P02-216 The contributes of cerebellum in higher cognitive and social behaviour in childhood

Many studies have confirmed the role of the cerebellum in the organization of superior brain functions in adults. Congenital cerebellar alterations are frequently observed in children with neurological diseases. These anatomical alterations are associated with neuropsychological or developmental disorders that often give rise to pictures of mental insufficiency of varying severity with behavioural changes even leading to autism.Aim:To evaluate of cerebellum role in cognitive and social organization also during development.We report 25 children with different kinds of acquired cerebellar lesions (12 with hemispheric astrocytoma, 12 with vermis medulloblastoma, and 1 with hemispheric stroke) who showed different clinical patterns according to the lesion localization. All subject were studied by neurological examination and MRI. Neuropsychological assessment included:•observation of spontaneous behaviour;•Recording of spontaneous language;•Intelligence evaluation (WISC-test);•Language evaluation;•Memory evaluation;•Assessment of frontal lobe functions (categorical memory, sequential memory, language fluency, design fluency, flexibility of reasoning and problem solving).Lesion in the vermis, mainly in the lower lobuli, caused different degrees of behavioural disturbances ranging from irritability to psychosis; lesions in the right hemisphere impaired language processing and symbolic sequencing, categorical memory and executive functions; lesions in the left hemisphere impaired speech prosody, visual sequential memory and design fluency.These data confirm that the connections from the cerebellum to the associative cortical areas are operative very early and that the cerebellum has an essential role in cognitive and social organization also during development

Voiding urosonography with ultrasound contrast agents for the diagnosis of vesicoureteric reflux in children: I. Procedure

Voiding urosonography (VUS) encompasses examination of the urinary tract with intravesical administration of US contrast agent (UCA) for diagnosis of vesicoureteric reflux (VUR). The real breakthrough for US examination of VUR came with the availability of stabilized UCAs in the mid-1990s. This article presents a comprehensive review of various procedural aspects of VUS. Different US modalities are available for detecting the echogenic microbubbles: fundamental mode, colour Doppler US, harmonic imaging and dedicated contrast imaging with multiple display options. The reflux is graded (1 to 5) in a similar manner to the system used in voiding cystourethrography (VCUG). The most commonly used UCA for VUS, Levovist, is galactose-based and contains air-filled microbubbles. The recommended concentration is 300 mg/ml at a dose of 5–10%, or less than 5%, of the bladder filling volume when using fundamental or harmonic imaging modes, respectively. There are preliminary reports of VUS using a second-generation UCA, SonoVue. Here the UCA volume is less than 1% of the bladder filling volume. There is no specific contraindication to intravesical administration of UCA. The safety profile of intravesical Levovist is very high with no reports of side effects over a decade of use in VUS

New devices to cross chronic total occlusion in critical limb ischemia

Chronic total occlusions (CTos) represent a technically demanding subset of lesions, which in most cases require special endovascular methods, advanced operator skills, and utilization of sophisticated assisting devices for successful treatment. CTo crossing devices offer an additional option to interventionists in the treatment of challenging lower extremity peripheral arterial occlusions. These devices may improve crossing rates, allowing delivery of therapeutic devices to the target lesion. initial technical results seem quite promising, although adequate data on patient and device selection are lacking. until long-term clinical data verify the durability of those techniques, these devices must be used in a stepwise fashion in selected patients with Cli. © 2016 Edizioni Minerva Medica

Distribution and Progression of Inflammatory Chorioretinal Lesions Related to Multifocal Choroiditis and Their Correlations with Clinical Outcomes at 24 Months

Purpose: To analyze distribution and progression of multifocal choroiditis (MFC) inflammatory lesions and their correlations with clinical outcomes at 24 months. Methods: Distribution and progression of inflammatory lesions were evaluated in eyes with MFC using a semi-automatic approach based on fundus autofluorescence. Twenty-four-months clinical outcomes were correlated with baseline features. Results: Twenty-five eyes from 20 patients were enrolled. Visual acuity (VA) significantly improved from baseline to 24 months. Chorioretinal lesions spared the fovea in most eyes. The area of inflammatory lesions at 24 months significantly increased. Final number and area of lesions were significantly influenced by baseline features. Inflammatory lesions enlarged over time regardless of MFC recurrences. New lesion and MFC relapses did not affect final outcomes. Conclusions: Final VA correlated with baseline VA. Scars resulting from MFC lesions enlarged overtime even when the disease was under control. New lesions and MFC relapses did not affect final outcomes

MR imaging in locally advanced rectal cancer: quantitative evaluation of the full response to neoadjuvant therapy

To assess the diagnostic performance of DW Imaging (DWI) for the discrimination of complete responder (CR) from the non-complete responder (n-CR) in patients with locally advanced rectal cancer (LARC) undergoing chemotherapy and radiation (CRT)