Letters to the Editors

PEDIATRICS ◽  
1981 ◽  
Vol 67 (5) ◽  
pp. 748-748
Author(s):  
Jeffrey D. Horbar ◽  
Jerold F. Lucey ◽  
Alistair G. S. Philip
Keyword(s):  
Subarachnoid Space ◽  
Subcutaneous Tissue ◽  
Human Infant ◽  
Sagittal Sinus ◽  
Wide Range

The Ladd sensor is an applanation device. When applied to a thin convex membrane enclosing a fluid-filled space the sensor will accurately reflect the fluid pressures over a wide range of application forces. The artificial monkey fontanel created by Myerberg may closely approximate this situation. The human infant fontanel, however, is not a thin convex membrane. It is often flat or concave and is separated from the subarachnoid space or sagittal sinus by compressible subcutaneous tissue.

scholarly journals Magnetic resonance cisternography imaging findings related to the leakage of Gadolinium into the subarachnoid space

2021 ◽  
Author(s):  
Rei Nakamichi ◽  
Toshiaki Taoka ◽  
Hisashi Kawai ◽  
Tadao Yoshida ◽  
Michihiko Sone ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Subarachnoid Space ◽  
Area Under The Curve ◽  
Rank Correlation ◽  
Predictive Performance ◽  
Roc Curves ◽  
Imaging Findings ◽  
Spearman’S Rank Correlation ◽  
Sagittal Sinus ◽  
Magnetic Resonance Cisternography

Abstract Purpose To identify magnetic resonance cisternography (MRC) imaging findings related to Gadolinium-based contrast agent (GBCA) leakage into the subarachnoid space. Materials and methods The number of voxels of GBCA leakage (V-leak) on 3D-real inversion recovery images was measured in 56 patients scanned 4 h post-intravenous GBCA injection. Bridging veins (BVs) were identified on MRC. The numbers of BVs with surrounding cystic structures (BV-cyst), with arachnoid granulations protruding into the superior sagittal sinus (BV-AG-SSS) and the skull (BV-AG-skull), and including any of these factors (BV-incl) were recorded. Correlations between these variables and V-leak were examined based on the Spearman’s rank correlation coefficient. Receiver-operating characteristic (ROC) curves were generated to investigate the predictive performance of GBCA leakage. Results V-leak and the number of BV-incl were strongly correlated (r = 0.609, p < 0.0001). The numbers of BV-cyst and BV-AG-skull had weaker correlations with V-leak (r = 0.364, p = 0.006; r = 0.311, p = 0.020, respectively). The number of BV-AG-SSS was not correlated with V-leak. The ROC curve for contrast leakage exceeding 1000 voxels and the number of BV-incl had moderate accuracy, with an area under the curve of 0.871. Conclusion The number of BV-incl may be a predictor of GBCA leakage and a biomarker for waste drainage function without using GBCA.

Ventricular perfusion in cats with kaolin-induced hydrocephalus

1974 ◽  
Vol 41 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Howard M. Eisenberg ◽  
James E. McLennan ◽  
Keasley Welch
Keyword(s):  
Spinal Cord ◽  
Subarachnoid Space ◽  
Central Canal ◽  
Ventricular System ◽  
Ventricular Pressure ◽  
Content Type ◽  
Lateral Ventricles ◽  
Spinal Subarachnoid Space ◽  
Wide Range ◽  
Fine Print

✓ Cats were made hydrocephalic by cisternal instillation of kaolin. Three to 8 weeks later it was found by perfusion between the ventricular system and the spinal subarachnoid space that communication had been reestablished through a demonstrably dilated central canal of the spinal cord. Absorption of fluid from the ventricular system, measured both by ventriculospinal perfusion and, after ligation of the spinal cord, by perfusion between the lateral ventricles, was found to be indistinguishable from zero over a wide range of ventricular pressure.

Persistence of naive CD45RA+ regulatory T cells in adult life

Blood ◽  
2006 ◽  
Vol 107 (7) ◽  
pp. 2830-2838 ◽  
Author(s):  
Nabila Seddiki ◽  
Brigitte Santner-Nanan ◽  
Stuart G. Tangye ◽  
Stephen I. Alexander ◽  
Michael Solomon ◽  
...  
Keyword(s):  
T Cells ◽  
Lymph Node ◽  
T Cell ◽  
Regulatory T Cells ◽  
Cord Blood ◽  
Peripheral Blood ◽  
Cell Subset ◽  
Human Infant ◽  
Wide Range ◽  
Adult Peripheral Blood

AbstractRegulatory T cells (TREGs) constitutively expressing CD4, CD25, and the transcription factor Foxp3 can prevent a wide range of experimental and spontaneous autoimmune diseases in mice. In humans, CD4+CD25bright T cells, predominantly within the CD45RO+ activated/memory subset in adults and the CD45RA+ naive T-cell subset in infants, are considered to be the equivalent subset. Using novel combinations of monoclonal antibodies (mAbs), we examined expression of CD25 in human infant thymus, cord blood, adult peripheral blood, lymph node, and spleen. In addition to the CD4+CD25bright T cells, subfractionation on the basis of CD45 splice variants indicated that all samples contained a second distinct population of cells expressing a slightly lower level of CD25. In adult peripheral blood, this population expressed a naive CD45RA+ phenotype. The corresponding population in lymph node, spleen, and cord blood showed some evidence of activation, and expressed markers characteristic of TREGs, such as cytotoxic T lymphocyte-associated antigen 4 (CTLA-4). Sorted CD4+CD25+CD45RA+ T cells from both cord and adult blood expressed very high levels of mRNA for Foxp3 and manifested equivalent suppressive activity in vitro, indicating that they are bone fide members of the regulatory T-cell lineage. Targeting naive TREGs in adults may offer new means of preventing and treating autoimmune disease.

scholarly journals A system for reporting and evaluating adverse drug reactions of herbal medicine in Taiwan from 1998 to 2016

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hen-Hong Chang ◽  
Su-Yin Chiang ◽  
Pei-Chun Chen ◽  
Chia-Han Tsai ◽  
Rong-Chi Yang ◽  
...  
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Herbal Medicine ◽  
Adverse Drug Reaction Reporting ◽  
Subcutaneous Tissue ◽  
Herbal Medicines ◽  
System Organ Class ◽  
Wide Range ◽  
Datura Suaveolens

AbstractThe Taiwan Adverse Drug Reaction Reporting System for Herbal Medicine (TADRRS-HM) has systematically documented suspected adverse events from adverse drug reaction (ADR) reports from 1998 (prior to its formal establishment in 2001) and evaluates safety profiles of herbal medicines. This article describes findings from 2079 ADR reports filed between 1998 and 2016: 941 reports involved single herbs and 87 involved folk herbals; 842 were generated from clinical trials, while 209 ADR reports involving foods, health foods, dietary supplement foods and herbal cuisine were grouped as Other. Severity assessments using the Modified Hartwig and Siegel scale classified 72.4% of ADRs as mild, 17.4% as moderate and 6.5% as severe. System Organ Class classification of the ADRs identified gastrointestinal system disorders as the most common (33.4%), followed by skin and subcutaneous tissue disorders (21.2%). The TADRRS-HM records indicate that herbal medicines may cause a wide range of ADRs. Aconiti Radix, Xiao-Qing-Long-Tang, and Datura suaveolens were the most commonly reported single herb, herbal formula, and folk herbal, respectively. The data indicate that herbal medicines may cause a wide range of ADRs. This system will confer long-term benefits for the development of Taiwan’s herbal medicines adverse reaction database and facilitate epidemiological analysis.

scholarly journals Primo Vascular System in the Subarachnoid Space of a Mouse Brain

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Sang-Ho Moon ◽  
Richard Cha ◽  
Geo-Lyong Lee ◽  
Jae-Kwan Lim ◽  
Kwang-Sup Soh
Keyword(s):  
Mouse Brain ◽  
Subarachnoid Space ◽  
Vascular System ◽  
Circulatory System ◽  
Central Canal ◽  
Polarization Microscopy ◽  
Sagittal Sinus ◽  
Average Size ◽  
The Brain ◽  
Transverse Sinuses

Objective. Recently, a novel circulatory system, the primo vascular system (PVS), was found in the brain ventricles and in the central canal of the spinal cord of a rat. The aim of the current work is to detect the PVS along the transverse sinuses between the cerebrum and the cerebellum of a mouse brain.Materials and Methods. The PVS in the subarachnoid space was analyzed after staining with4',6-diamidino-2-phenylindole (DAPI) and phalloidin in order to identify the PVS. With confocal microscopy and polarization microscopy, the primo vessel underneath the sagittal sinus was examined. The primo nodes under the transversal sinuses were observed after peeling off the dura and pia maters of the brain.Results. The primo vessel underneath the superior sagittal sinus was observed and showed linear optical polarization, similarly to the rabbit and the rat cases. The primo nodes were observed under the left and the right transverse sinuses at distances of 3,763 μm and 5,967 μm. The average size was 155 μm × 248 μm.Conclusion. The observation of primo vessels was consistent with previous observations in rabbits and rats, and primo nodes under the transverse sinuses were observed for the first time in this work.

scholarly journals Clinical aspects of reconstruction of the lower third of the leg with fasciocutaneous flap based on peroneal artery perforators

2014 ◽  
Vol 71 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Zoran Terzic ◽  
Boban Djordjevic
Keyword(s):  
Clinical Investigation ◽  
Reconstructive Surgical Procedures ◽  
Subcutaneous Tissue ◽  
Lower Leg ◽  
Fasciocutaneous Flap ◽  
Peroneal Artery ◽  
Clinical Aspects ◽  
Medial Malleolus ◽  
Recipient Site ◽  
Wide Range

Background/Aim. Fasciocutaneous flaps are tissue flaps that include the skin, subcutaneous tissue and underlying fascia, and are based on the septocutaneous system of blood vessels. They have a number of characteristics that give them an advantage in many cases, especially in treatment of lower extremity defects. The aim of this study was to clinically analyse the outcomes of patients surgically treated with a. peroneae perforator-based reverse flaps of the lower leg. Methods. This prospective study was conducted on a group of 22 patients with tissue defects in the lower third of the lower leg and foot. All the 22 patients underwent standard diagnostic procedures and the preoperative preparation for spinal anesthesia. During the surgery, the location of the recipient site with a future flap and an accompanying vascular stem was marked. Having prepared the recipient site in accordance with the surgical principles, the lobe was prepared, rotated and positioned in the defect region. Results. The proportion of male to female patients in our study group was 19 (86%) to 3 (14%), respectively. The maximal defect frequency (14 or 63%) was found in the age group of 30-50 years, i.e. working-age people. Trauma in 16 (72%) of patients was the most common reason for surgical treatment. The most common defects our patients had were found in the distal third of the leg (5, 22%), medial malleolus (4, 18%), the dorsum of the foot (3, 13%) and the foot (4, 18%). The number of lobes (18, 81%) applied in the course of our clinical study was statistically more significant (p < 0.05) than the number of lobes applied along with the skin autografts (4, 19%). During the final follow-up of the applied lobes, 6 (27.2%) of early and 2 (9%) of late complications were observed, making a total of 36.2% of complications occurring in the applied lobes, of which only 1 was lost. Conclusion. Clinical application of a.suralis superficialis mediani-based reverse flap is justified by a high percentage (95.5%) of preserved lobes. Functional recovery of Achilles tendon injuries treated with the fasciocutaneous flap appeared to be effective. The results obtained during the clinical investigation can be very helpful in using this flap more optimally and more often in a wide range of different reconstructive surgical procedures in the field of plastic surgery.

Direct venous spinal reabsorption of cerebrospinal fluid: a new concept with serial magnetic resonance cisternography in rabbits

2012 ◽  
Vol 16 (4) ◽  
pp. 394-401 ◽  
Author(s):  
Huseyin Biceroglu ◽  
Sait Albayram ◽  
Sabri Ogullar ◽  
Zehra Isik Hasiloglu ◽  
Hakan Selcuk ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Contrast Agent ◽  
Subarachnoid Space ◽  
White Male ◽  
Imaging Study ◽  
Contrast Injection ◽  
Mr Cisternography ◽  
Sagittal Sinus ◽  
Imaging Results

Object For nearly 100 years it has been believed that the main reabsorption of CSF occurs in arachnoid projections into the superior sagittal sinus, but a significant number of experiments and cases conflict with this hypothesis. According to recently published studies, CSF is permanently produced and absorbed in the whole CSF system. Clusters of arachnoidal villi, which are speculated to have a role in the reabsorption of CSF, have recently been revealed in the dorsal root of the spinal nerves. Huge absorptive surface areas of microvessels have been suggested to serve a putative role in reabsorption. The authors' aim was to observe direct venous connections between the subarachnoid space and the perispinal veins. Methods Eleven adult (6 months old) New Zealand white male rabbits weighing approximately 3.0 kg each were used in this experiment. After obtaining precontrast MR cisternography images, subarachnoid access was gained percutaneously via a cisternal approach by using a 20-gauge intravenous indwelling cannula. One rabbit died as a result of brainstem trauma during percutaneous cannulation before contrast administration, but contrast agent was still injected to see the possible MR imaging results of spinal CSF reabsorption after death. Magnetic resonance imaging was performed at 15, 60, 120, and 180 minutes after the administration of contrast agent. After intramuscular injections of anesthetic, 2 rabbits died 120 and 150 minutes after contrast injection, but the MR imaging study at 180 minutes after contrast injection was still performed. Results Direct connections between the subarachnoid space and the perispinal veins were observed in all rabbits during serial MR cisternography. The enhancement power was not affected by the amount of injected contrast agent or by cervical or lumbar penetration but was increased at higher contrast concentrations or upon seizure (physical activity). Conclusions Extracranial reabsorption of CSF has been finally proved with direct radiological confirmation of spinal venous reabsorption of CSF using serial MR cisternography. The authors believe that this study can help to develop a more accurate model of CSF dynamics, which will allow understanding of many CSF-related diseases, as well as the development of new strategies for treatment.

scholarly journals Self-measurement of Blood Glucose and Continuous Glucose Monitoring – Is There Only One Future?

2018 ◽  
Vol 14 (2) ◽  
pp. 24 ◽  
Author(s):  
Lutz Heinemann ◽  
Andreas Stuhr
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Subcutaneous Tissue ◽  
Glucose Monitoring ◽  
Relative Difference ◽  
Management Options ◽  
Measurement Quality ◽  
Glucose Levels ◽  
Wide Range ◽  
Patients With Diabetes

Monitoring glycaemic control in patients with diabetes has evolved dramatically over the past decades. The introduction of easy-to-use systems for self-monitoring of blood glucose (SMBG) utilising capillary blood samples has resulted in the availability of a wide range of systems, providing different measurement quality. Systems for continuous glucose monitoring (CGM) – used mainly in patients with type 1 diabetes (T1D) – were made possible by the development of glucose sensors that measure glucose levels in the interstitial fluid (ISF) in the subcutaneous tissue of the skin. CGM readings might not correspond exactly to SMBG measurement results taken at the same time, especially during rapid changes in either blood glucose or ISF glucose levels. The mean absolute relative difference is the most popular method used for characterising the measurement performance of CGM systems. Unlike the International Organization for Standardization 15197:2013 criteria for SMBG systems, no accuracy standards for CGM systems exist. Measurement quality of CGM systems can vary based on several factors, limiting their safety and effective use in managing diabetes. Patients have to be trained adequately to make safe and efficient use of CGM systems (like with SMBG systems). Also, systems for CGM must be evaluated in terms of patient safety and the ability to provide accurate measurements regardless of the fluctuation of glucose levels. As new technological advancements in glucose monitoring are essential for improved management options of diabetes, such as automated insulin dosing systems, there is a need for a critical view of all such developments. It is likely that both, SMBG and CGM systems, will play important future roles in the treatment of diabetes.

scholarly journals Vancomycin bone and tissue concentrations following tibial intraosseous administration – evaluated in a porcine model

2021 ◽  
Vol 6 (4) ◽  
pp. 99-106
Author(s):  
Josephine Olsen Kipp ◽  
Pelle Hanberg ◽  
Josefine Slater ◽  
Line Møller Nielsen ◽  
Stig Storgaard Jakobsen ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Cancellous Bone ◽  
Drug Concentration ◽  
Porcine Model ◽  
Subcutaneous Tissue ◽  
Target Site ◽  
Tissue Concentrations ◽  
Concentration Time ◽  
Intramedullary Canal ◽  
Wide Range

Abstract. Introduction. Systemic perioperative vancomycin may not provide sufficient prophylactic target-site concentrations in the prevention of prosthetic joint infections. Intraosseous vancomycin potentially provides high target-site concentrations. The objective of the present study was to evaluate the local bone and tissue concentrations following tibial intraosseous vancomycin administration in a porcine model. Methods. Eight pigs received 500 mg diluted vancomycin (50 mg/mL) through an intraosseous cannula into the proximal tibial cancellous bone. No tourniquet was applied. Microdialysis was applied for sampling of vancomycin concentrations in adjacent tibial cancellous bone, in cortical bone, in the intramedullary canal of the diaphysis, in the synovial fluid of the knee joint, and in the subcutaneous tissue. Plasma samples were obtained as a systemic reference. Samples were collected for 12 h. Results. High vancomycin concentrations were found in the tibial cancellous bone with a mean peak drug concentration of 1236 (range 28–5295) µg/mL, which remained high throughout the sampling period. The mean (standard deviation) peak drug concentration in plasma was 19 (2) µg/mL, which was obtained immediately after administration. Peak drug concentration, time to peak drug concentration, and area under the concentration–time curve were within the same range in the intramedullary canal, the synovial fluid of the knee, and the subcutaneous tissue. Conclusion. Tibial intraosseous administration of vancomycin provided high concentrations in tibial cancellous bone throughout a 12 h period but with an unpredictable and wide range of peak concentration. The systemic absorption was high and immediate, thus mirroring an intravenous administration. Low mean concentrations were found in all the remaining compartments.

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