Case report: Transvenous coil embolization of a high-grade Galenic dural arteriovenous fistula

Introduction: Galenic dural arteriovenous fistulas (dAVFs) are a rare form of dAVF and rarely described in the literature. Their distinct location requires different surgical approaches than dAVFs occurring at the nearby sites of the straight sinus and torcular Herophili, and their high risk of hemorrhage makes these dAVFs very challenging to approach surgically. In this report, we present a unique case of Galenic dAVF. Case description: The patient is a 54-year-old female who presented with a 2-year history of progressive headaches, cognitive decline, and papilledema. A cerebral angiogram demonstrated a complex dAVF to the vein of Galen (VoG). She underwent transarterial embolization with Onyx-18 which resulted in minimal reduction in arterial venous shunting. She subsequently underwent a successful transvenous coil embolization resulting in complete occlusion of dAVF. The patient’s postoperative course was complicated by interventricular hemorrhage; however, she had a remarkable clinical recovery with resolution of headaches and improvement in cognitive function. A follow-up angiogram completed 6 months post-embolization demonstrated very mild residual shunting. Conclusion: In the unique case presented here, we demonstrate the efficacy of transvenous embolization via an occluded straight sinus as an alternative therapeutic option to eliminate cortical venous reflux

Correlations Between Gene Expression and Mercury Levels in Blood of Boys With and Without Autism

Gene expression in blood was correlated with mercury levels in blood of 2- to 5-year-old boys with autism (AU) compared to age-matched typically developing (TD) control boys. This was done to address the possibility that the two groups might metabolize toxicants, such as mercury, differently. RNA was isolated from blood and gene expression assessed on whole genome Affymetrix Human U133 expression microarrays. Mercury levels were measured using an inductively coupled plasma mass spectrometer. Analysis of covariance (ANCOVA) was performed and partial correlations between gene expression and mercury levels were calculated, after correcting for age and batch effects. To reduce false positives, only genes shared by the ANCOVA models were analyzed. Of the 26 genes that correlated with mercury levels in both AU and TD boys, 11 were significantly different between the groups (P(Diagnosis*Mercury) ≤ 0.05). The expression of a large number of genes (n = 316) correlated with mercury levels in TD but not in AU boys (P ≤ 0.05), the most represented biological functions being cell death and cell morphology. Expression of 189 genes correlated with mercury levels in AU but not in TD boys (P ≤ 0.05), the most represented biological functions being cell morphology, amino acid metabolism, and antigen presentation. These data and those in our companion study on correlation of gene expression and lead levels show that AU and TD children display different correlations between transcript levels and low levels of mercury and lead. These findings might suggest different genetic transcriptional programs associated with mercury in AU compared to TD children

Group work support for the BlueJ IDE

Learning to work in teams is essential for every software professional. Developing software as a team project is the standard practice in industry, and should be practiced in university courses. Starting effective group work practices early can lead to better acceptance of group work as a standard development mode. Nonetheless, group work is often not included in introductory programming courses. The reason is often the necessary overhead associated with developing software in groups. We present a design and implementation of group work support tools integrated into the educational BlueJ IDE, which remove much of the tool overhead and make it easier to include group work in introductory courses