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关键词： Arteriovenous malformation   Dual lumen balloon   Embolization   Fistula   N-butyl cyanoacrylate  

摘要： Purpose N-butyl cyanoacrylate (NBCA) glue is a valuable liquid embolic agent for the endovascular treatment of brain arteriovenous malformations (BAVM). The use of NBCA carries a risk of embolic agent reflux and distal migration with ensuing possibility of venous drainage compromise. The aim of this technical note is to describe a single center case series of high-flow intranidal fistulas embolized though a dual lumen balloon under local flow-arrest conditions. Methods This article presents a retrospective description of a case series including five NBCA injections through a dual lumen balloon performed by a single operator in three patients with BAVM. Demographic, clinical, imaging and procedure-related data are reported. Results The three patients presented with ruptured BAVMs. Of the patients, one underwent proximal flow-related ruptured aneurysm coiling before planned BAVM embolization. In the three patients, staged BAVM embolization as a first line treatment was decided. Preliminary embolization of high-flow BAVM fistulas by NBCA using a dual lumen balloon under local flow-arrest conditions was performed and five separate injections were carried out without any complications. No balloon entrapment or rupture was observed. Conclusion High-flow BAVM fistulas can be treated with NBCA embolization using a dual lumen balloon under local flow-arrest conditions.

关键词： dose calculation   intensity-modulated proton therapy (IMPT)   Mcsquare   Monte Carlo method   robust optimization  

摘要： Purpose To commission an open source Monte Carlo (MC) dose engine, "MCsquare" for a synchrotron-based proton machine, integrate it into our in-house C++-based I/O user interface and our web-based software platform, expand its functionalities, and improve calculation efficiency for intensity-modulated proton therapy (IMPT). Methods We commissioned MCsquare using a double Gaussian beam model based on in-air lateral profiles, integrated depth dose of 97 beam energies, and measurements of various spread-out Bragg peaks (SOBPs). Then we integrated MCsquare into our C++-based dose calculation code and web-based second check platform "DOSeCHECK." We validated the commissioned MCsquare based on 12 different patient geometries and compared the dose calculation with a well-benchmarked GPU-accelerated MC (gMC) dose engine. We further improved the MCsquare efficiency by employing the computed tomography (CT) resampling approach. We also expanded its functionality by adding a linear energy transfer (LET)-related model-dependent biological dose calculation. Results Differences between MCsquare calculations and SOBP measurements were <2.5% (<1.5% for 85% of measurements) in water. The dose distributions calculated using MCsquare agreed well with the results calculated using gMC in patient geometries. The average 3D gamma analysis (2%/2 mm) passing rates comparing MCsquare and gMC calculations in the 12 patient geometries were 98.0 +/- 1.0%. The computation time to calculate one IMPT plan in patients' geometries using an inexpensive CPU workstation (Intel Xeon E5-2680 2.50 GHz) was 2.3 +/- 1.8 min after the variable resolution technique was adopted. All calculations except for one craniospinal patient were finished within 3.5 min. Conclusions MCsquare was successfully commissioned for a synchrotron-based proton beam therapy delivery system and integrated into our web-based second check platform. After adopting CT resampling and implementing LET model-dependent biological dose calcu

关键词： CSF leakage   sellar diaphragm   endoscopic endonasal surgery   pituitary adenomas  

摘要： This report introduces a new closure technique for the management of intraoperative cerebrospinal fluid (CSF) leakage during endoscopic endonasal surgery. The procedure is based on the combination of a traditional autologous tissue flap with a heterologous fibrin graft (TachoSil). We performed a retrospective analysis on 121 patients with pituitary adenomas treated in our center by the senior neurosurgeon (author V.R.B) in the previous 4 years. Only one patient (0.8%) developed a CSF leakage and no adverse events were found related to the use of TachoSil. Compared with other techniques used previously, sellar diaphragm reconstruction with TachoSil seems to be an effective and inexpensive alternative.

关键词： WEB   Intracranial aneurysms   Microcatheterization   Endovascular treatment   Wide-neck aneurysms  

摘要： Background. - Unfavorable aneurysm anatomy can make microwire navigation challenging, increasing the risk of complications. We present our experience of WEB-assisted microcatheterization in complex aneurysms. Clinical presentation. - Flow diversion was performed for three wide-neck large/giant intracranial aneurysms. A WEB was placed inside the sac, blocking the aneurysm neck and providing a contact surface to redirect the microwire across the aneurysm. Conclusion. - WEB-assisted microcatheterization appears an alternative strategy for the treatment of complex aneurysms. (C) 2019 Elsevier Masson SAS. All rights reserved.

关键词： Eosin-nigrosin   Semen analysis   Sperm vitality  

摘要： Research question: How many spermatozoa and slides need to be counted to make a reliable assessment of sperm vitality? Currently, various authorities recommend assessing human sperm vitality on counts of at least 200 cells, but on one or two slides. Design: This was an observational study on duplicate eosin-nigrosin stained sperm vitality slides made from 58 ejaculates. Assessments were made using counts of 2 x 100 and 1 x 200 cells per slide, all performed by the same trained expert observer. Results: Although assessments tend to show fewer and smaller outlier values when based on counts of 200 spermatozoa than 100, and on 2 x 200 than 1 x 200, counting 200 spermatozoa from one slide provides a result with sufficient accuracy for the clinical purpose of ascertaining whether the immotile spermatozoa in an ejaculate showing low sperm motility are alive or dead. Conclusions: While the increased accuracy of results derived from counts of 2 x 200 cells might be important in research studies where sperm vitality is the specific end-point of interest, counting at least 200 spermatozoa from one smear is sufficiently accurate for the clinical purpose of establishing whether the immotile spermatozoa seen in ejaculates with low sperm motility are alive or not. Consequently, the extra workload of performing replicate counts and the associated calculations does not increase the clinical value of the result, and hence is unnecessary in routine semen analysis. Careful laboratory technique as well as proper staff training and competence are essential. The conclusions might not be applicable to staining methods other than the recommended one-step eosin-nigrosin technique.

关键词： 本土文化   英语教学   跨文化   文化失语  

摘要： 经济的发展带来英语教学从教授西方文化规则向跨文化交际和双向文化交流的转变,但依旧普遍存在着“中国文化失语”和“本土文化缺失”的现象。本文就大学英语教育中“本土文化缺失”这一现象出现的原因进行探究并提出建议以供参考。