19 research outputs found
Edge density profiles in high-performance JET plasmas
Detailed electron density profiles of the scrape-off layer in high-performance JET plasmas (plasma current, I-p < 5 MA, neutral beam heating power, P-nbi similar to 17 MW) have been measured by means of a lithium beam diagnostic system featuring high spatial resolution [K. Kadota et al., Plasma Phys. Controlled Fusion 20 (1978) 1011]. Measurements were taken over a period of several seconds, allowing examination of the evolution of the edge profile at a location upstream from the divertor target. The data clearly show the effects of the H-mode transition - an increase in density near the plasma separatrix and a reduction in density scrape-off length. The profiles obtained under various plasma conditions are compared firstly with data from other diagnostics, located elsewhere in the vessel, and also with the predictions of an 'onion-skin' model (DIVIMP), which used, as initial parameters, data from an array of probes located in the divertor target
Strokes in the anterior circulation: comparison between bridging and intravenous thrombolysis.
BACKGROUND AND PURPOSE: To compare safety and efficacy of bridging approach with intravenous (IV) thrombolysis in patients with acute anterior strokes and proximal occlusions.
PATIENTS AND METHODS: Consecutive patients with ischemic anterior strokes admitted within a 4Â h 30Â min window in two different centers were included. The first center performed IV therapy (alteplase 0.6Â mg/kg) during 30Â min and, in absence of clinical improvement, mechanical thrombectomy with flow restoration using a Solitaire stent (StS); the second carried out IV thrombolysis (alteplase 0.9Â mg/kg) alone. Only T, M1 or M2 occlusions present on CT angiography were considered. Endpoints were clinical outcome and mortality at 3Â months.
RESULTS: There were 63 patients in the bridging and 163 in the IV group. No significant differences regarding baseline characteristics were observed. At 3 months, 46% (n = 29) of the patients treated in the combined and 23% (n = 38) of those treated in the IV group had a modified Rankin scale (mRS) of 0-1 (P < 0.001). A statistical significant difference was observed for all sites of occlusion. In a logistic regression model, National Institute of Health Stroke Scale (NIHSS) and bridging therapy were independent predictors of good outcome (respectively, P = 0.001 and P = 0.0018). Symptomatic hemorrhage was documented in 6.3% vs 3.7% in the bridging and in the IV group, respectively (P = 0.32). There was no difference in mortality.
CONCLUSIONS: Our results suggest that patients treated with a bridging approach were more likely to have minimal or no deficit at all at 3Â months as compared to the IV treated group
CSF IgA NMDAR antibodies are potential biomarkers for teratomas in anti-NMDAR encephalitis
OBJECTIVE: To evaluate the presence of immunoglobulin A (IgA) subtype of anti-NMDA receptor (NMDAR) antibodies (IgA-NMDAR-Abs) in the CSF of patients with immunoglobulin G (IgG)-NMDAR-Ab encephalitis and to describe the potential association with a specific clinical pattern. METHODS: The retrospective analysis for the presence of IgA-NMDAR-Abs in 94 CSF samples from patients with anti-NMDAR encephalitis diagnosed between October 2007 and February 2014 was conducted at the French Reference Centre on Paraneoplastic Neurological Syndrome. This observational study compared 39 patients with both IgA- and IgG-NMDAR-Abs to 55 patients with only IgG-NMDAR-Abs. RESULTS: In the retrospective cohort, 41% of the patients with NMDAR-Ab encephalitis had both CSF IgG- and IgA-NMDAR-Abs. Approximately half of the IgA-NMDAR-Ab-positive patients (18/38, 49%) definitively possessed associated tumors, primarily ovarian teratomas (17/18, 94%), compared with only 5% (3/55) of the patients in the IgA-NMDAR-Ab-negative group (p < 0.001). In the adult female population at risk for ovarian teratoma, the detection of CSF IgA-NMDAR-Ab positivity showed 85% sensitivity, 70% specificity, a 57% positive predictive value, and a 90% negative predictive value for the diagnosis of ovarian teratoma. No other specific clinical features or clinical outcome were associated with CSF IgA-NMDAR-Ab positivity. CONCLUSION: These results suggest that in patients with IgG-NMDAR-Ab encephalitis, CSF IgA-NMDAR-Abs could be used as a biological marker for the presence of an ovarian teratoma
Osteopontin in cerebrospinal fluid as diagnostic biomarker for central nervous system lymphoma
Central nervous system lymphoma (CNSL) is diagnostically challenging. The identification of reliable and easy to measure biomarkers is desirable to facilitate diagnosis. Here, we evaluated the value of cerebrospinal fluid (CSF) osteopontin (OPN) as a diagnostic biomarker for CNSL. OPN concentrations in CSF from 37 patients with CNSL (29 with primary CNSL and 8 with secondary CNS involvement of systemic lymphoma) and 36 controls [6 patients with inflammatory CNS disease other than multiple sclerosis (MS), 8 with MS, 9 with glioblastoma (GBM) and 13 healthy controls] were determined using an enzyme-linked immunosorbent assay. Non-parametric tests and receiver operating characteristic (ROC) curves were performed for determination of diagnostic accuracy. Median CSF OPN level in all CNSL patients was 620Â ng/mL and higher than in patients with inflammatory CNS disease (356Â ng/mL); Pâ<â.05, MS (163Â ng/mL); Pâ<â.01, GBM (41Â ng/mL); Pâ<â.01, or healthy controls (319Â ng/mL); Pâ<â.01. The area under the ROC curve was 0.865 [95â% confidence interval (CI) 0.745-0.985] for differentiating CNSL and patients with inflammatory CNS disease; 0.956 (95â% CI 0.898-1.000) for CNSL and MS patients; 0.988 (95â% CI 0.964-1.000) for CNSL and GBM patients, and 0.915 (95â% CI 0.834-0.996) for CNSL patients and healthy controls. In multivariate analysis, high CSF OPN level was associated with shorter progression-free (HR 1.61, 95â% CI 1.13-2.31; Pâ=â.009) and overall survival (HR 1.52, 95â% CI 1.04-2.21; Pâ=â.029). CSF OPN is a potential biomarker in CNSL