Technical challenges to surgical clipping of aneurysmal regrowth with coil herniation following endovascular treatment – a case report

In recent years, technical developments have made endovascular procedures attractive therapeutic options and enabled the endovascular surgeon to redefine the management of cerebral aneurysms. However, as the number of aneurysms undergoing endovascular therapy has grown, so has the number of patients with incompletely treated aneurysms who are presenting for further management. In cases of failure of endovascular treatment caused by either incomplete occlusion or regrowth of the aneurysm, a complementary treatment is often necessary. Surgical treatment of these patients is challenging. We present a case of a ruptured posterior cerebral artery aneurysm treated initially with endovascular coiling that left behind significant residual aneurysmal sac. Regrowth of the aneurysm documented on follow-up was treated surgically. At surgery, the coil was found to have herniated through the aneurysmal sac into the subarachnoid space, and the aneurysm was successfully clipped without removing the coils. We review the regrowth of aneurysms following endovascular therapy and potential problems and challenges of surgically managing these lesions

Molar form, enamel growth, and durophagy in Cercocebus and Lophocebus

Objectives: To test the hypothesis that differences in crown structure, enamel growth, and crown geometry in Cercocebus and Lophocebus molars covary with differences in the feeding strategies (habitual vs. fallback durophagy, respectively) of these two genera. Relative to Lophocebus molars, Cercocebus molars are predicted to possess features associated with greater fracture resistance and to differ in enamel growth parameters related to these features. Materials and Methods: Sample proveniences are as follows: Cercocebus atys molars are from the Taï Forest, Ivory Coast; Lophocebus albigena molars are from a site north of Makoua, Republic of Congo; and a Lophocebus atterimus molar is from the Lomako Forest, Democratic Republic of Congo. For μCT scans on which aspects of molar form were measured, sample sizes ranged from 5 to 35 for Cercocebus and 3 to 12 for Lophocebus. A subsample of upper molars was physically sectioned to measure enamel growth variables. Results: Partly as a function of their larger size, Cercocebus molars had significantly greater absolute crown strength (ACS) than Lophocebus molars, supporting the hypothesis. Greater crown heights in Cercocebus are achieved through faster enamel extension rates. Also supporting the hypothesis, molar flare and proportional occlusal basin enamel thickness were significantly greater in Cercocebus. Relative enamel thickness (RET), however, was significantly greater in Lophocebus. Discussion: If ACS is a better predictor of fracture resistance than RET, then Cercocebus molars may be more fracture resistant than those of Lophocebus. Greater molar flare and proportional occlusal basin thickness might also afford Cercocebus molars greater fracture resistance

A review of duodenal metastases from squamous cell carcinoma of the cervix presenting as an upper gastrointestinal bleed

Upper gastrointestinal bleeding due to duodenal metastases is extremely uncommon. Extra-pelvic spread of squamous cell carcinoma (SCC) of the cervix to the small bowel is rare with only 6 reported cases in the English literature since 1981(PubMed, Medline)

Enhancement of Rydberg-mediated single-photon nonlinearities by electrically tuned Förster resonances

We demonstrate experimentally that Stark-tuned Förster resonances can be used to substantially increase the interaction between individual photons mediated by Rydberg interaction inside an optical medium. This technique is employed to boost the gain of a Rydberg-mediated single-photon transistor and to enhance the non-destructive detection of single Rydberg atoms. Furthermore, our all-optical detection scheme enables high-resolution spectroscopy of two-state Förster resonances, revealing the fine structure splitting of high-n Rydberg states and the non-degeneracy of Rydberg Zeeman substates in finite fields. We show that the ∣50S1/2,48S1/2⟩↔∣49P1/2,48P1/2⟩ pair state resonance in 87Rb enables simultaneously a transistor gain G>100 and all-optical detection fidelity of single Rydberg atoms F>0.8. We demonstrate for the first time the coherent operation of the Rydberg transistor with G>2 by reading out the gate photon after scattering source photons. Comparison of the observed readout efficiency to a theoretical model for the projection of the stored spin wave yields excellent agreement and thus successfully identifies the main decoherence mechanism of the Rydberg transistor

Progress along developmental tracks for electronic health records implementation in the United States

The development and implementation of electronic health records (EHR) have occurred slowly in the United States. To date, these approaches have, for the most part, followed four developmental tracks: (a) Enhancement of immunization registries and linkage with other health records to produce Child Health Profiles (CHP), (b) Regional Health Information Organization (RHIO) demonstration projects to link together patient medical records, (c) Insurance company projects linked to ICD-9 codes and patient records for cost-benefit assessments, and (d) Consortia of EHR developers collaborating to model systems requirements and standards for data linkage. Until recently, these separate efforts have been conducted in the very silos that they had intended to eliminate, and there is still considerable debate concerning health professionals access to as well as commitment to using EHR if these systems are provided. This paper will describe these four developmental tracks, patient rights and the legal environment for EHR, international comparisons, and future projections for EHR expansion across health networks in the United States

USA et URSS

Gurian W. USA et URSS. In: Politique étrangère, n°5 - 1949 - 14ᵉannée. pp. 411-420

Relating metric crown dimensions to underlying internal daily secretion rates in antimeric premolars

Copyright \ua9 2023 Elsevier Ltd. All rights reserved. OBJECTIVES: The underlying cause for metric differences in antimeric tooth pairs is an important question for understanding dental variation. We hypothesize that localized variation in crown dimensions will be reflected in localized variation in daily enamel secretion rate. DESIGN: Casts of pairs of human premolars from a tissue bank were 3D scanned using an optical scanning system (n = 32). Histological slides were created, and daily secretion rates (DSRs) were recorded in two areas of enamel that corresponded to scanner measurements. Antimeres were compared for both metric measurements and DSRs. Outliers for scanner measures were compared to significant differences in DSRs measurements in right and left teeth in corresponding areas. RESULTS: Thirteen of the 16 individuals differed significantly in antimeric metric measurements, but only ten of those also differed in the underlying DSR. Fifteen of the 16 total individuals differed significantly in at least one DSR area. DISCUSSION: While some individuals were outliers for metric measurements and had multiple areas of DSR differences, the majority of individuals had antimeric DSR differences regardless of metric differences. While there was no conclusive correlation between 3D metric analysis and underlying DSR differences, the most important result of this study is that DSR differences between antimeres are common