Lerouge davası

Émile Gaboriau'nun İkdam'da yayımlanan Lerouge Davası adlı romanının ilk ve son tefrikalar

Intraoperative Neurophysiologic Monitoring and Mapping of the Motor System During Surgery for Supratentorial Lesions under General Anesthesia

The resection of supratentorial tumors may be associated with functional morbidity, particularly when the lesions are located near blood vessels or near the eloquent cortices and tracts (e.g., the motor cortex). New postoperative functional deficits during tumor resections might be caused by different patterns of injury. During surgery involving the insula, deficits are frequently caused by ischemic insult rather than mechanical injuries of the fiber tracts. During surgery in the paracentral region and close to the posterior limb of the internal capsule, direct mechanical injury to the motor cortex (M1) and the corticospinal tract (CST) may be of major concern. Therefore, motor preservation requires both mapping of the M1 and the CST (cortical stimulation, somatosensory-evoked potential [SSEP] phase reversal, subcortical mapping techniques) and continuous monitoring by motor-evoked potential (MEP) recordings. Both techniques can be performed with the patient under general total intravenous anesthesia. Stable MEP recordings allow for safe completion of surgery, whereas MEP deterioration due to surgical causes should lead to early surgical intervention. Restoration of the MEP signals may prevent the occurrence of permanent new deficits. Subcortical mapping techniques may even allow estimating the distance to the CST, thus providing functional guidance during tumor resection. Other functions such as language, vision, somatosensory perception, and even cognitive functions may be mapped and monitored in awake procedures or by other neurophysiologic and imaging methods. The following chapter focuses on intraoperative neurophysiological methods to preserve the motor system during surgery of supratentorial surgery

Vertical velocities at an ocean front

Publicación online disponible en: http://www.icm.csic.es/scimar/index.phpSimple scaling arguments conclude that the dominant motions in the ocean are horizontal. However, the vertical velocity plays a crucial role, connecting the active upper layer with the deep ocean. Vertical velocities are mostly associated with the existence of non-transient atmospheric wind forcing or with the presence of mesoscale features. The former are the well known upwelling areas, usually found at the eastern side of the oceans and characterised by upward vertical velocities. The latter have been observed more recently in a number of areas of the world´s oceans, where the vertical velocity has been found to be of the order of several tens of meters per day, that is, an order of magnitude higher than the largest vertical velocity usually observed in upwelling areas. Nevertheless, at present, vertical velocities cannot be measured and indirect methods are therefore needed to estimate them. In this paper, the vertical velocity field is inferred via the quasi-geostrophic omega equation, using density data from a quasi-permanent upper ocean front located at the northern part of the western Alborán gyre.Peer reviewe

Intraindividual comparison of selective intraarterial versus systemic intravenous 68Ga-DOTATATE PET/CT in patients with inoperable meningioma

Aim Here we describe the results of superselective intraarterial application of diagnostic Ga-68-DOTA0, Tyr3-octreotate (Ga-68-DOTATATE) in a series of patients with inoperable WHO grade II meningiomas which were no longer amenable to radiotherapy. Methods Four patients with inoperable WHO grade II meningioma underwent systemic venous infusion of Ga-68-DOTATATE followed by PET/CT. Ga-68-DOTATATE application was repeated intraarterially via transfemoral catheterization of vessels supplying the meningioma and another PET/CT was performed. Results Selective arterial infusion of Ga-68-DOTATATE increased the median value for the maximum standardized uptake value (SUV) by 2.6-fold (median venous: 7.1, median arterial: 21.6; range 2.0-5.0) and the median value for mean SUV by 2.7-fold (median venous: 4.3, median arterial: 11.2; range 1.6-5.6) compared to systemic intravenous infusion. Arterial application was well tolerated by all patients without complications. When compared to liver uptake, intravenous tracer uptake was insufficient for PRRT, whereas tracer uptake after superselective intraarterial tracer injection was sufficient to allow for peptide receptor radionuclide therapy (PRRT) in all patients. Conclusion Insufficient tracer uptake in meningiomas after intravenous application of Ga-68-DOTATATE may be safely increased by a factor of 2-5 using transfemoral selective intraarterial tracer application