Analysis of the symmetric configuration of the circle of Willis in a series of autopsied corpses

Introduction. The forming of the blood vessels network configuration at the base of the brain and interconnecting of blood vessels during the embryogenesis is directly related to the phylogenetic development of the brain and brain structures. A blood vessel configuration at the brain base, in the form of a ring or a hexagon, stands in direct relation to the perfusion needs of certain parts of the brain during its primary differentiation. The aim of this paper was to determine the incidence of certain blood vessel configurations at the base of the brain and understanding their symmetry or asymmetry. Methods. Analysis of the blood vessels at the base of the brain was performed on the autopsied subjects. The object of observation was the anterior segment of the circle of Willis consisting of C1- a. carotis interna (ICA), above a. communicaus posterior (PcoA), the segment A1 a. cerebri anterior (ACA) from a. carotis interna bifurcation to the a. communicans anterior (AcoA) and a. communicans anterior itself, as well as the posterior segment consisting of PcoA and the segment P1 - a. cerebri posterior (PCA) from the a. basilaris bifurcation to the PcoA. For the purpose of grouping the findings, the four basic configuration types of the circle of Willis were identified based on its symmetry or asymmetry. Type-A (symmetric circle of Willis), type-B (asymmetric circle of Willis' due to the unilateral hypoplastic A1-ACA); type-C (symmetric circle of Willis with bilateral symmetric changes on PcoA) and type-D (asymmetric circle of Willis due to the asymmetric changes on PcoA). Results. Autopsy was performed on 56 corpses. A total of 41 (73.2%) subjects were recorded with a symmetric configuration of the circle of Willis', of which 27 (48.2%) subjects had type A and 14 (25%) type C. The asymmetric configuration was present in 15 (26.8%) subjects, of whom 9 (16%) had type B and 6 (10.8%) type D. The symmetric Willis group (73.2%) did not have a homogeneous finding that would fit into the schematic presentation of the symmetric type A and type C. A total of 17 (30.4%) findings were classified in this group of the so-called conditionally symmetric configurations. In all the cases, type B (16%) had unilaterally reduced diameter A1 and hyperplastic AcoA. Conclusion. The presence of asymmetric Willis configuration in 26.8% of the cases, which makes up more than one fourth, indicates that the asymmetric configurations do not represent a pathological form of connecting the blood vessels at the base of the brain, but rather one aspect of its adaptation. The forming of the basic types of configurations of the circle of Willis is associated with a tendency toward certain types of hemodynamic disorders and more frequent pathological changes in places of reduced resistance.

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CTNI-03. IMAGING FEATURES OF LEPTOMENINGEAL METASTASES OF NON-SMALL CELL LUNG CANCER: A SINGLE-CENTER REAL-WORLD STUDY

Neuro-Oncology ◽

10.1093/neuonc/noaa215.170 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii41-ii41

Author(s):

Junjie Zhen ◽

Lei Wen ◽

Shaoqun Li ◽

Mingyao Lai ◽

Changguo Shan ◽

...

Keyword(s):

Spinal Cord ◽

Type A ◽

Brain Parenchyma ◽

Imaging Features ◽

Type B ◽

Type D ◽

Mri Examination ◽

Mri Features ◽

Brain And Spinal Cord ◽

The Brain

Abstract BACKGROUND According to EANO-ESMO clinical practice guidelines, the MRI findings of LM are divided into 4 types, namely linear enhancement (type A), nodular enhancement (type B), linear combined with nodular enhancement (type C), and sign of hydrocephalus (type D). METHODS The MRI features of brain and spinal cord in patients diagnosed with NSCLC-LM in Guangdong Sanjiu Brain Hospital from 2010 until 2019 were investigated, and then were classified into 4 types. The imaging features were analyzed. RESULTS A total of 80 patients were enrolled in the study. The median age of the patients was 53.5 years old, and the median time from the initial diagnosis to the confirmed diagnosis of LM was 11.6 months. The results of enhanced MRI examination of the brain in 79 cases showed that the number of cases with enhancements of type A, B, C and D were 50 (63.3%), 0, 26 (32.9%) and 3 (3.8%), respectively, and that LM with metastases to the brain parenchyma was found in 42 cases (53.2%). The results of enhanced MRI examination of spinal cord in 59 cases showed that there were only enhancements of type A and C in 40 cases (67.8%) and 3 cases (5.0%), and no enhancement sign in the other 16 cases (27.2%). CONCLUSION MRI examination of brain and spinal cord will improve the detection rate of LM. The MRI features of NSCLC-LM in real world are mainly characterized by the linear enhancements of brain and spinal cord, followed by linear combined with nodular enhancement. The enhancements of type B and type D are rare in clinic. Almost half of the patients have LM and metastases to the brain parenchyma. Therefore, the differentiation of tumor metastases is needed to be paid attention to for the early diagnosis and the formulation of reasonable treatment plans.

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The effectiveness of TiO2 additions to mortar to maintain initial conditions in terms of its reflectance to solar radiation

Ambiente Construído ◽

10.1590/s1678-86212017000300161 ◽

2017 ◽

Vol 17 (3) ◽

pp. 39-56 ◽

Cited By ~ 3

Author(s):

Sérgio Roberto Andrade Dantas ◽

Fulvio Vittorino ◽

Kai Loh

Keyword(s):

Solar Radiation ◽

Ultraviolet Radiation ◽

Initial Conditions ◽

Type A ◽

Just Noticeable Difference ◽

Type B ◽

Climate Conditions ◽

Type D ◽

Type C ◽

Over Time

Abstract Contact of facades with degradation agents and direct incidence of ultraviolet radiation on external coatings make them more opaque over time, affecting their colour and reflectance characteristics. This study evaluated the effect of adding different TiO2 contents to mortars applied in concrete substrates in order to verify the reflectance maintenance on surfaces after exposure over time. Mortar with different concentrations of TiO2 (1%, 5%, 10%) were produced in relation to the total dry premix, added as a powder and compared to unpainted mortar without TiO2 (type "A") and painted mortar without TiO2 (type "B"), both used as a reference for colour and reflectance. Exposed over 16 months to climate conditions in São Paulo, regarding the maintenance of reflectance and solar radiation, the results showed that type "B" (0%TiO2) painted mortar presented the best performance. Type "C" (1%TiO2) and type "D" (5%TiO2) unpainted mortar remained more stable. Type "A" (0%TiO2) and type "E" (10%TiO2) unpainted mortar showed greater differences according to the Just Noticeable Difference (JND) range caused by dirt pick up.

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Postsurgical residual lung complications following left upper trisegmentectomy

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz273 ◽

2019 ◽

Author(s):

Yutaro Koike ◽

Aritoshi Hattori ◽

Takeshi Matsunaga ◽

Kazuya Takamochi ◽

Shiaki Oh ◽

...

Keyword(s):

Surgical Intervention ◽

Type A ◽

X Rays ◽

Limited Information ◽

Type B ◽

Type D ◽

Thoracic Computed Tomography ◽

Isolated Segment ◽

Type C ◽

Lung Torsion

AbstractOBJECTIVESSegmentectomy has become an increasingly popular surgical procedure for small-sized lung lesions. Left upper trisegmentectomy (LUTS) is one of the most common segmentectomies performed because of its relative ease and simplicity; however, limited information is currently available on the specific postoperative complications associated with this procedure.METHODSAmong 2060 surgically resected cases in our institute between 2009 and 2016, 129 (6.2%) underwent LUTS. Postoperative chest X-rays and/or thoracic computed tomography (CT) scans were retrospectively assessed for all cases to assess postsurgical residual lung complications following LUTS. We categorized cases into 4 groups: type A (atelectasis of the lingular segment), type B (lung torsion of the lingular segment), type C (necrosis of the ‘isolated segment’) and type D (haematoma along stapling lines).RESULTSPostsurgical lung complications following LUTS were observed in 17 (13.1%) patients (type A: n = 7, type B: n = 1, type C: n = 4 and type D: n = 5). Three patients (2.3%) required surgical intervention because of type B (n = 1) and type C (n = 2), namely, decreased permeability and remaining ground glass opacities in the residual lung, showing an exacerbated systemic inflammatory response. In contrast, type A and D cases were successfully observed by chest CT without any surgical intervention, and patients recovered within a few months of surgery.CONCLUSIONSWe identified several postoperative residual lung complications following LUTS. Lung torsion or necrosis of the residual segment may require intensive care, including reoperation. Potentially serious complications always need to be ruled out after LUTS when radiological consolidation is detected postoperatively.

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A New Classification of Cochleovestibular Malformations and Implications for Predicting Speech Perception Ability after Cochlear Implantation

Audiology and Neurotology ◽

10.1159/000365584 ◽

2015 ◽

Vol 20 (2) ◽

pp. 90-101 ◽

Cited By ~ 12

Author(s):

Sung-Wook Jeong ◽

Lee-Suk Kim

Keyword(s):

Speech Perception ◽

Cochlear Implantation ◽

Test Scores ◽

Type A ◽

Cochlear Nerve ◽

Type B ◽

New Classification ◽

Type D ◽

Type C

Objectives: The aims of this study were to introduce a new classification of cochleovestibular malformation (CVM) and to investigate how well this classification can predict speech perception ability after cochlear implantation in children with CVM. Methods: Fifty-nine children with CVM who had used a cochlear implant for more than 3 years were included. CVM was classified into 4 subtypes based on the morphology of the cochlea and the modiolus on temporal bone computed tomography (TBCT): normal cochlea and normal modiolus (type A, n = 16), malformed cochlea and partial modiolus (type B, n = 31), malformed cochlea and no modiolus (type C, n = 6), and no cochlea and no modiolus (type D, n = 6). Speech perception test scores were compared between the subtypes of CVM using analysis of covariance with post hoc Bonferroni test. Univariate and multivariate regression analyses were used to identify the significant predictors of the speech perception test scores. Results: The speech perception test scores after implantation were significantly better in children with CVM type A or type B than in children with CVM type C or type D. The test scores did not differ significantly between the implanted children with CVM type A or type B and those without CVM. In univariate regression analysis, the type of CVM was a significant predictor of the speech perception test scores in implanted children with CVM. Multivariate regression analysis revealed that the age at cochlear implantation, cochlear nerve size and preimplantation speech perception test scores were significant predictors of the postimplantation speech perception test scores. The chance of cochlear nerve deficiency increased progressively from CVM type A to type D. Conclusion: The new classification of CVM based on the morphology of the cochlea and the modiolus is simple and easy to use, and correlated well with postimplantation speech perception ability and cochlear nerve status. This simple classification of CVM using TBCT with cochlear nerve assessment by magnetic resonance imaging is helpful in the preoperative evaluation of children with CVM.

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Microsurgical Management of Hypoglossal Schwannomas Over 3 Decades: A Modified Grading Scale to Guide Surgical Approach

Operative Neurosurgery ◽

10.1227/neu.0b013e318223b637 ◽

2011 ◽

Vol 69 (suppl_2) ◽

pp. ons121-ons140 ◽

Cited By ~ 9

Author(s):

Yoichi Nonaka ◽

Peter M. Grossi ◽

Ketan R. Bulsara ◽

Raymond M. Taniguchi ◽

Allan H. Friedman ◽

...

Keyword(s):

Sural Nerve ◽

Hypoglossal Nerve ◽

Type A ◽

Nerve Graft ◽

Type B ◽

Nerve Reconstruction ◽

Type D ◽

Grading Scale ◽

Type C ◽

Sural Nerve Graft

Abstract BACKGROUND Schwannomas originating from the hypoglossal nerve are extremely rare. Microsurgical resection with the goal for cure has traditionally been associated with a high risk of postoperative deficits. OBJECTIVE To summarize our clinical experience using tailored cranial base approaches for these formidable lesions. METHODS The clinical records of 13 patients were retrospectively reviewed. In addition, all reported patients in the literature were reviewed. The extreme lateral infrajugular transcondylar-transtubercular exposure approach was used in all of our patients. Based on our experience and literature analysis, we propose the following modified grading scale to facilitate surgical planning: type A, intradural tumors; type B, dumbbell-shaped tumors; type C, extracranial tumors; and type D, peripheral tumors. RESULTS All 13 patients underwent total, near-total, or subtotal tumor resection. Eight patients were men, 5 were women (mean age, 41.7 years). Sural nerve graft reconstruction for the hypoglossal nerve was performed in 4 patients. Three of the 4 patients in whom nerve reconstruction was performed regained satisfactory movement of their tongue. In the review of the literature, the mean patient age was 45.8 years. Patients presented with tongue atrophy (91.6%), headache (60.9%), and dysphagia (31.8%). The tumors were categorized as type A in 31.7% of these patients, type B in 38.6%, type C in 6.2%, and type D in 23.4%. CONCLUSION The extreme lateral infrajugular transcondylar-transtubercular exposure approach, which is a modification of the extreme lateral suboccipital approach, provides sufficient exposure for most intracranial dumbbell-shaped hypoglossal schwannomas. Hypoglossal nerve reconstruction using a sural nerve graft improves tongue atrophy and movement for patients with resected nerves.

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Pigmentary demarcation lines: a clinical profile of 50 subjects and report of new pattern of pigmentation observed

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20182082 ◽

2018 ◽

Vol 4 (3) ◽

pp. 323

Author(s):

Anju Antony ◽

Pramod Kumar

Keyword(s):

Family History ◽

Type A ◽

Common Type ◽

Type B ◽

Demarcation Line ◽

Abrupt Transition ◽

Type D ◽

History Of ◽

Type C ◽

The Common

Background: Pigmentary demarcation lines (PDL) correspond to a border of abrupt transition between the more deeply pigmented skin of the outer surfaces and the lighter inner surfaces. On the basis of their location they have been classified into eight types, type A to type H. The present study is an attempt to obtain a better understanding of the clinical types of pigmentary demarcation lines in Indians, and to report any previously undescribed patterns of pigmentation.Methods: Patients attending the Outpatient Department for various complaints were examined for the presence of pigmentary demarcation lines, and those with pigmentary demarcation lines were analysed further.Results: 50 subjects of Fitzpatrick skin types 4 and 5, with pigmentary demarcation lines were examined in detail. The various types of pigmentary demarcation lines seen were Type A (38%), Type B (14%), Type C (24%), Type F (22%), Type G (4%), Type H (4%). All types were more common in females with the exception of Type C, which was observed only in males. Type D and Type E PDL were not observed in any of the subjects screened.Conclusions: The most common type of PDL observed in our study was Type A PDL, followed by Type C PDL. The youngest subject was 2 years old, the oldest was aged 75.The majority were seen in adults; Type A and Type C PDL were the common types seen in children. A family history of PDL was present in 5 (10%) and all were females. A hitherto undescribed pigmentary demarcation line is also described along with this study.

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Decomposition of VOC in Air Using a Streamer Corona Discharge Reactor Combined with Catalyst

Journal of Advanced Oxidation Technologies ◽

10.1515/jaots-2003-0113 ◽

2003 ◽

Vol 6 (1) ◽

Cited By ~ 2

Author(s):

Toshikazu Ohkubo ◽

Duan Li ◽

Daisuke Yakushiji ◽

Seiji Kanazawa ◽

Yukiharu Nomoto

Keyword(s):

Corona Discharge ◽

Catalyst Layer ◽

Type A ◽

Electrode System ◽

Plasma Reactors ◽

Type B ◽

Type D ◽

Streamer Corona ◽

Type C ◽

Basic Configuration

AbstractIn this study, the improvement in the decomposition of volatile organic compounds (VOCs) was investigated by combining discharge plasma with catalyst. DC streamer corona plasma reactors combined with a catalyst were developed. The basic configuration of the reactors is a multineedle-to-plane mesh electrode system. By changing the position of catalyst against the plasma region, several reactors were developed and compared with each other. As a catalyst, a honeycomb catalyst (Mn type) was tested. A catalyst layer was located between the needles and plane mesh electrodes (type A reactor), or the catalyst layer was placed just behind the mesh electrode (type B reactor). In other reactors, the catalyst layer was followed by the needles-to- plane mesh electrode system (type C reactor) or the catalyst layer was removed (type D reactor). The needles- to-plane mesh electrode system produced the stable streamer corona discharge. The streamers covered the surface of the catalyst layer in the type A and type B reactors. However, the characteristics of the streamer were different for the type A and type B reactors. Toluene (C

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3. Shang and Zhou Bronze Nao Bells Excavated in South China

Early China ◽

10.1017/s036250280000290x ◽

1986 ◽

Vol 9 (S1) ◽

pp. 5-7

Author(s):

Gao Zhixi

Keyword(s):

South China ◽

Type A ◽

Entire Body ◽

Type B ◽

Type D ◽

Type C ◽

Western Zhou ◽

Set Up ◽

Cloud Pattern

ABSTRACTTwenty-two bronze nao-bells dating to the late Shang and early Western Zhou periods have been unearthed from the five southern provinces of Hunan, Jiangsi, Zhejiang, Jiangsu, and Fujian. Of these, sixteen were from Hunan, three from Zhejiang, and one each from the remaining three provinces. These bells can be classified into four categories: type A has an animal mask decoration (eleven examples); type B has a cloud pattern (three examples); type C has nipples (only one example); type D has stalks (mei, seven examples).The nao is a bell that can produce two tones. It can be used in sacrificial offerings as well as war. Because most of these bells have been discovered at the top, mid-section, or foot of mountains or on the banks of a river, we surmise that they may have been used in contemporary sacrifices to the mountains and streams, wind and rain, and stars, etc. Based on the periodization of the style of their shape and decoration we conclude that type A may be as early as late Shang, type B can be assigned to the end of the Shang, type C is from the beginning of the Zhou and type D belongs to the early Western Zhou. They developed from type A to B to C to D and then to the yong-bell. The characteristics of southern nao bells are: they are large, thick and heavy; most have whorls on the circular handle; many animal masks and cloud and lightning patterns are formed from thick lines among the decoration; the entire body is usually covered with decoration; most appear singly, and they were set up on their stands with the mouth facing up. In contrast, northern nao-bells are very small, they have no whorls on the handle, their decoration is simple, and they are unearthed in groups of several together.

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Depositional models for moraine formation in East Antarctic coastal oases

Journal of Glaciology ◽

10.1017/s0022143000003208 ◽

1997 ◽

Vol 43 (144) ◽

pp. 256-264 ◽

Cited By ~ 15

Author(s):

Sean J. Fitzsimons

Keyword(s):

Type A ◽

Structural Features ◽

Type B ◽

Debris Accumulation ◽

Type D ◽

Unconsolidated Sediment ◽

History Of ◽

Quaternary History ◽

Type C ◽

Depositional Models

AbstractThis paper examines the origin of moraine ridges in East Antarctic coastal oases and derives depositional models appropriate for the reconstruction of Quaternary history. On the basis of morphology, structure and sedimentology, four principal types of ridge may be identified: (1) type A moraines from when the basal debris zone crops out near an ice margin; (2) type B moraines form when large recumbent folds develop in the basal debris zone; (3) type C moraines are ice-contact screes and fans which form when debris accumulates at steep or cliffed ice margins; and (4) type D moraines are thrust-block moraines that form when unconsolidated sediment is entrained by freezing, shearing and thrusting of sediment blocks at the base of the glacier. Simple calculations of the rate of debris accumulation at ice margins suggest that type A, B and C moraines take thousands of years to form and record stable ice margins. Type D moraines are structural features that may form relatively quickly when ice margins override unconsolidated sediment. Constructing models to explain the origin of the moraines is an important part of reconstructing the Quaternary history of Antarctic coastal oases, because the models provide a basis for reconstructing the position and behaviour of the ice sheet during advance and retreat

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Nesting type choice in the red-legged partridge (Alectoris rufa)

Animal Science ◽

10.1017/s1357729800055521 ◽

2001 ◽

Vol 72 (1) ◽

pp. 29-34 ◽

Cited By ~ 8

Author(s):

R. Robles ◽

M.E. Alonso ◽

J. M. Sánchez ◽

J.A. Olmedo ◽

V.R. Gaudioso

Keyword(s):

Type A ◽

Alectoris Rufa ◽

Type B ◽

Escape Route ◽

Type D ◽

Cone Type ◽

In Captivity ◽

Type C ◽

Nesting Place ◽

Square Box

AbstractIn order to avoid the decrease in the numbers of wild red-legged partridge, Alectoris rufa, observed in several areas, the most appropiate solution is to repopulate using animals from game farms. The nesting place chosen by 30 pairs of red-legged partridge in captivity was studied. There were five different nest types combined in groups of three in 30 cages. Type A nest: made with natural bush plants tied together at one end and placed invertedly forming a cone. Type B: made with the same natural bush plants as the previous type but placed over an internal wire structure and having preformed entrances. Type C: a wooden structure in the form of a roof with two slopes. Type D: similar to the type C but on one of the laterals the opaque material only covers the upper half, and a plastic mesh covers the lower half. Type E: a wooden square box covered with an inclined plank of opaque and waterproof material. Our study shows that the type A nest received significantly (P < 0·05) more eggs than the others, possibly because this type of nest allowed for better vigilance and a better sense of protection for the animals. Type E nest was the second most preferred. In this type, the partridge was able to monitor the surroundings through the space between the walls and the roof and this space could be used as an escape route. From a production and industrial perspective, type E has some advantages over type A, being easy to build, clean and disinfect, and allowing the birds to see through the nest.

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