (193, 87.3 %) of hemangiomas one session of photocoagulation was enough to achieve a good cosmetic effect. However, 28 (12.7 %) hemangiomas were treated repeatedly, 11 (5%) of them needed 4-7 sessions. In 8 children with cavernous and combined hemangiomas both distant and interstitial laser coagulation were used. In all, good or excellent results were obtained in 96,3 % of the patients. In 6 (3.7%) patients with extensive combined hematomas the considerable improvement was achieved.

  12. Flow diversion in vasculitic intracranial aneurysms? Repair of giant complex cavernous carotid aneurysm in polyarteritis nodosa using Pipeline embolization devices: first reported case.

    PubMed

    Santos, Jaime Martinez; Kaderali, Zul; Spears, Julian; Rubin, Laurence A; Marotta, Thomas R

    2015-05-29

    Intracranial aneurysms in polyarteritis nodosa (PAN) are exceedingly rare lesions with unpredictable behavior that pose real challenges to microsurgical and endovascular interventions owing to their inflammatory nature. We introduce a safe and effective alternative for treating these aneurysms using Pipeline embolization devices (PEDs). A 20-year-old man presented with diplopia, headaches, chronic abdominal pain, and weight loss. Diagnostic evaluations confirmed PAN, including bilateral giant cavernous carotid aneurysms. Cyclophosphamide and steroids achieved significant and sustained clinical improvement, with a decision to follow the aneurysms serially. Seven years later the left unruptured aneurysm enlarged, causing a sudden severe headache and a cavernous sinus syndrome. Treatment of the symptomatic aneurysm was pursued using flow diversion (PED) and the internal carotid artery was successfully reconstructed with a total of four overlapping PEDs. At 6 months follow-up, complete exclusion of the aneurysm was demonstrated, with symptomatic recovery. This is the first description of using a flow-diverting technique in an inflammatory vasculitis. In this case, PEDs not only attained a definitive closure of the aneurysm but also reconstructed the damaged and fragile arterial segment affected with vasculitis. 2015 BMJ Publishing Group Ltd.

  13. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kirby, Carolyn L; Lord, Anna C. Snider

    The Bryan Mound caprock was subjected to extens ive sulphur mining prior to the development of the Strategic Petroleum Reserve. Undoubtedl y, the mining has modified the caprock integrity. Cavern wells at Bryan Mound have been subject to a host of well integr ity concerns with many likely compromised by the cavernous capro ck, surrounding corrosive environment (H 2 SO 4 ), and associated elevated residual temperatures al l of which are a product of the mining activities. The intent of this study was to understand the sulphur mining process and how the mining has affected the stability of themore » caprock and how the compromised caprock has influenced the integrity of the cavern wells. After an extensiv e search to collect pert inent information through state agencies, literature sear ches, and the Sandia SPR librar y, a better understanding of the caprock can be inferred from the knowledge gaine d. Specifically, the discovery of the original ore reserve map goes a long way towards modeling caprock stability. In addition the gained knowledge of sulphur mining - subs idence, superheated corrosive wa ters, and caprock collapse - helps to better predict the post mi ning effects on wellbore integrity. This page intentionally left blank« less

  14. nNOS-positive minor-branches of the dorsal penile nerves is associated with erectile function in the bilateral cavernous injury model of rats.

    PubMed

    Chen, Yen-Lin; Chao, Ting-Ting; Wu, Yi-No; Chen, Meng-Chuan; Lin, Ying-Hung; Liao, Chun-Hou; Wu, Chien-Chih; Chen, Kuo-Chiang; Chou, Shang-Shing P; Chiang, Han-Sun

    2018-01-17

    The changes in neuronal nitric oxide synthases (nNOS) in the dorsal penile nerves (DPNs) are consistent with cavernous nerve (CN) injury in rat models. However, the anatomical relationship and morphological changes between the minor branches of the DPNs and the CNs after injury have never been clearly explored. There were forty 12 week old male Sprague-Dawley rats receiving bilateral cavernous nerve injury (BCNI). Erectile function of intracavernous pressure and mean arterial pressure were measured. The histology and ultrastructure with H&E stain, Masson's trichrome stain and immunohistochemical stains were applied on the examination of CNs and DPNs. We demonstrated communicating nerve branches between the DPNs and the CNs in rats. The greatest damage and lowest erectile function were seen in the 14 th day and partially recovered in the 28 th day after BCNI. The nNOS positive DPN minor branches' number was significantly correlated with erectile function. The sub-analysis of the number of nNOS positive DPN minor branches also matched with the time course of the erectile function after BCNI. We suggest the regeneration of the DPNs minor branches would ameliorate the erectile function in BCNI rats.

  15. Removal of an orbital apex hemangioma using an endoscopic transethmoidal approach: technical note.

    PubMed

    Karaki, Masayuki; Kobayashi, Ryuichi; Mori, Nozomu

    2006-07-01

    The posterior orbit contains a number of important and vulnerable structures, including the optic nerve, the ophthalmic artery and vein, and the ocular muscles and their motor nerves, which makes surgical access to the lesion in this region quite difficult. Transfrontal, transfrontal-ethmoidal, and transmaxillary procedures have the disadvantage of possible injuries to a number of nontumor structures, whereas an endoscopic transethmoidal approach is a minimally invasive surgery for the retrobulbar lesions. Retrobulbar cavernous hemangioma was successfully removed by a transethmoidal approach. Tumor removal was performed in a patient with an intraconal cavernous hemangioma of approximately 15 mm in diameter. By a transethmoidal approach, the medial-inferior part of the orbit, as well as the apex of the orbit, were clearly visualized after endonasal ethmoidectomy. After the removal of the medial orbital bone, the orbital periosteum was incised and elevated. By elevating the orbital fat, the tumor could be identified separately from the orbital contents. Cavernous hemangioma at the orbital apex was removed without complications. An endoscopic transethmoidal approach, which requires no skin incision, is a minimally invasive surgery for retrobulbar orbital tumor, leading to excellent cosmetic results with less bleeding.

  16. Characterization of Gas Transport Properties of Fractured Rocks By Borehole and Chamber Tests.

    NASA Astrophysics Data System (ADS)

    Shimo, M.; Shimaya, S.; Maejima, T.

    2014-12-01

    Gas transport characteristics of fractured rocks is a great concern to variety of engineering applications such as underground storage of LPG, nuclear waste disposal, CCS and gas flooding in the oil field. Besides absolute permeability, relative permeability and capillary pressure as a function of water saturation have direct influences to the results of two phase flow simulation. However, number of the reported gas flow tests for fractured rocks are limited, therefore, the applicability of the conventional two-phase flow functions used for porous media, such as Mualem-van Genuchten model, to prediction of the gas transport in the fractured rock mass are not well understood. The authors conducted the two types of in-situ tests, with different scales, a borehole gas-injection test and a chamber gas-injection test in fractured granitic rock. These tests were conducted in the Cretaceous granitic rocks at the Namikata underground LPG storage cavern construction site in Ehime Prefecture in Japan, preceding to the cavern scale gas-tightness test. A borehole injection test was conducted using vertical and sub-vertical boreholes drilled from the water injection tunnel nearly at the depth of the top of the cavern, EL-150m. A new type downhole gas injection equipment that is capable to create a small 'cavern' within a borehole was developed. After performing a series of preliminary tests to investigate the hydraulic conductivity and gas-tightness, i.e. threshold pressure, gas injection tests were conducted under different gas pressure. Fig.1 shows an example of the test results From a chamber test using a air pressurizing chamber with volume of approximately166m3, the gas-tightness was confirmed within the uncertainty of 22Pa under the storage pressure of 0.7MPa, however, significant air leakage occurred possibly through an open fracture intersecting the chamber just after cavern pressure exceeds the initial hydrostatic pressure at the ceiling level of the chamber. Anomalies were detected in the data of the pore pressure as well as AE monitoring around the chamber. Results from the above two tests were simulated using a multi-phase transport simulator, TOUGH2, developed at Lawrence Berkeley National Laboratory. Fig.2 shows the model and an example of the simulation.

  17. Stent-Assisted Coil Embolization for Cavernous Carotid Artery Aneurysms

    PubMed Central

    KONO, Kenichi; SHINTANI, Aki; OKADA, Hideo; TANAKA, Yuko; TERADA, Tomoaki

    2014-01-01

    Internal carotid artery (ICA) occlusion with or without a bypass surgery is the traditional treatment for cavernous sinus (CS) aneurysms with cranial nerve (CN) dysfunction. Coil embolization without stents frequently requires retreatment because of the large size of CS aneurysms. We report the mid-term results of six unruptured CS aneurysms treated with stent-assisted coil embolization (SACE). The mean age of the patients was 72 years. The mean size of the aneurysms was 19.8 mm (range: 13–26 mm). Before treatment, four patients presented with CN dysfunction and two patients had no symptoms. SACE was performed under local or general anesthesia in three patients each. Mean packing density was 29.1% and tight packing was achieved. There were no neurological complications. CN dysfunction was cured in three patients (75%) and partly resolved in one patient (25%). Transient new CN dysfunction was observed in two patients (33%). Clinical and imaging follow-up ranged from 6 to 26 months (median: 16 months). Recanalization was observed in three patients (50%; neck remnant in two patients and dome filling in one patient), but no retreatment has yet been required. No recurrence of CN dysfunction has occurred yet. In summary, SACE increases packing density and may reduce requirement of retreatment with an acceptable cure rate of CN dysfunction. SACE may be a superior treatment for coiling without stents and be an alternative treatment of ICA occlusion for selected patients, such as older patients and those who require a high-flow bypass surgeryor cannot receive general anesthesia. PMID:24257503

  18. Gamma Knife radiosurgery for hemangioma of the cavernous sinus.

    PubMed

    Lee, Cheng-Chia; Sheehan, Jason P; Kano, Hideyuki; Akpinar, Berkcan; Martinez-Alvarez, Roberto; Martinez-Moreno, Nuria; Guo, Wan-Yuo; Lunsford, L Dade; Liu, Kang-Du

    2017-05-01

    OBJECTIVE Cavernous sinus hemangiomas (CSHs) are rare vascular tumors. A direct microsurgical approach usually results in massive hemorrhage and incomplete tumor resection. Although stereotactic radiosurgery (SRS) has emerged as a therapeutic alternative to microsurgery, outcome studies are few. Authors of the present study evaluated the role of SRS for CSH. METHODS An international multicenter study was conducted to review outcome data in 31 patients with CSH. Eleven patients had initial microsurgery before SRS, and the other 20 patients (64.5%) underwent Gamma Knife SRS as the primary management for their CSH. Median age at the time of radiosurgery was 47 years, and 77.4% of patients had cranial nerve dysfunction before SRS. Patients received a median tumor margin dose of 12.6 Gy (range 12-19 Gy) at a median isodose of 55%. RESULTS Tumor regression was confirmed by imaging in all 31 patients, and all patients had greater than 50% reduction in tumor volume at 6 months post-SRS. No patient had delayed tumor growth, new cranial neuropathy, visual function deterioration, adverse radiation effects, or hypopituitarism after SRS. Twenty-four patients had presented with cranial nerve disorders before SRS, and 6 (25%) of them had gradual improvement. Four (66.7%) of the 6 patients with orbital symptoms had symptomatic relief at the last follow-up. CONCLUSIONS Stereotactic radiosurgery was effective in reducing the volume of CSH and attaining long-term tumor control in all patients at a median of 40 months. The authors' experience suggests that SRS is a reasonable primary and adjuvant treatment modality for patients in whom a CSH is diagnosed.

  19. Seneca Compressed Air Energy Storage (CAES) Project

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None, None

    2012-11-30

    Compressed Air Energy Storage (CAES) is a hybrid energy storage and generation concept that has many potential benefits especially in a location with increasing percentages of intermittent wind energy generation. The objectives of the NYSEG Seneca CAES Project included: for Phase 1, development of a Front End Engineering Design for a 130MW to 210 MW utility-owned facility including capital costs; project financials based on the engineering design and forecasts of energy market revenues; design of the salt cavern to be used for air storage; draft environmental permit filings; and draft NYISO interconnection filing; for Phase 2, objectives included plant constructionmore » with a target in-service date of mid-2016; and for Phase 3, objectives included commercial demonstration, testing, and two-years of performance reporting. This Final Report is presented now at the end of Phase 1 because NYSEG has concluded that the economics of the project are not favorable for development in the current economic environment in New York State. The proposed site is located in NYSEG’s service territory in the Town of Reading, New York, at the southern end of Seneca Lake, in New York State’s Finger Lakes region. The landowner of the proposed site is Inergy, a company that owns the salt solution mining facility at this property. Inergy would have developed a new air storage cavern facility to be designed for NYSEG specifically for the Seneca CAES project. A large volume, natural gas storage facility owned and operated by Inergy is also located near this site and would have provided a source of high pressure pipeline quality natural gas for use in the CAES plant. The site has an electrical take-away capability of 210 MW via two NYSEG 115 kV circuits located approximately one half mile from the plant site. Cooling tower make-up water would have been supplied from Seneca Lake. NYSEG’s engineering consultant WorleyParsons Group thoroughly evaluated three CAES designs and concluded that any of the designs would perform acceptably. Their general scope of work included development of detailed project construction schedules, capital cost and cash flow estimates for both CAES cycles, and development of detailed operational data, including fuel and compression energy requirements, to support dispatch modeling for the CAES cycles. The Dispatch Modeling Consultant selected for this project was Customized Energy Solutions (CES). Their general scope of work included development of wholesale electric and gas market price forecasts and development of a dispatch model specific to CAES technologies. Parsons Brinkerhoff Energy Storage Services (PBESS) was retained to develop an air storage cavern and well system design for the CAES project. Their general scope of work included development of a cavern design, solution mining plan, and air production well design, cost, and schedule estimates for the project. Detailed Front End Engineering Design (FEED) during Phase 1 of the project determined that CAES plant capital equipment costs were much greater than the $125.6- million originally estimated by EPRI for the project. The initial air storage cavern Design Basis was increased from a single five million cubic foot capacity cavern to three, five million cubic foot caverns with associated air production wells and piping. The result of this change in storage cavern Design Basis increased project capital costs significantly. In addition, the development time required to complete the three cavern system was estimated at approximately six years. This meant that the CAES plant would initially go into service with only one third of the required storage capacity and would not achieve full capability until after approximately five years of commercial operation. The market price forecasting and dispatch modeling completed by CES indicated that the CAES technologies would operate at only 10 to 20% capacity factors and the resulting overall project economics were not favorable for further development. As a result of all of these factors, the Phase 1 FEED developed an installed CAES plant cost estimate of approximately $2,300/KW for the 210MW CAES 1A and 2 cycles. The capital cost for the 136 MW CAES 1 cycle was even higher due to the lower generating capacity of the cycle. Notably, the large equipment could have generated additional capacity (up to 270MW) which would have improved the cost per KW; however, the output was limited by the night time transmission system capability. The research herein, therefore, is particular to the site-specific factors that influenced the design and the current and forecasted generation mix and energy prices in Upstate New York and may not necessarily indicate that CAES plants cannot be economically constructed in other places in New York State or the world.« less

  20. Mechanical Characteristics Analysis of Surrounding Rock on Anchor Bar Reinforcement

    NASA Astrophysics Data System (ADS)

    Gu, Shuan-cheng; Zhou, Pan; Huang, Rong-bin

    2018-03-01

    Through the homogenization method, the composite of rock and anchor bar is considered as the equivalent material of continuous, homogeneous, isotropic and strength parameter enhancement, which is defined as reinforcement body. On the basis of elasticity, the composite and the reinforcement are analyzed, Based on strengthening theory of surrounding rock and displacement equivalent conditions, the expression of reinforcement body strength parameters and mechanical parameters is deduced. The example calculation shows that the theoretical results are close to the results of the Jia-mei Gao[9], however, closer to the results of FLAC3D numerical simulation, it is proved that the model and surrounding rock reinforcement body theory are reasonable. the model is easy to analyze and calculate, provides a new way for determining reasonable bolt support parameters, can also provides reference for the stability analysis of underground cavern bolting support.

  1. Imaging of retinal and choroidal vascular tumours

    PubMed Central

    Heimann, H; Jmor, F; Damato, B

    2013-01-01

    The most common intraocular vascular tumours are choroidal haemangiomas, vasoproliferative tumours, and retinal haemangioblastomas. Rarer conditions include cavernous retinal angioma and arteriovenous malformations. Options for ablating the tumour include photodynamic therapy, argon laser photocoagulation, trans-scleral diathermy, cryotherapy, anti-angiogenic agents, plaque radiotherapy, and proton beam radiotherapy. Secondary effects are common and include retinal exudates, macular oedema, epiretinal membranes, retinal fibrosis, as well as serous and tractional retinal detachment, which are treated using standard methods (ie, intravitreal anti-angiogenic agents or steroids as well as vitreoretinal procedures, such as epiretinal membrane peeling and release of retinal traction). The detection, diagnosis, and monitoring of vascular tumours and their complications have improved considerably thanks to advances in imaging. These include spectral domain and enhanced depth imaging optical coherence tomography (SD-OCT and EDI-OCT, respectively), wide-angle photography and angiography as well as wide-angle fundus autofluorescence. Such novel imaging has provided new diagnostic clues and has profoundly influenced therapeutic strategies so that vascular tumours and secondary effects are now treated concurrently instead of sequentially, enhancing any opportunities for conserving vision and the eye. In this review, we describe how SD-OCT, EDI-OCT, autofluorescence, wide-angle photography and wide-angle angiography have facilitated the evaluation of eyes with the more common vascular tumours, that is, choroidal haemangioma, retinal vasoproliferative tumours, and retinal haemangioblastoma. PMID:23196648

  2. Anaglyph Image Technology As a Visualization Tool for Teaching Geology of National Parks

    NASA Astrophysics Data System (ADS)

    Stoffer, P. W.; Phillips, E.; Messina, P.

    2003-12-01

    Anaglyphic stereo viewing technology emerged in the mid 1800's. Anaglyphs use offset images in contrasting colors (typically red and cyan) that when viewed through color filters produce a three-dimensional (3-D) image. Modern anaglyph image technology has become increasingly easy to use and relatively inexpensive using digital cameras, scanners, color printing, and common image manipulation software. Perhaps the primary drawbacks of anaglyph images include visualization problems with primary colors (such as flowers, bright clothing, or blue sky) and distortion factors in large depth-of-field images. However, anaglyphs are more versatile than polarization techniques since they can be printed, displayed on computer screens (such as on websites), or projected with a single projector (as slides or digital images), and red and cyan viewing glasses cost less than polarization glasses and other 3-D viewing alternatives. Anaglyph images are especially well suited for most natural landscapes, such as views dominated by natural earth tones (grays, browns, greens), and they work well for sepia and black and white images (making the conversion of historic stereo photography into anaglyphs easy). We used a simple stereo camera setup incorporating two digital cameras with a rigid base to photograph landscape features in national parks (including arches, caverns, cactus, forests, and coastlines). We also scanned historic stereographic images. Using common digital image manipulation software we created websites featuring anaglyphs of geologic features from national parks. We used the same images for popular 3-D poster displays at the U.S. Geological Survey Open House 2003 in Menlo Park, CA. Anaglyph photography could easily be used in combined educational outdoor activities and laboratory exercises.

  3. Analysis of Multi-Arm Caliper Data for the U.S. Strategic Petroleum Reserve

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Roberts, Barry L.

    The U.S. Strategic Petroleum Reserve (SPR) has an increasing reliance on mul t i - arm caliper surveys to assess the integrity of casing for cavern access wells and to determine priorities for casing remediation. Multi - arm caliper (MAC) surveys provide a view of well casing deformation by reporting radial measurements of the inner cas ing wall as the tool is drawn through the casing. Over the last several years the SPR has collected a large number of modern MAC surveys. In total, these surveys account for over 100 million individual measurements. The surveys were collected using diff eringmore » survey vendors and survey hardware. This has resulted in a collection of disparate data sets which confound attempts to make well - to - well or time - dependent evaluations. In addition, the vendor supplied MAC interpretations often involve variables wh ich are not well defined or which may not be applicable to casings for cavern access wells. These factors reduce the usability of these detailed data sets. In order to address this issue and provide an independent analysis of multi - arm caliper survey data, Sandia National Labs has developed processing techniques and analysis variables which allow for the comparison of MAC survey data regardless of the source of the survey data. These techniques use the raw radial arm information and newly developed analysis variables to assess the casing status and provide a means for well - to - well and time - dependent analyses. Well - to - well and t ime - dependent investigation of the MAC survey data provide s information to prioritize well remediation activities and identify wells with integrity issues. This paper presents the challenges in using disparate MAC survey data, techniques developed to address these challenges and some o f the insights gained from these new techniques.« less

  4. Cranio-orbital primary intraosseous haemangioma

    PubMed Central

    Gupta, T; Rose, G E; Manisali, M; Minhas, P; Uddin, J M; Verity, D H

    2013-01-01

    Purpose Primary intraosseous haemangioma (IOH) is a rare benign neoplasm presenting in the fourth and fifth decades of life. The spine and skull are the most commonly involved, orbital involvement is extremely rare. We describe six patients with cranio-orbital IOH, the largest case series to date. Patients and methods Retrospective review of six patients with histologically confirmed primary IOH involving the orbit. Clinical characteristics, imaging features, approach to management, and histopathological findings are described. Results Five patients were male with a median age of 56. Pain and diplopia were the most common presenting features. A characteristic ‘honeycomb' pattern on CT imaging was demonstrated in three of the cases. Complete surgical excision was performed in all cases with presurgical embolisation carried out in one case. In all the cases, histological studies identified cavernous vascular spaces within the bony tissue. These channels were lined by single layer of cytologically normal endothelial cells. Discussion IOCH of the cranio-orbital region is rare; in the absence of typical imaging features, the differential diagnosis includes chondroma, chondrosarcoma, bony metastasis, and lymphoma. Surgical excision may be necessary to exclude more sinister pathology. Intraoperative haemorrhage can be severe and may be reduced by preoperative embolisation. PMID:23989119

  5. Cavernous Hemangioma Between the Elastomer and Fibrous Capsule of a Breast Implant.

    PubMed

    de Mello Tucunduva, Tatiana Cardoso; Gaziero, Antonio; Tostes, Vivian Siqueira; Stiepcich, Monica Maria Agata; Torres, Ulysses S; Ohara, Patricia; Andrade, Wesley Pereira; Ferreira, Adriana Helena Padovan Grassmann; Missrie, Debora Rejtman; de Mello, Giselle Guedes Netto

    2018-06-05

    Hemangiomas are described in many locations, but breast hemangioma (BH) is rare, accounting for only 0.4% of all breast tumors. These tumors are difficult to diagnose preoperatively using conventional imaging modalities because they lack pathognomonic characteristics. Mammographic and sonographic appearances of BH were described in just a few case reports, and breast implant-related hemangiomas are even rarer. We report a case of the tumor arising in an atypical location-between the elastomer and fibrous capsule of a breast implant.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  6. Outcome of Surgical Treatment of 200 Children With Cushing's Disease

    PubMed Central

    Lonser, Russell R.; Wind, Joshua J.; Nieman, Lynnette K.; Weil, Robert J.; DeVroom, Hetty L.

    2013-01-01

    Context: Factors influencing the outcome of surgical treatment of pediatric Cushing's disease (CD) have not been fully established. Objective: The aim of this study was to examine features influencing the outcome of surgery for pediatric CD. Design: In this prospective observational study, the clinical, imaging, endocrinological, and operative outcomes were analyzed in consecutive patients treated at the National Institutes of Health (NIH) from 1982 through 2010. Setting: The study was conducted in a tertiary referral center. Results: Two hundred CD patients (106 females, 94 males) were included. Mean age at symptom development was 10.6 ± 3.6 years (range, 4.0 to 19.0 y). Mean age at NIH operation was 13.7 ± 3.7 years. Twenty-seven patients (13%) had prior surgery at another institution. Magnetic resonance imaging identified adenomas in 97 patients (50%). When positive, magnetic resonance imaging accurately defined a discrete adenoma in 96 of the 97 patients (99%), which was more accurate than the use of ACTH ratios during inferior petrosal sinus sampling to determine adenoma lateralization (accurate in 72% of patients without prior surgery). A total of 195 of the 200 patients (98%) achieved remission after surgery (189 [97%] were hypocortisolemic; 6 [3%] were eucortisolemic postoperatively). Factors associated with initial remission (P < .05) included identification of an adenoma at surgery, immunohistochemical ACTH-producing adenoma, and noninvasive ACTH adenoma. Younger age, smaller adenoma, and absence of cavernous sinus wall or other dural invasion were associated with long-term remission (P < .05). A minimum morning serum cortisol of less than 1 μg/dl after surgery had a positive predictive value for lasting remission of 96%. Conclusions: With rare disorders, such as pediatric CD, enhanced outcomes are obtained by evaluation and treatment at centers with substantial experience. Resection of pituitary adenomas in pediatric CD in that setting can be safe, effective, and durable. Early postoperative endocrine testing predicts lasting remission. Because lasting remission is associated with younger age at surgery, smaller adenomas, and lack of dural invasion, early diagnosis should improve surgical outcome. PMID:23372173

  7. Spontaneous Carotid-Cavernous Fistula in the Type IV Ehlers-Danlos Syndrome

    PubMed Central

    Kim, Jeong Gyun; Cho, Won-Sang; Kim, Jeong Eun

    2014-01-01

    Ehlers-Danlos syndrome (EDS) is a rare inherited connective disease. Among several subgroups, type IV EDS is frequently associated with spontaneous catastrophic bleeding from a vascular fragility. We report on a case of carotid-cavernous fistula (CCF) in a patient with type IV EDS. A 46-year-old female presented with an ophthalmoplegia and chemosis in the right eye. Subsequently, seizure and cerebral infarction with micro-bleeds occurred. CCF was completely occluded with transvenous coil embolization without complications. Thereafter, the patient was completely recovered. Transvenous coil embolization can be a good treatment of choice for spontaneous CCF with type IV EDS. However, every caution should be kept during invasive procedure. PMID:24653803

  8. Muon-Induced Neutrons Do Not Explain the DAMA Data

    NASA Astrophysics Data System (ADS)

    Klinger, J.; Kudryavtsev, V. A.

    2015-04-01

    We present an accurate model of the muon-induced background in the DAMA/LIBRA experiment. Our work challenges proposed mechanisms which seek to explain the observed DAMA signal modulation with muon-induced backgrounds. Muon generation and transport are performed using the MUSIC /MUSUN code, and subsequent interactions in the vicinity of the DAMA detector cavern are simulated with Geant4. We estimate the total muon-induced neutron flux in the detector cavern to be Φnν=1.0 ×10-9 cm-2 s-1 . We predict 3.49 ×10-5 counts /day /kg /keV , which accounts for less than 0.3% of the DAMA signal modulation amplitude.

  9. Spontaneous Carotid-Cavernous Fistula in the Type IV Ehlers-Danlos Syndrome.

    PubMed

    Kim, Jeong Gyun; Cho, Won-Sang; Kang, Hyun-Seung; Kim, Jeong Eun

    2014-02-01

    Ehlers-Danlos syndrome (EDS) is a rare inherited connective disease. Among several subgroups, type IV EDS is frequently associated with spontaneous catastrophic bleeding from a vascular fragility. We report on a case of carotid-cavernous fistula (CCF) in a patient with type IV EDS. A 46-year-old female presented with an ophthalmoplegia and chemosis in the right eye. Subsequently, seizure and cerebral infarction with micro-bleeds occurred. CCF was completely occluded with transvenous coil embolization without complications. Thereafter, the patient was completely recovered. Transvenous coil embolization can be a good treatment of choice for spontaneous CCF with type IV EDS. However, every caution should be kept during invasive procedure.

  10. An electrophysiologic study of female ejaculation.

    PubMed

    Shafik, Ahmed; Shafik, Ismail A; El Sibai, Olfat; Shafik, Ali A

    2009-01-01

    Opinions vary over whether female ejaculation exists or not. We investigated the hypothesis that female orgasm is not associated with ejaculation. Thirty-eight healthy women were studied. The study comprised of glans clitoris electrovibration with simultaneous recording of vaginal and uterine pressures as well as electromyography of corpus cavernous and ischio- and bulbo-cavernosus muscles. Glans clitoris electrovibration was continued until and throughout orgasm. Upon glans clitoris electrovibration, vaginal and uterine pressures as well as corpus cavernous electromyography diminished until a full erection occurred when the silent cavernosus muscles were activated. At orgasm, the electromyography of ischio-and bulbo-cavernosus muscles increased intermittently. The female orgasm was not associated with the appearance of fluid coming out of the vagina or urethra.

  11. Influence of an optical pulsed discharge on the structure of a supersonic air flow

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Malov, A N; Orishich, A M

    We present the results of investigation of the parameters of an optical pulsed discharge (OPD) and their relation with gasdynamic parameters of a supersonic flow and with characteristics of laser radiation. For the first time the discrete objects are detected in the OPD by an optical method, namely, low-density caverns moving along with the flow. The propagation velocity of the thermal track arising in a supersonic flow under the action of the OPD is measured. It is found that at a pulse repetition rate of 90 – 120 kHz the caverns unite into a single plasma jet. (laser applications andmore » other topics in quantum electronics)« less

  12. Ehlers-Danlos syndrome type IV

    PubMed Central

    Germain, Dominique P

    2007-01-01

    Ehlers-Danlos syndrome type IV, the vascular type of Ehlers-Danlos syndromes (EDS), is an inherited connective tissue disorder defined by characteristic facial features (acrogeria) in most patients, translucent skin with highly visible subcutaneous vessels on the trunk and lower back, easy bruising, and severe arterial, digestive and uterine complications, which are rarely, if at all, observed in the other forms of EDS. The estimated prevalence for all EDS varies between 1/10,000 and 1/25,000, EDS type IV representing approximately 5 to 10% of cases. The vascular complications may affect all anatomical areas, with a tendency toward arteries of large and medium diameter. Dissections of the vertebral arteries and the carotids in their extra- and intra-cranial segments (carotid-cavernous fistulae) are typical. There is a high risk of recurrent colonic perforations. Pregnancy increases the likelihood of a uterine or vascular rupture. EDS type IV is inherited as an autosomal dominant trait that is caused by mutations in the COL3A1 gene coding for type III procollagen. Diagnosis is based on clinical signs, non-invasive imaging, and the identification of a mutation of the COL3A1 gene. In childhood, coagulation disorders and Silverman's syndrome are the main differential diagnoses; in adulthood, the differential diagnosis includes other Ehlers-Danlos syndromes, Marfan syndrome and Loeys-Dietz syndrome. Prenatal diagnosis can be considered in families where the mutation is known. Choriocentesis or amniocentesis, however, may entail risk for the pregnant woman. In the absence of specific treatment for EDS type IV, medical intervention should be focused on symptomatic treatment and prophylactic measures. Arterial, digestive or uterine complications require immediate hospitalisation, observation in an intensive care unit. Invasive imaging techniques are contraindicated. Conservative approach is usually recommended when caring for a vascular complication in a patient suffering from EDS type IV. Surgery may, however, be required urgently to treat potentially fatal complications. PMID:17640391

  13. High-Resolution Seismic Imaging of Near-Surface Voids

    NASA Astrophysics Data System (ADS)

    Gritto, R.; Korneev, V. A.; Elobaid, E. A.; Mohamed, F.; Sadooni, F.

    2017-12-01

    A major hazard in Qatar is the presence of karst, which is ubiquitous throughout the country including depressions, sinkholes, and caves. Causes for the development of karst include faulting and fracturing where fluids find pathways through limestone and dissolve the host rock to form caverns. Of particular concern in rapidly growing metropolitan areas that expand in heretofore unexplored regions are the collapse of such caverns. Because Qatar has seen a recent boom in construction, including the planning and development of complete new sub-sections of metropolitan areas, the development areas need to be investigated for the presence of karst to determine their suitability for the planned project. We present a suite of seismic techniques applied to a controlled experiment to detect, locate and estimate the size of a karst analog in form of a man-made water shaft on the campus of Qatar University, Doha, Qatar. Seismic waves are well suited for karst detection and characterization. Voids represent high-contrast seismic objects that exhibit strong responses due to incident seismic waves. However, the complex geometry of karst, including shape and size, makes their imaging nontrivial. While karst detection can be reduced to the simple problem of detecting an anomaly, karst characterization can be complicated by the 3D nature of the problem of unknown scale, where irregular surfaces can generate diffracted waves of different kind. In our presentation, we employ a variety of seismic techniques to demonstrate the detection and characterization of a vertical water collection shaft analyzing the phase, amplitude and spectral information of seismic waves that have been scattered by the object. We use the reduction in seismic wave amplitudes and the delay in phase arrival times in the geometrical shadow of the vertical shaft to independently detect and locate the object in space. Additionally, we use narrow band-pass filtered data combining two orthogonal transmission surveys to detect and locate the object. Furthermore, we show that ambient noise recordings may generate data with sufficient signal-to-noise ratio to successfully detect and locate subsurface voids. Being able to use ambient noise recordings would eliminate the need to employ active seismic sources that are time consuming and more expensive to operate.

  14. Histopathological effects of fibrin glue on penile fracture in a rat model.

    PubMed

    Tasdemir, Cemal; Samdanci, Emine T; Turtay, Muhammet G; Firat, Cemal; Oguzturk, Hakan; Ozdemir, Hulya

    2011-12-01

    To evaluate both histopathological effects and potential clinical application of fibrin glue on the penile cavernosal tissue. Experimental penile fracture was formed by incising from the proximal dorsal side of the penis in 32 Wistar Albino rats. The rats were randomly assigned to four main groups of eight animals each. In the control group, the incision was not repaired and it was left to secondary healing. In the primary repair group, the incision was primarily repaired. In the fibrin glue group, glue was applied only to the incision. In the final group, fibrin glue was applied to the incision following primary repair. Three weeks later, penectomy tissue was examined histopathologically. When the control group was compared with primary repair+fibrin glue group, the differences in cavernous tissue healing with fibrosis and inflammation were statistically significant (p = 0.04 and 0.01, respectively). The primary repair+fibrin glue group, showed the best cavernous healing with fibrosis observed in only one rat. . There was no significant difference between the control group and the other groups according to cavernous tissue healing with fibrosis and inflammation (p = 0.11 and 0.12). Hyperemia was observed in the all groups of rats. Fibrin glue can be used in cavernoseal surgeries due to its adhesive and potentially anti-inflammatory features.

  15. Continuous-wave infrared optical nerve stimulation for potential diagnostic applications

    NASA Astrophysics Data System (ADS)

    Tozburun, Serhat; Cilip, Christopher M.; Lagoda, Gwen A.; Burnett, Arthur L.; Fried, Nathaniel M.

    2010-09-01

    Optical nerve stimulation using infrared laser radiation has recently been developed as a potential alternative to electrical nerve stimulation. However, recent studies have focused primarily on pulsed delivery of the laser radiation and at relatively low pulse rates. The objective of this study is to demonstrate faster optical stimulation of the prostate cavernous nerves using continuous-wave (cw) infrared laser radiation for potential diagnostic applications. A thulium fiber laser (λ=1870 nm) is used for noncontact optical stimulation of the rat prostate cavernous nerves in vivo. Optical nerve stimulation, as measured by an intracavernous pressure (ICP) response in the penis, is achieved with the laser operating in either cw mode, or with a 5-ms pulse duration at 10, 20, 30, 40, 50, and 100 Hz. Successful optical stimulation is observed to be primarily dependent on a threshold nerve temperature (42 to 45 °C), rather than an incident fluence, as previously reported. cw optical nerve stimulation provides a significantly faster ICP response time using a lower power (and also less expensive) laser than pulsed stimulation. cw optical nerve stimulation may therefore represent an alternative mode of stimulation for intraoperative diagnostic applications where a rapid response is critical, such as identification of the cavernous nerves during prostate cancer surgery.

  16. A new model of cavern diameter based on a validated CFD study on stirring of a highly shear-thinning fluid.

    PubMed

    Story, Anna; Jaworski, Zdzisław

    2017-01-01

    Results of numerical simulations of momentum transfer for a highly shear-thinning fluid (0.2% Carbopol) in a stirred tank equipped with a Prochem Maxflo T type impeller are presented. The simulation results were validated using LDA data and both tangential and axial force measurements in the laminar and early transitional flow range. A good agreement between the predicted and experimental results of the local fluid velocity components was found. From the predicted and experimental values of both tangential and axial forces, the power number, Po , and thrust number, Th , were also calculated. Values of the absolute relative deviations were below 4.0 and 10.5%, respectively, for Po and Th , which confirms a satisfactory agreement with experiments. An intensive mixing zone, known as cavern, was observed near the impeller. In this zone, the local values of fluid velocity, strain rate, Metzner-Otto coefficient, shear stress and intensity of energy dissipation were all characterized by strong variability. Based on the results of experimental study a new model using non-dimensional impeller force number was proposed to predict the cavern diameter. Comparative numerical simulations were also carried out for a Newtonian fluid (water) and their results were similarly well verified using LDA measurements, as well as experimental power number values.

  17. Microsurgical Resection of a Solitary Spinal Epidural Cavernous Angioma: 3-Dimensional Operative Video.

    PubMed

    Ceccato, Guilherme H W; Henning, Lucélio; Prado, Julyana L; Rassi, Marcio S; Borba, Luis A B

    2018-05-21

    Solitary spinal epidural cavernous angiomas are rare vascular malformations. Surgical excision is the treatment of choice, as these lesions tend to grow or bleed at some point. In this 3-dimensional, narrated video, we present the case of a 61-year-old male who presented with progressive pain in the right paravertebral region secondary to an epidural cavernous angioma located at the T6/T7 level. Under intraoperative neurophysiological monitoring, a laminectomy between T5 and T7 was performed. A reddish, well delimited, and highly vascularized epidural mass was identified and dissected from the adjacent dura and nerve root, and an en bloc total resection was achieved. The patient was discharged neurologically intact on postoperative day 4, presenting a remarkable improvement of his pain at 2-month follow-up. Total excision of these lesions is possible in most of cases, remaining the standard treatment, with minimum complications. All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All data related to patient identification were removed from this surgical video and manuscript, with no need of a written informed consent.

  18. The effect of different antihypertensive drugs on cavernous tissue in experimental chronic renal insufficiency.

    PubMed

    Toblli, Jorge E; Stella, Inés; Mazza, Osvaldo N; Ferder, León; Inserra, Felipe

    2006-01-01

    Male erectile dysfunction increases in prevalence in patients with severe chronic renal failure. Since arterial hypertension induces significant damage in cavernous tissue (CT), and considering that hypertension is extremely common in patients with end-stage renal disease (ESRD), the aim of this study was to evaluate the effect of the most conventionally employed antihypertensive drugs on CT in a rat model of renal insufficiency. Five groups of male rats with subtotal nephrectomy (STNx) and 1 with sham operations were studied over 6 months: STNx without treatment, STNx with benazepril (BZ), STNx with losartan (LS), STNx with amlodipine (AML) and STNx with atenolol (AT) plus the sham group. All rats were sacrificed at 6 months after STNx, and penises processed for LM and immunohistochemical studies. Cavernous smooth muscle (CSM) and vascular smooth muscle (VSM) from cavernous arteries and the amount of collagen type III were evaluated. All groups with antihypertensive drugs showed similar control in blood pressure throughout the study. Un-treated STNx, STNx with AML and STNx with AT presented significant (p<0.01) hypertrophy in both VSM and CSM, together with an increased amount of collagen type III in CT. Conversely, STNx with either BZ or LS showed a substantial (p<0.01) reduction in all of these variables, with values not different from the sham group. There was a significant (p<0.01) negative correlation between creatinine clearance and the amount of VSM, CSM and collagen type III deposition in CT in untreated STNx, STNx with AML and STNx with AT, but not in STNx with BZ, STNx with LS and sham. These results suggest that the interactions against the renin-angiotensin system (RAS) either by ACE inhibitors or angiotensin AT1 receptor blockers produce considerable benefits regarding structural abnormalities in CT in this animal model of renal insufficiency beyond blood pressure control.

  19. Expression of the apelin-APJ pathway and effects on erectile function in a mouse model of vasculogenic erectile dysfunction.

    PubMed

    Kwon, Mi-Hye; Tuvshintur, Buyankhuu; Kim, Woo Jean; Jin, Hai-Rong; Yin, Guo Nan; Song, Kang-Moon; Choi, Min Ji; Kwon, Ki-Dong; Batbold, Dulguun; Ryu, Ji-Kan; Suh, Jun-Kyu

    2013-12-01

    Much attention has recently been focused on therapeutic angiogenesis as a treatment for erectile dysfunction (ED). The apelin and apelin receptor (APJ) system is known to cause endothelium-dependent vasodilatation and to be involved in angiogenesis. To examine the differential expression of apelin and APJ in animal models of vasculogenic ED and to determine whether and how enhancement of apelin-APJ signaling restores erectile function in hypercholesterolemic mice. Acute cavernous ischemia was induced in C57BL/6J mice by bilateral occlusion of internal iliac arteries, and chronic vasculogenic ED was induced by feeding a high-cholesterol diet or by intraperitoneal injection of streptozotocin. Messenger RNA (mRNA) levels of apelin and APJ were determined in cavernous tissue of each vasculogenic ED model by semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). We evaluated erectile function by electrical stimulation of the cavernous nerve in hypercholesterolemic mice 1, 3, 7, and 14 days after a single intracavernous injection of apelin protein (5 μg/20 μL). The penis was harvested for histologic examinations and Western blot analysis. The cavernous mRNA expression of apelin and APJ was up-regulated in acute ischemia model and down-regulated in chronic vasculogenic ED models. A significant restoration of erectile function was noted 1 day after injection of apelin protein into the penis of hypercholesterolemic mice; however, erectile function returned to baseline values thereafter. The beneficial effects of apelin on erectile function resulted mainly from an activation of endothelial nitric oxide synthase and increase in nitric oxide bioavailability through reduction in reactive oxygen species-mediated endothelial apoptosis rather than through direct endothelial cell proliferation. These findings suggest that apelin-APJ signaling is a potential therapeutic target in the treatment of vasculogenic ED. Further studies are needed to develop a potent agonist for APJ and to determine the role of repeated dosing of apelin on long-term recovery of erectile function. © 2013 International Society for Sexual Medicine.

  20. Reliability analysis of hydrologic containment of liquefied petroleum gas within unlined rock caverns.

    NASA Astrophysics Data System (ADS)

    Gao, X.; Yan, E. C.; Yeh, T. C. J.; Wang, Y.; Liang, Y.; Hao, Y.

    2017-12-01

    Notice that most of the underground liquefied petroleum gas (LPG) storage caverns are constructed in unlined rock caverns (URCs), where the variability of hydraulic properties (in particular, hydraulic conductivity) has significant impacts on hydrologic containment performance. However, it is practically impossible to characterize the spatial distribution of these properties in detail at the site of URCs. This dilemma forces us to cope with uncertainty in our evaluations of gas containment. As a consequence, the uncertainty-based analysis is deemed more appropriate than the traditional deterministic analysis. The objectives of this paper are 1) to introduce a numerical first order method to calculate the gas containment reliability within a heterogeneous, two-dimensional unlined rock caverns, and 2) to suggest a strategy for improving the gas containment reliability. In order to achieve these goals, we first introduced the stochastic continuum representation of saturated hydraulic conductivity (Ks) of fractured rock and analyzed the spatial variability of Ks at a field site. We then conducted deterministic simulations to demonstrate the importance of heterogeneity of Ks in the analysis of gas tightness performance of URCs. Considering the uncertainty of the heterogeneity in the real world situations, we subsequently developed a numerical first order method (NFOM) to determine the gas tightness reliability at crucial locations of URCs. Using the NFOM, the effect of spatial variability of Ks on gas tightness reliability was investigated. Results show that as variance or spatial structure anisotropy of Ks increases, most of the gas tightness reliability at crucial locations reduces. Meanwhile, we compare the results of NFOM with those of Monte Carlo simulation, and we find the accuracy of NFOM is mainly affected by the magnitude of the variance of Ks. At last, for improving gas containment reliability at crucial locations at this study site, we suggest that vertical water-curtain holes should be installed in the pillar rather than increasing density of horizontal water-curtain boreholes.

  1. [Pathophysiology of hemorrhoids].

    PubMed

    Bruch, H P; Roblick, U J

    2001-06-01

    It is not easy to define haemorrhoidal complaints precisely since this automatically means the entire aetiology and pathogenesis. What Stelzner describes as a complex compound of arteriovenous links in the rectal mucosa with an interlace of unstriated muscles, elastic fibres and connective tissue forms the anatomic base of the "corpus cavernosum recti". This cavernous vascular padding is a crucial component of the continence organ and ensures a gas-tight seal. According to Thomson's studies, haemorrhoids are to be regarded as a consequence of the disintegration of muscular and elastic components, caused by a distal shift of the vascular padding. The changes can cause growth up to prolapse, as well as haemorrhage or congestion. The reasons have not yet been conclusively clarified. Malfunctioning intestines--in particular constipational changes with hard stool--seem to be causal factors. The mechanisms of function and control of arteriovenous links as well as the influence of hereditary, social and cultural disposition continue to be unclear.

  2. A Case of Acromegaly in which a Pituitary Gland Tumor was Reduced Significantly by Administering Octreotide Long Acting Release (LAR) and Could Be Removed Surgically.

    PubMed

    Arao, Tadashi; Okada, Yosuke; Uemura, Fumi; Nishizawa, Shigeru; Tanaka, Yoshiya

    A 54-year-old woman was admitted to our hospital for detailed examination of acromegaly because she noticed bilateral hand and finger swelling at the age of 43 and plantar thickening, facial changes and unclear articulation at the age of 49. She had prominent brow ridges, mandibular protrusion, and enlargement of the hands, feet, nasal wings, lips and tongue. Her growth hormone (GH) level was 39.8 ng/ml, insulin-like growth factor-1 (IGF-1) level was 717 ng/ml, GH level was not suppressed (22.9 ng/ml) during a 75-g oral glucose tolerance test (OGTT). Radiography showed cauliflower-like enlargement of the distal phalanx of the fingers, thickening/enlargement of the plantar soft tissues, and increased antero-posterior diameter of the sella turcica. Magnetic resonance imaging showed a mass (21×17 mm) growing towards the right suprasellar region and invading the cavernous sinus. She was diagnosed with acromegaly based on the characteristic physical findings, GH excess, high IGF-1, lack of GH suppression during the 75-g OGTT, and the presence of a pituitary tumor. She was started on octreotide long acting release (Oct-LAR) 20 mg/4w for tumor shrinkage. After three doses, her GH and IGF-1 levels decreased to 2.19 ng/ml (1.69 during the 75-g OGTT) and 205 ng/ml, respectively, meeting cure criteria for acromegaly. In this case, a decrease in GH and IGF-1 levels, tumor shrinkage, and resolution of cavernous sinus invasion allowed the patient to undergo surgery with curative intent (the first-line treatment for acromegaly) without postoperative complications. Thus, preoperative Oct-LAR administration has the potential to improve treatment outcomes of acromegaly.

  3. Inclusion of attentional networks in the pre-surgical neuroimaging assessment of a large deep hemispheric cavernous malformation: an FMRI case report.

    PubMed

    Mickleborough, Marla J S; Kelly, Michael E; Gould, Layla; Ekstrand, Chelsea; Lorentz, Eric; Ellchuk, Tasha; Babyn, Paul; Borowsky, Ron

    2015-01-01

    Functional magnetic resonance imaging (fMRI) is a noninvasive and reliable tool for mapping eloquent cortex in patients prior to brain surgery. Ensuring intact perceptual and cognitive processing is a key goal for neurosurgeons, and recent research has indicated the value of including attentional network processing in pre-surgical fMRI in order to help preserve such abilities, including reading, after surgery. We report a 42-year-old patient with a large cavernous malformation, near the left basal ganglia. The lesion measured 3.8 × 1.7 × 1.8 cm. In consultation with the patient and the multidisciplinary cerebrovascular team, the decision was made to offer the patient surgical resection. The surgical resection involved planned access via the left superior parietal lobule using stereotactic location. The patient declined an awake craniotomy; therefore, direct electrocortical stimulation (ECS) could not be used for intraoperative language localization in this case. Pre-surgical planning included fMRI localization of language, motor, sensory, and attentional processing. The key finding was that both reading and attention-processing tasks revealed consistent activation of the left superior parietal lobule, part of the attentional control network, and the site of the planned surgical access. Given this information, surgical access was adjusted to avoid interference with the attentional control network. The lesion was removed via the left inferior parietal lobule. The patient had no new neurologic deficits postoperatively but did develop mild neuropathic pain in the left hand. This case report supports recent research that indicates the value of including fMRI maps of attentional tasks along with traditional language-processing tasks in preoperative planning in patients undergoing neurosurgery procedures. © 2015 S. Karger AG, Basel.

  4. Anomalous vascularization in a Wnt medulloblastoma: a case report.

    PubMed

    Di Giannatale, Angela; Carai, Andrea; Cacchione, Antonella; Marrazzo, Antonio; Dell'Anna, Vito Andrea; Colafati, Giovanna Stefania; Diomedi-Camassei, Francesca; Miele, Evelina; Po, Agnese; Ferretti, Elisabetta; Locatelli, Franco; Mastronuzzi, Angela

    2016-07-15

    Medulloblastoma is the most common malignant brain tumor in children. To date only few cases of medulloblastoma with hemorrhages have been reported in the literature. Although some studies speculate on the pathogenesis of this anomalous increased vascularization in medulloblastoma, the specific mechanism is still far from clearly understood. A correlation between molecular medulloblastoma subgroups and hemorrhagic features has not been reported, although recent preliminary studies described that WNT-subtype tumors display increased vascularization and hemorrhaging. Herein, we describe a child with a Wnt-medulloblastoma presenting as cerebellar-vermian hemorrhagic lesion. Brain magnetic resonance imaging (MRI) showed the presence of a midline posterior fossa mass with a cystic hemorrhagic component. The differential diagnosis based on imaging included cavernous hemangioma, arteriovenous malformation and traumatic lesion. At surgery, the tumor appeared richly vascularized as documented by the preoperative angiography. The case we present showed that Wnt medulloblastoma may be associated with anomalous vascularization. Further studies are needed to elucidate if there is a link between the hypervascularization and the Wnt/β-catenin signaling activation and if this abnormal vasculature might influence drug penetration contributing to good prognosis of this medulloblastoma subgroup.

  5. Comparison of phase-contrast MR imaging and endovascular sonography for intracranial blood flow velocity measurements.

    PubMed

    Schneiders, J J; Ferns, S P; van Ooij, P; Siebes, M; Nederveen, A J; van den Berg, R; van Lieshout, J; Jansen, G; vanBavel, E; Majoie, C B

    2012-10-01

    Local hemodynamic information may help to stratify rupture risk of cerebral aneurysms. Patient-specific modeling of cerebral hemodynamics requires accurate data on BFV in perianeurysmal arteries as boundary conditions for CFD. The aim was to compare the BFV measured with PC-MR imaging with that obtained by using intra-arterial Doppler sonography and to determine interpatient variation in intracranial BFV. In 10 patients with unruptured intracranial aneurysms, BFV was measured in the cavernous ICA with PC-MR imaging in conscious patients before treatment, and measured by using an intra-arterial Doppler sonography wire when the patient was anesthetized with either propofol (6 patients) or sevoflurane (4 patients). Both techniques identified a pulsatile blood flow pattern in cerebral arteries. PSV differed >50 cm/s between patients. A mean velocity of 41.3 cm/s (95% CI, 39.3-43.3) was measured with PC-MR imaging. With intra-arterial Doppler sonography, a mean velocity of 29.3 cm/s (95% CI, 25.8-32.8) was measured with the patient under propofol-based intravenous anesthesia. In patients under sevoflurane-based inhaled anesthesia, a mean velocity of 44.9 cm/s (95% CI, 40.6-49.3) was measured. We showed large differences in BFV between patients, emphasizing the importance of using patient-specific hemodynamic boundary conditions in CFD. PC-MR imaging measurements of BFV in conscious patients were comparable with those obtained with the intra-arterial Doppler sonography when the patient was anesthetized with a sevoflurane-based inhaled anesthetic.

  6. Neurofibromatosis type 1 with external genitalia involvement presentation of 4 patients.

    PubMed

    Pascual-Castroviejo, Ignacio; Lopez-Pereira, Pedro; Savasta, Salvatore; Lopez-Gutierrez, Juan Carlos; Lago, Carlos Míguelez; Cisternino, Mariangela

    2008-11-01

    Genitourinary neurofibromas with clitoral involvement in neurofibromatosis type 1 are rare, and even more infrequent are the neurofibromas involving genitalia in males. The most frequent presenting sign of neurofibroma in females is clitoromegaly with pseudopenis, and enlarged penis is the most common sign in males. Labium majus neurofibroma not associated with clitoral involvement is extremely rare. Magnetic resonance imaging demonstration of the neurofibromas has seldom been reported. We report 4 children, 3 girls and 1 boy, with plexiform neurofibromas involving the external genitalia. Three of the 4 patients had histologic confirmation of neurofibroma. Two girls with clitoral hypertrophy had a neurofibroma that infiltrated the clitoris and extended unilaterally to the lower bladder wall. One girl had a plexiform neurofibroma that affected a labium. One boy with asymmetric penile hypertrophy since 2 years of age and ipsilateral gluteal hypertrophy had plexiform neurofibromas that extended between the left lumbogluteal and penile regions, infiltrating the left rectum wall and bladder with compression of both structures, the left prostate, and the left half of the cavernous corpi with hypertrophy of this part and asymmetry of the penis. Magnetic resonance imaging demonstrated in all patients that external genitalia and plexiform neurofibroma formed images of nondetachable structures. However, hermaphroditism was discarded by chromosomal study in all 3 girls before ratifying the diagnosis of external genitalia neurofibroma.

  7. Structural Stability Monitoring of a Physical Model Test on an Underground Cavern Group during Deep Excavations Using FBG Sensors.

    PubMed

    Li, Yong; Wang, Hanpeng; Zhu, Weishen; Li, Shucai; Liu, Jian

    2015-08-31

    Fiber Bragg Grating (FBG) sensors are comprehensively recognized as a structural stability monitoring device for all kinds of geo-materials by either embedding into or bonding onto the structural entities. The physical model in geotechnical engineering, which could accurately simulate the construction processes and the effects on the stability of underground caverns on the basis of satisfying the similarity principles, is an actual physical entity. Using a physical model test of underground caverns in Shuangjiangkou Hydropower Station, FBG sensors were used to determine how to model the small displacements of some key monitoring points in the large-scale physical model during excavation. In the process of building the test specimen, it is most successful to embed FBG sensors in the physical model through making an opening and adding some quick-set silicon. The experimental results show that the FBG sensor has higher measuring accuracy than other conventional sensors like electrical resistance strain gages and extensometers. The experimental results are also in good agreement with the numerical simulation results. In conclusion, FBG sensors could effectively measure small displacements of monitoring points in the whole process of the physical model test. The experimental results reveal the deformation and failure characteristics of the surrounding rock mass and make some guidance for the in situ engineering construction.

  8. Structural Stability Monitoring of a Physical Model Test on an Underground Cavern Group during Deep Excavations Using FBG Sensors

    PubMed Central

    Li, Yong; Wang, Hanpeng; Zhu, Weishen; Li, Shucai; Liu, Jian

    2015-01-01

    Fiber Bragg Grating (FBG) sensors are comprehensively recognized as a structural stability monitoring device for all kinds of geo-materials by either embedding into or bonding onto the structural entities. The physical model in geotechnical engineering, which could accurately simulate the construction processes and the effects on the stability of underground caverns on the basis of satisfying the similarity principles, is an actual physical entity. Using a physical model test of underground caverns in Shuangjiangkou Hydropower Station, FBG sensors were used to determine how to model the small displacements of some key monitoring points in the large-scale physical model during excavation. In the process of building the test specimen, it is most successful to embed FBG sensors in the physical model through making an opening and adding some quick-set silicon. The experimental results show that the FBG sensor has higher measuring accuracy than other conventional sensors like electrical resistance strain gages and extensometers. The experimental results are also in good agreement with the numerical simulation results. In conclusion, FBG sensors could effectively measure small displacements of monitoring points in the whole process of the physical model test. The experimental results reveal the deformation and failure characteristics of the surrounding rock mass and make some guidance for the in situ engineering construction. PMID:26404287

  9. Numerical simulation for the coupled thermo-mechanical performance of a lined rock cavern for underground compressed air energy storage

    NASA Astrophysics Data System (ADS)

    Zhou, Shu-Wei; Xia, Cai-Chu; Zhao, Hai-Bin; Mei, Song-Hua; Zhou, Yu

    2017-12-01

    Compressed air energy storage (CAES) is a technology that uses compressed air to store surplus electricity generated from low power consumption time for use at peak times. This paper presents a thermo-mechanical modeling for the thermodynamic and mechanical responses of a lined rock cavern used for CAES. The simulation was accomplished in COMSOL Multiphysics and comparisons of the numerical simulation and some analytical solutions validated the thermo-mechanical modeling. Air pressure and temperatures in the sealing layer and concrete lining exhibited a similar trend of ‘up-down-down-up’ in one cycle. Significant temperature fluctuation occurred only in the concrete lining and sealing layer, and no strong fluctuation was observed in the host rock. In the case of steel sealing, principal stresses in the sealing layer were larger than those in the concrete and host rock. The maximum compressive stresses of the three layers and the displacement on the cavern surface increased with the increase of cycle number. However, the maximum tensile stresses exhibited the opposite trend. Polymer sealing achieved a relatively larger air temperature and pressure compared with steel and air-tight concrete sealing. For concrete layer thicknesses of 0 and 0.1 m and an initial air pressure of 4.5 MPa, the maximum rock temperature could reach 135 °C and 123 °C respectively in a 30 day simulation.

  10. Flow diversion in vasculitic intracranial aneurysms? Repair of giant complex cavernous carotid aneurysm in polyarteritis nodosa using Pipeline embolization devices: first reported case.

    PubMed

    Martinez Santos, Jaime; Kaderali, Zul; Spears, Julian; Rubin, Laurence A; Marotta, Thomas R

    2016-07-01

    Intracranial aneurysms in polyarteritis nodosa (PAN) are exceedingly rare lesions with unpredictable behavior that pose real challenges to microsurgical and endovascular interventions owing to their inflammatory nature. We introduce a safe and effective alternative for treating these aneurysms using Pipeline embolization devices (PEDs). A 20-year-old man presented with diplopia, headaches, chronic abdominal pain, and weight loss. Diagnostic evaluations confirmed PAN, including bilateral giant cavernous carotid aneurysms. Cyclophosphamide and steroids achieved significant and sustained clinical improvement, with a decision to follow the aneurysms serially. Seven years later the left unruptured aneurysm enlarged, causing a sudden severe headache and a cavernous sinus syndrome. Treatment of the symptomatic aneurysm was pursued using flow diversion (PED) and the internal carotid artery was successfully reconstructed with a total of four overlapping PEDs. At 6 months follow-up, complete exclusion of the aneurysm was demonstrated, with symptomatic recovery. This is the first description of using a flow-diverting technique in an inflammatory vasculitis. In this case, PEDs not only attained a definitive closure of the aneurysm but also reconstructed the damaged and fragile arterial segment affected with vasculitis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Multidisciplinary management of an intra-sellar cavernous hemangioma: Case report and review of the literature.

    PubMed

    Chibbaro, S; Cebula, H; Ganau, M; Gubian, A; Todeschi, J; Lhermitte, B; Proust, F; Noel, G

    2018-06-01

    Extra-axial cavernous hemangiomas (ECH) are rare vascular lesions with a tendency to grow within the medial structures of the middle cranial fossa. This pathological entity lacks specific symptoms, and falls into the category of differential diagnosis of space occupying lesions in the cavernous sinus (CS) with or without sellar involvement, including those of tumoral, vascular and inflammatory nature. Of note, ECH can also be indolent, and is at times discovered incidentally during autopsy investigations. On radiological studies, ECH with sellar extension are frequently mistaken at first for pituitary adenomas. Total removal of intrasellar-CS ECH is technically demanding and burdened by remarkable morbidity and mortality rates, mostly related to the complex neuroanatomy of the CS-sellar region (i.e., peri and postoperative bleeding, and transitory or permanent nerve palsies, hormonal deficits). Consequently, only a few cases of successful total removal have been reported so far in the literature. Surgical debulking with cranial nerve decompression followed by stereotactic radiosurgery is currently considered the best alternative to total removal when the latter carries excessive perioperative risks. We present a rare case of a mainly located intrasellar ECH extending to the left CS discussing its clinical features and focusing on the most relevant aspects of the surgical management along with a review of the pertinent literature. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Geomechanical analysis to predict the oil leak at the wellbores in Big Hill Strategic Petroleum Reserve

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Park, Byoung Yoon

    2014-02-01

    Oil leaks were found in wellbores of Caverns 105 and 109 at the Big Hill Strategic Petroleum Reserve site. According to the field observations, two instances of casing damage occurred at the depth of the interbed between the caprock bottom and salt top. A three dimensional finite element model, which contains wellbore element blocks and allows each cavern to be configured individually, is constructed to investigate the wellbore damage mechanism. The model also contains element blocks to represent interface between each lithology and a shear zone to examine the interbed behavior in a realistic manner. The causes of the damagedmore » casing segments are a result of vertical and horizontal movements of the interbed between the caprock and salt dome. The salt top subsides because the volume of caverns below the salt top decrease with time due to salt creep closure, while the caprock subsides at a slower rate because the caprock is thick and stiffer. This discrepancy yields a deformation of the well. The deformed wellbore may fail at some time. An oil leak occurs when the wellbore fails. A possible oil leak date of each well is determined using the equivalent plastic strain failure criterion. A well grading system for a remediation plan is developed based on the predicted leak dates of each wellbore.« less

  13. Geomechanical Simulation to Predict the Oil Leak at the Wellbores in Big Hill Strategic Petroleum Reserve.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Park, Byoung; Herrick, Courtney G.

    2015-02-01

    Oil leaks were found in wellbores of Caverns 105 and 109 at the Big Hill Strategic Petroleum Reserve site. According to the field observations, two instances of casing damage occurred at the depth of the interbed between the caprock bottom and salt top. A three dimensional finite element model, which contains wellbore element blocks and allows each cavern to be configured individually, is constructed to investigate the wellbore damage mechanism. The model also contains element blocks to represent interface between each lithology and a shear zone to examine the interbed behavior in a realistic manner. The causes of the damagedmore » casing segments are a result of vertical and horizontal movements of the interbed between the caprock and salt dome. The salt top subsides because the volume of caverns below the salt top decrease with time due to salt creep closure, while the caprock subsides at a slower rate because the caprock is thick and stiffer. This discrepancy produces a deformation of the well. The deformed wellbore may fail at some time. An oil leak occurs when the wellbore fails. A possible oil leak date of each well is determined using an equivalent plastic strain failure criterion. A well grading system for a remediation plan is developed based on the predicted leak dates of each wellbore.« less

  14. Cavernous sinus thrombosis

    MedlinePlus

    ... Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

  15. Brine-in-crude-oil emulsions at the Strategic Petroleum Reserve

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nemer, Martin B.; Lord, David L.; MacDonald, Terry L.

    2013-10-01

    Metastable water-in-crude-oil emulsion formation could occur in a Strategic Petroleum Reserve (SPR) cavern if water were to flow into the crude-oil layer at a sufficient rate. Such a situation could arise during a drawdown from a cavern with a broken-hanging brine string. A high asphaltene content (> 1.5 wt %) of the crude oil provides the strongest predictor of whether a metastable water-in-crude-oil emulsion will form. However there are many crude oils with an asphaltene content > 1.5 wt % that don't form stable emulsions, but few with a low asphaltene content that do form stable emulsions. Most of themore » oils that form stable emulsions are "sour" by SPR standards indicating they contain total sulfur > 0.50 wt %.« less

  16. [Bilateral spontaneous carotid-cavernous fistula revealing Ehler-Danlos disease].

    PubMed

    Girardin, M; Puzenat, E; Humbert, P; Aubin, F

    2013-04-01

    A 34-year-old woman with an extensive surgical history developed two spontaneous carotido-cavernous fistula bilaterally. Skin examination revealed an acrogeric form of vascular Ehlers-Danlos syndrome and this diagnosis was confirmed by genetic analysis. Vascular Ehlers-Danlos syndrome is a rare autosomal dominant genetic disease that may be suspected on the grounds of clinical symptoms. Severe complications can occur in early life and are associated with a high mortality rate. The prognosis of vascular Ehlers-Danlos syndrome has been radically changed by the use of beta-blockers. The originality of our observation lies in the long time to onset of the initial complications in the absence of any problems during the numerous operations undergone by the patient, as well as the two childbirths. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  17. Topical nitroglycerin: a potential treatment for impotence.

    PubMed

    Owen, J A; Saunders, F; Harris, C; Fenemore, J; Reid, K; Surridge, D; Condra, M; Morales, A

    1989-03-01

    The effect of 2 per cent nitroglycerin paste applied to the penile shaft of impotent subjects was evaluated in a placebo controlled double-blind study under laboratory conditions. After application of nitroglycerin paste or a placebo ointment base, penile tumescence was recorded through a strain gauge transducer while subjects viewed an erotic video presentation. Relative to the placebo paste the number of subjects demonstrating an increase in penile circumference after nitroglycerin (18 of 26) was significantly different than all other outcome possibilities (p less than 0.05). Noninvasive vascular assessment by ultrasonography demonstrated an increase in diameter and blood flow in the cavernous arteries after application of nitroglycerin paste. Nitroglycerin paste increases blood flow in the cavernous arteries and improves tumescence after erotic stimulation. This agent may represent a new therapy for impotence.

  18. Interactive evolution concept for analyzing a rock salt cavern under cyclic thermo-mechanical loading

    NASA Astrophysics Data System (ADS)

    König, Diethard; Mahmoudi, Elham; Khaledi, Kavan; von Blumenthal, Achim; Schanz, Tom

    2016-04-01

    The excess electricity produced by renewable energy sources available during off-peak periods of consumption can be used e.g. to produce and compress hydrogen or to compress air. Afterwards the pressurized gas is stored in the rock salt cavities. During this process, thermo-mechanical cyclic loading is applied to the rock salt surrounding the cavern. Compared to the operation of conventional storage caverns in rock salt the frequencies of filling and discharging cycles and therefore the thermo-mechanical loading cycles are much higher, e.g. daily or weekly compared to seasonally or yearly. The stress strain behavior of rock salt as well as the deformation behavior and the stability of caverns in rock salt under such loading conditions are unknown. To overcome this, existing experimental studies have to be supplemented by exploring the behavior of rock salt under combined thermo-mechanical cyclic loading. Existing constitutive relations have to be extended to cover degradation of rock salt under thermo-mechanical cyclic loading. At least the complex system of a cavern in rock salt under these loading conditions has to be analyzed by numerical modeling taking into account the uncertainties due to limited access in large depth to investigate material composition and properties. An interactive evolution concept is presented to link the different components of such a study - experimental modeling, constitutive modeling and numerical modeling. A triaxial experimental setup is designed to characterize the cyclic thermo-mechanical behavior of rock salt. The imposed boundary conditions in the experimental setup are assumed to be similar to the stress state obtained from a full-scale numerical simulation. The computational model relies primarily on the governing constitutive model for predicting the behavior of rock salt cavity. Hence, a sophisticated elasto-viscoplastic creep constitutive model is developed to take into account the dilatancy and damage progress, as well as the temperature effects. The contributed input parameters in the constitutive model are calibrated using the experimental measurements. In the following, the initial numerical simulation is modified based on the introduced constitutive model implemented in a finite element code. However, because of the significant levels of uncertainties involved in the design procedure of such structures, a reliable design can be achieved by employing probabilistic approaches. Therefore, the numerical calculation is extended by statistical tools such as sensitivity analysis, probabilistic analysis and robust reliability-based design. Uncertainties e.g. due to limited site investigation, which is always fragmentary within these depths, can be compensated by using data sets of field measurements for back calculation of input parameters with the developed numerical model. Monitoring concepts can be optimized by identifying sensor localizations e.g. using sensitivity analyses.

  19. Multimodal Navigation in Endoscopic Transsphenoidal Resection of Pituitary Tumors Using Image-Based Vascular and Cranial Nerve Segmentation: A Prospective Validation Study.

    PubMed

    Dolati, Parviz; Eichberg, Daniel; Golby, Alexandra; Zamani, Amir; Laws, Edward

    2016-11-01

    Transsphenoidal surgery (TSS) is the most common approach for the treatment of pituitary tumors. However, misdirection, vascular damage, intraoperative cerebrospinal fluid leakage, and optic nerve injuries are all well-known complications, and the risk of adverse events is more likely in less-experienced hands. This prospective study was conducted to validate the accuracy of image-based segmentation coupled with neuronavigation in localizing neurovascular structures during TSS. Twenty-five patients with a pituitary tumor underwent preoperative 3-T magnetic resonance imaging (MRI), and MRI images loaded into the navigation platform were used for segmentation and preoperative planning. After patient registration and subsequent surgical exposure, each segmented neural or vascular element was validated by manual placement of the navigation probe or Doppler probe on or as close as possible to the target. Preoperative segmentation of the internal carotid artery and cavernous sinus matched with the intraoperative endoscopic and micro-Doppler findings in all cases. Excellent correspondence between image-based segmentation and the endoscopic view was also evident at the surface of the tumor and at the tumor-normal gland interfaces. Image guidance assisted the surgeons in localizing the optic nerve and chiasm in 64% of cases. The mean accuracy of the measurements was 1.20 ± 0.21 mm. Image-based preoperative vascular and neural element segmentation, especially with 3-dimensional reconstruction, is highly informative preoperatively and potentially could assist less-experienced neurosurgeons in preventing vascular and neural injury during TSS. In addition, the accuracy found in this study is comparable to previously reported neuronavigation measurements. This preliminary study is encouraging for future prospective intraoperative validation with larger numbers of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Intracranial Management of Perineural Spread in the Trigeminal Nerve.

    PubMed

    Redmond, Michael J; Panizza, Benedict J

    2016-04-01

    Since the mid-1960s surgeons have attempted to cure intracranial perineural spread (PNS) of cutaneous malignancies. Untreated patients with trigeminal PNS die from brainstem invasion and leptomeningeal disease. It was understood that resection with clear margins was potentially curative, but early surgical attempts were unsuccessful. The prevailing wisdom considered that this surgery failed to improve the results achieved with radiation therapy alone and was associated with high morbidity. However, with improved imaging, surgical equipment, and better understanding of cavernous sinus (CS) anatomy and access, contemporary surgeons can improve outcomes for this disease. The aim of this paper is to describe a technique to access the interdural compartment of the CS and treat PNS of cutaneous squamous cell carcinoma (cSCC) in the intracranial trigeminal nerve and ganglion. It is based on the experience of the Queensland Skull Base Unit, Australia in managing PNS of cutaneous squamous cell carcinoma of the head and neck (cSCCHN).

  1. A primary cavernous hemangioma of the thyroid gland: A case report and literature review.

    PubMed

    Miao, Jie; Chen, Shubo; Li, Yongcai; Fu, Lin; Li, Hui

    2017-12-01

    Thyroid hemangioma is benign and associated with fine-needle aspiration (FNA) biopsy or trauma in most cases. Its differential diagnosis is very difficult. We presented the case of a 48-year-old man complained of slowly progressed swelling in the anterior neck for 20 years. Ultrasound and CT scan revealed a hypoechogenic and heterogeneous mass measuring 4 × 3.5 cm located in the right lobe of thyroid gland. Postoperative pathological and immunohistochemical examinations of the surgical specimen revealed a primary hemangioma of the thyroid gland. The patient received a right lobectomy of the thyroid. The patient had been followed up for 10 months after surgery without complications and remained asymptomatic. Primary thyroid hemangioma should be considered when there is a well-circumscribed capsule mass on medical imaging without history of FNA or any other cervical procedures or trauma.

  2. Chapter 8: Invasive fungal rhinosinusitis.

    PubMed

    Duggal, Praveen; Wise, Sarah K

    2013-01-01

    Invasive fungal rhinosinusitis (IFRS) is a disease of the paranasal sinuses and nasal cavity that typically affects immunocompromised patients in the acute fulminant form. Early symptoms can often mimic rhinosinusitis, while late symptoms can cause significant morbidity and mortality. Swelling and mucosal thickening can quickly progress to pale or necrotic tissue in the nasal cavity and sinuses, and the disease can rapidly spread and invade the palate, orbit, cavernous sinus, cranial nerves, skull base, carotid artery, and brain. IFRS can be life threatening if left undiagnosed or untreated. While the acute fulminant form of IFRS is the most rapidly progressive and destructive, granulomatous and chronic forms also exist. Diagnosis of IFRS often mandates imaging studies in conjunction with clinical, endoscopic, and histopathological examination. Treatment of IFRS consists of reversing the underlying immunosuppression, antifungal therapy, and aggressive surgical debridement. With early diagnosis and treatment, IFRS can be treated and increase patient survival.

  3. Chapter 8: Invasive fungal rhinosinusitis.

    PubMed

    Duggal, Praveen; Wise, Sarah K

    2013-05-01

    Invasive fungal rhinosinusitis (IFRS) is a disease of the paranasal sinuses and nasal cavity that typically affects immunocompromised patients in the acute fulminant form. Early symptoms can often mimic rhinosinusitis, while late symptoms can cause significant morbidity and mortality. Swelling and mucosal thickening can quickly progress to pale or necrotic tissue in the nasal cavity and sinuses, and the disease can rapidly spread and invade the palate, orbit, cavernous sinus, cranial nerves, skull base, carotid artery, and brain. IFRS can be life threatening if left undiagnosed or untreated. While the acute fulminant form of IFRS is the most rapidly progressive and destructive, granulomatous and chronic forms also exist. Diagnosis of IFRS often mandates imaging studies in conjunction with clinical, endoscopic, and histopathological examination. Treatment of IFRS consists of reversing the underlying immunosuppression, antifungal therapy, and aggressive surgical debridement. With early diagnosis and treatment, IFRS can be treated and increase patient survival.

  4. Massive Oculomotor Nerve Enlargement: A Case of Presumed Schwannomatosis.

    PubMed

    Donaldson, Laura; Rebello, Ryan; Rodriguez, Amadeo

    2017-06-01

    A 45-year-old man presented with a slowly progressive pupil-involving third nerve palsy. Magnetic resonance imaging (MRI) revealed a tubular lesion extending from the interpeduncular cistern through the cavernous sinus and into the left orbit where it branched into a superior and an inferior division, clearly outlining the anatomy of the third cranial nerve. Multiple other, less pronounced, enlarged cranial nerves were noted. The differential diagnosis included chronic inflammatory demyelinating polyneuropathy (CIDP), hereditary motor and sensory neuropathy (HMSN), neurofibromatosis (NF), and schwannomatosis. The absence of other muscle weakness and of sensory symptoms combined with normal peripheral nerve conduction studies effectively ruled out the hypertrophic polyneuropathies and pointed to a syndromic cause of multiple benign peripheral nerve sheath tumours (PNSTs). The authors are treating this case as presumed schwannomatosis, a syndrome similar to NF2 with much lower frequency of acoustic neuromas.

  5. Massive Oculomotor Nerve Enlargement: A Case of Presumed Schwannomatosis

    PubMed Central

    Donaldson, Laura; Rebello, Ryan; Rodriguez, Amadeo

    2017-01-01

    ABSTRACT A 45-year-old man presented with a slowly progressive pupil-involving third nerve palsy. Magnetic resonance imaging (MRI) revealed a tubular lesion extending from the interpeduncular cistern through the cavernous sinus and into the left orbit where it branched into a superior and an inferior division, clearly outlining the anatomy of the third cranial nerve. Multiple other, less pronounced, enlarged cranial nerves were noted. The differential diagnosis included chronic inflammatory demyelinating polyneuropathy (CIDP), hereditary motor and sensory neuropathy (HMSN), neurofibromatosis (NF), and schwannomatosis. The absence of other muscle weakness and of sensory symptoms combined with normal peripheral nerve conduction studies effectively ruled out the hypertrophic polyneuropathies and pointed to a syndromic cause of multiple benign peripheral nerve sheath tumours (PNSTs). The authors are treating this case as presumed schwannomatosis, a syndrome similar to NF2 with much lower frequency of acoustic neuromas. PMID:28512503

  6. Cavernous Angioma and Children

    MedlinePlus

    ... of activity restrictions. The following table lists the comparative risks of activities for children with epilepsy and ... have access to one, can help you to design a program that could work for your child. ...

  7. Modeling of coupled thermodynamic and geomechanical performance of underground compressed air energy storage in lined rock caverns

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rutqvist, Jonny; Kim, Hyung-Mok; Ryu, Dong-Woo

    We applied coupled nonisothermal, multiphase fluid flow and geomechanical numerical modeling to study the coupled thermodynamic and geomechanical performance of underground compressed air energy storage (CAES) in concrete-lined rock caverns. The paper focuses on CAES in lined caverns at relatively shallow depth (e.g., 100 m depth) in which a typical CAES operational pressure of 5 to 8 MPa is significantly higher than both ambient fluid pressure and in situ stress. We simulated a storage operation that included cyclic compression and decompression of air in the cavern, and investigated how pressure, temperature and stress evolve over several months of operation. Wemore » analyzed two different lining options, both with a 50 cm thick low permeability concrete lining, but in one case with an internal synthetic seal such as steel or rubber. For our simulated CAES system, the thermodynamic analysis showed that 96.7% of the energy injected during compression could be recovered during subsequent decompression, while 3.3% of the energy was lost by heat conduction to the surrounding media. Our geomechanical analysis showed that tensile effective stresses as high as 8 MPa could develop in the lining as a result of the air pressure exerted on the inner surface of the lining, whereas thermal stresses were relatively smaller and compressive. With the option of an internal synthetic seal, the maximum effective tensile stress was reduced from 8 to 5 MPa, but was still in substantial tension. We performed one simulation in which the tensile tangential stresses resulted in radial cracks and air leakage though the lining. This air leakage, however, was minor (about 0.16% of the air mass loss from one daily compression) in terms of CAES operational efficiency, and did not significantly impact the overall energy balance of the system. However, despite being minor in terms of energy balance, the air leakage resulted in a distinct pressure increase in the surrounding rock that could be quickly detected using pressure monitoring outside the concrete lining.« less

  8. Gamma knife radiosurgery in patients with persistent acromegaly or Cushing's disease: long-term risk of hypopituitarism.

    PubMed

    Cohen-Inbar, Or; Ramesh, Arjun; Xu, Zhiyuan; Vance, Mary Lee; Schlesinger, David; Sheehan, Jason P

    2016-04-01

    For patient with a recurrent or residual acromegaly or Cushing's disease (CD) after resection, gamma knife radiosurgery (GKRS) is often used. Hypopituitarism is the most common adverse effect after GKRS treatment. The paucity of studies with long-term follow-up has hampered understanding of the latent risks of hypopituitarism in patients with acromegaly or CD. We report the long-term risks of hypopituitarism for patients treated with GKRS for acromegaly or CD. From a prospectively created, IRB-approved database, we identified all patients with acromegaly or CD treated with GKRS at the University of Virginia from 1989 to 2008. Only patients with a minimum endocrine follow-up of 60 months were included. The median follow-up is 159·5 months (60·1-278). Thorough radiological and endocrine assessments were performed immediately before GKRS and at regular follow-up intervals. New onset of hypopituitarism was defined as pituitary hormone deficits after GKRS requiring corresponding hormone replacement. Sixty patients with either acromegaly or CD were included. Median tumour volume at time of GKRS was 1·3 cm(3) (0·3-13·4), and median margin dose was 25 Gy (6-30). GKRS-induced new pituitary deficiency occurred in 58·3% (n = 35) of patients. Growth hormone deficiency was most common (28·3%, n = 17). The actuarial overall rates of hypopituitarism at 3, 5 and 10 years were 10%, 21·7% and 53·3%, respectively. The median time to hypopituitarism was 61 months after GKRS (range, 12-160). Cavernous sinus invasion of the tumour was found to correlate with the occurrence of a new or progressive hypopituitarism after GKRS (P = 0·018). Delayed hypopituitarism increases as a function of time after radiosurgery. Hormone axes appear to vary in terms of radiosensitivity. Patients with adenoma in the cavernous sinus are more prone to develop loss of pituitary function after GKRS. © 2015 John Wiley & Sons Ltd.

  9. Cavernous Angioma CARE Center Act of 2012

    THOMAS, 112th Congress

    Sen. Udall, Tom [D-NM

    2012-02-09

    Senate - 02/09/2012 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  10. Cavernous Angioma CARE Center Act of 2010

    THOMAS, 111th Congress

    Sen. Udall, Tom [D-NM

    2010-08-02

    Senate - 08/02/2010 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  11. Cavernous Angioma Research Resource Act of 2013

    THOMAS, 113th Congress

    Sen. Udall, Tom [D-NM

    2013-06-26

    Senate - 06/26/2013 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  12. Genetics Home Reference: cerebral cavernous malformation

    MedlinePlus

    ... R, Irthum B, Jacquet G, Lonjon M, Moreau JJ, Neau JP, Parker F, Tremoulet M, Tournier-Lasserve ... F, Loiseau H, Menei P, Mercier P, Moreau JJ, Nivelon-Chevallier A, Parker F, Redondo AM, Scarabin ...

  13. Neuroprotective and Nerve Regenerative Approaches for Treatment of Erectile Dysfunction after Cavernous Nerve Injury

    PubMed Central

    Campbell, Jeffrey D.; Burnett, Arthur L.

    2017-01-01

    Erectile dysfunction (ED) is a significant cause of reduced quality of life in men and their partners. Cavernous nerve injury (CNI) during pelvic surgery results in ED in greater than 50% of patients, regardless of additional patient factors. ED related to CNI is difficult to treat and typically poorly responsive to first- and second-line therapeutic options. Recently, a significant amount of research has been devoted to exploring neuroprotective and neuroregenerative approaches to salvage erectile function in patients with CNI. In addition, therapeutic options such as neuregulins, immunophilin ligands, gene therapy, stem cell therapy and novel surgical strategies, have shown benefit in pre-clinical, and limited clinical studies. In the era of personalized medicine, these new therapeutic technologies will be the future of ED treatment and are described in this review. PMID:28820434

  14. Unilateral facial palsy in an infant: an unusual presentation of familial multiple cerebral cavernous malformation

    PubMed Central

    Zakaria, Zaitun; Kaliaperumal, Chandrasekaran; Caird, John; Sattar, Mohammad

    2012-01-01

    Cerebral cavernous malformation (CCM) in infants tends to have genetic predisposition. These cavernomas have a progressive course of events and associated neurological symptoms with increase in age. They most commonly present with seizure and syndrome of increased intracranial pressure comprising of headache, vomiting and focal neurological signs. We describe a case of a 7-month-old infant who presented with an acute onset of right facial paralysis with a background of familial CCM. The CT and MRI scan revealed fresh haemorrhage in the right cerebellar and pontine cavernomas with surrounding oedema and no evidence of obstructive hydrocephalus. These two cavernomas re-bled in a week duration causing episodes of incessant crying and irritability. After discussing the pros and cons of treatment, owing to stable clinical status, the patient is currently been managed conservatively. PMID:23203183

  15. A Comparison of Simplified Two-dimensional Flow Models Exemplified by Water Flow in a Cavern

    NASA Astrophysics Data System (ADS)

    Prybytak, Dzmitry; Zima, Piotr

    2017-12-01

    The paper shows the results of a comparison of simplified models describing a two-dimensional water flow in the example of a water flow through a straight channel sector with a cavern. The following models were tested: the two-dimensional potential flow model, the Stokes model and the Navier-Stokes model. In order to solve the first two, the boundary element method was employed, whereas to solve the Navier-Stokes equations, the open-source code library OpenFOAM was applied. The results of numerical solutions were compared with the results of measurements carried out on a test stand in a hydraulic laboratory. The measurements were taken with an ADV probe (Acoustic Doppler Velocimeter). Finally, differences between the results obtained from the mathematical models and the results of laboratory measurements were analysed.

  16. Purely neuroendoscopic resection of an intraventricular cavernous angioma: case report.

    PubMed

    Giannetti, Alexandre Varella

    2013-01-01

    Intraventricular cavernomas are rare and generally treated by microsurgical approach. With the advances in neuroendoscopy, intraventricular lesions have been managed by this technique. However, tumor size and vascular nature are considered restrictive factors. As far as we are concerned, there are two cases in the literature of intraventricular cavernoma resection done by neuroendoscopy. We describe a case of a man who presented with hydrocephalus secondary to a mesencephalic cavernoma and a second cavernous angioma located at the dorsum thalamus. This second lesion was successfully removed using a pure neuroendoscopic technique at the same time as a third ventriculostomy was performed. As neuroendoscopy evolves, we see that lesions considered impossible to be managed by neuroendoscopy before today are being treated with the advantages that the minimally invasive surgery offers. Georg Thieme Verlag KG Stuttgart · New York.

  17. Origin of honeycombs: Testing the hydraulic and case hardening hypotheses

    NASA Astrophysics Data System (ADS)

    Bruthans, Jiří; Filippi, Michal; Slavík, Martin; Svobodová, Eliška

    2018-02-01

    Cavernous weathering (cavernous rock decay) is a global phenomenon, which occurs in porous rocks around the world. Although honeycombs and tafoni are considered to be the most common products of this complex process, their origin and evolution are as yet not fully understood. The two commonly assumed formation hypotheses - hydraulic and case hardening - were tested to elucidate the origin of honeycombs on sandstone outcrops in a humid climate. Mechanical and hydraulic properties of the lips (walls between adjacent pits) and backwalls (bottoms of pits) of the honeycombs were determined via a set of established and novel approaches. While the case hardening hypothesis was not supported by the determinations of either tensile strength, drilling resistance or porosity, the hydraulic hypothesis was clearly supported by field measurements and laboratory tests. Fluorescein dye visualization of capillary zone, vapor zone, and evaporation front upon their contact, demonstrated that the evaporation front reaches the honeycomb backwalls under low water flow rate, while the honeycomb lips remain dry. During occasional excessive water flow events, however, the evaporation front may shift to the lips, while the backwalls become moist as a part of the capillary zone. As the zone of evaporation corresponds to the zone of potential salt weathering, it is the spatial distribution of the capillary and vapor zones which dictates whether honeycombs are created or the rock surface is smoothed. A hierarchical model of factors related to the hydraulic field was introduced to obtain better insights into the process of cavernous weathering.

  18. Follow-Up of 58 Traumatic Carotid-Cavernous Fistulas after Endovascular Detachable-Balloon Embolization at a Single Center

    PubMed Central

    Xu, Xiao-Quan; Liu, Sheng; Zu, Qing-Quan; Zhao, Lin-Bo; Xia, Jin-Guo; Zhou, Chun-Gao; Zhou, Wei-Zhong

    2013-01-01

    Background and Purpose This study evaluated the clinical value of detachable-balloon embolization for traumatic carotid-cavernous fistula (TCCF), focusing on the frequency, risk factors, and retreatment of recurrence. Methods Fifty-eight patients with TCCF underwent transarterial detachable-balloon embolization between October 2004 and March 2011. The clinical follow-up was performed every 3 months until up to 3 years postprocedure. Each patient was placed in either the recurrence group or the nonrecurrence group according to whether a recurrence developed after the first procedure. The relevant factors including gender, fistula location, interval between trauma and the interventional procedure, blood flow in the carotid-cavernous fistula, number of balloons, and whether the internal carotid artery (ICA) was sacrificed were evaluated. Results All 58 TCCFs were successfully treated with transarterial balloon embolization, including 7 patients with ICA sacrifice. Recurrent fistulas occurred in seven patients during the follow-up period. Univariate analysis indicated that the interval between trauma and the interventional procedure (p=0.006) might be the main factor related to the recurrence of TCCF. The second treatments involved ICA sacrifice in two patients, fistula embolization with balloons in four patients, and placement of a covered stent in one patient. Conclusions Detachable balloons can still serve as the first-line treatment for TCCFs and recurrent TCCFs despite having a nonnegligible recurrence rate. Shortening the interval between trauma and the interventional procedure may reduce the risk of recurrence. PMID:23626645

  19. Beneficial Effects of Scutellaria baicalensis on Penile Erection in Streptozotocin-Induced Diabetic Rats.

    PubMed

    Li, Xiang; Lee, Yun Jung; Kim, Hye Yoom; Tan, Rui; Park, Min Cheol; Kang, Dae Gill; Lee, Ho Sub

    2016-01-01

    We have reported that ethanol extracts of the root from Scutellaria baicalensis Georgi (ESB) relax cavernous smooth muscles via the NO/cGMP system and Ca[Formula: see text]-sensitive K[Formula: see text] channels in the rabbit corpus cavernosum. In the present study, erectile function was assessed by intracavernous pressure (ICP) and mean arterial pressure (MAP) during electrical stimulation of the cavernous nerve. The ICP/MAP ratio was dose-dependently increased by the treatment of ESB in normal SD rats ([Formula: see text]). To investigate the beneficial effect of ESB on erectile dysfunction in a diabetic animal model, male SD rats were injected with streptozotocin (60[Formula: see text]mg/kg) and then 300[Formula: see text]mg/kg/day ESB was administered daily for eight weeks. In our in vivo study, administration of ESB in STZ rats significantly increased the ICP, ICP/MAP ratio, area under the curve (AUC), as well as the cavernous cGMP levels. Morphometric analyses showed that ESB administration increased both smooth muscle volume and the regular arrangement of collagen fibers compared to the STZ group. The protein expression levels of endothelial nitric oxide synthase (eNOS) and SM [Formula: see text]-actin from penile tissues were also significantly increased in the ESB-treated rats. Taken together, these results suggest that ESB ameliorates penile erectile dysfunction via the activation of the NO/cGMP pathways of the penile corpus cavernosum in a streptozotocin-induced diabetic rat model.

  20. Cavernous sinus hemangioma: a fourteen year single institution experience.

    PubMed

    Bansal, Sumit; Suri, Ashish; Singh, Manmohan; Kale, Shashank Sharad; Agarwal, Deepak; Sharma, Manish Singh; Mahapatra, Ashok Kumar; Sharma, Bhawani Shankar

    2014-06-01

    Cavernous sinus hemangioma (CSH) is a rare extra-axial vascular neoplasm that accounts for 2% to 3% of all cavernous sinus tumors. Their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures are factors which present difficulty in excising these lesions. The authors describe their experience of 22 patients with CSH over 14 years at a tertiary care center. Patients were managed with microsurgical resection using a purely extradural transcavernous approach (13 patients) and with Gamma Knife radiosurgery (GKRS; Elekta AB, Stockholm, Sweden) (nine patients). Retrospective data analysis found headache and visual impairment were the most common presenting complaints, followed by facial hypesthesia and diplopia. All but one patient had complete tumor excision in the surgical series. Transient ophthalmoparesis (complete resolution in 6-8 weeks) was the most common surgical complication. In the GKRS group, marked tumor shrinkage (>50% tumor volume reduction) was achieved in two patients, slight shrinkage in five and no change in two patients, with symptom improvement in the majority of patients. To our knowledge, we describe one of the largest series of CSH managed at a single center. Although microsurgical resection using an extradural transcavernous approach is considered the treatment of choice in CSH and allows complete excision with minimal mortality and long-term morbidity, GKRS is an additional tool for treating residual symptomatic lesions or in patients with associated comorbidities making surgical resection unsuitable. Copyright © 2013. Published by Elsevier Ltd.

  1. [Investigation of fat in the dural sinus].

    PubMed

    Tokiguchi, S

    1991-08-25

    Detection of fat in the cranium usually indicates the presence of a fat-containing tumor such as lipoma, dermoid cyst or teratoma. However, since 1982, Hasso et al demonstrated with CT the presence of normal adipose tissue in the cavernous sinus, the mere existence of fat in the cranium does not necessarily mean the presence of a fatty tumor. The author first described fat deposition in the superior sagittal sinus and torcular Herophili following a CT study performed in 1986. The purpose of this study was to investigate the distribution, frequency, and anatomical correlations of fat in the dural sinus as demonstrated on CT. Fat was detected in the cavernous sinus in 20% of all cases (492/2408), and occurred more frequently (25%) in those older than 50 years. Fat was less frequent in the other dural sinuses (3%; 75/2296). The most common location was the torcular Herophili, followed in decreasing order of frequency by the straight sinus, inferior sagittal sinus, superior sagittal sinus and transverse sinus. Pathological examination was performed in three cases. Fat deposition was composed of normal adipose tissue and was devoid of fibrous encapsulation or infiltration. In one case, the fat seemed to be partly exposed to the subarachnoid space on CT, whereas on autopsy, thin dura mater covering the fat nodule was confirmed. Fat in the dural sinus must be differentiated from cavernous nodule or sinus thrombosis. The Hounsfield unit may be helpful in making a definitive diagnosis.

  2. Clinical diagnostic dilemma of intracranial germinoma manifesting as wide skull base extension.

    PubMed

    Zhou, Zhi-hang; Zhang, Hai-bo; Rao, Jun; Bian, Xiu-wu

    2014-09-01

    The aims of this study were to present an uncommon intracranial germinoma manifesting as skull base extension and analyze its clinical characteristics to give valuable insight into such uncommon radiologic variant. This is a clinical study of a 15-year-old girl with intracranial germinoma manifesting as skull base extension. Clinical characteristics, magnetic resonance imaging scan observations, pathologic findings, and flow of the treatment procedure were presented and analyzed. She had a 5-month history of diuresis and diplopia. magnetic resonance imaging observation displayed a neoplasm located in the right-side central skull base and suprasellar area with wide extension into the cavernous sinus, intraorbital region, ethmoidal sinus, sphenoid sinus, and pituitary fossa. After administration of contrast medium, strong and heterogeneous enhancement of the mass was observed, with a dural tail sign along the right cerebellar tentorial. Right pterional approach was performed, and intraoperative histologic examination suspected the diagnosis of germinoma; partial resection was achieved, and postoperative radiotherapy was administered. Cranial nerve palsy improved greatly 6 months postoperatively. Although highly unusual, germinoma should be included in the differential diagnosis of all masses with extension along the midline region of skull base, especially when it happens in young female patients.

  3. Aneurysms with persistent filling after failed treatment with the Pipeline embolization device.

    PubMed

    Daou, Badih; Atallah, Elias; Chalouhi, Nohra; Starke, Robert M; Oliver, Jeffrey; Montano, Maria; Jabbour, Pascal; Rosenwasser, Robert H; Tjoumakaris, Stavropoula I

    2018-05-04

    OBJECTIVE The Pipeline embolization device (PED) has become a valuable tool in the treatment of cerebral aneurysms. Although failures with PED treatment have been reported, the characteristics and course of these aneurysms remain a topic of uncertainty. METHODS Electronic medical records and imaging studies were reviewed for all patients treated with the PED between July 2010 and March 2015 to identify characteristics of patients and aneurysms with residual filling after PED treatment. RESULTS Of 316 cases treated at a single institution, 281 patients had a long-term follow-up. A total of 52 (16.4%) aneurysms with residual filling were identified and constituted the study population. The mean patient age in this population was 58.8 years. The mean aneurysm size was 10.1 mm ± 7.15 mm. Twelve aneurysms were fusiform (23%). Of the aneurysms with residual filling, there were 20 carotid ophthalmic (CO) aneurysms (20% of all CO aneurysms treated), 10 other paraclinoid aneurysms (16.4% of all paraclinoid aneurysms), 7 posterior communicating artery (PCoA) aneurysms (21.9% of all PCoA aneurysms), 7 cavernous internal carotid artery (ICA) aneurysms (14.9% of all cavernous ICA aneurysms), 4 vertebrobasilar (VB) junction aneurysms (14.8% of all VB junction aneurysms), and 3 middle cerebral artery (MCA) aneurysms (25% of all MCA aneurysms). Eleven patients underwent placement of more than one PED (21.2%), with a mean number of devices of 1.28 per case. Eight of 12 aneurysms were previously treated with a stent (15.4%). Nineteen patients underwent re-treatment (36.5%); the 33 patients who did not undergo re-treatment (63.5%) were monitored by angiography or noninvasive imaging. In multivariate analysis, age older than 65 years (OR 2.65, 95% CI 1.33-5.28; p = 0.05), prior stent placement across the target aneurysm (OR 2.94, 95% CI 1.15-7.51; p = 0.02), aneurysm location in the distal anterior circulation (MCA, PCoA, and anterior choroidal artery: OR 2.72, 95% CI 1.19-6.18; p = 0.017), and longer follow-up duration (OR 1.06, 95% CI 1.03-1.09; p < 0.001) were associated with incomplete aneurysm occlusion. CONCLUSIONS While the PED can allow for treatment of large, broad-necked aneurysms with high efficacy, treatment failures do occur (16.4%). Aneurysm size, shape, and previous treatment may influence treatment outcome.

  4. LaJolla Spring Cave Complex - Meramec Caverns

    EPA Pesticide Factsheets

    EPA Region 7 is directing the potentially responsible party at a groundwater contamination Superfund site in Franklin County, Mo., to perform additional work to protect workers and visitors from potentially harmful exposures at LaJolla Springs Cave Complex

  5. A multiparallel bioreactor for the cultivation of mammalian cells in a 3D-ceramic matrix.

    PubMed

    Goralczyk, Vicky; Driemel, Gregor; Bischof, Andreas; Peter, Andrea; Berthold, Almuth; Kroh, Lothar; Blessing, Lucienne; Schubert, Helmut; King, Rudibert

    2010-01-01

    For adherently growing cells, cultivation is limited by the provided growth surface. Excellent surface-to-volume ratios are found in highly porous matrices, which have to face the challenge of nutrient supply inside the matrices' caverns. Therefore, perfusion strategies are recommended which often have to deal with the need of developing an encompassing bioreactor periphery. We present a modular bioreactor system based on a porous ceramic matrix that enables the supply of cells with oxygen and nutrients by perfusion. The present version of the reactor system focuses on simple testing of various inoculation and operation modes. Moreover, it can be used to efficiently test different foam structures. Protocols are given to set-up the system together with handling procedures for long-time cultivation of a CHO cell line. Experimental results confirm vital growth of cells inside the matrices' caverns.

  6. Lunar Lava Tube Sensing

    NASA Technical Reports Server (NTRS)

    York, Cheryl Lynn; Walden, Bryce; Billings, Thomas L.; Reeder, P. Douglas

    1992-01-01

    Large (greater than 300 m diameter) lava tube caverns appear to exist on the Moon and could provide substantial safety and cost benefits for lunar bases. Over 40 m of basalt and regolith constitute the lava tube roof and would protect both construction and operations. Constant temperatures of -20 C reduce thermal stress on structures and machines. Base designs need not incorporate heavy shielding, so lightweight materials can be used and construction can be expedited. Identification and characterization of lava tube caverns can be incorporated into current precursor lunar mission plans. Some searches can even be done from Earth. Specific recommendations for lunar lava tube search and exploration are (1) an Earth-based radar interferometer, (2) an Earth-penetrating radar (EPR) orbiter, (3) kinetic penetrators for lunar lava tube confirmation, (4) a 'Moon Bat' hovering rocket vehicle, and (5) the use of other proposed landers and orbiters to help find lunar lava tubes.

  7. A locus for cerebral cavernous malformations maps to chromosome 7q in two families

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Marchuk, D.A.; Gallione, C.J.; Morrison, L.A.

    1995-07-20

    Cavernous malformations (angiomas) affecting the central nervous system and retina can be inherited in autosomal dominant pattern (OMIM 116860). These vascular lesions may remain clinically silent or lead to a number of neurological symptoms including seizure, intracranial hemorrhage, focal neurological deficit, and migraine. We have mapped a gene for this disorder in two families, one of Italian-American origin and one of Mexican-American origin, to markers on proximal 7q, with a combined maximum lod score of 3.92 ({theta} of zero) with marker D7S479. Haplotype analysis of these families places the locus between markers D7S502 proximally and D7S515 distally, an interval ofmore » approximately 41 cM. The location distinguishes this disorder from an autosomal dominant vascular malformation syndrome where lesions are primarily cutaneous and that maps to 9p21. 16 refs., 3 figs., 1 tab.« less

  8. [Analysis of variability of cardiac rhythm and sexual function in men with arterial hypertension during therapy with biosporolol and nebivolol].

    PubMed

    Nurmamedova, G S; Mustafaev, I I

    2012-01-01

    The aim of the work was to study effect of bisoprolol and nebivolol therapy on the sexual function of men with AH. 20 men aged 35-55 (48 +/- 3.5) yr with grade I and II AH received either drug for 2 months. Cardiac rhythm variability (CRV) was estimated in the end of the 4-week placebo period and after 2-month monotherapy. Dopplerography of penile arteries and a questionnaire study (as described by Vasilchenko) were conducted. Both drugs significantly increased the tone of the parasympathetic component of the vegetative nervous system, improved systolic blood flow in cavernous and dorsal arteries. The questionnaire study failed to revel significant changes of the sexual function. It is concluded that biosporolol and nebivolol did not compromise the sexual function of men with AH; they improve spectral CRV characteristics and blood flow in cavernous arteries.

  9. Can muon-induced backgrounds explain the DAMA data?

    NASA Astrophysics Data System (ADS)

    Klinger, Joel; Kudryavtsev, Vitaly A.

    2016-05-01

    We present an accurate simulation of the muon-induced background in the DAMA/LIBRA experiment. Muon sampling underground has been performed using the MUSIC/MUSUN codes and subsequent interactions in the rock around the DAMA/LIBRA detector cavern and the experimental setup including shielding, have been simulated with GEANT4.9.6. In total we simulate the equivalent of 20 years of muon data. We have calculated the total muon-induced neutron flux in the DAMA/LIBRA detector cavern as Φμ n = 1.0 × 10-9 cm-2s-1, which is consistent with other simulations. After selecting events which satisfy the DAMA/LIBRA signal criteria, our simulation predicts 3.49 × 10-5 cpd/kg/keV which accounts for less than 0.3% of the DAMA/LIBRA modulation amplitude. We conclude from our work that muon-induced backgrounds are unable to contribute to the observed signal modulation.

  10. Virtual Walk: The Construction of the Long Baseline Neutrino Facility

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    This 2-minute animation shows a virtual walk through the large caverns of the Long-Baseline Neutrino Facility, which will house the Deep Underground Neutrino Experiment. To create the caverns for the huge DUNE particle detectors, construction crews will excavate more than 800,000 tons of rock a mile underground at the Sanford Underground Research Facility in South Dakota. Scientists and dignitaries broke ground for this project on July 21, 2017. When construction is complete, DUNE scientists will send an intense neutrino beam through 1,300 kilometers of rock from the Department of Energy’s Fermilab to the DUNE particle detectors to understand the rolemore » that neutrinos – the most abundant matter particles in the universe – play in our cosmos. About 1,000 scientists from more than 160 institutions in 30 countries work on the Deep Underground Neutrino Experiment.« less

  11. A comparison of different transarterial embolization techniques for direct carotid cavernous fistulas: a single center experience in 32 patients

    PubMed Central

    Lu, Xiaojian; Hussain, Mohammed; Ni, Lanchun; Huang, Qinfeng; Zhou, Fei; Gu, Zhikai; Chen, Jian; Ding, Yuchuan; Xu, Feng

    2014-01-01

    Objective Transarterial treatment of direct carotid cavernous fistulas (DCCF) via embolic materials has been well documented. This study reports, validates, and compares with existing literature our experience treating DCCFs via endovascular approaches by using detachable balloons, coils, and covered stents. Methods Between June 2006 to October 2011, 32 patients (21 male, 11 female) with 32 DCCFs (30 traumatic, 2 spontaneous cavernous ICA aneurysms) were embolized endovascularly. Followup was performed for at least 6 months. Results Among the 32 DCCFs, 21 (65.6%) were embolized using detachable balloons, eight (25.0%) with coils, one (3.1%) with balloons and coils, and two (6.3%) with covered stents. Complete DCCF obliteration was achieved in 31 (96.9%) cases. One fistula failed to respond due to premature balloon detachment. Intracranial bruit in 31 (100%) chemosis and exophthalmos in 28 (100%) cases resolved after embolization. Visual acuity and oculomotor palsy improved in 18 (90%) and 18 (69.2%) cases, respectively. There was no evidence of DCCF recurrence. Thirteen DCCFs were followed up by MRI and five by DSA. In these cases, four (4/13, 30.8%) balloon-embolized DCCFs showed pseudoaneurysms. Three patients were asymptomatic; one had minor left oculomotor palsy. Conclusions Our results correlate and reinforce literature regarding endovascular treatment of DCCFs. Application of Transarterial embolization with detachable balloons, despite extensive use has been decreasing. Coil embolization is an effective and safe alternative for treatment, especially when balloon embolization fails. Covered stent placement may be used as another alternative for selected cases. PMID:25566340

  12. Endovascular embolization of carotid-cavernous fistulas: A pioneering experience in Peru

    PubMed Central

    Plasencia, Andres R.; Santillan, Alejandro

    2012-01-01

    Background: Endovascular embolization represents the method of choice for the treatment of carotid-cavernous fistulas (CCFs). Methods: We report our experience using the endovascular technique in 24 patients harboring 25 CCFs treated between October 1994 and April 2010, with an emphasis on the role of detachable balloons for the treatment of direct CCFs. Results: Of the 16 patients who presented with direct CCFs (Barrow Type A CCFs) (age range, 7–62 years; mean age, 34.3 years), 14 were caused by traumatic injury and 2 by a ruptured internal carotid artery (ICA) aneurysm. Eight patients (age range, 32–71 years; mean age, 46.5 years) presented with nine indirect CCFs (Barrow Types B, C, and D). The clinical follow-up after endovascular treatment ranged from 2 to 108 months (mean, 35.2 months). In two cases (8%), the endovascular approach failed. Symptomatic complications related to the procedure occurred in three patients (12.5%): transient cranial nerve palsy in two patients and a permanent neurological deficit in one patient. Detachable balloons were used in 13 out of 16 (81.3%) direct CCFs and were associated with a cure rate of 92.3%. Overall, the angiographic cure rate was obtained in 22 out of 25 (88%) fistulas. Patients presenting with III nerve palsy improved gradually between 1 day and 6 months after treatment. Good clinical outcomes [modified Rankin scale (mRS) ≤ 2] were observed in 22 out of 24 (91.6%) patients at last follow-up. Conclusions: Endovascular treatment using detachable balloons still constitutes a safe and effective method to treat direct carotid-cavernous fistulas. PMID:22363900

  13. Fractionated Stereotactic Radiotherapy Treatment of Cavernous Sinus Meningiomas: A Study of 100 Cases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Litre, Claude Fabien; Colin, Philippe; Noudel, Remy

    Purpose: We discuss our experiences with fractionated stereotactic radiotherapy (FSR) in the treatment of cavernous sinus meningiomas. Methods and Materials: From 1995 to 2006, we monitored 100 patients diagnosed with cavernous sinus meningiomas; 84 female and 16 male patients were included. The mean patient age was 56 years. The most common symptoms were a reduction in visual acuity (57%), diplopia (50%), exophthalmy (30%), and trigeminal neuralgia (34%). Surgery was initially performed on 26 patients. All patients were treated with FSR. A total of 45 Gy was administered to the lesion, with 5 fractions of 1.8 Gy completed each week. Patientmore » treatment was performed using a Varian Clinac linear accelerator used for cranial treatments and a micro-multileaf collimator. Results: No side effects were reported. Mean follow-up period was 33 months, with 20% of patients undergoing follow-up evaluation of more than 4 years later. The tumor control rate at 3 years was 94%. Three patients required microsurgical intervention because FSR proved ineffective. In terms of functional symptoms, an 81% improvement was observed in patients suffering from exophthalmy, with 46% of these patients being restored to full health. A 52% improvement was observed in diplopia, together with a 67% improvement in visual acuity and a 50% improvement in type V neuropathy. Conclusions: FSR facilitates tumor control, either as an initial treatment option or in combination with microsurgery. In addition to being a safe procedure with few side effects, FSR offers the significant benefit of superior functional outcomes.« less

  14. Enhanced recharge and karst, Edwards aquifer, south central Texas

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hammond, W.W. Jr.

    1993-02-01

    Enhanced recharge is a water management strategy which can add significant quantities of ground water to the available water resources of the San Antonio region by utilizing the immense storage capacity of the unconfined zone of the Edwards aquifer. The Edwards aquifer presently is the sole source of water for a population of over 1,200,000, meeting public supply, industrial, and irrigation demands over a wide area of south central Texas. Valdina Farms Sinkhole is located adjacent to Seco Creek in Medina County and is in the recharge zone of the aquifer. Initial studies indicated that the sinkholes was capable ofmore » taking flood flows from Seco Creek and functioning as a recharge structure. Stream channels in the cavern system associated with Valdina Farms Sinkhole were incised into cave deposits and flood debris was present in the caverns at some distance from the sinkhole. Chemical analyses of samples of water from the cave and from nearby wells showed nitrate concentrations that decreased with distance from the cavern. Gradient of the potentiometric surface in the vicinity of the cave was very low, indicating high values of hydraulic conductivity for the aquifer. Based on evidence from these field studies a dam was constructed in 1982 on Seco Creek and a flood diversion channel was excavated to the sinkhole. Reservoir capacity is 2 acre-feet and design recharge rate is 3.8-6.7 m[sup 3]/sec. Annual recharge at the sinkhole has varied from 0 during periods of low runoff to 12,915 acre-feet.« less

  15. The effect of audio tours on learning and social interaction: An evaluation at Carlsbad Caverns National Park

    NASA Astrophysics Data System (ADS)

    Novey, Levi T.; Hall, Troy E.

    2007-03-01

    Auditory forms of nonpersonal communication have rarely been evaluated in informal settings like parks and museums. This study evaluated the effect of an interpretive audio tour on visitor knowledge and social behavior at Carlsbad Caverns National Park. A cross-sectional pretest/posttest quasi-experimental design compared the responses of audio tour users (n = 123) and nonusers (n = 131) on several knowledge questions. Observations (n = 700) conducted at seven sites within the caverns documented sign reading, time spent listening to the audio, within group conversation, and other social behaviors for a different sample of visitors. Pretested tour users and nonusers did not differ in visitor characteristics, knowledge, or attitude variables, suggesting the two populations were similar. On a 12-item knowledge quiz, tour users' scores increased from 5.7 to 10.3, and nonusers' scores increased from 6.2 to 8.4. Most visitors were able to identify some of the park's major messages when presented with a multiple-choice question, but more audio users than nonusers identified resource preservation as a primary message in an open-ended question. Based on observations, audio tour users and nonusers did not differ substantially in their interactions with other members of their group or in their reading of interpretive signs in the cave. Audio tour users had positive reactions to the tour, and these reactions, coupled with the positive learning outcomes and negligible effects on social interaction, suggest that audio tours can be an effective communication medium in informal educational settings.

  16. Liver Hemangioma

    MedlinePlus

    Liver hemangioma Overview A liver hemangioma (he-man-jee-O-muh) is a noncancerous (benign) mass in the liver. A liver hemangioma is made up of a tangle of blood vessels. Other terms for a liver hemangioma are hepatic hemangioma and cavernous hemangioma. Most ...

  17. Surgical management of brain-stem cavernous malformations: report of 137 cases.

    PubMed

    Wang, Chung-cheng; Liu, Ali; Zhang, Jun-ting; Sun, Bo; Zhao, Yuan-li

    2003-06-01

    With the improvement in neuroimaging and microsurgical techniques, brain stem cavernous malformations are no longer considered inoperable. Surgical indications for brainstem cavernoma are evolving, with better understanding of its natural history and decreasing surgical complications. During 1986 through 1998, a series of 137 patients (4 patients each with two brain stem lesions, total number of lesions, 141) with brain stem cavernous malformations were treated microsurgically at Beijing Neurosurgery Institute. The age distribution, lesion location, and clinical presentations were analyzed. The bleeding rate, surgical indications and microsurgical techniques were also discussed. In our series, 92 of 137 cases (67.2%) suffered more than one hemorrhage. Female patients had a higher risk of recurrent hemorrhage than that of male patients. Unlike cavernomas malformations from other locations, repeated hemorrhages from brain stem malformations are much more common and usually lead to new neurologic deficits. Among all 137 surgically treated patients, there was no operative mortality. Ninety-nine patients (72.3%) either improved or remained clinically stable postoperatively. The size of the cavernoma/hematoma does not necessarily correlate with the surgical result. While the acute hematoma can facilitate the surgical dissection, longer clinical history with multiple hemorrhages often makes total surgical resection difficult, partially because of the firmer capsule that may not shrink or collapse after hematoma is released. Pathologically those capsules were associated with more hyaline degeneration, fibrous proliferation and even calcifications. During the follow-up period between 0.5 to 11 years in 129 cases, 115 patients (89.2%) have been working, studying, or doing house work. Three patients (2.3%) suffered recurrent hemorrhages. Surgical indications of brain stem cavernoma include (1) progressive neurologic deficits; (2) overt acute or subacute hemorrhage on MRI either inside or outside cavernous malformations with mass effect; (3) cavernoma/hematoma reaching brainstem surface (<2 mm brain tissue between cavernoma /hematoma and pial surface). Grave clinical presentations like coma, respiratory, or cardiac instability are not surgical contraindications. Emergent surgical evacuation may lead to satisfactory outcome. Repeated hemorrhages will worsen the pre-existing neurologic deficits and possibly make the surgical dissections more difficult. Patients with minimum, stable neurologic deficits and lesion/hematoma that has not reached the brain stem surface should be followed conservatively.

  18. LOOP marine and estuarine monitoring program, 1978-95 : volume 2 : water chemistry.

    DOT National Transportation Integrated Search

    1998-01-01

    The proposed construction and use of facilities in an environmentally sensitive area led to questions about various consequential environmental impacts arising from the following activities: 1) oil storage caverns were created by leaching out a salt ...

  19. The ATLAS Experiment at the CERN Large Hadron Collider

    NASA Astrophysics Data System (ADS)

    ATLAS Collaboration; Aad, G.; Abat, E.; Abdallah, J.; Abdelalim, A. A.; Abdesselam, A.; Abdinov, O.; Abi, B. A.; Abolins, M.; Abramowicz, H.; Acerbi, E.; Acharya, B. S.; Achenbach, R.; Ackers, M.; Adams, D. L.; Adamyan, F.; Addy, T. N.; Aderholz, M.; Adorisio, C.; Adragna, P.; Aharrouche, M.; Ahlen, S. P.; Ahles, F.; Ahmad, A.; Ahmed, H.; Aielli, G.; Åkesson, P. F.; Åkesson, T. P. A.; Akimov, A. V.; Alam, S. M.; Albert, J.; Albrand, S.; Aleksa, M.; Aleksandrov, I. N.; Aleppo, M.; Alessandria, F.; Alexa, C.; Alexander, G.; Alexopoulos, T.; Alimonti, G.; Aliyev, M.; Allport, P. P.; Allwood-Spiers, S. E.; Aloisio, A.; Alonso, J.; Alves, R.; Alviggi, M. G.; Amako, K.; Amaral, P.; Amaral, S. P.; Ambrosini, G.; Ambrosio, G.; Amelung, C.; Ammosov, V. V.; Amorim, A.; Amram, N.; Anastopoulos, C.; Anderson, B.; Anderson, K. J.; Anderssen, E. C.; Andreazza, A.; Andrei, V.; Andricek, L.; Andrieux, M.-L.; Anduaga, X. S.; Anghinolfi, F.; Antonaki, A.; Antonelli, M.; Antonelli, S.; Apsimon, R.; Arabidze, G.; Aracena, I.; Arai, Y.; Arce, A. T. H.; Archambault, J. P.; Arguin, J.-F.; Arik, E.; Arik, M.; Arms, K. E.; Armstrong, S. R.; Arnaud, M.; Arnault, C.; Artamonov, A.; Asai, S.; Ask, S.; Åsman, B.; Asner, D.; Asquith, L.; Assamagan, K.; Astbury, A.; Athar, B.; Atkinson, T.; Aubert, B.; Auerbach, B.; Auge, E.; Augsten, K.; Aulchenko, V. M.; Austin, N.; Avolio, G.; Avramidou, R.; Axen, A.; Ay, C.; Azuelos, G.; Baccaglioni, G.; Bacci, C.; Bachacou, H.; Bachas, K.; Bachy, G.; Badescu, E.; Bagnaia, P.; Bailey, D. C.; Baines, J. T.; Baker, O. K.; Ballester, F.; Baltasar Dos Santos Pedrosa, F.; Banas, E.; Banfi, D.; Bangert, A.; Bansal, V.; Baranov, S. P.; Baranov, S.; Barashkou, A.; Barberio, E. L.; Barberis, D.; Barbier, G.; Barclay, P.; Bardin, D. Y.; Bargassa, P.; Barillari, T.; Barisonzi, M.; Barnett, B. M.; Barnett, R. M.; Baron, S.; Baroncelli, A.; Barone, M.; Barr, A. J.; Barreiro, F.; Barreiro Guimarães da Costa, J.; Barrillon, P.; Barriuso Poy, A.; Barros, N.; Bartheld, V.; Bartko, H.; Bartoldus, R.; Basiladze, S.; Bastos, J.; Batchelor, L. E.; Bates, R. L.; Batley, J. R.; Batraneanu, S.; Battistin, M.; Battistoni, G.; Batusov, V.; Bauer, F.; Bauss, B.; Baynham, D. E.; Bazalova, M.; Bazan, A.; Beauchemin, P. H.; Beaugiraud, B.; Beccherle, R. B.; Beck, G. A.; Beck, H. P.; Becks, K. H.; Bedajanek, I.; Beddall, A. J.; Beddall, A.; Bednár, P.; Bednyakov, V. A.; Bee, C.; Behar Harpaz, S.; Belanger, G. A. N.; Belanger-Champagne, C.; Belhorma, B.; Bell, P. J.; Bell, W. H.; Bella, G.; Bellachia, F.; Bellagamba, L.; Bellina, F.; Bellomo, G.; Bellomo, M.; Beltramello, O.; Belymam, A.; Ben Ami, S.; Ben Moshe, M.; Benary, O.; Benchekroun, D.; Benchouk, C.; Bendel, M.; Benedict, B. H.; Benekos, N.; Benes, J.; Benhammou, Y.; Benincasa, G. P.; Benjamin, D. P.; Bensinger, J. R.; Benslama, K.; Bentvelsen, S.; Beretta, M.; Berge, D.; Bergeaas, E.; Berger, N.; Berghaus, F.; Berglund, S.; Bergsma, F.; Beringer, J.; Bernabéu, J.; Bernardet, K.; Berriaud, C.; Berry, T.; Bertelsen, H.; Bertin, A.; Bertinelli, F.; Bertolucci, S.; Besson, N.; Beteille, A.; Bethke, S.; Bialas, W.; Bianchi, R. M.; Bianco, M.; Biebel, O.; Bieri, M.; Biglietti, M.; Bilokon, H.; Binder, M.; Binet, S.; Bingefors, N.; Bingul, A.; Bini, C.; Biscarat, C.; Bischof, R.; Bischofberger, M.; Bitadze, A.; Bizzell, J. P.; Black, K. M.; Blair, R. E.; Blaising, J. J.; Blanch, O.; Blanchot, G.; Blocker, C.; Blocki, J.; Blondel, A.; Blum, W.; Blumenschein, U.; Boaretto, C.; Bobbink, G. J.; Bocci, A.; Bocian, D.; Bock, R.; Boehm, M.; Boek, J.; Bogaerts, J. A.; Bogouch, A.; Bohm, C.; Bohm, J.; Boisvert, V.; Bold, T.; Boldea, V.; Bondarenko, V. G.; Bonino, R.; Bonis, J.; Bonivento, W.; Bonneau, P.; Boonekamp, M.; Boorman, G.; Boosten, M.; Booth, C. N.; Booth, P. S. L.; Booth, P.; Booth, J. R. 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N.; Sivoklokov, S.; Sjölin, J.; Skubic, P.; Skvorodnev, N.; Slattery, P.; Slavicek, T.; Sliwa, K.; Sloan, T. J.; Sloper, J.; Smakhtin, V.; Small, A.; Smirnov, S. Yu; Smirnov, Y.; Smirnova, L.; Smirnova, O.; Smith, N. A.; Smith, B. C.; Smith, D. S.; Smith, J.; Smith, K. M.; Smith, B.; Smizanska, M.; Smolek, K.; Snesarev, A. A.; Snow, S. W.; Snow, J.; Snuverink, J.; Snyder, S.; Soares, M.; Soares, S.; Sobie, R.; Sodomka, J.; Söderberg, M.; Soffer, A.; Solans, C. A.; Solar, M.; Sole, D.; Solfaroli Camillocci, E.; Solodkov, A. A.; Solov'yanov, O. V.; Soloviev, I.; Soluk, R.; Sondericker, J.; Sopko, V.; Sopko, B.; Sorbi, M.; Soret Medel, J.; Sosebee, M.; Sosnovtsev, V. V.; Sospedra Suay, L.; Soukharev, A.; Soukup, J.; Spagnolo, S.; Spano, F.; Speckmayer, P.; Spegel, M.; Spencer, E.; Spighi, R.; Spigo, G.; Spila, F.; Spiriti, E.; Spiwoks, R.; Spogli, L.; Spousta, M.; Sprachmann, G.; Spurlock, B.; St. Denis, R. D.; Stahl, T.; Staley, R. J.; Stamen, R.; Stancu, S. N.; Stanecka, E.; Stanek, R. W.; Stanescu, C.; Stapnes, S.; Starchenko, E. A.; Staroba, P.; Stastny, J.; Staude, A.; Stavina, P.; Stavrianakou, M.; Stavropoulos, G.; Stefanidis, E.; Steffens, J. L.; Stekl, I.; Stelzer, H. J.; Stenzel, H.; Stewart, G.; Stewart, T. D.; Stiller, W.; Stockmanns, T.; Stodulski, M.; Stonjek, S.; Stradling, A.; Straessner, A.; Strandberg, J.; Strandlie, A.; Strauss, M.; Strickland, V.; Striegel, D.; Strizenec, P.; Ströhmer, R.; Strom, D. M.; Strong, J. A.; Stroynowski, R.; Stugu, B.; Stumer, I.; Su, D.; Subramania, S.; Suchkov, S. I.; Sugaya, Y.; Sugimoto, T.; Suk, M.; Sulin, V. V.; Sultanov, S.; Sun, Z.; Sundal, B.; Sushkov, S.; Susinno, G.; Sutcliffe, P.; Sutton, M. R.; Sviridov, Yu M.; Sykora, I.; Szczygiel, R. R.; Szeless, B.; Szymocha, T.; Sánchez, J.; Ta, D.; Taboada Gameiro, S.; Tadel, M.; Tafirout, R.; Taga, A.; Takai, H.; Takashima, R.; Takeda, H.; Takeshita, T.; Talby, M.; Talyshev, A.; Tamsett, M. C.; Tanaka, J.; Tanaka, K.; Tanaka, R.; Tanaka, S.; Tanaka, S.; Tanaka, Y.; Tappern, G. P.; Tapprogge, S.; Tarem, S.; Tarrade, F.; Tarrant, J.; Tartarelli, G.; Tas, P.; Tasevsky, M.; Tayalati, Y.; Taylor, F. E.; Taylor, G.; Taylor, G. N.; Taylor, R. P.; Tcherniatine, V.; Tegenfeldt, F.; Teixeira-Dias, P.; Ten Kate, H.; Teng, P. K.; Ter-Antonyan, R.; Terada, S.; Terron, J.; Terwort, M.; Teuscher, R. J.; Tevlin, C. M.; Thadome, J.; Thion, J.; Thioye, M.; Thomas, A.; Thomas, J. P.; Thomas, T. L.; Thomas, E.; Thompson, R. J.; Thompson, A. S.; Thun, R. P.; Tic, T.; Tikhomirov, V. O.; Tikhonov, Y. A.; Timm, S.; Timmermans, C. J. W. P.; Tipton, P.; Tique Aires Viegas, F. J.; Tisserant, S.; Titov, M.; Tobias, J.; Tocut, V. M.; Toczek, B.; Todorova-Nova, S.; Tojo, J.; Tokár, S.; Tokushuku, K.; Tomasek, L.; Tomasek, M.; Tomasz, F.; Tomoto, M.; Tompkins, D.; Tompkins, L.; Toms, K.; Tonazzo, A.; Tong, G.; Tonoyan, A.; Topfel, C.; Topilin, N. D.; Torrence, E.; Torres Pais, J. G.; Toth, J.; Touchard, F.; Tovey, D. R.; Tovey, S. N.; Towndrow, E. F.; Trefzger, T.; Treichel, M.; Treis, J.; Tremblet, L.; Tribanek, W.; Tricoli, A.; Trigger, I. M.; Trilling, G.; Trincaz-Duvoid, S.; Tripiana, M. F.; Trischuk, W.; Trka, Z.; Trocmé, B.; Troncon, C.; C-L Tseng, J.; Tsiafis, I.; Tsiareshka, P. V.; Tsipolitis, G.; Tskhadadze, E. G.; Tsukerman, I. I.; Tsulaia, V.; Tsuno, S.; Turala, M.; Turk Cakir, I.; Turlay, E.; Tuts, P. M.; Twomey, M. S.; Tyndel, M.; Typaldos, D.; Tyrvainen, H.; Tzamarioudaki, E.; Tzanakos, G.; Ueda, I.; Uhrmacher, M.; Ukegawa, F.; Ullán Comes, M.; Unal, G.; Underwood, D. G.; Undrus, A.; Unel, G.; Unno, Y.; Urkovsky, E.; Usai, G.; Usov, Y.; Vacavant, L.; Vacek, V.; Vachon, B.; Vahsen, S.; Valderanis, C.; Valenta, J.; Valente, P.; Valero, A.; Valkar, S.; Valls Ferrer, J. A.; Van der Bij, H.; van der Graaf, H.; van der Kraaij, E.; Van Eijk, B.; van Eldik, N.; van Gemmeren, P.; van Kesteren, Z.; van Vulpen, I.; Van Berg, R.; Vandelli, W.; Vandoni, G.; Vaniachine, A.; Vannucci, F.; Varanda, M.; Varela Rodriguez, F.; Vari, R.; Varnes, E. W.; Varouchas, D.; Vartapetian, A.; Varvell, K. E.; Vassilakopoulos, V. I.; Vassilieva, L.; Vataga, E.; Vaz, L.; Vazeille, F.; Vedrine, P.; Vegni, G.; Veillet, J. J.; Vellidis, C.; Veloso, F.; Veness, R.; Veneziano, S.; Ventura, A.; Ventura, S.; Vercesi, V.; Verducci, M.; Verkerke, W.; Vermeulen, J. C.; Vertogardov, L.; Vetterli, M. C.; Vichou, I.; Vickey, T.; Viehhauser, G. H. A.; Vigeolas, E.; Villa, M.; Villani, E. G.; Villate, J.; Villella, I.; Vilucchi, E.; Vincent, P.; Vincke, H.; Vincter, M. G.; Vinogradov, V. B.; Virchaux, M.; Viret, S.; Virzi, J.; Vitale, A.; Vivarelli, I.; Vives, R.; Vives Vaques, F.; Vlachos, S.; Vogt, H.; Vokac, P.; Vollmer, C. F.; Volpi, M.; Volpini, G.; von Boehn-Buchholz, R.; von der Schmitt, H.; von Toerne, E.; Vorobel, V.; Vorobiev, A. P.; Vorozhtsov, A. S.; Vorozhtsov, S. B.; Vos, M.; Voss, K. C.; Voss, R.; Vossebeld, J. H.; Vovenko, A. S.; Vranjes, N.; Vrba, V.; Vreeswijk, M.; Anh, T. Vu; Vuaridel, B.; Vudragovic, M.; Vuillemin, V.; Vuillermet, R.; Wänanen, A.; Wahlen, H.; Walbersloh, J.; Walker, R.; Walkowiak, W.; Wall, R.; Wallny, R. S.; Walsh, S.; Wang, C.; Wang, J. C.; Wappler, F.; Warburton, A.; Ward, C. P.; Warner, G. P.; Warren, M.; Warsinsky, M.; Wastie, R.; Watkins, P. M.; Watson, A. T.; Watts, G.; Waugh, A. T.; Waugh, B. M.; Weaverdyck, C.; Webel, M.; Weber, G.; Weber, J.; Weber, M.; Weber, P.; Weidberg, A. R.; Weilhammer, P. M.; Weingarten, J.; Weiser, C.; Wellenstein, H.; Wellisch, H. P.; Wells, P. S.; Wemans, A.; Wen, M.; Wenaus, T.; Wendler, S.; Wengler, T.; Wenig, S.; Wermes, N.; Werneke, P.; Werner, P.; Werthenbach, U.; Wheeler-Ellis, S. J.; Whitaker, S. P.; White, A.; White, M. J.; White, S.; Whittington, D.; Wicek, F.; Wicke, D.; Wickens, F. J.; Wiedenmann, W.; Wielers, M.; Wienemann, P.; Wiesmann, M.; Wiesmann, M.; Wijnen, T.; Wildauer, A.; Wilhelm, I.; Wilkens, H. G.; Williams, H. H.; Willis, W.; Willocq, S.; Wilmut, I.; Wilson, J. A.; Wilson, A.; Wingerter-Seez, I.; Winton, L.; Witzeling, W.; Wlodek, T.; Woehrling, E.; Wolter, M. W.; Wolters, H.; Wosiek, B.; Wotschack, J.; Woudstra, M. J.; Wright, C.; Wu, S. L.; Wu, X.; Wuestenfeld, J.; Wunstorf, R.; Xella-Hansen, S.; Xiang, A.; Xie, S.; Xie, Y.; Xu, G.; Xu, N.; Yamamoto, A.; Yamamoto, S.; Yamaoka, H.; Yamazaki, Y.; Yan, Z.; Yang, H.; Yang, J. C.; Yang, S.; Yang, U. K.; Yang, Y.; Yang, Z.; Yao, W.-M.; Yao, Y.; Yarradoddi, K.; Yasu, Y.; Ye, J.; Yilmaz, M.; Yoosoofmiya, R.; Yorita, K.; Yoshida, H.; Yoshida, R.; Young, C.; Youssef, S. P.; Yu, D.; Yu, J.; Yu, M.; Yu, X.; Yuan, J.; Yurkewicz, A.; Zaets, V. G.; Zaidan, R.; Zaitsev, A. M.; Zajac, J.; Zajacova, Z.; Zalite, A. Yu; Zalite, Yo K.; Zanello, L.; Zarzhitsky, P.; Zaytsev, A.; Zdrazil, M.; Zeitnitz, C.; Zeller, M.; Zema, P. F.; Zendler, C.; Zenin, A. V.; Zenis, T.; Zenonos, Z.; Zenz, S.; Zerwas, D.; Zhang, H.; Zhang, J.; Zheng, W.; Zhang, X.; Zhao, L.; Zhao, T.; Zhao, X.; Zhao, Z.; Zhelezko, A.; Zhemchugov, A.; Zheng, S.; Zhichao, L.; Zhou, B.; Zhou, N.; Zhou, S.; Zhou, Y.; Zhu, C. G.; Zhu, H. Z.; Zhuang, X. A.; Zhuravlov, V.; Zilka, B.; Zimin, N. I.; Zimmermann, S.; Ziolkowski, M.; Zitoun, R.; Zivkovic, L.; Zmouchko, V. V.; Zobernig, G.; Zoccoli, A.; Zoeller, M. M.; Zolnierowski, Y.; Zsenei, A.; zur Nedden, M.; Zychacek, V.

    2008-08-01

    The ATLAS detector as installed in its experimental cavern at point 1 at CERN is described in this paper. A brief overview of the expected performance of the detector when the Large Hadron Collider begins operation is also presented.

  20. Endosphenoidal coil for intraoperative magnetic resonance imaging of the pituitary gland during transsphenoidal surgery.

    PubMed

    Chittiboina, Prashant; Talagala, S Lalith; Merkle, Hellmut; Sarlls, Joelle E; Montgomery, Blake K; Piazza, Martin G; Scott, Gretchen; Ray-Chaudhury, Abhik; Lonser, Russell R; Oldfield, Edward H; Koretsky, Alan P; Butman, John A

    2016-12-01

    OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing's disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that can be placed within the sphenoid sinus (the endosphenoidal coil [ESC]) during transsphenoidal surgery (TSS) was developed and assessed. METHODS Five cadaver heads were used for preclinical testing of the ESC. The ESC (a double-turn, 12-mm-diameter surface coil made from 1-mm-diameter copper wire) was developed to obtain images in a 1.5-T MR scanner. The ESC was placed (via a standard sublabial TSS approach) on the anterior sella face. Clinical MR scans were obtained using the 8-channel head coil and ESC as the receiver coils. Using the ESC, ultra-high-resolution, 3D, balanced fast field echo (BFFE) and T1-weighted imaging were performed at resolutions of 0.25 × 0.25 × 0.50 mm 3 and 0.15 × 0.15 × 0.30 mm 3 , respectively. RESULTS Region-of-interest analysis indicated a 10-fold increase in the signal-to-noise ratio (SNR) of the pituitary when using the ESC compared with the 8-channel head coil. ESC-related improvements (p < 0.01) in the SNR were inversely proportional to the distance from the ESC tip to the anterior pituitary gland surface. High-resolution BFFE MR imaging obtained using ESC revealed a number of anatomical features critical to pituitary surgery that were not visible on 8-channel MR imaging, including the pituitary capsule, the intercavernous sinus, and microcalcifications in the pars intermedia. These ESC imaging findings were confirmed by the pathological correlation with whole-mount pituitary sections. CONCLUSIONS ESC can significantly improve SNR in the sellar region intraoperatively using current 1.5-T MR imaging platforms. Improvement in SNR can provide images of the sella and surrounding structures with unprecedented resolution. Clinical use of this ESC may allow for MR imaging detection of previously occult pituitary adenomas and identify microscopic invasion of the dura or cavernous sinus.

  1. Endosphenoidal coil for intraoperative magnetic resonance imaging of the pituitary gland during transsphenoidal surgery

    PubMed Central

    Chittiboina, Prashant; Talagala, S. Lalith; Merkle, Hellmut; Sarlls, Joelle E.; Montgomery, Blake K.; Piazza, Martin G.; Scott, Gretchen; Ray-Chaudhury, Abhik; Lonser, Russell R.; Oldfield, Edward H.; Koretsky, Alan P.; Butman, John A.

    2016-01-01

    OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing’s disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that can be placed within the sphenoid sinus (the endosphenoidal coil [ESC]) during transsphenoidal surgery (TSS) was developed and assessed. METHODS Five cadaver heads were used for preclinical testing of the ESC. The ESC (a double-turn, 12-mm-diameter surface coil made from 1-mm-diameter copper wire) was developed to obtain images in a 1.5-T MR scanner. The ESC was placed (via a standard sublabial TSS approach) on the anterior sella face. Clinical MR scans were obtained using the 8-channel head coil and ESC as the receiver coils. Using the ESC, ultra–high-resolution, 3D, balanced fast field echo (BFFE) and T1-weighted imaging were performed at resolutions of 0.25 × 0.25 × 0.50 mm3 and 0.15 × 0.15 × 0.30 mm3, respectively. RESULTS Region-of-interest analysis indicated a 10-fold increase in the signal-to-noise ratio (SNR) of the pituitary when using the ESC compared with the 8-channel head coil. ESC-related improvements (p < 0.01) in the SNR were inversely proportional to the distance from the ESC tip to the anterior pituitary gland surface. High-resolution BFFE MR imaging obtained using ESC revealed a number of anatomical features critical to pituitary surgery that were not visible on 8-channel MR imaging, including the pituitary capsule, the intercavernous sinus, and microcalcifications in the pars intermedia. These ESC imaging findings were confirmed by the pathological correlation with whole-mount pituitary sections. CONCLUSIONS ESC can significantly improve SNR in the sellar region intraoperatively using current 1.5-T MR imaging platforms. Improvement in SNR can provide images of the sella and surrounding structures with unprecedented resolution. Clinical use of this ESC may allow for MR imaging detection of previously occult pituitary adenomas and identify microscopic invasion of the dura or cavernous sinus. PMID:26991390

  2. Intraoperative magnetic resonance imaging-assisted transsphenoidal pituitary surgery in patients with acromegaly.

    PubMed

    Bellut, David; Hlavica, Martin; Schmid, Christoph; Bernays, René L

    2010-10-01

    Acromegaly is a rare disease, usually caused by a growth hormone (GH)-producing pituitary adenoma. If untreated, severe cardiovascular, metabolic, cosmetic, and orthopedic disturbances will result. Surgery is generally recommended as the first-line treatment. Transsphenoidal surgical techniques were recently extended by the introduction of intraoperative MR (iMR) imaging. In the present study, the contribution of ultra-low-field (0.15-T) iMR imaging to tumor resection, complication avoidance, and endocrinological and neurological outcome was analyzed. A series of 39 consecutive transsphenoidal iMR imaging-guided (using the PoleStar N20 device) surgical procedures performed between September 2005 and August 2009 for GH-producing pituitary adenomas was retrospectively analyzed. In addition to the patients' clinical data, the following criteria were evaluated independently: duration of surgery; length of hospital stay; endocrinological parameters; results of neurological examinations; and pre-, post-, and intraoperative MR imaging results. Thirty-seven patients with acromegaly underwent 39 transsphenoidal surgeries for pituitary adenomas. During a median follow-up period of 30 months (range 9-56 months), the remission rate was 73.5% in 34 patients with primary surgery and 20% in 5 cases with previous surgery; overall the remission rate was 66.7%. There were no serious postoperative complications. Detection of tumor remnant on iMR imaging led to a 5.1% increase in remission rate. In this largest study to date of GH-producing pituitary adenomas in which iMR imaging-guided transsphenoidal surgery was analyzed, the results suggest that this method is a highly effective and safe treatment modality, even compared with previously published surgical series in which high-field iMR imaging was used. Limitations of iMR imaging are the detection of small residual tumor in the cavernous sinus and persisting disease that could not be observed, even on diagnostic high-field follow-up MR images. This points to a general limitation regarding remission rates that can be achieved using iMR imaging. Nevertheless, iMR imaging led to an increase of the remission rate in this study.

  3. [A case of traumatic middle meningeal arteriovenous fistula on the side of the head opposite to the injured side].

    PubMed

    Takeuchi, Satoru; Takasato, Yoshio; Masaoka, Hiroyuki; Hayakawa, Takanori; Otani, Naoki; Yoshino, Yoshikazu; Yatsushige, Hiroshi; Sugawara, Takashi; Aoyagi, Chikashi; Suzuki, Go

    2009-10-01

    A rare case of a traumatic middle meningeal arteriovenous fistula on the side of the head opposite to the injured side was reported. A 21-year-old man was admitted to our hospital after a traffic accident in which the right side of his head was hit. CT scans and MR images on admission showed a right temporal bone fracture, traumatic subarachnoid hemorrhage, and a left frontal lobe contusion. Three months after the head injury, he complained of tinnitus and exophthalmos. One year after the head injury, left external carotid angiograms showed a dural arteriovenous fistula fed by the left dilated middle meningeal artery and draining into the middle meningeal vein. Early filling of the sphenoparietal sinus, cavernous sinus, superior ophthalmic vein, and the cortical vein were also detected. Transarterial embolization of the left middle meningeal fistula was performed, resulting in the disappearance of the lesion. The postoperative course was uneventful.

  4. Management of Cerebral Radiation Necrosis: A Retrospective Study of 12 Patients.

    PubMed

    Liao, Chenlong; Visocchi, Massimiliano; Zhang, Wenchuan; Yang, Min; Zhong, Wenxiang; Liu, Pengfei

    2017-01-01

    Cerebral radiation necrosis (RN) is a severe complication of radiotherapy for cerebral pathologies. This study discusses the radiographic and pathological features of 12 patients with RN and investigates the management strategy. Eleven patients with brain tumors, and one with cerebral cavernous angioma, treated by surgical resection or Gamma Knife alone before radiotherapy developed RN during follow-up. Surgical resection for the cerebral RN was performed in nine patients, and the other three patients received medical treatment. The clinical features, magnetic resonance imaging (MRI), surgical findings, and pathological sections are reviewed. The diagnosis of RN was confirmed by histological study in all the patients; those with surgical and medical treatment recovered. As a major complication of radiotherapy, from the clinical and neuroradiological points of view, RN may simulate tumor recurrence. Due to the increasing number of patients with RN who will need to be treated in future years, the definite diagnosis and appropriate treatment of RN remain critical.

  5. Long-period Seismicity at the Napoleonville Salt Dome: Implications for Local Seismic Monitoring of Underground Hydrocarbon Storage Caverns

    NASA Astrophysics Data System (ADS)

    Dreger, D. S.; Ford, S. R.; Nayak, A.

    2015-12-01

    The formation of a large sinkhole at the Napoleonville salt dome, Assumption Parish, Louisiana, in August 2012 was accompanied by a rich sequence of complex seismic events, including long-period (LP) events that were recorded 11 km away at Transportable Array station 544A in White Castle, Louisiana. The LP events have relatively little energy at short periods, which make them difficult to detect using standard high-frequency power detectors, and the majority of energy that reaches the station is peaked near 0.4 Hz. The analysis of the local records reveals that the onset of the 0.4 Hz signals coincides with the S-wave arrival, and therefore it may be a shaking induced resonance in a fluid filled cavern. We created a low-frequency (0.1-0.6 Hz) power detector (short-term average / long-term average) that operated on all three components of the broadband instrument, since considerable energy was detected on the horizontal components. The detections from the power detector were then used as templates in three-channel correlation detectors thereby increasing the number of detections by a little more than a factor of two to nearly 3000. The rate of LP events is approximately one event every other day at the beginning of recording in March 2011. Around 2 May 2012 the rate changes to approximately 7 events per day and then increases to 25 events per day at the beginning of July 2012. Finally, in the days leading up to the sinkhole formation there are approximately 200 LP events per day. The analysis of these events could aid in the development of local seismic monitoring methods for underground industrial storage caverns. Prepared by LLNL under Contract DE-AC52-07NA27344.

  6. Long-Term Endovascular Treatment Outcome of 46 Patients with Cavernous Sinus Dural Arteriovenous Fistulas Presenting with Ophthalmic Symptoms

    PubMed Central

    Pashapour, Ali; Mohammadian, Reza; Salehpour, Firooz; Sharifipour, Ehsan; Mansourizade, Reza; Mahdavifard, Ali; Salehi, Mohamadgharib; Mirzaii, Farhad; Sariaslani, Payam; Fatahzade Ardalani, Ghasem; Altafi, Davar

    2014-01-01

    Summary Ocular symptoms are regularly observed in patients with cavernous sinus dural arteriovenous fistulas (cDAVF). We aimed to evaluate the long-term efficacy and safety of endovascular approaches in patients with cDAVF presenting with different ocular symptoms. In a prospective study between June 2008 and March 2013, 46 patients with ocular symptoms due to cDAVF who were not eligible for conservative therapy, met the inclusion criteria and underwent endovascular treatment. They underwent a transarterial approach with histoacryl glue injections or transvenous coil embolization, all in one session. They were followed up for a mean period of 17.3 months (range 7 to 30 months) clinically and using angiography. The mean age of patients was 36.8 years (18-60) and 65% of them were male. All patients showed venous drainage into the superior and inferior orbital veins. Access to the cavernous sinus was transvenous in ten patients, transarterial in 26 patients, and mixed in ten patients. Initial symptoms were improved in 97.8% of patients and did not recur during the study follow-up. The procedural complications included: blurred vision, transient sixth nerve palsy and exacerbation of chemoproptosis in two, one and two patients respectively that completely resolved in initial weeks with no recurrence. No patient worsened or developed new symptoms suggestive of a recurrent fistula during the follow-up period. One patient experienced intracranial dissection of the internal carotid artery and ischemic stroke with an unfinished procedure. The relief of early presentation was durable in long-term follow-up and the cured lesions were stable in angiographic controls. Favorable and durable outcomes could be obtained following endovascular approaches for cDAVF presenting with different ocular symptoms. PMID:25196621

  7. Geotechnical Feasibility Analysis of Compressed Air Energy Storage (CAES) in Bedded Salt Formations: a Case Study in Huai'an City, China

    NASA Astrophysics Data System (ADS)

    Zhang, Guimin; Li, Yinping; Daemen, Jaak J. K.; Yang, Chunhe; Wu, Yu; Zhang, Kai; Chen, Yanlong

    2015-09-01

    The lower reaches of the Yangtze River is one of the most developed regions in China. It is desirable to build compressed air energy storage (CAES) power plants in this area to ensure the safety, stability, and economic operation of the power network. Geotechnical feasibility analysis was carried out for CAES in impure bedded salt formations in Huai'an City, China, located in this region. First, geological investigation revealed that the salt groups in the Zhangxing Block meet the basic geological conditions for CAES storage, even though the possible unfavorable characteristics of the salt formations include bedding and different percentages of impurities. Second, mechanical tests were carried out to determine the mechanical characteristics of the bedded salt formations. It is encouraging that the samples did not fail even when they had undergone large creep deformation. Finally, numerical simulation was performed to evaluate the stability and volume shrinkage of the CAES under the following conditions: the shape of a single cavern is that of a pear; the width of the pillar is adopted as two times the largest diameter; three regular operating patterns were adopted for two operating caverns (internal pressure 9-10.5 MPa, 10-11.5 MPa, and 11-12.5 MPa), while the other two were kept at high pressure (internal pressure 10.5, 11.5, and 12.5 MPa) as backups; an emergency operating pattern in which two operating caverns were kept at atmospheric pressure (0.1 MPa) for emergency while the backups were under operation (9-10.5 MPa), simulated for 12 months at the beginning of the 5th year. The results of the analysis for the plastic zone, displacement, and volume shrinkage support the feasibility of the construction of an underground CAES power station.

  8. Long-Term Endocrine Outcomes Following Endoscopic Endonasal Transsphenoidal Surgery for Acromegaly and Associated Prognostic Factors.

    PubMed

    Babu, Harish; Ortega, Alicia; Nuno, Miriam; Dehghan, Aaron; Schweitzer, Aaron; Bonert, H Vivien; Carmichael, John D; Cooper, Odelia; Melmed, Shlomo; Mamelak, Adam N

    2017-08-01

    Long-term remission rates from endoscopic transsphenoidal surgery for acromegaly and their relationship to prognostic indicators of disease aggressiveness are not well documented. To investigate long-term remission rates in patients with acromegaly after endoscopic transsphenoidal surgery, and correlate this with molecular and radiographic markers of disease aggressiveness. We identified all patients undergoing endoscopic transsphenoidal surgery for acromegaly from 2005 to 2013 at Cedars-Sinai Pituitary Center. Hormonal remission was established by normal insulin-like growth factor (IGF)-1, basal serum growth hormone <2.5 ng/mL, and growth hormone suppression to <1 ng/mL following oral glucose tolerance test. Oral glucose tolerance test was performed at 3 months after surgery, and then as indicated. IGF-1 was measured at 3 months and then at least annually. We evaluated tumor granularity, nuclear expression of p21, Ki67 index, and extent of cavernous sinus invasion, and correlated these with remission status. Fifty-eight patients that underwent surgery had follow-up from 38 to 98 months (mean 64 ± 32.2 months). There were 21 microadenomas and 37 macroadenomas. Three months after surgery 40 of 58 patients (69%) were in biochemical remission. Four additional patients were in remission at 6 months after surgery, and 1 patient had recurrence within the first year after surgery. At last follow-up, 43 of 44 (74.1%) of patients remained in remission. Cavernous sinus invasion by tumor predicted failure to achieve remission. Prognostic markers of disease aggressiveness other than cavernous sinus invasion did not correlate with surgical outcome. Long-term remission after surgery alone was achieved in 74% of patients, indicating long-term efficacy of endoscopic surgery. Copyright © 2017 by the Congress of Neurological Surgeons

  9. Transcription of G-protein coupled receptors in corporeal smooth muscle is regulated by the endogenous neutral endopeptidase inhibitor sialorphin.

    PubMed

    Tong, Yuehong; Tiplitsky, Scott I; Tar, Moses; Melman, Arnold; Davies, Kelvin P

    2008-08-01

    Several reports suggest that the rat Vcsa1 gene is down-regulated in models of erectile dysfunction. The Vcsa protein product sialorphin is an endogenous neutral endopeptidase inhibitor and its down-regulation could result in prolonged activation of G-protein activated signaling pathways by their peptide agonists. We investigated whether Vcsa1 down-regulation could result in an adaptive change in GPCR (G-protein coupled receptor) expression. Gene expression in cultured rat corporeal smooth muscle cells following treatment with siRNA directed against Vcsa1 or the neutral endopeptidase gene was analyzed using microarray and quantitative reverse transcriptase-polymerase chain reaction. In rats Vcsa1 is one of the most down-regulated genes following bilateral transection of the cavernous nerves. In that animal model we also investigated whether Vcsa1 down-regulation was accompanied by similar changes in gene expression in corporeal smooth muscle cells in which Vcsa1 was knocked down in vitro. Microarray analysis and quantitative reverse transcriptase-polymerase chain reaction demonstrated that corporeal smooth muscle cells treated in vitro with siRNA against Vcsa1 resulted in GPCR up-regulation as a functional group. In contrast, treatment of corporeal smooth muscle cells that lowered neutral endopeptidase activity resulted in decreased GPCR expression. These results suggest that the peptide product of Vcsa1, sialorphin, can effect GPCR expression by acting on neutral endopeptidase. In animals with bilaterally transected cavernous nerves the decreased Vcsa1 expression is accompanied by increased GPCR expression in cavernous tissue. These experiments suggest that the mechanism by which Vcsa1 modulates erectile function is partly mediated through changes in GPCR expression.

  10. Effects of Electrostatic Environment on Charged Particle Transport near Lunar Holes

    NASA Astrophysics Data System (ADS)

    Miyake, Y.; Nishino, M. N.

    2017-12-01

    The Moon has neither dense atmosphere nor intrinsic magnetic field, and solar wind interactions with lunar surfaces are one of major plasma processes. The near-surface, dayside electrostatic environment is governed mainly by volume charges of solar wind plasma and photoelectrons as well as charged lunar surfaces. In fact, the electric environment strongly depends on surface topologies, as it will produce a shaded region, the electric environment of which can be very different from that in a sunlit condition. As one of high-profile terrains on the Moon, we have been focusing on the lunar vertical holes (or lunar pits), identified by the KAGUYA satellite and the Lunar Reconnaissance Orbiter. In order to model the distinctive electric and dust environments near the holes, we have started three-dimensional particle simulation analysis. The present study addresses the plasma environment of a lunar hole that is accompanied with a subsurface cavern. Besides the topographical effect of having a cavern, an investigation is focused on the following points. The first point is how deeply the solar wind protons are accessible into the hole and cavern. This point is relevant not only to an electric environment but also to possible existence of volatiles at permanently shaded regions of the hole. In order to examine the possibility, we implemented a proton scattering process at lunar surfaces into the simulation model. The other is the role of some minor current components such as secondary electrons, scattered protons, and charged dust grains at the lunar surface. Such minor currents become important for the charging of shaded surfaces, as major current components (solar wind plasma and photoelectrons) are not accessible there. We address these points based on kinetic model descriptions.

  11. Icariside II Promotes the Differentiation of Adipose Tissue-Derived Stem Cells to Schwann Cells to Preserve Erectile Function after Cavernous Nerve Injury.

    PubMed

    Zheng, Tao; Zhang, Tian-Biao; Wang, Chao-Liang; Zhang, Wei-Xing; Jia, Dong-Hui; Yang, Fan; Sun, Yang-Yang; Ding, Xiao-Ju; Wang, Rui

    2018-06-14

    Icariside II (ICA II) is used in erectile dysfunction treatment. Adipose tissue-derived stem cells (ADSCs) are efficient at improving erectile function. This study aimed to explore the action mechanism of ADSCs in improving erectile function. ADSCs were isolated from the adipose tissues of rats. Cell proliferation was determined using the Cell Counting Kit-8 (CCK-8) assay. The expressions of mRNA and protein were determined separately through qRT-PCR and western blot. The endogenous expressions of related genes were regulated using recombinant plasmids and cell transfection. A Dual- Luciferase Reporter Assay was performed to determine the interaction between miR-34a and STAT3. Rat models with bilateral cavernous nerve injuries (BCNIs) were used to assess erectile function through the detection of mean arterial pressure (MAP) and intracavernosal pressure (ICP). ICA II promoted ADSCs' proliferation and differentiation to Schwann cells (SCs) through the inhibition of miR-34a. Suppressed miR-34a promoted the differentiation of ADSCs to SCs by upregulating STAT3. ICA II promoted the differentiation of ADSCs to SCs through the miR-34a/STAT3 pathway. The combination of ICA II and ADSCs preserved the erectile function of the BCNI model rats. ADSCs treated with ICA II markedly preserved the erectile function of the BCNI model rats, which was reversed through miR-34a overexpression. ICA II promotes the differentiation of ADSCs to SCs through the miR- 34a/STAT3 pathway, contributing to erectile function preservation after the occurrence of a cavernous nerve injury.

  12. Case report of a modified Meso-Rex bypass as a treatment technique for late-onset portal vein cavernous transformation with portal hypertension after adult deceased-donor liver transplantation.

    PubMed

    Han, Dongdong; Tang, Rui; Wang, Liang; Li, Ang; Huang, Xin; Shen, Shan; Dong, Jiahong

    2017-06-01

    Portal vein thrombosis is a complication after liver transplantation and cavernous transformation of the portal vein (CTPV) is a result of portal vein thrombosis, with symptoms of portal hypertension revealed by an enhanced CT scan. Meso-Rex bypass is an artificial shunt connecting the left portal vein to the superior mesenteric vein and is mainly used for idiopathic cavernomas. This technique is also used for post-transplant portal vein thrombosis in pediatric patients thereby bypassing obstructed sites of the extrahepatic portal vein. Here we report about an adult patient who was treated by connecting the cystic part of the portal vein to the splenic vein instead of the superior mesenteric vein. An adult male patient with post-liver transplantation portal vein cavernous transformation suffered from hypersplenism and elevated hepatic enzymes. The last follow up revealed irregular and obvious hypersplenism, and splenomegaly had occurred, while an enhanced CT scan revealed serious esophagogastric varices and CTPV in addition to occluded right and common PV trunks. The patient was treated by connecting the cystic part of the portal vein to the splenic vein instead of the superior mesenteric vein. After the operation, a satisfactory velocity was confirmed 1 month postoperatively and the shunt still remained patent at the 6-month postoperation follow-up. A Meso-Rex bypass intervention connecting the left portal vein to the splenic vein instead of the superior mesenteric vein after liver transplantation in an adult patient with right and common portal vein occlusions has been successfully performed as an alternative approach.

  13. Sequoia National Park

    NASA Image and Video Library

    2017-12-08

    Naked peaks, sheltered valleys, snowfields, towering trees, and alpine meadows make up the varied landscape of Sequoia National Park in California. Established as a National Park by Congress on September 25, 1890, Sequoia National Park is the second-oldest U.S. National Park, after Yellowstone. This national park borders Kings Canyon National Park. The Thematic Mapper sensor on NASA’s Landsat 5 satellite captured this true-color image of Sequoia National Park, outlined in white, on October 22, 2008. Sunlight illuminates southern slopes, leaving northern faces in shadow in this autumn image. In the west, deep green conifers carpet most of the land. These forested mountains are home to the park’s most famous giant sequoia trees. Sequoia National Park sits at the southern end of the Sierra Nevada mountains. Terrain alternates between extremes, from peaks such as Mt. Whitney—the highest peak in the contiguous United States—to deep caverns. The rivers and lakes in this region are part of a watershed valuable not only to the plants and animals of the park, but also to farms and cities in California’s Central Valley. Read more: go.nasa.gov/2bzGOXr Credit: NASA/Landsat5 NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  14. Dissolution-Enlarged Fractures Imaging Using Electrical Resistivity Tomography (ERT)

    NASA Astrophysics Data System (ADS)

    Siami-Irdemoosa, Elnaz

    In recent years the electrical imaging techniques have been largely applied to geotechnical and environmental investigations. These techniques have proven to be the best geophysical methods for site investigations in karst terrain, particularly when the overburden soil is clay-dominated. Karst is terrain with a special landscape and distinctive hydrological system developed by dissolution of rocks, particularly carbonate rocks such as limestone and dolomite, made by enlarging fractures into underground conduits that can enlarge into caverns, and in some cases collapse to form sinkholes. Bedding planes, joints, and faults are the principal structural guides for underground flow and dissolution in almost all karstified rocks. Despite the important role of fractures in karst development, the geometry of dissolution-enlarged fractures remain poorly unknown. These features are characterized by an strong contrast with the surrounding formations in terms of physical properties, such as electrical resistivity. Electrical resistivity tomography (ERT) was used as the primary geophysical tool to image the subsurface in a karst terrain in Greene County, Missouri. Pattern, orientation and density of the joint sets were interpreted from ERT data in the investigation site. The Multi-channel Analysis of Surface Wave (MASW) method and coring were employed to validate the interpretation results. Two sets of orthogonal visually prominent joints have been identified in the investigation site: north-south trending joint sets and west-east trending joint sets. However, most of the visually prominent joint sets are associated with either cultural features that concentrate runoff, natural surface drainage features or natural surface drainage.

  15. 75 FR 14590 - Petal Gas Storage, L.L.C.; Notice of Intent To Prepare an Environmental Assessment for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-26

    ... Conversion Gas Storage Project and Request for Comments on Environmental Issues March 19, 2010. The staff of... (EA) that will discuss the environmental impacts of the Cavern 12A Conversion Gas Storage Project...

  16. Use of MALDI-TOF Mass Spectrometry and a Custom Database to Characterize Bacteria Indigenous to a Unique Cave Environment (Kartchner Caverns, AZ, USA)

    PubMed Central

    Zhang, Lin; Vranckx, Katleen; Janssens, Koen; Sandrin, Todd R.

    2015-01-01

    MALDI-TOF mass spectrometry has been shown to be a rapid and reliable tool for identification of bacteria at the genus and species, and in some cases, strain levels. Commercially available and open source software tools have been developed to facilitate identification; however, no universal/standardized data analysis pipeline has been described in the literature. Here, we provide a comprehensive and detailed demonstration of bacterial identification procedures using a MALDI-TOF mass spectrometer. Mass spectra were collected from 15 diverse bacteria isolated from Kartchner Caverns, AZ, USA, and identified by 16S rDNA sequencing. Databases were constructed in BioNumerics 7.1. Follow-up analyses of mass spectra were performed, including cluster analyses, peak matching, and statistical analyses. Identification was performed using blind-coded samples randomly selected from these 15 bacteria. Two identification methods are presented: similarity coefficient-based and biomarker-based methods. Results show that both identification methods can identify the bacteria to the species level. PMID:25590854

  17. Use of MALDI-TOF mass spectrometry and a custom database to characterize bacteria indigenous to a unique cave environment (Kartchner Caverns, AZ, USA).

    PubMed

    Zhang, Lin; Vranckx, Katleen; Janssens, Koen; Sandrin, Todd R

    2015-01-02

    MALDI-TOF mass spectrometry has been shown to be a rapid and reliable tool for identification of bacteria at the genus and species, and in some cases, strain levels. Commercially available and open source software tools have been developed to facilitate identification; however, no universal/standardized data analysis pipeline has been described in the literature. Here, we provide a comprehensive and detailed demonstration of bacterial identification procedures using a MALDI-TOF mass spectrometer. Mass spectra were collected from 15 diverse bacteria isolated from Kartchner Caverns, AZ, USA, and identified by 16S rDNA sequencing. Databases were constructed in BioNumerics 7.1. Follow-up analyses of mass spectra were performed, including cluster analyses, peak matching, and statistical analyses. Identification was performed using blind-coded samples randomly selected from these 15 bacteria. Two identification methods are presented: similarity coefficient-based and biomarker-based methods. Results show that both identification methods can identify the bacteria to the species level.

  18. Pediatric Pontine Cavernous Malformations: The Presigmoid, Posterior Petrosal Approach.

    PubMed

    Kulwin, Charles G; Payner, Troy D; Nelson, Rick F; Ackerman, Laurie L; Fulkerson, Daniel H

    2018-03-03

    Brainstem cavernous malformations (cavernomas) in children have a high risk of hemorrhage and neurological deterioration. This risk is magnified if the child has a genetic predisposition for cavernoma formation. The surgical management is challenging and carries a significant risk of morbidity. To describe the feasibility of a posterior petrosal approach to brainstem cavernomas in a pediatric population. A single institution operative experience with this technique was reviewed; 2 cases were identified and are technically described here with supportive figures and illustrations, as well as a focused literature review. Two pediatric cases with multiple symptomatic hemorrhages from large expanding pontine cavernomas were identified. Both cavernomas were resected through a presigmoid posterior petrosal approach. While this approach is well described in the adult literature for ventral brainstem lesions, its description for the treatment of pontine cavernomas in the pediatric populations is scarce. This study demonstrates the utility and feasibility of the posterior petrosal approach in two pediatric patients at different points in cranial base development.

  19. Cervical cystic lymphangioma in a patient with blue rubber bleb nevus syndrome: clinical case report and review of the literature.

    PubMed

    Marín-Manzano, Elena; Utrilla López, Agustin; Puras Magallay, Enrique; Cuesta Gimeno, Carmen; Marín-Aznar, J L

    2010-11-01

    We present the case of a 9-year-old boy diagnosed with blue rubber bleb nevus syndrome, who showed a very large left cervical cystic lymphangioma. He was previously subjected to various treatments for lesions in the intestinal tract including blood transfusions for anemia, sclerosis, enterotomies or resections. The tumor was resected without any complications and the anatomopathologic report confirmed this diagnosis. The blue cavernous hemangioma syndrome (or blue rubber bleb nevus syndrome) is a rare disease characterized by cavernous angiomas involving the skin and gastrointestinal tract. Several cases of cystic lymphangiomas associated with this syndrome have been published recently and lymphomatous differentiation has been identified in the cells of cutaneous lesions. Given their common embryological origin, we underscore the importance of bearing in mind that it is possible for different types of vascular malformations to coexist in the same patient. Copyright © 2010. Published by Elsevier Inc.

  20. Cerebral cavernous malformations: natural history and clinical management.

    PubMed

    Gross, Bradley A; Du, Rose

    2015-01-01

    Cavernous malformations (CMs) are angiographically-occult clusters of dilated sinusoidal channels that may present clinically with seizures, focal neurological deficits and/or hemorrhage. Across natural history studies, the annual hemorrhage rate ranged from 1.6-3.1% per patient-year, decreasing to 0.08-0.2% per patient-year for incidental CMs and to 0.3-0.6% for the collective group of unruptured CMs. Prior hemorrhage is a significant risk factor for subsequent CM hemorrhage. Hemorrhage clustering, particularly within the first 2 years, is an established phenomenon that may confound results of natural history studies evaluating the rate of rehemorrhage. Indeed, rehemorrhage rates for hemorrhagic CMs range from 4.5-22.9% in the literature. Surgical resection is the gold standard treatment for surgically-accessible, symptomatic CMs. Incidental CMs or minimally symptomatic, surgically inaccessible eloquent lesions may be considered for observation. Stereotactic radiosurgery is a controversial treatment approach of consideration only for cases of highly aggressive, surgically inaccessible CMs.

  1. Development of syndrome of inappropriate antidiuretic hormone secretion (SIADH) after Onyx embolisation of a cavernous carotid fistula

    PubMed Central

    Chen, Tsinsue; Kalani, M Yashar S; Ducruet, Andrew F; Albuquerque, Felipe C; McDougall, Cameron G

    2016-01-01

    Patients with cavernous carotid fistulas (CCFs) can present with pituitary hypoperfusion and hypopituitarism; however, there are no previous reports of pituitary or hormonal abnormalities developing after CCF embolisation in an asymptomatic patient. We describe a patient with no hormonal abnormalities who developed syndrome of inappropriate antidiuretic hormone (SIADH) secretion after CCF embolisation. The patient had bilateral indirect CCFs, which were completely embolised via a transvenous approach, and was neurologically stable postoperatively and discharged. In the subsequent 2 weeks the patient was readmitted twice for acute hyponatraemia and a tonic-clonic seizure. Laboratory studies revealed severe SIADH. Clinical status and sodium levels improved after treatment. One year later the patient was weaned off all medications and remained neurologically stable. SIADH may be a delayed phenomenon after CCF embolisation. Given the proximity of embolised vessels to the pituitary's vascular supply, CCF treatment may result in flow disturbance, ischaemia and hormonal abnormalities. PMID:27001597

  2. Modified three-dimensional skull base model with artificial dura mater, cranial nerves, and venous sinuses for training in skull base surgery: technical note.

    PubMed

    Mori, Kentaro; Yamamoto, Takuji; Oyama, Kazutaka; Ueno, Hideaki; Nakao, Yasuaki; Honma, Keiichirou

    2008-12-01

    Experience with dissection of the cavernous sinus and the temporal bone is essential for training in skull base surgery, but the opportunities for cadaver dissection are very limited. A modification of a commercially available prototype three-dimensional (3D) skull base model, made by a selective laser sintering method and incorporating surface details and inner bony structures such as the inner ear structures and air cells, is proposed to include artificial dura mater, cranial nerves, venous sinuses, and the internal carotid artery for such surgical training. The transpetrosal approach and epidural cavernous sinus surgery (Dolenc's technique) were performed on this modified model using a high speed drill or ultrasonic bone curette under an operating microscope. The model could be dissected in almost the same way as a real cadaver. The modified 3D skull base model provides a good educational tool for training in skull base surgery.

  3. Peptide amphiphile nanofiber hydrogel delivery of sonic hedgehog protein to the cavernous nerve to promote regeneration and prevent erectile dysfunction.

    PubMed

    Choe, Shawn; Bond, Christopher W; Harrington, Daniel A; Stupp, Samuel I; McVary, Kevin T; Podlasek, Carol A

    2017-01-01

    Erectile dysfunction (ED) has high impact on quality of life in prostatectomy, diabetic and aging patients. An underlying mechanism is cavernous nerve (CN) injury, which causes ED in up to 80% of prostatectomy patients. We examine how sonic hedgehog (SHH) treatment with innovative peptide amphiphile nanofiber hydrogels (PA), promotes CN regeneration after injury. SHH and its receptors patched (PTCH1) and smoothened (SMO) are localized in PG neurons and glia. SMO undergoes anterograde transport to signal to downstream targets. With crush injury, PG neurons degenerate and undergo apoptosis. SHH protein decreases, SMO localization changes to the neuronal cell surface, and anterograde transport stops. With SHH treatment SHH is taken up at the injury site and undergoes retrograde transport to PG neurons, allowing SMO transport to occur, and neurons remain intact. SHH treatment prevents neuronal degeneration, maintains neuronal, glial and downstream target signaling, and is significant as a regenerative therapy. Published by Elsevier Inc.

  4. Toward an endovascular internal carotid artery classification system.

    PubMed

    Shapiro, M; Becske, T; Riina, H A; Raz, E; Zumofen, D; Jafar, J J; Huang, P P; Nelson, P K

    2014-02-01

    Does the world need another ICA classification scheme? We believe so. The purpose of proposed angiography-driven classification is to optimize description of the carotid artery from the endovascular perspective. A review of existing, predominantly surgically-driven classifications is performed, and a new scheme, based on the study of NYU aneurysm angiographic and cross-sectional databases is proposed. Seven segments - cervical, petrous, cavernous, paraophthlamic, posterior communicating, choroidal, and terminus - are named. This nomenclature recognizes intrinsic uncertainty in precise angiographic and cross-sectional localization of aneurysms adjacent to the dural rings, regarding all lesions distal to the cavernous segment as potentially intradural. Rather than subdividing various transitional, ophthalmic, and hypophyseal aneurysm subtypes, as necessitated by their varied surgical approaches and risks, the proposed classification emphasizes their common endovascular treatment features, while recognizing that many complex, trans-segmental, and fusiform aneurysms not readily classifiable into presently available, saccular aneurysm-driven schemes, are being increasingly addressed by endovascular means. We believe this classification may find utility in standardizing nomenclature for outcome tracking, treatment trials and physician communication.

  5. Cranial arterial patterns of the alpaca (Camelidae: Vicugna pacos).

    PubMed

    O'Brien, Haley D

    2017-03-01

    Artiodactyl cranial arterial patterns deviate significantly from the standard mammalian pattern, most notably in the possession of a structure called the carotid rete (CR)-a subdural arterial meshwork that is housed within the cavernous venous sinus, replacing the internal carotid artery (ICA). This relationship between the CR and the cavernous sinus facilitates a suite of unique physiologies, including selective brain cooling. The CR has been studied in a number of artiodactyls; however, to my knowledge, only a single study to date documents a subset of the cranial arteries of New World camelids (llamas, alpacas, vicugñas and guanacoes). This study is the first complete description of the cranial arteries of a New World camelid species, the alpaca ( Vicugna pacos ), and the first description of near-parturition cranial arterial morphology within New World camelids. This study finds that the carotid arterial system is conserved between developmental stages in the alpaca, and differs significantly from the pattern emphasized in other long-necked ruminant artiodactyls in that a patent, homologous ICA persists through the animal's life.

  6. The bridge permeameter; An alternative method for single-phase, steady-state permeability measurements

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Graf, D.C.; Warpinski, N.R.

    Laboratory measurements of single-phase, steady-state permeability of porous rock are important for a number of different applications. The oil and gas industry uses permeability data as a key indicator of the producability of a hydrocarbon reservoir; effective containment of large volumes of oil in underground salt caverns is directly dependent upon the permeability of the adjacent cavern walls; and safe, long term underground isolation of radioactive and hazardous waste is contingent upon the flow and transport characteristics of the surrounding geologic formations. An alternative method for measuring single-phase, steady-state permeability of porous rock is presented. The use of troublesome andmore » expensive mass flow meters is eliminated and replaced with a bridge configuration of flow resistors. Permeability values can be determined directly from differential pressures across the bridge network, resulting in potentially significant cost savings and simplification for conducting these types of measurements. Results from the bridge permeameter are compared with results obtained using conventional methods.« less

  7. A Continuous Holocene Record of Hydroclimate from Kartchner Cavern, AZ, Supported by Multiyear Dripwater Monitoring

    NASA Astrophysics Data System (ADS)

    Cole, J. E.; Hlohowskyj, S.; Vetter, L.; King, J.; Casavant, R. R.; Woodhead, J. D.; Drysdale, R.; Truebe, S.; Henderson, G. M.

    2017-12-01

    In the arid southwest, hydroclimatic variability is critical to natural and human systems. Cave records provide the chance to reconstruct past variations in moisture, including the seasonal hydroclimatic response to known forcings such as the seasonal distribution of insolation. At Kartchner Caverns State Park, AZ, a sample dating to 12,000 years before present reveals a continuous Holocene history of the Southwest monsoon in its stable isotope content. We interpret the large ( 4‰) changes in speleothem d18O in terms of seasonal precipitation balance, based on modern isotope studies. The Kartchner record confirms a shorter ( 6500 yr) reconstruction from the neighboring Cave of the Bells in describing a strong trend of declining monsoon moisture during the Holocene. The Kartchner sample reveals an early Holocene monsoon peak defined by a broad δ18O peak between 7000 and 9000 years ago, following a gradual strengthening from the start of the record. Between 7000-2000 years ago, the monsoon weakened, and the oxygen isotope values show no trend over the past 2000 years. Substantial multidecadal-multicentury variability is present throughout the record. This pattern is consistent with a sensitive response of the Southwest monsoon to orbital forcing of seasonal radiation. A new laser-ICPMS multi-element dataset spans the past 2400 years and adds information to our isotope-based reconstruction. In particular, Ba and Sr highlight intervals of overall wet and dry conditions, complementing the isotopic record of seasonal precipitation distribution. Dripwater monitoring since 2011 at 4 sites in the cave allows us to identify seasonal and interannual controls on the isotopic and elemental variations of dripwater. Drips differ in their isotopic behavior, with some dominated by relatively steady, low (winter) values and others exhibiting highly variable δ18O. This study provides one of the first cave-based reconstructions of the North American monsoon spanning the entire Holocene. The modern dripwater data shed light on how isotopic and elemental signals vary over space and time and create the multivariate climate record preserved in cave calcite.

  8. 78 FR 67292 - Amendment of Class E Airspace; Carlsbad, NM

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ...) Standard Instrument Approach Procedures at Cavern City Air Terminal. The FAA is taking this action to enhance the safety and management of Instrument Flight Rule (IFR) operations at the airport. DATES... feet above the surface to contain aircraft executing new standard instrument approach procedures at...

  9. Managing Fire in the Northern Chihuahuan Desert: A Review and Analysis of the Literature

    USGS Publications Warehouse

    Gebow, Brooke S.; Halvorson, William L.

    2005-01-01

    Executive Summary This report began as a literature review (Gebow and Halvorson 2001) conducted for fire planners at Carlsbad Caverns National Park who were seeking information about (1) the natural state of park vegetation, (2) northern Chihuahuan Desert natural fire regimes, and (3) fire effects on park plant species. It is the goal of managers there to continue to refine the wildland and prescribed fire program as they learn more about the ecosystems at the park.The park has a history of grazing and then fire suppression in the 20th century. The current effort revisits questions asked by earlier workers at the park, Walter Kittams and Gary Ahlstrand, who began fire studies in the 1970s. This document addresses ecosystems and historical change to those systems in Chihuahuan Desert areas of southeast Arizona, southern New Mexico, west Texas, or in neighboring regions that share the same plant species. It examines fire literature for situations possibly analogous to those at Carlsbad Caverns. It also includes papers that offer advice on extrapolating future ecological trends from past ones (Swetnam et al. 1999) and on resource management decision-making (Grumbine 1997), and other pieces that address broader aspects of fire or landscape change (Goldman 1994; Marston 1996; Mutch 1994, 1995). These more philosophical works were included in the original review at the park's request and have been retained here because they discuss other issues relevant to fire management. Individual reviews of 35 papers, as requested originally by Carlsbad Caverns, appear in Appendix 1. The results section-summary of key findings-discusses historical changes to plant communities then focuses on burn intervals observed or recommended by workers for particular plant communities. Results from a search of the USDA Forest Service's Fire Effects Information System (www.fs.fed.us/database/feis) are also included in this report, supplemented with information from a review conducted by Ahlstrand (1981b) that included much of his own work. This database contains comprehensive plant species accounts and fire effects data. Entries are available for a number of the dominant species at Carlsbad Caverns, though the information frequently applies to the plants in other parts of their ranges. The literature presents highly variable fire effects and observed/recommended burn intervals for similar plant communities in the northern Chihuahuan Desert region. While local and longer-term fire-effects studies are still needed to guide resource managers, the variability seen in the literature itself translates into a fire management goal. Preserving the irregularity in time and space of fires would likely best replicate 'natural' fire regimes.

  10. Dumbbell-shaped intrathoracic-extradural haemangioma of the thoracic spine.

    PubMed

    Doyle, P M; Abou-Zeid, A; Du Plessis, D; Herwadkar, A; Gnanalingham, K K

    2008-04-01

    Spinal haemangiomas are benign vasoproliferative lesions that are typically intra-osseous and generally asymptomatic, although localized pain can be a symptom. Capillary and cavernous variants have been described. We describe a rare case of a dumbbell-shaped haemangioma of the thoracic spine with both an intraspinal-extradural and intrathoracic component.

  11. 76 FR 52649 - Golden Triangle Storage, Inc.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... Triangle Storage, Inc.; Notice of Application On August 5, 2011, Golden Triangle Storage, Inc. (Golden... construct and operate two new salt dome storage caverns at its existing storage site located in Jefferson... Triangle Storage, Inc., 1200 Smith Street, Suite 900, Houston, TX 77002, (832) 397-8642 or John F...

  12. 78 FR 77445 - Tres Palacios Gas Storage LLC; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-23

    ... Gas Storage LLC; Notice of Application Take notice that on December 6, 2013, Tres Palacios Gas Storage... working gas storage capacity in its salt cavern natural gas storage facility located in Matagorda, Colorado, and Wharton Counties, Texas. Tres Palacios states that the proposed abandonment of storage...

  13. A framework for joint image-and-shape analysis

    NASA Astrophysics Data System (ADS)

    Gao, Yi; Tannenbaum, Allen; Bouix, Sylvain

    2014-03-01

    Techniques in medical image analysis are many times used for the comparison or regression on the intensities of images. In general, the domain of the image is a given Cartesian grids. Shape analysis, on the other hand, studies the similarities and differences among spatial objects of arbitrary geometry and topology. Usually, there is no function defined on the domain of shapes. Recently, there has been a growing needs for defining and analyzing functions defined on the shape space, and a coupled analysis on both the shapes and the functions defined on them. Following this direction, in this work we present a coupled analysis for both images and shapes. As a result, the statistically significant discrepancies in both the image intensities as well as on the underlying shapes are detected. The method is applied on both brain images for the schizophrenia and heart images for atrial fibrillation patients.

  14. Trial Readiness in Cavernous Angiomas With Symptomatic Hemorrhage (CASH).

    PubMed

    Polster, Sean P; Cao, Ying; Carroll, Timothy; Flemming, Kelly; Girard, Romuald; Hanley, Daniel; Hobson, Nicholas; Kim, Helen; Koenig, James; Koskimäki, Janne; Lane, Karen; Majersik, Jennifer J; McBee, Nichol; Morrison, Leslie; Shenkar, Robert; Stadnik, Agnieszka; Thompson, Richard E; Zabramski, Joseph; Zeineddine, Hussein A; Awad, Issam A

    2018-04-11

    Brain cavernous angiomas with symptomatic hemorrhage (CASH) are uncommon but exact a heavy burden of neurological disability from recurrent bleeding, for which there is no proven therapy. Candidate drugs to stabilize the CASH lesion and prevent rebleeding will ultimately require testing of safety and efficacy in multisite clinical trials. Much progress has been made in understanding the epidemiology of CASH, and novel biomarkers have been linked to the biological mechanisms and clinical activity in lesions. Yet, the ability to enroll and risk-stratify CASH subjects has never been assessed prospectively at multiple sites. Biomarkers and other outcomes have not been evaluated for their sensitivity and reliability, nor have they been harmonized across sites. To address knowledge gaps and establish a research network as infrastructure for future clinical trials, through the Trial Readiness grant mechanism, funded by National Institute of Neurological Disorders and Stroke/National Institutes of Health. This project includes an observational cohort study to assess (1) the feasibility of screening, enrollment rates, baseline disease categorization, and follow-up of CASH using common data elements at multiple sites, (2) the reliability of imaging biomarkers including quantitative susceptibility mapping and permeability measures that have been shown to correlate with lesion activity, and (3) the rates of recurrent hemorrhage and change in functional status and biomarker measurements during prospective follow-up. We propose a harmonized multisite assessment of enrollment rates of CASH, baseline features relevant to stratification in clinical trials, and follow-up assessments of functional outcomes in relation to clinical bleeds. We introduce novel biomarkers of vascular leak and hemorrhage, with firm mechanistic foundations, which have been linked to clinical disease activity. We shall test their reliability and validity at multiple sites, and assess their changes over time, with and without clinical rebleeds, hence their fitness as outcome instruments in clinical trials. The timing cannot be more opportune, with therapeutic targets identified, exceptional collaboration among researchers and the patient community, along with several drugs ready to benefit from development of a path to clinical testing using this network in the next 5 years.

  15. Significant improvement of intractable headache after transsphenoidal surgery in patients with pituitary adenomas; preoperative neuroradiological evaluation and intraoperative intrasellar pressure measurement.

    PubMed

    Hayashi, Yasuhiko; Kita, Daisuke; Iwato, Masayuki; Fukui, Issei; Oishi, Masahiro; Tsutsui, Taishi; Tachibana, Osamu; Nakada, Mitsutoshi

    2016-04-01

    Headache is the most common symptom of both primary and metastatic brain tumor, and is generally considered the primary symptom in patients with large pituitary adenomas. However, patients with small pituitary adenomas rarely complain of intractable headache, and neurosurgeons are unsure whether such small adenomas actually contribute to headache. If conventional medical treatments for headache prove ineffective, surgical removal of the adenoma can be considered as an alternative management strategy. We conducted a retrospective review of 180 patients who underwent transsphenoidal surgery (TSS) for pituitary adenomas at Kanazawa University Hospital between 2006 and 2014. Patients with acute phase intratumoral hemorrhage were excluded. We identified nine patients with intractable headache as the chief complaint associated with small pituitary adenoma (diameters 15.8 ± 2.6 mm, 11-20 mm), non-functioning in eight, and prolactin-secreting in one. The preoperative neuroradiological studies and headache characteristics were assessed retrospectively, and the intrasellar pressure evaluation was performed during TSS in the last seven patients. All nine patients had complete or substantial resolution of their formerly intractable headache after TSS. Headaches consisted of ocular pain ipsilateral to the adenoma localization within the sella in four cases and bifrontal headache in five. Magnetic resonance imaging of these patients revealed small diaphragmatic foramen, which were so narrow that only the pituitary stalk could pass. Computed tomography scans showed ossification beneath the sellar floor in the sphenoid sinus, presellar type in six cases, and choncal type in three. The adenomas included cysts in seven cases. There was no cavernous sinus invasion. Intrasellar pressure measurements averaged 41.5 ± 8.5 mmHg, range 34-59, significantly higher than in control patients without headache (n = 12), namely 22.2 ± 10.6 mmHg (16-30). In this study, the authors demonstrated the validity of TSS in the treatment of intractable headache associated with pituitary adenoma. The presence of ocular pain, especially ipsilateral to the adenoma, integrity of the diaphragm sella, and ossification in the sphenoid sinus, cyst or hemorrhage and the absence of cavernous sinus invasion were the indications for TSS for patients complaining of intractable headache and having pituitary adenomas.

  16. Seismic Techniques for Subsurface Voids Detection

    NASA Astrophysics Data System (ADS)

    Gritto, Roland; Korneev, Valeri; Elobaid Elnaiem, Ali; Mohamed, Fathelrahman; Sadooni, Fadhil

    2016-04-01

    A major hazards in Qatar is the presence of karst, which is ubiquitous throughout the country including depressions, sinkholes, and caves. Causes for the development of karst include faulting and fracturing where fluids find pathways through limestone and dissolve the host rock to form caverns. Of particular concern in rapidly growing metropolitan areas that expand in heretofore unexplored regions are the collapse of such caverns. Because Qatar has seen a recent boom in construction, including the planning and development of complete new sub-sections of metropolitan areas, the development areas need to be investigated for the presence of karst to determine their suitability for the planned project. In this paper, we present the results of a study to demonstrate a variety of seismic techniques to detect the presence of a karst analog in form of a vertical water-collection shaft located on the campus of Qatar University, Doha, Qatar. Seismic waves are well suited for karst detection and characterization. Voids represent high-contrast seismic objects that exhibit strong responses due to incident seismic waves. However, the complex geometry of karst, including shape and size, makes their imaging nontrivial. While karst detection can be reduced to the simple problem of detecting an anomaly, karst characterization can be complicated by the 3D nature of the problem of unknown scale, where irregular surfaces can generate diffracted waves of different kind. In our presentation we employ a variety of seismic techniques to demonstrate the detection and characterization of a vertical water collection shaft analyzing the phase, amplitude and spectral information of seismic waves that have been scattered by the object. We used the reduction in seismic wave amplitudes and the delay in phase arrival times in the geometrical shadow of the vertical shaft to independently detect and locate the object in space. Additionally, we use narrow band-pass filtered data combining two orthogonal transmission surveys to detect and locate the object. Furthermore, we showed that ambient noise recordings may generate data with sufficient signal-to-noise ratio to successfully detect and locate subsurface voids. Being able to use ambient noise recordings would eliminate the need to employ active seismic sources that are time consuming and more expensive to operate.

  17. Petrosal sinus sampling: technique and rationale.

    PubMed

    Miller, D L; Doppman, J L

    1991-01-01

    Bilateral simultaneous sampling of the inferior petrosal sinuses is an extremely sensitive, specific, and accurate test for diagnosing Cushing disease and distinguishing between that entity and the ectopic ACTH syndrome. It is also valuable for lateralizing small hormone-producing adenomas within the pituitary gland. The inferior petrosal sinuses connect the cavernous sinuses with the ipsilateral internal jugular veins. The anatomy of the anastomoses between the inferior petrosal sinus, the internal jugular vein, and the venous plexuses at the base of the skull varies, but it is almost always possible to catheterize the inferior petrosal sinus. In addition, variations in size and anatomy are often present between the two inferior petrosal sinuses in a patient. Advance preparation is required for petrosal sinus sampling. Teamwork is a critical element, and each member of the staff should know what he or she will be doing during the procedure. The samples must be properly labeled, processed, and stored. Specific needles, guide wires, and catheters are recommended for this procedure. The procedure is performed with specific attention to the three areas of potential technical difficulty: catheterization of the common femoral veins, crossing the valve at the base of the left internal jugular vein, and selective catheterization of the inferior petrosal sinuses. There are specific methods for dealing with each of these areas. The sine qua non of correct catheter position in the inferior petrosal sinus is demonstration of reflux of contrast material into the ipsilateral cavernous sinus. Images must always be obtained to document correct catheter position. Special attention must be paid to two points to prevent potential complications: The patient must be given an adequate dose of heparin, and injection of contrast material into the inferior petrosal sinuses and surrounding veins must be done gently and carefully. When the procedure is performed as outlined, both inferior petrosal sinuses can be catheterized in more than 98% of patients. The complication rate is low, and the theoretical risk of major morbidity or death is less than 1% (neither has yet occurred, to our knowledge). The most common complication is groin hematoma.

  18. Image fusion pitfalls for cranial radiosurgery.

    PubMed

    Jonker, Benjamin P

    2013-01-01

    Stereotactic radiosurgery requires imaging to define both the stereotactic space in which the treatment is delivered and the target itself. Image fusion is the process of using rotation and translation to bring a second image set into alignment with the first image set. This allows the potential concurrent use of multiple image sets to define the target and stereotactic space. While a single magnetic resonance imaging (MRI) sequence alone can be used for delineation of the target and fiducials, there may be significant advantages to using additional imaging sets including other MRI sequences, computed tomography (CT) scans, and advanced imaging sets such as catheter-based angiography, diffusor tension imaging-based fiber tracking and positon emission tomography in order to more accurately define the target and surrounding critical structures. Stereotactic space is usually defined by detection of fiducials on the stereotactic head frame or mask system. Unfortunately MRI sequences are susceptible to geometric distortion, whereas CT scans do not face this problem (although they have poorer resolution of the target in most cases). Thus image fusion can allow the definition of stereotactic space to proceed from the geometrically accurate CT images at the same time as using MRI to define the target. The use of image fusion is associated with risk of error introduced by inaccuracies of the fusion process, as well as workflow changes that if not properly accounted for can mislead the treating clinician. The purpose of this review is to describe the uses of image fusion in stereotactic radiosurgery as well as its potential pitfalls.

  19. Spontaneous Recanalization After Carotid Artery Dissection: The Case for an Ultrasound-Only Monitoring Strategy

    PubMed Central

    Lumsden, Sarah; Rosta, Gabor; Bismuth, Jean; Lumsden, Alan B.; Garami, Zsolt

    2017-01-01

    Dissection of the internal carotid artery (ICA) accounts for 5% to 25% of ischemic strokes in young adults. We report a case of spontaneous recanalization of a traumatic ICA dissection in which carotid duplex (CDU) and transcranial color-coded duplex ultrasound (TCCD) were used. A 47-year-old male presented with intermittent episodes of headache, blurry vision, anisocoria, and loss of taste sensation following a whiplash injury while body surfing. Magnetic resonance angiogram (MRA) of the neck revealed absent flow in the cavernous ICA and a clot at the skull base. Carotid duplex, used to further evaluate flow, demonstrated reverberating color Doppler and spectrum signal. A TCCD showed ICA occlusion and smaller-caliber intracranial ICA. The patient reported for follow-up after 1 month on anticoagulation therapy. Upon his return, CDU and TCCD were normal and the ICA showed normal color and spectrum signals. Computed tomography angiogram confirmed ultrasound findings of a dramatic improvement of ICA patency. Additionally, the patient reported that his headaches had resolved. Extracranial CDU and TCCD are useful for monitoring patient progress in cases of spontaneous recanalization following carotid artery dissection. These inexpensive and noninvasive imaging modalities proved to be critical in the initial and follow-up evaluations of the extracranial and intracranial vascular system, providing a strong alternative to expensive magnetic resonance imaging and invasive angiograms and offering more hemodynamic information than “static” MRA. PMID:29744017

  20. Real-Time Ultrasound-Guided Catheter Navigation for Approaching Deep-Seated Brain Lesions: Role of Intraoperative Neurosonography with and without Fusion with Magnetic Resonance Imaging.

    PubMed

    Manjila, Sunil; Karhade, Aditya; Phi, Ji Hoon; Scott, R Michael; Smith, Edward R

    2017-01-01

    Brain shift during the exposure of cranial lesions may reduce the accuracy of frameless stereotaxy. We describe a rapid, safe, and effective method to approach deep-seated brain lesions using real-time intraoperative ultrasound placement of a catheter to mark the dissection trajectory to the lesion. With Institutional Review Board approval, we retrospectively reviewed the radiographic, pathologic, and intraoperative data of 11 pediatric patients who underwent excision of 12 lesions by means of this technique. Full data sets were available for 12 lesions in 11 patients. Ten lesions were tumors and 2 were cavernous malformations. Lesion locations included the thalamus (n = 4), trigone (n = 3), mesial temporal lobe (n = 3), and deep white matter (n = 2). Catheter placement was successful in all patients, and the median time required for the procedure was 3 min (range 2-5 min). There were no complications related to catheter placement. The median diameter of surgical corridors on postresection magnetic resonance imaging was 6.6 mm (range 3.0-12.1 mm). Use of real-time ultrasound guidance to place a catheter to aid in the dissection to reach a deep-seated brain lesion provides advantages complementary to existing techniques, such as frameless stereotaxy. The catheter insertion technique described here provides a quick, accurate, and safe method for reaching deep-seated lesions. © 2017 S. Karger AG, Basel.

  1. Vascular Complications of Intercavernous Sinuses during Transsphenoidal Surgery: An Anatomical Analysis Based on Autopsy and Magnetic Resonance Venography.

    PubMed

    Deng, Xuefei; Chen, Shijun; Bai, Ya; Song, Wen; Chen, Yongchao; Li, Dongxue; Han, Hui; Liu, Bin

    2015-01-01

    Vascular complications induced by intercavernous sinus injury during dural opening in the transsphenoidal surgery may contribute to incomplete tumour resections. Preoperative neuro-imaging is of crucial importance in planning surgical approach. The aim of this study is to correlate the microanatomy of intercavernous sinuses with its contrast-enhanced magnetic resonance venography (CE-MRV). Eighteen human adult cadavers and 24 patients were examined based on autopsy and CE-MRV. Through dissection of the cadavers and CE-MRV, the location, shape, number, diameter and type of intercavernous sinuses were measured and compared. Different intercavernous sinuses were identified by their location and shape in all the cadavers and CE-MRV. Compared to the cadavers, CE-MRV revealed 37% of the anterior intercavernous sinus, 48% of the inferior intercavernous sinus, 30% of the posterior intercavernous sinus, 30% of the dorsum sellae sinus and 100% of the basilar sinus. The smaller intercavernous sinuses were not seen in the neuro-images. According to the presence of the anterior and inferior intercavernous sinus, four types of the intercavernous sinuses were identified in cadavers and CE-MRV, and the corresponding operative space in the transsphenoidal surgical approach was implemented. The morphology and classification of the cavernous sinus can be identified by CE-MRV, especially for the larger vessels, which cause bleeding more easily. Therefore, CE-MRV provides a reliable measure for individualized preoperative planning during transsphenoidal surgery.

  2. Direct Administration of Nerve-Specific Contrast to Improve Nerve Sparing Radical Prostatectomy

    PubMed Central

    Barth, Connor W.; Gibbs, Summer L.

    2017-01-01

    Nerve damage remains a major morbidity following nerve sparing radical prostatectomy, significantly affecting quality of life post-surgery. Nerve-specific fluorescence guided surgery offers a potential solution by enhancing nerve visualization intraoperatively. However, the prostate is highly innervated and only the cavernous nerve structures require preservation to maintain continence and potency. Systemic administration of a nerve-specific fluorophore would lower nerve signal to background ratio (SBR) in vital nerve structures, making them difficult to distinguish from all nervous tissue in the pelvic region. A direct administration methodology to enable selective nerve highlighting for enhanced nerve SBR in a specific nerve structure has been developed herein. The direct administration methodology demonstrated equivalent nerve-specific contrast to systemic administration at optimal exposure times. However, the direct administration methodology provided a brighter fluorescent nerve signal, facilitating nerve-specific fluorescence imaging at video rate, which was not possible following systemic administration. Additionally, the direct administration methodology required a significantly lower fluorophore dose than systemic administration, that when scaled to a human dose falls within the microdosing range. Furthermore, a dual fluorophore tissue staining method was developed that alleviates fluorescence background signal from adipose tissue accumulation using a spectrally distinct adipose tissue specific fluorophore. These results validate the use of the direct administration methodology for specific nerve visualization with fluorescence image-guided surgery, which would improve vital nerve structure identification and visualization during nerve sparing radical prostatectomy. PMID:28255352

  3. Imaging and radiological interventions in extra-hepatic portal vein obstruction

    PubMed Central

    Pargewar, Sudheer S; Desai, Saloni N; Rajesh, S; Singh, Vaibhav P; Arora, Ankur; Mukund, Amar

    2016-01-01

    Extrahepatic portal vein obstruction (EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension (PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late. Characteristic imaging findings include multiple parabiliary venous collaterals which form to bypass the obstructed portal vein with resultant changes in biliary tree termed portal biliopathy or portal cavernoma cholangiopathy. Ultrasound with Doppler, computed tomography, magnetic resonance cholangiography and magnetic resonance portovenography are non-invasive techniques which can provide a comprehensive analysis of degree and extent of EHPVO, collaterals and bile duct abnormalities. These can also be used to assess in surgical planning as well screening for shunt patency in post-operative patients. The multitude of changes and complications seen in EHPVO can be addressed by various radiological interventional procedures. The myriad of symptoms arising secondary to vascular, biliary, visceral and neurocognitive changes in EHPVO can be managed by various radiological interventions like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, balloon occluded retrograde obliteration of portosystemic shunt (PSS) and revision of PSS. PMID:27358683

  4. Direct Administration of Nerve-Specific Contrast to Improve Nerve Sparing Radical Prostatectomy.

    PubMed

    Barth, Connor W; Gibbs, Summer L

    2017-01-01

    Nerve damage remains a major morbidity following nerve sparing radical prostatectomy, significantly affecting quality of life post-surgery. Nerve-specific fluorescence guided surgery offers a potential solution by enhancing nerve visualization intraoperatively. However, the prostate is highly innervated and only the cavernous nerve structures require preservation to maintain continence and potency. Systemic administration of a nerve-specific fluorophore would lower nerve signal to background ratio (SBR) in vital nerve structures, making them difficult to distinguish from all nervous tissue in the pelvic region. A direct administration methodology to enable selective nerve highlighting for enhanced nerve SBR in a specific nerve structure has been developed herein. The direct administration methodology demonstrated equivalent nerve-specific contrast to systemic administration at optimal exposure times. However, the direct administration methodology provided a brighter fluorescent nerve signal, facilitating nerve-specific fluorescence imaging at video rate, which was not possible following systemic administration. Additionally, the direct administration methodology required a significantly lower fluorophore dose than systemic administration, that when scaled to a human dose falls within the microdosing range. Furthermore, a dual fluorophore tissue staining method was developed that alleviates fluorescence background signal from adipose tissue accumulation using a spectrally distinct adipose tissue specific fluorophore. These results validate the use of the direct administration methodology for specific nerve visualization with fluorescence image-guided surgery, which would improve vital nerve structure identification and visualization during nerve sparing radical prostatectomy.

  5. [Pulmonary non invasive infection by Scedosporium apiospermum].

    PubMed

    Cruz, Rodrigo; Barros, Manuel; Reyes, Mirtha

    2015-08-01

    We reported a case of non-invasive pulmonary infection by Scedosporium apiospermum in 67 years old female with bronchiectasis and caverns secondary to tuberculosis. Diagnosis was made with lung CT and bronchial lavage cultures. The patient was initially treated with itraconazole for six weeks without success and then voriconazole for 16 weeks, with good clinical response.

  6. 78 FR 48839 - Proposed Amendment of Class E Airspace; Carlsbad, NM

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... accommodate new Standard Instrument Approach Procedures (SIAP) at Cavern City Air Terminal. The FAA is taking this action to enhance the safety and management of Instrument Flight Rules (IFR) operations for SIAPs... the airport, to retain the safety and management of IFR aircraft in Class E airspace to/from the en...

  7. 75 FR 70727 - Perryville Gas Storage LLC ; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-18

    ... Storage LLC ; Notice of Application November 10, 2010. Take notice that on November 5, 2010, Perryville Gas Storage LLC (Perryville), Three Riverway, Suite 1350, Houston, Texas 77056, filed in Docket No... interpretations for the location of the edge of the salt dome relative to the approved natural gas storage Cavern...

  8. 75 FR 52937 - Turtle Bayou Gas Storage Company, LLC; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    ...] Turtle Bayou Gas Storage Company, LLC; Notice of Application August 20, 2010. Take notice that on August 6, 2010, Turtle Bayou Gas Storage Company, LLC (Turtle Bayou), One Office Park Circle, Suite 300..., operate, and maintain a new salt dome natural gas storage facility in two caverns and related facilities...

  9. DNA analysis of fecal bacteria to augment an epikarst dye trace study at Crump's Cave, Kentucky

    USDA-ARS?s Scientific Manuscript database

    A rainfall simulation experiment was performed to investigate the transport behavior of fecal-derived bacteria through shallow karst soils and through the epikarst. The experiment was conducted at Cave Springs Cavern located just south of Mammoth Cave National Park on the Sinkhole Plain of South Cen...

  10. Cerebral dominance for speech and handwriting of patients with cortical vascular malformations.

    PubMed

    Sass, K J; Buchanan, C P; Westerveld, M; Spencer, D D

    1994-10-01

    Lateralization of speech dominance was established using amobarbital for 22 patients with vascular malformations lateralized to the left cerebral hemisphere. Patients' histories were negative for clinically evident neurological events (e.g., seizures or hemorrhage) prior to adulthood. The vascular lesions were categorized as high flow arteriovenous malformations (AVMs) (n = 4), low flow AVMs (n = 6), cavernous hemangiomas (n = 10), or venous angiomas (n = 2) by reviewing angiographic findings and surgical pathology for those patients whose lesions were excised. Three of the malformations encroached upon primary language areas. The frequency of right hemisphere speech dominance was not significantly elevated in comparison with the normal population, even though the incidence of nonright-handedness was. Ninety-five percent of the patients were left hemisphere dominant for speech: only one patient, with a parietal lobe cavernous hemangioma, was found to be right hemisphere dominant for speech. This malformation did not involve the primary language areas. These findings suggest that vascular malformations do not affect speech dominance as readily as other neurological diseases, but frequently affect manual dominance.

  11. Cranial arterial patterns of the alpaca (Camelidae: Vicugna pacos)

    PubMed Central

    2017-01-01

    Artiodactyl cranial arterial patterns deviate significantly from the standard mammalian pattern, most notably in the possession of a structure called the carotid rete (CR)—a subdural arterial meshwork that is housed within the cavernous venous sinus, replacing the internal carotid artery (ICA). This relationship between the CR and the cavernous sinus facilitates a suite of unique physiologies, including selective brain cooling. The CR has been studied in a number of artiodactyls; however, to my knowledge, only a single study to date documents a subset of the cranial arteries of New World camelids (llamas, alpacas, vicugñas and guanacoes). This study is the first complete description of the cranial arteries of a New World camelid species, the alpaca (Vicugna pacos), and the first description of near-parturition cranial arterial morphology within New World camelids. This study finds that the carotid arterial system is conserved between developmental stages in the alpaca, and differs significantly from the pattern emphasized in other long-necked ruminant artiodactyls in that a patent, homologous ICA persists through the animal's life. PMID:28405385

  12. Indirect carotid cavernous fistula mimicking ocular myasthenia.

    PubMed

    Leishangthem, Lakshmi; Satti, Sudhakar Reddy

    2017-10-19

    71-year-old woman with progressive left-sided, monocular diplopia and ptosis. Her symptoms mimicked ocular myasthenia, but she had an indirect carotid cavernous fistula (CCF). She was diagnosed with monocular myasthenia gravis (negative acetylcholinesterase antibody) after a positive ice test and started on Mestinon and underwent a thymectomy complicated by a brachial plexus injury. Months later, she developed left-sided proptosis and ocular bruit. She was urgently referred to neuro-interventional surgery and was diagnosed with an indirect high-flow left CCF, which was treated with Onyx liquid and platinum coil embolisation. Mestinon was discontinued. Her ophthalmic symptoms resolved. However, she was left with a residual left arm and hand hemiparesis and dysmetria secondary to a brachial plexus injury. Indirect CCF usually can present with subtle and progressive symptoms leading to delayed diagnosis or misdiagnosis. It is important for ophthalmologists to consider this differential in a patient with progressive ocular symptoms. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Recognition of microclimate zones through radon mapping, Lechuguilla Cave, Carlsbad Caverns National Park, New Mexico

    USGS Publications Warehouse

    Cunningham, K.I.; LaRock, E.J.

    1991-01-01

    Radon concentrations range from <185 to 3,515 Bq m-3 throughout Lechuguilla Cave, Carlsbad Caverns National Park, New Mexico. Concentrations in the entrance passages and areas immediately adjacent to these passages are controlled by outside air temperature and barometric pressure, similar to other Type 2 caves. Most of the cave is developed in three geographic branches beneath the entrance passages; these areas maintain Rn levels independent of surface effects, an indication that Rn levels in deep, complex caves or mines cannot be simply estimated by outside atmospheric parameters. These deeper, more isolated areas are subject to convective ventilation driven by temperature differences along the 477-m vertical extent of the cave. Radon concentrations are used to delineate six microclimate zones (air circulation cells) throughout the cave in conjunction with observed airflow data. Suspected surface connections contribute fresh air to remote cave areas demonstrated by anomalous Rn lows surrounded by higher values, the presence of mammalian skeletal remains, CO2 concentrations and temperatures lower than the cave mean, and associated surficial karst features.

  14. Structure and vascular function of MEKK3–cerebral cavernous malformations 2 complex

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fisher, Oriana S.; Deng, Hanqiang; Liu, Dou

    Cerebral cavernous malformations 2 (CCM2) loss is associated with the familial form of CCM disease. The protein kinase MEKK3 (MAP3K3) is essential for embryonic angiogenesis in mice and interacts physically with CCM2, but how this interaction is mediated and its relevance to cerebral vasculature are unknown. Here we report that Mekk3 plays an intrinsic role in embryonic vascular development. Inducible endothelial Mekk3 knockout in neonatal mice is lethal due to multiple intracranial haemorrhages and brain blood vessels leakage. We discover direct interaction between CCM2 harmonin homology domain (HHD) and the N terminus of MEKK3, and determine a 2.35 Å cocrystalmore » structure. We find Mekk3 deficiency impairs neurovascular integrity, which is partially dependent on Rho–ROCK signalling, and that disruption of MEKK3:CCM2 interaction leads to similar neurovascular leakage. We conclude that CCM2:MEKK3-mediated regulation of Rho signalling is required for maintenance of neurovascular integrity, unravelling a mechanism by which CCM2 loss leads to disease.« less

  15. [Effect of monotherapy with nebivolol, bisoprolol, carvedilol on the state of vegetative nervous system and sexual function in men with arterial hypertension].

    PubMed

    Mustafaev, I I; Nurmamedova, G S

    2013-01-01

    Aim of the study was to assess effect of monotherapy with nebivolol, bisoprolol, carvedilol for 2 months on sexual function in men with arterial hypertension (AH). Men with 1-2 degree of AH (n=75, age 35-55 years, mean age 48+/-3,5 years) received monotherapy with these drugs for 2 months. Registration of parameters of heart rate variability (HRV), Dopplerography of penile arteries, and the Vasilchenko questionnaire were implemented at the end of 4 months of placebo period and after 2 months of therapy with a study drug. Therapy with bisoprolol, carvedilol, and nebivolol was associated with significant elevation of parasympathetic part of vegetative nervous system tone, improvement of systolic blood flow in cavernous and dorsal arteries. Analysis of data obtained by Vasilchenko questionnaire demonstrated improvement of psychic and erectile components of sexual function. Thus bisoprolol, carvedilol, and nebivolol did not worsen sexual function of men with AH, improved spectral parameters of HRV and vascular blood flow in arteries of cavernous bodies.

  16. Tailoring of the care concept for practicality, safety and robustness

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kawamura, Hideki; McKinley, Ian G

    2013-07-01

    The Cavern Retrievable (CARE) concept was originally developed to provide flexibility in tailoring disposal of vitrified HLW to small volunteer host sites, where high emplacement density leads to significant challenges in terms of the management of radiogenic heat. Including an extended storage period in underground caverns prior to sealing solved the heat issue, but also provided benefits in terms of a slow decision-making process that provided more opportunities to engage stakeholders. Recently, direct disposal of spent fuel is being considered in Japan and this gives more severe challenges for heat management, even for conventional disposal concepts. Due to great uncertaintiesmore » in the future of nuclear power in Japan, this may also be associated with a desire to preserve the option of retrieval for extended periods. The basic CARE concept has thus been re-assessed to consider these aspects - and also the need to be able to develop a robust safety case that can be readily communicated to stakeholders, who are more sensitive to nuclear issues than they were in the past. (authors)« less

  17. Extensive basal ganglia edema caused by a traumatic carotid-cavernous fistula: a rare presentation related to a basal vein of Rosenthal anatomical variation.

    PubMed

    Ract, Isabelle; Drier, Aurélie; Leclercq, Delphine; Sourour, Nader; Gabrieli, Joseph; Yger, Marion; Nouet, Aurélien; Dormont, Didier; Chiras, Jacques; Clarençon, Frédéric

    2014-07-01

    The authors report a very rare presentation of traumatic carotid-cavernous fistula (CCF) with extensive edema of the basal ganglia and brainstem because of an anatomical variation of the basal vein of Rosenthal (BVR). A 45-year-old woman was admitted to the authors' institution for left hemiparesis, dysarthria, and a comatose state caused by right orbital trauma from a thin metal rod. Brain MRI showed a right CCF and vasogenic edema of the right side of the brainstem, right temporal lobe, and basal ganglia. Digital subtraction angiography confirmed a high-flow direct CCF and revealed a hypoplastic second segment of the BVR responsible for the hypertension in inferior striate veins and venous congestion. Endovascular treatment was performed on an emergency basis. One month after treatment, the patient's symptoms and MRI signal abnormalities almost totally disappeared. Basal ganglia and brainstem venous congestion may occur in traumatic CCF in cases of a hypoplastic or agenetic second segment of the BVR and may provoke emergency treatment.

  18. Methodology to assess water presence on speleothems during periods of low precipitation, with implications for recharge sources - Kartchner Caverns, Arizona

    USGS Publications Warehouse

    Blasch, Kyle W.

    2011-01-01

    Beginning in January 2005, recharge processes and the presence of water on speleothems were monitored in Kartchner Caverns during a 44-month period when annual rainfall rates were 6 to 18 percent below the long-term mean. Electrical-resistance sensors designed to detect the presence of water were used to identify ephemeral streamflow in the channels overlying the cave as well as the movement of water within the cave system. Direct infiltration of precipitation through overhead rocks provided consistent inflow to the cave, but precipitation rates and subsequent infiltration rates were reduced during the comparatively dry years. Ephemeral stream-channel recharge through autogenic and allogenic processes, the predominant recharge mechanism during wetter periods, was limited to two low-volume events. From visual observations, it appeared that recharge from channel infiltration was equal to or less than recharge from overhead infiltration. Electrical-resistance sensors were able to detect thin films of water on speleothems, including stalactites, ribbons, and stalagmites. These films of water were directly attributed to overhead infiltration of precipitation. Periods of low precipitation resulted in decreased speleothem wetness.

  19. Continuous-wave optical stimulation of the rat prostate nerves using an all-single-mode 1455 nm diode laser and fiber system

    NASA Astrophysics Data System (ADS)

    Tozburun, Serhat; Lagoda, Gwen A.; Burnett, Arthur L.; Fried, Nathaniel M.

    2011-03-01

    Optical nerve stimulation (ONS) has recently been reported as a potential alternative to electrical nerve stimulation. Continuous-wave (CW) laser stimulation of the prostate cavernous nerves (CN) in a rat model, in vivo, has also been demonstrated in our previous studies. The objective of this study is to present a new all-single-mode-fiber configuration for ONS with the laser operating in CW mode for potential diagnostic applications. An infrared pigtailed single-mode diode laser (λ = 1455 nm) was used in this study for noncontact ONS. This new all-fiber approach introduces several advantages including: (1) a less expensive and more compact ONS system, (2) elimination of alignment of optical components, and (3) an improved spatial beam profile. Successful optical stimulation of the rat CN using this new design was observed after the CN reached a threshold temperature of ~ 41 °C with response times as short as 3 s. Upon further study, this configuration may be useful for identification and preservation of the cavernous nerves during prostate cancer surgery.

  20. Evoked Cavernous Activity: Normal Values

    PubMed Central

    Yang, Claire C.; Yilmaz, Ugur; Vicars, Brenda G.

    2009-01-01

    Purpose We present normative data for evoked cavernous activity (ECA), an electrodiagnostic test that evaluates the autonomic innervation of the corpora cavernosa. Material and Methods We enrolled 37 healthy, sexually active and potent men for the study. Each subject completed an IIEF questionnaire and underwent simultaneous ECA and hand and foot sympathetic skin response (SSR) testing. The sympathetic skin response tests were performed as autonomic controls. Results Thirty six men had discernible ECA and SSRs. The mean IIEF erectile domain score was 27. ECA is a low frequency wave that is morphologically and temporally similar in both corpora. The amplitudes of the responses were highly variable. The latencies, although variable, always occurred after the hand SSR. There was no change in the quality or the latency of the ECA with age. Conclusions ECA is measurable in healthy, potent men in a wide range of ages. Similar to other evoked responses of the autonomic nervous system, the measured waveform is highly variable, but its presence is consistent. The association between ECA and erectile function is to be determined. PMID:18423763

  1. The keys to successful TIPS in patients with portal vein thrombosis and cavernous transformation.

    PubMed

    Lombardo, S; Espejo, J J; Pérez-Montilla, M E; Zurera, L J; González-Galilea, Á

    Portal vein thrombosis is a common complication in patients with cirrhosis. Anticoagulation involves a high risk of bleeding secondary to portal hypertension, so placing transjugular intrahepatic portosystemic shunts (TIPS) has become an alternative treatment for portal vein thrombosis. Three strategies for TIPS placement have been reported: 1) portal recanalization and conventional implantation of the TIPS through the jugular vein; 2) portal recanalization through percutaneous transhepatic/transsplenic) access; and (3) insertion of the TIPS between the suprahepatic vein and a periportal collateral vessel without portal recanalization. We describe different materials that can be used as fluoroscopic targets for the TIPS needle and for portal recanalization. This article aims to show the success of TIPS implantation using different combinations of the techniques listed above, which is a good treatment alternative in these patients whose clinical condition makes them difficult to manage, and to show that portal vein thrombosis/cavernous transformation should not be considered a contraindication for TIPS. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Staged curative treatment of a complex direct carotid-cavernous fistula with a large arterial defect and an 'oversized' internal carotid artery.

    PubMed

    Bender, Matthew T; Lin, Li-Mei; Coon, Alexander L; Colby, Geoffrey P

    2017-06-14

    This is a case of a high-flow, post-traumatic direct carotid-cavernous fistula with a widened arterial defect and a large-diameter internal carotid artery (ICA). The unique aspect of this case is the oversized ICA, >8mm in diameter, which is both a pathological and a therapeutic challenge, given the lack of available neuroendovascular devices for full vessel reconstruction. We present a planned two-stage embolisation paradigm for definitive treatment. Transarterial coil embolisation is performed as the first stage to disconnect the fistula and normalise flow in the ICA. A 3-month recovery period is then allowed for reduction in carotid diameter. Repair of the large vessel defect and pseudoaneurysm is performed as a second stage in a delayed fashion with a flow-diverting device. Follow-up angiography at 6 months demonstrates obliteration of the fistula and curative ICA reconstruction to a diameter <5mm. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. SPR Hydrostatic Column Model Verification and Validation.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bettin, Giorgia; Lord, David; Rudeen, David Keith

    2015-10-01

    A Hydrostatic Column Model (HCM) was developed to help differentiate between normal "tight" well behavior and small-leak behavior under nitrogen for testing the pressure integrity of crude oil storage wells at the U.S. Strategic Petroleum Reserve. This effort was motivated by steady, yet distinct, pressure behavior of a series of Big Hill caverns that have been placed under nitrogen for extended period of time. This report describes the HCM model, its functional requirements, the model structure and the verification and validation process. Different modes of operation are also described, which illustrate how the software can be used to model extendedmore » nitrogen monitoring and Mechanical Integrity Tests by predicting wellhead pressures along with nitrogen interface movements. Model verification has shown that the program runs correctly and it is implemented as intended. The cavern BH101 long term nitrogen test was used to validate the model which showed very good agreement with measured data. This supports the claim that the model is, in fact, capturing the relevant physical phenomena and can be used to make accurate predictions of both wellhead pressure and interface movements.« less

  4. Uranium-isotope variations in groundwaters of the Floridan aquifer and Boulder Zone of south Florida

    USGS Publications Warehouse

    Cowart, J.B.; Kaufman, M.I.; Osmond, J.K.

    1978-01-01

    Water samples from four wells from the main Floridan aquifer (300-400 m below mean sea level) in southeast Florida exhibit 234U 233U activity ratios that are significantly lower than the secular equilibrium value of 1.00. Such anomalous values have been observed previously only in waters from sedimentary aquifers in the near-surface oxidizing environments. These four wells differ from six others, all producing from the same general horizon, in being located in cavernous highly transmissive zones. We hypothesize that the low activity ratios are indicative of a relic circulation pattern whereby water from the surface aquifer was channelled to lower levels when sea level was much lower. At a deeper cavernous level, known as the Boulder Zone (800-1,000 m below mean sea level), the U isotopes, along with other chemical constituents, show progressive changes with increasing distance from an inferred flow source in the Straits of Florida. This tends to support the hypothesized landward flow (though with a more northerly component) of cold seawater in the extensively transmissive Boulder Zone. ?? 1978.

  5. A servo controlled gradient loading triaxial model test system for deep-buried cavern.

    PubMed

    Chen, Xu-guang; Zhang, Qiang-yong; Li, Shu-cai

    2015-10-01

    A servo controlled gradient loading model test system is developed to simulate the gradient geostress in deep-buried cavern. This system consists of the gradient loading apparatus, the digital servo control device, and the measurement system. Among them, the gradient loading apparatus is the main component which is used for exerting load onto the model. This loading apparatus is placed inside the counterforce wall/beam and is divided to several different loading zones, with each loading zone independently controlled. This design enables the gradient loading. Hence, the "real" geostress field surrounding the deep-buried cavern can be simulated. The loading or unloading process can be controlled by the human-computer interaction machines, i.e., the digital servo control system. It realizes the automation and visualization of model loading/unloading. In addition, this digital servo could control and regulate hydraulic loading instantaneously, which stabilizes the geostress onto the model over a long term. During the loading procedure, the collision between two adjacent loading platens is also eliminated by developing a guide frame. This collision phenomenon is induced by the volume shrinkage of the model when compressed in true 3D state. In addition, several accurate measurements, including the optical and grating-based method, are adopted to monitor the small deformation of the model. Hence, the distortion of the model could be accurately measured. In order to validate the performance of this innovative model test system, a 3D geomechanical test was conducted on a simulated deep-buried underground reservoir. The result shows that the radial convergence increases rapidly with the release of the stress in the reservoir. Moreover, the deformation increases with the increase of the gas production rate. This observation is consistence with field observation in petroleum engineering. The system is therefore capable of testing deep-buried engineering structures.

  6. Estrogen-Induced Maldevelopment of the Penis Involves Down-Regulation of Myosin Heavy Chain 11 (MYH11) Expression, a Biomarker for Smooth Muscle Cell Differentiation1

    PubMed Central

    Okumu, L.A.; Bruinton, Sequoia; Braden, Tim D.; Simon, Liz; Goyal, Hari O.

    2012-01-01

    ABSTRACT Cavernous smooth muscle cells are essential components in penile erection. In this study, we investigated effects of estrogen exposure on biomarkers for smooth muscle cell differentiation in the penis. Neonatal rats received diethylstilbestrol (DES), with or without the estrogen receptor (ESR) antagonist ICI 182,780 (ICI) or the androgen receptor (AR) agonist dihydrotestosterone (DHT), from Postnatal Days 1 to 6. Tissues were collected at 7, 10, or 21 days of age. The smooth muscle cell biomarker MYH11 was studied in depth because microarray data showed it was significantly down-regulated, along with other biomarkers, in DES treatment. Quantitative real time-PCR and Western blot analyses showed 50%–80% reduction (P ≤ 0.05) in Myh11 expression in DES-treated rats compared to that in controls; and ICI and DHT coadministration mitigated the decrease. Temporally, from 7 to 21 days of age, Myh11 expression was onefold increased (P ≥ 0.05) in DES-treated rats versus threefold increased (P ≤ 0.001) in controls, implying the long-lasting inhibitory effect of DES on smooth muscle cell differentiation. Immunohistochemical localization of smooth muscle alpha actin, another biomarker for smooth muscle cell differentiation, showed fewer cavernous smooth muscle cells in DES-treated animals than in controls. Additionally, DES treatment significantly up-regulated Esr1 mRNA expression and suppressed the neonatal testosterone surge by 90%, which was mitigated by ICI coadministration but not by DHT coadministration. Collectively, results provided evidence that DES treatment in neonatal rats inhibited cavernous smooth muscle cell differentiation, as shown by down-regulation of MYH11 expression at the mRNA and protein levels and by reduced immunohistochemical staining of smooth muscle alpha actin. Both the ESR and the AR pathways probably mediate this effect. PMID:22976277

  7. Comparison and Tensorial Formulation of Inelastic Constitutive Models of Salt Rock Behaviour and Efficient Numerical Implementatio

    NASA Astrophysics Data System (ADS)

    Nagel, T.; Böttcher, N.; Görke, U. J.; Kolditz, O.

    2014-12-01

    The design process of geotechnical installations includes the application of numerical simulation tools for safety assessment, dimensioning and long term effectiveness estimations. Underground salt caverns can be used for the storage of natural gas, hydrogen, oil, waste or compressed air. For their design one has to take into account fluctuating internal pressures due to different levels of filling, the stresses imposed by the surrounding rock mass, irregular geometries and possibly heterogeneous material properties [3] in order to estimate long term cavern convergence as well as locally critical wall stresses. Constitutive models applied to rock salt are usually viscoplastic in nature and most often based on a Burgers-type rheological model extended by non-linear viscosity functions and/or plastic friction elements. Besides plastic dilatation, healing and damage are sometimes accounted for as well [2]. The scales of the geotechnical system to be simulated and the laboratory tests from which material parameters are determined are vastly different. The most common material testing modalities to determine material parameters in geoengineering are the uniaxial and the triaxial compression tests. Some constitutive formulations in widespread use are formulated based on equivalent rather than tensorial quantities valid under these specific test conditions and are subsequently applied to heterogeneous underground systems and complex 3D load cases. We show here that this procedure is inappropriate and can lead to erroneous results. We further propose alternative formulations of the constitutive models in question that restore their validity under arbitrary loading conditions. For an efficient numerical simulation, the discussed constitutive models are integrated locally with a Newton-Raphson algorithm that directly provides the algorithmically consistent tangent matrix for the global Newton iteration of the displacement based finite element formulation. Finally, the finite element implementations of the proposed constitutive formulations are employed to simulate an underground salt cavern used for compressed air energy storage with OpenGeoSys [1]. Transient convergence and stress fields are evaluated for typical fluctuating operation pressure regimes.

  8. Patterns of local recurrence after primary resection of cancers that arise in the sinonasal region and the maxillary alveolus.

    PubMed

    McMahon, Jeremy D; Wong, Ling Siew; Crowther, John; Taylor, William M; McManners, Joseph; Devine, John C; Wales, Craig; Maciver, Colin

    2013-07-01

    Local recurrence remains the most important sign of relapse of disease after treatment of advanced cancer of the maxilla and sinonasal region. In this retrospective study we describe patterns of recurrence in a group of patients who had had open resection for cancer of the sinonasal region and posterior maxillary alveolus with curative intent. Casenotes and imaging studies were reviewed to find out the pattern of any relapse, with particular reference to local recurrence. The minimum follow-up period was 12 months. Of 50 patients a total of 16 developed recurrences, 11 of which were local. Of those 11, a total of 8 were in posterior and superior locations (the orbit, the infratemporal and pterygopalatine fossas, the traversing neurovascular canals of the body of the sphenoid to the cavernous sinus, the Gasserian ganglion, and the dura of the middle cranial fossa). Advanced cancer of the midface often equates with disease at the skull base. Treatment, including surgical tactics, should reflect that. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Endoscopic endonasal pituitary adenomas surgery: the surgical experience of 178 consecutive patients and learning curve of two neurosurgeons.

    PubMed

    Shou, Xuefei; Shen, Ming; Zhang, Qilin; Zhang, Yichao; He, Wenqiang; Ma, Zengyi; Zhao, Yao; Li, Shiqi; Wang, Yongfei

    2016-11-30

    We aim to study surgical technique and analyze the related factors affecting tumor total removal and postoperative endocrinological remission for endoscopic endonasal pituitary adenomas surgery. We retrospectively analyzed 178 endoscopic endonasal pituitary adenomas surgery from March 2011 to May 2014. Endonasal approach included the routine transnasal-sphenoidal approach, transnasal- maxillary sinus approach in four cases and transnasal-clivus approach in one case. According to postoperative imaging data and endocrine examination results, total removal was achieved in 129 patients (72.5%), and endocrinological remission was achieved in 38 patients with functional adenomas (44.1%). Statistical analysis of the clinical data showed that total removal rate was much closely related to tumor volume (P = 0.006), and tumor invasiveness (P < 0.001). In this study, we found tumor sizes and invasion of cavernous sinus were related to total removal rate and endocrinological remission rate; the direction and degree of tumor invasion, and the surgeon's experience were the key influence factors of the endocrinological remission rate for invasive functional pituitary adenomas.

  10. Infundibuloneurohypophysitis presenting a large sellar-juxtasellar mass: case report.

    PubMed

    Kanou, Yukari; Arita, Kazunori; Kurisu, Kaoru; Tominaga, Atsushi; Akimitsu, Tomohide

    2004-03-01

    Infundibuloneurohypophysitis (INH) is reported to be a self-limiting inflammatory disease involving neurohypophysis. The authors experienced a case of INH presenting a large mass compressing the brain stem. The patient exhibited polyuria followed by left hemiparesis and dysarthria lasting a year. Magnetic resonance imaging showed a large sellar mass extending into the right cavernous sinus and prepontine cistern and compressing pons. Endocrinologically, diabetes insipidus was diagnosed and anterior pituitary function was almost normal. Microscopic examination of the surgical specimen obtained by a transsphenoidal route demonstrated diffuse infiltration of lymphoid cells with predominance of B cells over T cells and the granulation tissue. The patient underwent 40 Gy local radiation because of initial misinterpretation of histologic findings as malignant lymphoma and short-term corticostertoid administration. The mass gradually shrank and the patient has become neurologically intact in 6 months. At this moment, 67 months after the onset, the patient is free from disease and has no other lesion. INH seems to be a clinical entity possessing a wide spectrum from infundibular tumorlet to an aggressive sellar mass trespassing on surrounding structures.

  11. Total En Bloc Spondylectomy for Locally Aggressive Vertebral Hemangioma Causing Neurological Deficits

    PubMed Central

    Ogawa, Ryo; Hikata, Tomohiro; Fujita, Nobuyuki; Iwanami, Akio; Watanabe, Kota; Ishii, Ken; Nakamura, Masaya; Toyama, Yoshiaki; Matsumoto, Morio

    2015-01-01

    Vertebral hemangiomas are common; however, aggressive vertebral hemangiomas with extraosseous extensions causing neurological deficits are rare. The treatment for this subtype of hemangioma remains controversial, since there are few reports on long-term clinical outcomes or tumor recurrence rates. We describe a case of aggressive vertebral hemangioma treated by total en bloc spondylectomy, with a literature review focusing on long-term recurrence. A 52-year-old male with a two-month history of numbness in the bilateral lower extremities was referred to our hospital. Imaging studies showed a tumor originating in the T9 vertebra and extending to the T8 and T10 vertebrae, with extraosseous extension causing spinal-cord compression. Ten months after onset, the patient presented with progressive paraparesis and hypalgesia. Total en bloc spondylectomy was performed, and pathology was consistent with cavernous hemangioma. Motor and sensory deficits improved significantly, and no signs of recurrence are seen at 2.5 years after operation. A review of literature revealed a recurrence rate of 12.7% (10/79 cases). The available evidence indicates satisfactory long-term outcomes for total tumor resection without adjuvant radiotherapy. PMID:25918662

  12. Penile involvement in Systemic Sclerosis: New Diagnostic and Therapeutic Aspects

    PubMed Central

    Aversa, Antonio; Bruzziches, Roberto; Francomano, Davide; Rosato, Edoardo; Salsano, Felice; Spera, Giovanni

    2010-01-01

    Systemic Sclerosis (SSc) is a connective tissue disorder featuring vascular alterations and an immunological activation leading to a progressive and widespread fibrosis of several organs such as the skin, lung, gastrointestinal tract, heart, and kidney. Men with SSc are at increased risk of developing erectile dysfunction (ED) because of the evolution of early microvascular tissutal damage into corporeal fibrosis. The entity of penile vascular damage in SSc patients has been demonstrated by using Duplex ultrasonography and functional infra-red imaging and it is now clear that this is a true clinical entity invariably occurring irrespective of age and disease duration and constituting the ‘‘sclerodermic penis”. Once-daily phosphodiesterase type-5 (PDE5) inhibitors improve both sexual function and vascular measures of cavernous arteries by improving surrogate markers of endothelial dysfunction, that is, plasma endothelin-1 and adrenomedullin levels, which may play a potential role in preventing progression of penile fibrosis and ED. Also, the beneficial effect of long-term PDE5i add-on therapy to SSc therapy in the treatment of Raynaud's phenomenon is described. PMID:20981315

  13. Image fusion pitfalls for cranial radiosurgery

    PubMed Central

    Jonker, Benjamin P.

    2013-01-01

    Stereotactic radiosurgery requires imaging to define both the stereotactic space in which the treatment is delivered and the target itself. Image fusion is the process of using rotation and translation to bring a second image set into alignment with the first image set. This allows the potential concurrent use of multiple image sets to define the target and stereotactic space. While a single magnetic resonance imaging (MRI) sequence alone can be used for delineation of the target and fiducials, there may be significant advantages to using additional imaging sets including other MRI sequences, computed tomography (CT) scans, and advanced imaging sets such as catheter-based angiography, diffusor tension imaging-based fiber tracking and positon emission tomography in order to more accurately define the target and surrounding critical structures. Stereotactic space is usually defined by detection of fiducials on the stereotactic head frame or mask system. Unfortunately MRI sequences are susceptible to geometric distortion, whereas CT scans do not face this problem (although they have poorer resolution of the target in most cases). Thus image fusion can allow the definition of stereotactic space to proceed from the geometrically accurate CT images at the same time as using MRI to define the target. The use of image fusion is associated with risk of error introduced by inaccuracies of the fusion process, as well as workflow changes that if not properly accounted for can mislead the treating clinician. The purpose of this review is to describe the uses of image fusion in stereotactic radiosurgery as well as its potential pitfalls. PMID:23682338

  14. New DICOM extensions for softcopy and hardcopy display consistency.

    PubMed

    Eichelberg, M; Riesmeier, J; Kleber, K; Grönemeyer, D H; Oosterwijk, H; Jensch, P

    2000-01-01

    The DICOM standard defines in detail how medical images can be communicated. However, the rules on how to interpret the parameters contained in a DICOM image which deal with the image presentation were either lacking or not well defined. As a result, the same image frequently looks different when displayed on different workstations or printed on a film from various printers. Three new DICOM extensions attempt to close this gap by defining a comprehensive model for the display of images on softcopy and hardcopy devices: Grayscale Standard Display Function, Grayscale Softcopy Presentation State and Presentation Look Up Table.

  15. 46 CFR 7.115 - Santa Catalina Island, CA.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Coast § 7.115 Santa Catalina Island, CA. (a) A line drawn from the northernmost point of Lion Head to the north tangent of Bird Rock Island; thence to the northernmost point of Blue Cavern Point. (b) A... 46 Shipping 1 2013-10-01 2013-10-01 false Santa Catalina Island, CA. 7.115 Section 7.115 Shipping...

  16. 46 CFR 7.115 - Santa Catalina Island, CA.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Coast § 7.115 Santa Catalina Island, CA. (a) A line drawn from the northernmost point of Lion Head to the north tangent of Bird Rock Island; thence to the northernmost point of Blue Cavern Point. (b) A... 46 Shipping 1 2014-10-01 2014-10-01 false Santa Catalina Island, CA. 7.115 Section 7.115 Shipping...

  17. 46 CFR 7.115 - Santa Catalina Island, CA.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Coast § 7.115 Santa Catalina Island, CA. (a) A line drawn from the northernmost point of Lion Head to the north tangent of Bird Rock Island; thence to the northernmost point of Blue Cavern Point. (b) A... 46 Shipping 1 2011-10-01 2011-10-01 false Santa Catalina Island, CA. 7.115 Section 7.115 Shipping...

  18. 46 CFR 7.115 - Santa Catalina Island, CA.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Coast § 7.115 Santa Catalina Island, CA. (a) A line drawn from the northernmost point of Lion Head to the north tangent of Bird Rock Island; thence to the northernmost point of Blue Cavern Point. (b) A... 46 Shipping 1 2012-10-01 2012-10-01 false Santa Catalina Island, CA. 7.115 Section 7.115 Shipping...

  19. 46 CFR 7.115 - Santa Catalina Island, CA.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Coast § 7.115 Santa Catalina Island, CA. (a) A line drawn from the northernmost point of Lion Head to the north tangent of Bird Rock Island; thence to the northernmost point of Blue Cavern Point. (b) A... 46 Shipping 1 2010-10-01 2010-10-01 false Santa Catalina Island, CA. 7.115 Section 7.115 Shipping...

  20. High activity iodine 125 endocurietherapy for recurrent skull base tumors

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kumar, P.P.; Good, R.R.; Leibrock, L.G.

    1988-04-15

    Experience with endocurietherapy of skull base tumors is reviewed. We present our cases of recurrent pituitary hemangiopericytoma, radiation-induced recurrent meningioma, recurrent clival chordoma, recurrent nasopharyngeal cancer involving the cavernous sinus, and recurrent parotid carcinoma of the skull base which were all successfully retreated with high-activity 125-iodine (I-125) permanent implantation.76 references.

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