Uncorrected Ebstein's anomaly with atrial septal defect complicated by brain abscess in an adult patient

We report the case of a 56-year-old male patient affected by a severe form of Ebstein's anomaly (type C of Carpentier classification) with secundum atrial septal defect, who presented to the emergency department with impaired consciousness, seizures, and trismus. The brain computed tomography scan showed evidence of a mass located in the frontal lobe, confirmed by brain MRI consistent with brain abscess. Both echocardiography and cardiac MRI showed no evidence of valvular vegetation. This case shows how the combination of increased atrial pressure and bidirectional shunt through atrial septal defect may lead to paradoxical embolization

SafeEV: Current and planned activities

Within the next ten to 15 years more and more small (and alternativedrive train) vehicles will come to the roads. The latest results of theAutomotive Landscape study by Roland Berger Consulting states that„Small vehicles will grow fastest across the globe“ by 2025.This trend will motivate in particular the development andmarket introduction of alternatively powered / small electric vehicles.Especially for urban areas these SEVs will be beneficial due to e.g.less space required, better mobility incl. parking, zero/reduced localemissions (related to local regulations), etc.The main objective of SafeEV is the development and application ofnew advanced simulation tools & methods aimed at improvedprotection of pedestrian and occupants of electric vehicles (EVs) in thefuture on urban areas

Motor Representation of the hand in the human cortex:a fMRI study with a conventional 1.5 T clinical unit

The purpose of this study was to show a gradient of possible bilateral activation for movements of the non-dominant vs. dominant hand, as well as for areas involved in complex vs. simple hand movements. A standard 1.5 T magnetic resonance imaging (MRI) system has been utilized to localize the cortical motor hand areas, using the blood oxygen level dependent contrast (BOLDc) technique and single-section fast low-angle shot (FLASH) imaging. Ten normal right-handed subjects volunteered for the study. The motor tasks consisted of simple (flexion-extension) finger movements of either hand, and complex movements (finger-to-thumb opposition in a repeating, pre-planned sequence) of the non-dominant hand. Simple movements caused contralateral activation of the primary motor area (MA); ipsilateral activation was observed for the non-dominant hand only. Supplementary motor area (SMA) was also activated, with a clear contralateral prevalence. The ratio of bilateral activation of MA did not change with complex movements of the non-dominant hand, while SMA as well as lateral premotor area were largely bilaterally activated in this task. In conclusion, the ipsilateral MA is activated for movements--even simple--performed with the non-dominant hand. There is widespread functional activity, involving both contralateral and ipsilateral SMA, for complex movements

Spleen stiffness measurement for assessing the response to \u3b2-blockers therapy for high-risk esophageal varices patients

Non-selective \u3b2-blocker (NSBB) therapy is the treatment of choice for primary prophylaxis of cirrhotic patients with high-bleeding risk esophageal varices (HRV). The hemodynamic response to NSBB is assessed by the measurement of the hepatic venous pressure gradient (HVPG). Recently, liver and spleen stiffness measurements (LSM and SSM) were proposed as non-invasive surrogates of HVPG. We aimed to evaluate LSM and SSM changes for assessing hemodynamic response in these patients

Improvements to the protection of vulnerable road users: retrofittable, energy-absorbing front-end for heavy goods vehicles

Reducing road fatalities by 50% - as postulated in the European Union (EU) White Paper - requires research on road user groups and accident configurations that have not been addressed adequately so far: The Workpackage 2.1 of the EU-funded project APROSYS initiated the research on accidents involving heavy goods vehicles (HGVs) and vulnerable road users (VRUs). The project provides tools for evaluating the aggressiveness of HGV in relation to VRU and outlines the add-on solutions and improved designs for an enhanced protection of VRU. Priorities for enhanced VRU protection include the avoidance of run over at closing velocities below 20 km/h by improving the sight to the front and the side of the vehicle and the mitigation of primary and secondary impacts of VRUs at closing velocities between 15 and 40 km/h by increasing the energy absorption and changing the shape of the front end. The Graz University of Technology, the Politecnico di Torino and the Centro Ricerche FIAT studied the different approaches for an energy-absorbing front end that is lightweight, cost-efficient, retrofittable and compact - and that does not limit either the cooling or the lighting of the HGV. The study highlights the injury risk reduction by means of numerical simulations and experimental testing - including a full-scale test with a pedestrian dummy. It is shown that the risk for injuries to head and lower extremities may be reduced by up to 90% at impact velocities of up to 40 km/h. The study also shows that the concept of an energy-absorbing front end for HGVs might contribute to the aims defined in the EU White Paper at low costs. \ua9 2008 Taylor & Francis