Ct

This review summarizes the current state-of-the-art regarding the endovascular management of acute ischemic stroke. Beginning with intravenous tissue plasminogen activator, this paper traces the gradual shift of systemic thrombolysis from a competing to complementary treatment modality. Intra-arterial thrombolysis, mechanical thrombectomy with the Merci (Concentric Medical, Mountain View, California) and Penumbra (Penumbra, Inc., Alameda, California) systems, angioplasty, primary intracranial stenting, and emerging stentriever devices are sequentially reviewed. Ultimately, this paper lays the foundation for current endovascular stroke management and considers future areas of progress and research.

The antihyperglycemic and hypolipidemic activities of Hibiscus schizopetalus (Mast) Hook (Malvaceae) flower and leaves extracts were investigated in alloxan-induced diabetic rats. The hypoglycemic activity of both the extracts (100mg/kg, body weight) was tested in fasting normal rat, glucose loaded rats. Observation on body weight was also recorded. The extracts showed a significant (P<0.001) reduction in blood glucose level in normal fasting rats. In glucose tolerance test, significant (P<0.01) decreased observed in all glucose loaded animals. While in alloxan induced diabetic rats, the percent blood glucose reduction was 59.94% and 45.14% in extracts treated groups. The results obtained were compared with the reference standard drug Tolbutamide (100mg/kg, body weight). The diabetic rats showed sign of decreased in their body weight during the treatment period. Cholesterol and triglycerides levels were significantly decreased (P<0.001) by HFE. The results obtained demonstrated the potential hypoglycemic activity of methanolic extracts of H. schizopetalus. There is need of bioassay-directed assay of the active principles responsible for the anti-diabetic activity. The methanolic extracts showed the presence of carbohydrates, alkaloids, steroids, terpenes, saponins and glycosides.

The complexity of the equine skull makes the temporomandibular joint a difficult area to evaluate radiographically. The goal of this study was to determine the optimal angle for a complementary radiographic projection of the equine temporomandibular joint based on a computed tomography (CT) cadaver study. CT was performed on six equine cadaver heads of horses that were euthanized for other reasons than temporomandibular joint disease. After the CT examination, 3D reconstruction of the equine skull was performed to subjectively determine the angle for a complementary radiographic projection of the temporomandibular joint. The angle was measured on the left and right temporomandibular joint of each head. Based on the measurements obtained from the CT images, a radiographic projection of the temporomandibular joint in a rostra-l451ventral-caudodorsal oblique (R451V-CdDO) direction was developed by placing the X-ray unit 301 laterally, maintaining at the same time the R451V-CdDO angle (R451V301L-CdDLO). This radiographic projection was applied to all cadaver heads and on six live horses. In three of the live horses abnormal findings associated with the temporomandibular joint were detected. We conclude that this new radiographic projection of the temporomandibular joint provides superior visualization of the temporomandibular joint space and the articular surface of the mandibular condyle.

The antiviral effect against hepatitis B virus (HBV) of artemisinin, its derivative artesunate and other compounds highly purified from traditional Chinese medicine remedies, were investigated. HBV production by permanently transfected HepG2 2.2.15 cells was determined by measuring the release of surface protein (HBsAg) and HBV-DNA after drug exposure (0.01-100 M) for 21 days. The forms of HBV-DNA released were investigated by Southern-blotting. Neutral Red retention test was used to evaluate drug-induced toxicity on host cells. The compounds were classified according to their potential interest as follows: (i) none: they had no effect on viral production (daidzein, daidzin, isonardosinon, nardofuran, nardosinon, tetrahydronardosinon and quercetin); (ii) low: they were able to markedly reduce viral production, but also induced toxicity on host cells (berberine and tannic acid) or they had no toxic effect on host cells but only had a moderate ability to reduce viral production (curcumin, baicalein, baicalin, bufalin, diallyl disulphide, glycyrrhizic acid and puerarin); (iii) high: they induced strong inhibition of viral production at concentrations at which host cell viability was not affected (artemisinin and artesunate). Moreover, artesunate in conjunction with lamivudine had synergic anti-HBV effects, which warrants further evaluation of artemisinin/artesunate as antiviral agents against HBV infection.

To determine the sensitivity and specificity of the semiquantitative latex agglutination plasma fibrin D-dimer assay for the diagnosis of acute pulmonary embolism by using computed tomographic (CT) angiography as the diagnostic reference standard. • Patients and Methods: From January 1, 1998, to June 26, 2000, patients who had both semiquantitative latex agglutination plasma fibrin D-dimer testing and CT angiography for suspected acute pulmonary embolism were selected for the study. A D-dimer value greater than 250 ng/mL was considered positive for thromboembolic disease. Diagnosis of acute pulmonary embolism was based solely on the interpretation of the CT angiogram. The Ddimer assay results were then compared with the CT angiographic diagnoses. • Results: Of 946 CT studies, 172 (18%) were positive for acute pulmonary embolism. The D-dimer assay was positive for 612 (65%) of the 946 patients. For acute pul-CI = confidence interval; CT = computed tomography; ELISA = enzyme-linked immunosorbent assay

Two new ruthenium(II) complexes [Ru(bpy) 2 (HBT)] 2þ (1) and [Ru(phen) 2 (HBT)] 2þ (2) (bpy ¼ 2,2 0bipyridine; phen ¼ 1,10-phenanthroline; HBT ¼ 11H, 13H-4, 5,9,10,12,14-hexaaza-benzo [b] triphenylene) have been synthesized and characterized by elemental analysis, mass spectra, 1 H NMR and cyclic voltammetry. The DNA binding property of the two complexes has been investigated employing absorption spectroscopy, fluorescence spectroscopy and viscosity measurements. Both complexes 1 and 2 have been found to prefer intercalative binding to DNA. The DNA binding constants for the two complexes have been measured to be 5.71 AE 0.20 Â 10 7 and 4.65 AE 0.20 Â 10 7 M À1 through ethidium bromide displacement method. Molecular modeling studies too indicate that both complexes 1 and 2 prefer intercalative binding to DNA and both these complexes exhibit similar DNA binding energies. Both complexes 1 and 2 bring about photocleavage of plasmid DNA when irradiated at 440 nm.

Axial X-ray computed tomography CT scanning provides a convenient means of recording the three-dimensional form of soil structure. The technique has been used for nearly two decades, but initial development has concentrated on qualitative description of images. More recently, increasing effort has been put into quantifying the geometry and topology of macropores likely to contribute to preferential flow in soils.

To determine the gastrointestinal toxic effects of idarubicin and cytosine arabinoside combination therapy in patients with newly diagnosed acute myelogenous leukemia (AML). We performed a single-institution retrospective analysis of the incidence of neutropenic colitis in patients with newly diagnosed AML receiving idarubicin and cytosine arabinoside combination therapy. Using pharmacy records, we identified 78 patients who received idarubicin during the study period of January 1997 to September 1998 and who agreed to a review of their medical records. Patients with preexisting bowel conditions were excluded from this analysis. We used a strict definition of neutropenic colitis that included clinical findings (severe abdominal pain, diarrhea, hematochezia, and/or peritoneal signs) plus radiographic evidence of bowel inflammation in the absence of an identified bacterial pathogen. Of the 78 patients receiving idarubicin and cytosine arabinoside for treatment of AML, 65 were included...

This study investigates the dose from the 1 mm collimator width megavoltage fan-beam CT (fine, normal and coarse pitch) available on tomotherapy as well as for whole-breast tomotherapy treatments. The BEIR VII lifetime attributable risk model was utilised to assess the significance of the imaging dose relative to the treatment dose.

Superior cervical ganglionectomy (SCGx) is a valuable microsurgical model to study the role of the sympathetic nervous system in a vast array of physiological and pathological processes, including homeostatic regulation, circadian biology and the dynamics of neuronal dysfunction and recovery after injury. Despite having several experimental applications in the rat, a thorough description of a standardized procedure has never been published. Here, we provide a brief review of the principal features and experimental uses of the SCGx, the surgical anatomy of the neck and sympathetic cervical chain, and a step-by-step description of how to consistently remove the superior cervical ganglia through the omohyoid muscle or the carotid triangle. Furthermore, we suggest procedures and precautions to be taken during and after surgery to optimize results and describe tools to validate surgical success. We expect that the following standardized and optimized protocol will allow researchers to organize knowledge into a cohesive framework in those areas where the SCGx is applied.

Background: Pseudoaneuryms of the MMA are rare lesions, accounting for less than 1% of all intracranial aneurysms. Case Description: We report a case of a spontaneous intracerebral hematoma that DSA revealed as ispilateral traumatic PMMA. The lesion was managed through an endovascular approach, and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection was carried out. Recovery and follow-up were uneventful. We discuss the management of those lesions, emphasizing the current neuroendovascular tools and techniques. Conclusion: Pseudoaneurysm of the MMA is uncommon but has a potential aggressive natural history. As it can occur with different patterns of intracranial hemorrhage, the external carotid arteries have to be included in hemorrhagic investigational DSA. Once diagnosed, it must be treated. The minimally invasive endovascular approach and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection are safe and effective. D

Background: The efficacy of BioGlue R (CryoLife, Inc, Atlanta, Ga) surgical adhesive in transsphenoidal surgery was assessed as an adjunct in the prevention of postoperative CSF leaks. Methods: All patients in whom BioGlue R was used for an intraoperative skull base reconstruction were retrospectively identified. Intraoperative CSF leaks were graded according to size (grade 1, small weeping leak without obvious diaphragmatic defect; grade 2, moderate leak with a definite diaphragmatic defect; grade 3, large diaphragmatic and/or dural defect). CSF leak repair was tailored to CSF leak grade. BioGlue R was applied as a reinforcement over collagen sponge as the last layer of the repair. Results: Over 28 months, a total of 282 patients underwent endonasal surgery. Of these patients, 124 (79 women; age range, 8-84 years), in 128 procedures, had an intraoperative CSF leak repair reinforced with BioGlue R . Pathology included 80 pituitary adenomas, 11 craniopharyngiomas, 7 Rathke's cleft cysts, 6 chordomas, 5 meningiomas, 4 spontaneous CSF leaks, 3 arachnoid cysts, and 8 other parasellar pathologies. There were 62 (48.4%) grade 1, 41 (32.0%) grade 2, and 25 (19.5%) grade 3 leak repairs. The overall repair failure rate was 1.6% (2 cases), with the failures occurring in patients with grade 3 leaks, including 1 who developed meningitis; there was no failure of grades 1 and 2 leaks. The 2 failures were attributed largely to technical aspects of the repair rather than to failure of BioGlue R per se. Conclusions: BioGlue R appears to be an effective adjunct in preventing postoperative CSF leaks after transsphenoidal surgery. However, careful attention to technical details of the repair is still required to prevent failures, especially when closing large dural and diaphragmatic defects. D

The introduction of multidetector-row CT (MDCT) has provided the abdominal radiologists with dramatic changes for the imaging of the liver. At just present, establishment of new and optimal injection protocol in multiphasic contrast-enhanced MDCT of the liver has been yearned because the difficulty and the importance to optimize the scan timing for each phase imaging have obviously increased because of the extremely rapid scan speed with MDCT scanners. Among technical factors employed in an injection protocol for multiphasic contrastenhanced MDCT of the liver, to make an injection duration of contrast material fixed is the most important for the precise estimation of the scan timing for each phase imaging. With the fixed injection duration, the peak enhancement time of the aorta, portal vein, and liver constantly appear approximately 10, 20, and 30 s after the any fixed injection durations (completion of injection of contrast material), respectively. Moreover, using a combination of the fixed injection duration and patients' body-weight-tailored dose of contrast material, similarity of time-density curves of each organ in shape and pattern can be achieved for individual patient with different body weight. In this issue, we will attempt to determine an ultimately optimal, but practical injection/scan protocol to successfully realize multiphasic contrast-enhanced MDCT of the liver based on the contrast-enhancement theory.

There is an agreement about the principle that bones are optimized to resist daily loads. This has never been ascertained for the human tibia. One of the main load components in the tibia in vivo is a cantilever load (with a linearly varying bending moment, with its largest component in the sagittal plane). investigated if the cross-section of the diaphysis and its variation along the tibia make it an optimized structure with respect to such loads. Six cadaveric tibias were CT-scanned. The geometry and material properties were extracted from the CT-scans, and analyzed along the tibias. A linear variation along the tibia was found for the second moments of area and inertia, and the section modulus in the sagittal plane (slightly less linear in the frontal plane). Conversely, the other properties (polar moments and crosssection are) were much less linear. This suggests that the structure is optimized to resist a bending moment that varies linearly along the tibia. The tibias were instrumented with 28 triaxial straingauges each. Strain was measured under cantilever loading in the sagittal and frontal planes, under quasiconstant-bending in the sagittal and frontal planes, under torsional loading, and with an axial force. The strain distribution was remarkably uniform when cantilever loading was applied in the sagittal plane and slightly less uniform when cantilever loading was applied in the frontal plane. Strain variations were one order of magnitude larger for all other loading configurations. This shows that the tibia is a uniformstress structure (i.e. optimized) for cantilever loading.

Diabetes mellitus (DM) is recognised as a major health problem. Ninety-nine percent of diabetics suffer from type 2 DM and 10% from type 1 and other types of DM. The number of diabetic patients worldwide is expected to reach 380 millions over the next 15 years. The duration of diabetes is an important factor in the pathogenesis of complications, but other factors frequently coexisting with type 2 DM, such as hypertension, obesity and dyslipidaemia, also contribute to the development of diabetic angiopathy. Microvascular complications include retinopathy, nephropathy and neuropathy. Macroangiopathy mainly affects coronary arteries, carotid arteries and arteries of the lower extremities. Eighty percent of deaths in the diabetic population result from cardiovascular incidents. DM is considered an equivalent of coronary heart disease (CHD). Stroke and peripheral artery disease (PAD) are other main manifestations of diabetic macroangiopathy. Diabetic cardiomyopathy (DC) represents another chronic complication that occurs independently of CHD and hypertension. The greater susceptibility of diabetic patients to infections completes the spectrum of the main consequences of DM. The serious complications of DM make it essential for physicians to be aware of the screening guidelines, allowing for earlier patient diagnosis and treatment.

Most electrolarynges do not allow hands-free use or pitch modulation. This study presents the potential of pattern recognition to support electrolarynx use by predicting fundamental frequency (F0) and voicing state (VS) from neck surface EMG and respiratory trace. Respiratory trace and neck surface EMG were collected from 10 normal, adult males (18-60 years old) during different vocal tasks. Time-domain features were extracted from both signals, and a Support Vector Machine (SVM) classifier was employed to model F0 and VS. An average mean-squared-error (MSE) of 8.21 ± 3.5 semitones 2 was achieved for the estimation of vocal frequency. An average classification accuracy of 78.05 ± 6.3 % was achieved for the prediction of voicing state from EMG and 65.24 ± 7.8 % from respiratory trace. Our results show that pattern classification of neck-muscle EMG and respiratory trace has merit in the prediction of F0 and VS during vocalization.

A case of cervical neural foraminal widening due to tortuous vertebral artery is presented. This entity is rarely seen. Plain radiography, CT, 3-D CT angiography, MRI, and MRA findings of the case are presented and the importance of this vascular anomaly in the differential diagnosis of neural foraminal widening is discussed. D

The past decade has seen considerable progress in the development of models simulating pesticide transport in structured soils subject to preferential flow (PF). Most PF pesticide transport models are based on the two-region concept and usually assume one (vertical) dimensional flow and transport. Stochastic parameter sets are sometimes used to account for the effects of spatial variability at the field scale. In the past decade, PF pesticide models were also coupled with Geographical Information Systems (GIS) and groundwater flow models for application at the catchment and larger regional scales. A review of PF pesticide model applications reveals that the principal difficulty of their application is still the appropriate parameterization of PF and pesticide processes. Experimental solution strategies involve improving measurement techniques and experimental designs. Model strategies aim at enhancing process descriptions, studying parameter sensitivity, uncertainty, inverse parameter identification, model calibration, and effects of spatial variability, as well as generating model emulators and databases. Model comparison studies demonstrated that, after calibration, PF pesticide models clearly outperform chromatographic models for structured soils. Considering nonlinear and kinetic sorption reactions further enhanced the pesticide transport description. However, inverse techniques combined with typically available experimental data are often limited in their ability to simultaneously identify parameters for describing PF, sorption, degradation and other processes. On the other hand, the predictive capacity of uncalibrated PF pesticide models currently allows at best an approximate (order-of-magnitude) estimation of concentrations. Moreover, models should target the entire soil-plant-atmosphere system, including often neglected above-ground processes such as pesticide volatilization, interception, sorption to plant residues, root uptake, and losses by runoff. The conclusions compile progress, problems, and future research choices for modelling pesticide displacement in structured soils.

The various manufacturers of digitization systems speak of the effectiveness and accuracy of their tools under optimal conditions, but actual experimentation with simple or complex objects and different materials yields results that on occasions refute the effectiveness of those systems. In order to help choose a digitization system on the basis of its accuracy and the quality of the distribution of points and triangular meshes, in the field of reverse engineering, we compared five digitization techniques (three versions of the laser scanner, a fringe projection version and an X-ray version): (1) an ordered point cloud obtained with a laser incorporated in a CMM, (2) a disordered point cloud obtained with a manual laser the position of which is determined with a Krypton Camera, (3) an Exascan manual laser with targets, (4) an ordered point cloud obtained by high precision Computerized Tomography (CT) and an Atos fringe projection scanner with targets. Each of the three calibrated pieces (a sphere, a cylinder and a gauge block) was measured five times by the five digitization systems to confirm the accuracy of the measurement. A comparison was also made of the meshes generated by the five software packages (Focus-Inspection, Metris, VxScan, Mimics and Atos) of the five digitization systems for the three calibrated pieces and two more complex pieces (a bone and an automobile window winder pulley) to determine meshing quality. Finally, all the pieces were meshed by triangulation in the Catia V5 DSE (Digitized Shape Editor) module in order to test the quality of the points distribution.

Purpose: Radical prostatectomy is a challenging operation demanding a high level of surgical expertise and experience. Urinary leakage at the urethrovesical anastomosis is one of the most common short-term complications of radical prostatectomy, reaching an incidence of 0.3% to 15.4%. In this review we investigate and discuss all matters directly related to urethrovesical anastomotic leak, specifically how to diagnose it properly, how to determine when it is clinically significant and when intervention is required, how to prevent or predict it and, finally, the possible long-term sequelae.

Methods for chlorophenols (CPs) determination (with low limits of detection) that can be applied to real environmental samples (waters, sediments, soils, biological tissues) and food are reviewed. Special emphasis is given to sampling, storage conditions and the application of preconcentration techniques for the determination of CPs using chromatographic methods. Solid phase extraction, solid phase microextraction, stir bar sorptive extraction, liquid phase microextraction, dispersive liquid-liquid microextraction, liquid-liquid-liquid microextraction and purge and trap methods are considered. Methods for microwave and ultrasonic extraction of CPs from solid matrices are also focused.

Comme pour beaucoup de centres de médecine nucléaire, la décision Afssaps du 25 novembre 2008 a modifié quelque peu nos habitudes. Même si l'obligation de maintenance et de contrôle de qualité en médecine nucléaire existait depuis l'arrêté du 3 mars 2003, cette nouvelle décision précise la nature et la fréquence des contrôles à effectuer. Les centres de médecine nucléaire pourvus en physiciens médicaux réalisaient déjà la plupart de ces contrôles, et ce concept n'était pas nouveau pour eux. Mais qu'en est-il pour les autres centres ? Les uns réalisaient néanmoins ces contrôles, d'autres comptaient sur le constructeur pour les effectuer lors de maintenances régulières, souvent rien n'était formalisé, voire effectué. Notre expérience dans le domaine du contrôle qualité en médecine nucléaire est récente, mais nous trouvons intéressant de soulever quelques problèmes qui nous semblent légitimes, notamment le temps que tous ces contrôles nécessitent, les délégations qui sont envisageables, les moyens à mettre en place et les difficultés liées à leur application. # 2010 Elsevier Masson SAS. Tous droits réservés.

Palaeontology was established as a science in the Victorian era, yet has roots that stretch deeper into the recesses of history. More than 2000 years ago, the Greek philosopher Aristotle deduced that fossil sea shells were once living organisms, and around 500 ad Xenophanes used fossils to argue that many areas of land must have previously been submarine. In 1027, the Persian scholar Avicenna suggested that organisms were fossilized by petrifying fluids; this theory was accepted by most natural philosophers up until the eighteenth century Enlightenment, and even beyond. The late 1700s were notable for the work of Georges Cuvier who established the reality of extinction. This, coupled with advances in the recognition of faunal successions made by the canal engineer William Smith, laid the framework for the discipline that would become known as palaeontology. As the nineteenth century progressed, the scientific community became increasingly well organized. Most fossil workers were gentleman scientists and members of the clergy, who self-funded their studies in a new and exciting field. Many of the techniques used to study fossils today were developed during this ‘classical’ period. Perhaps the most fundamental of these is to expose a fossil by splitting the rock housing it, and then conduct investigations based upon the exposed surface (Fig. 1). This approach has served the science well in the last two centuries, having been pivotal to innumerable advances in our understanding of the history of life. Nevertheless, there are many cases where splitting a rock in this way results in incomplete data recovery; those where the fossils are not flattened, but are preserved in three-dimensions. Even the ephemeral soft-tissues of organisms are occasionally preserved in a three-dimensional state, for example in the Herefordshire, La Voulte Sûr Rhone and Orsten ‘Fossil Lagerstätten’ (sites of exceptional fossil preservation). These rare and precious deposits provide a wealth of information about the history of life on Earth, and are perhaps our most important resource in the quest to understand the palaeobiology of extinct organisms. With the aid of twenty-first century technology, we can now make the most of these opportunities through the field of ‘virtual palaeontology’—computer-aided visualization of fossils.

The purpose of this study was to measure the dimensions of critical thinking (CT) of nursing students at baccalaureate nursing program and registered nurses at general hospital in Japan. Relevant literature on the current environment of Japanese nursing practice and education is reviewed as it provides the background to the key aspects of dimensions of Japanese nurses' and students' CT. The California Critical Thinking Disposition Inventory (CCTDI) was used to measure the dimensions of CT skills. The convenience sample consisted of three small groups: generic students (n ¼ 82) including freshmen and juniors; transfer students (n ¼ 16) at selected baccalaureate nursing program; and registered nurses (n ¼ 67) at selected general hospital were administered CCTDI.

This review addresses a fundamental neuroscientific question in food perception: how multimodal features of food are integrated. Much research and conceptualization has emerged related to multisensory integration in vision, audition and somatosensation, while it remains poorly understood and researched within the chemical and mouth feel senses. This review aims to bridge this gap.

CT of the equine head is an established imaging technique. It is used routinely in the academic setting and, as CT scanners have become more affordable, is being used more often in private practice. CT is considered more effective than survey radiography in depicting the complex anatomy of the nasal cavity and calvarium, as it eliminates superimposition of overlying structures such as the bones forming the brain case and nasal cavity. The normal CT appearance of the head and nasal cavity as well as the CT features of common diseases affecting the brain, dental arcades, and sinuses are well described in the literature. The examination requires general anesthesia and hence takes longer than survey radiographs. As with any other imaging modality, it is most effective when is performed to answer specific questions generated by the clinical examination. Though costs of facilities and CT equipment are higher than survey radiography, the benefit derived from the accurate assessment of a given pathological process of the head makes this modality an effective addition to the equine practice. This chapter reviews the technical considerations associated with the procedure. It also provides an anatomical atlas of the area as well as a discussion of common diseases to highlight the advantages and disadvantages of the technique. A complete list of references is also included for the reader who wants to obtain a deeper understanding of the technique and its capabilities.

Advances in analytical methodologies, principally nuclear magnetic resonance spectroscopy (NMR) and mass spectrometry (MS), during the last decade have made large-scale analysis of the human metabolome a reality. This is leading to the reawakening of the importance of metabolism in human diseases, particularly cancer. The metabolome is the functional readout of the genome, functional genome, and proteome; it is also an integral partner in molecular regulations for homeostasis. The interrogation of the metabolome, or metabolomics, is now being applied to numerous diseases, largely by metabolite profiling for biomarker discovery, but also in pharmacology and therapeutics. Recent advances in stable isotope tracer-based metabolomic approaches enable unambiguous tracking of individual atoms through compartmentalized metabolic networks directly in human subjects, which promises to decipher the complexity of the human metabolome at an unprecedented pace. This knowledge will revolutionize our understanding of complex human diseases, clinical diagnostics, as well as individualized therapeutics and drug response.

Diffusion Tensor Imaging (DTI) is increasingly being used as a research tool in mild Traumatic Brain Injury (mTBI). This article reviews the concepts of diffusion tensor imaging, neuropsychological testing and results to date when applied to mTBI in adults. DTI is being used in conjunction with neuropsychological and electrophysiological measures to provide improved structural/functional correlations of mTBI. Future directions and applications of DTI in mTBI research are suggested.

The central USA contains some of the most productive agricultural land of the world. Due to the high proportion of land area committed to crops and pasture in this region, the carbon (C) stored and greenhouse gas (GHG) emission due to agriculture represent a large percentage of the total for the USA. Our objective was to summarize potential soil organic C (SOC) sequestration and GHG emission from this region and identify how tillage and cropping system interact to modify these processes. Conservation tillage (CST), including no-tillage (NT), has become more widespread in the region abating erosion and loss of organic rich topsoil and sequestering SOC. The rate of SOC storage in NT compared to conventional tillage (CT) has been significant, but variable, averaging 0.40 AE 0.61 Mg C ha À1 year À1 (44 treatment pairs). Conversion of previous cropland to grass with the conservation reserve program increased SOC sequestration by 0.56 AE 0.60 Mg C ha À1 year À1 (five treatment pairs). The relatively few data on GHG emission from cropland and managed grazing land in the central USA suggests a need for more research to better understand the interactions of tillage, cropping system and fertilization on SOC sequestration and GHG emission. #

Warburg effect Aerobic glycolysis Glycolytic inhibitors Targeted drug delivery to cancer Delocalized lipophilic cations Inhibitors of mitochondrial electron transport chain Biosynthetic alterations in cancer cells Mitochondrial redox system Mitochondrial apoptotic machinery Triphenylphosphonium compounds Cancer cells are characterized by self-sufficiency in the absence of growth signals, their ability to evade apoptosis, resistance to anti-growth signals, sustained angiogenesis, uncontrolled proliferation, and invasion and metastasis. Alterations in cellular bioenergetics are an emerging hallmark of cancer. The mitochondrion is the major organelle implicated in the cellular bioenergetic and biosynthetic changes accompanying cancer. These bioenergetic modifications contribute to the invasive, metastatic and adaptive properties typical in most tumors. Moreover, mitochondrial DNA mutations complement the bioenergetic changes in cancer. Several cancer management therapies have been proposed that target tumor cell metabolism and mitochondria. Glycolytic inhibitors serve as a classical example of cancer metabolism targeting agents. Several TCA cycle and OXPHOS inhibitors are being tested for their anticancer potential. Moreover, agents targeting the PDC/PDK (pyruvate dehydrogenase complex/pyruvate dehydrogenase kinase) interaction are being studied for reversal of Warburg effect. Targeting of the apoptotic regulatory machinery of mitochondria is another potential anticancer field in need of exploration. Additionally, oxidative phosphorylation uncouplers, potassium channel modulators, and mitochondrial redox are under investigation for their anticancer potential. To this end there is an increased demand for agents that specifically hit their target. Delocalized lipophilic cations have shown tremendous potential in delivering anticancer agents selectively to tumor cells. This review provides an overview of the potential anticancer agents that act by targeting cancer cell metabolism and mitochondria, and also brings us face to face with the emerging opportunities in cancer therapy. permeability transition; MPTP, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine; 99 m-Tc-MIBI, 99 m-Tc-Sestamibi; MTD, maximum tolerated dose; mTOR, mammalian target of rapamycin; NAD + , nicotinamide adenine dinucleotide (oxidized); NADH, nicotinamide adenine dinucleotide (reduced); NADPH, nicotinamide adenine dinucleotide phosphate (reduced); NCI, National Cancer Institute; NFAT, nuclear factor of activated T cells; NO, nitric oxide; OXPHOS, oxidative phosphorylation; PCD, programmed cell death; PDC, pyruvate dehydrogenase

The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more...

S INCE THE EARLY 1980s computed tomography (CT) has come to play a greater role in the initial evaluation of patients sustaining blunt or penetrating trauma. CT has largely replaced abdominal radiography, nuclear scintigraphy, intravenous pyelography (IVP), and sonography in the acute evaluation of the abdomen. Numerous publications have addressed the relative strengths and weaknesses of CT scanning of the abdomen versus the more traditional diagnostic peritoneal lavage (DPL). CT is advantageous over DPL in that (1) CT can assess the retroperitoneum, (2) CT decreases the rate of nontherapeutic laparotomies, which varies from 6% to 25%, that are performed based on a positive DPL result,1-3 (3) CT is more specific regarding the precise site and extent of injury, (4) CT can identify retroperitoneal or pelvic sources of hemorrhage that may create a false-positive DPL, (5) CT is noninvasive, (6) CT can detect intraparenchymal injury or subcapsular hemorrhage that may be missed by DPL, and CT can be used serially to assess resolution or progression of injuries including those managed either expectantly or surgically.