Suboccipital Approach for Primitive Trigeminal Artery Obliteration Associated with Cavernous Aneurysm

OBJECTIVE: A 63-year-old woman presented with diplopia resulting from abducens paralysis. Examination revealed a giant cavernous aneurysm supplied by the internal carotid artery (ICA) and primitive trigeminal artery (PTA) via the vertebrobasilar system. METHODS: After evaluation of balloon test occlusion (BTO) at the distal side of the PTA origin, the aneurysm was treated with PTA obliteration through the suboccipital route in the lateral position followed by cervical carotid ligation with superficial temporal artery-to-middle cerebral artery anastomosis in the supine position. RESULTS: The aneurysm showed marked shrinkage after the surgery. CONCLUSION: PTA obliteration through the retrosigmoid opening is a therapeutic surgical option in a patient with a cavernous aneurysm supplied by the PTA.ArticleWORLD NEUROSURGERY. 74(4-5):494-496 (2010)journal articl

Atlantoaxial Stabilization Using C1 and C2 Laminar Screw Fixation

We describe the use of a C1 laminar screw in combination with a C2 laminar screw as a salvage technique to treat two patients, one with persistent first intersegmental artery and the other with vertebral artery occlusion after cervical spine fracture. The combined use of C1 and C2 laminar screws allows for good fixation of the atlantoaxial joint with a lower risk of vertebral artery injury; therefore, it can be an alternative surgical procedure for patients with congenital or traumatic anomalous vertebral artery

Support for UNRWA's survival

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres, some of which are affected by the ongoing humanitarian disasters in Syria and the Gaza Strip. It has dramatically reduced the prevalence of infectious diseases, mortality, and illiteracy. Its social services include rebuilding infrastructure and homes that have been destroyed by conflict and providing cash assistance and micro-finance loans for Palestinians whose rights are curtailed and who are denied the right of return to their homeland

Comparison of heat-transfer performance of a flat-plate pulsating heat pipe based on heating orientation and cross-sectional shape of the pipe

The effects of cross-sectional shapes of flat-plate pulsating heat pipes (PHPs) on heat-transfer performance were experimentally investigated. The flat-plate PHP, made of aluminum alloy, has a closed-end serpentine channel with 22 turns. Four PHP samples with different channel shape (square or circular), the hydraulic diameter of the channel (1 or 1.2 mm), and plate thickness (3 or 2 mm) were prepared. The working fluid in the channel is R1336mzz(Z), and its filling ratio was increased from 30 mass% to 70 mass% in increments of 10 mass%. The heating section of the PHP is heated at power from 20 to 180 W in one of three heating orientations (vertical bottom, top, and horizontal) and the cooling section of the PHP is kept at 40 °C. Equivalent thermal conductivity is calculated from temperature on the surface of the PHP and heat transport rate. The experimental results indicate that the larger the cross-sectional area of the channel-wall material, the more likely it is that working-fluid oscillation will occur in the case of the top and horizontal heating orientations. Within the scope of this study, The PHP sample with a 1.2×1.2-mm square channel, the thickness of 3 mm, and filling ratio of 40 mass% has the highest equivalent thermal conductivity, namely, 2880 W/(m･K) at heat-transport rate Q of 146 W in top-heating orientation, 2750 W/(m･K) at Q = 146 W in horizontal-heating orientation, and 6540 W/(m･K) at Q = 36 W in bottom-heating orientation. As for that PHP, when Q is 80 W or more, equivalent thermal conductivities are the same regardless of heating orientation. It is thus considered that under that condition, working-fluid behaviors of the PHP become equivalent regardless of the heating orientation

Numerical Model of Radical Photopolymerization Based on Interdiffusion

An accurate reaction model is required to analyze the characteristics of photopolymers. For this purpose, we propose a numerical model for radical photopolymerization. In the proposed model, elementary reactions such as initiation, propagation, and termination are considered, and we assume interdiffusion for each component in the material. We analyzed the diffraction characteristics of a radical photopolymer based on the proposed interdiffusion model with the beam propagation method. Moreover, we also performed hologram-recording experiments and evaluated the diffraction characteristics of the photopolymer medium. By comparing the numerical and experimental results, medium parameters such as reaction rate and diffusion coefficient can be estimated. We confirmed that the interdiffusion model can reproduce the experimental results and showed that the medium parameters affect the diffraction characteristics

Developing a scale to measure nurses' difficulty related to the treatment of gender dysphoric patients

　This study aimed to develop a scale to measure the perceived difficulty experienced by nurses in treating and caring for patients diagnosed with gender dysphoria and examine its reliability and validity. We developed a 26-item preliminary scale through discussions with experts in gender dysphoria treatment. We administered a questionnaire including this scale to 1,010 nurses working at Okayama University Hospital and analyzed the data of 346 nurses who had been involved in the treatment of gender dysphoria and had no missing responses. 　A total of 20 items consisting of two factors, “relationship building” and “negative emotion for gender dysphoria,” were extracted by exploratory factor analysis, and we used them in the final version of the scale. Cronbach's alpha coefficient for the entire scale was 0.879, indicating a high degree of internal consistency. 　However, the correlations with a communication skills scale (ENDCOREs) and the Scale of Gender Conception were limited, and the external validity could not be proven. This scale may be useful for evaluating nursing practice and educational support for nurses; however, there is room for further study on the scale validation

Visit-to-visit HbA1c variability is inversely related to baroreflex sensitivity independently of HbA1c value in type 2 diabetes

Abstract Background The relationship between long-term glycemic variability (GV) represented by visit-to-visit HbA1c variability and baroreflex sensitivity (BRS) in type 2 diabetes mellitus (T2DM) has not been clarified by previous literature. The present study is the first to examine the relationships between visit-to-visit HbA1c variability and BRS. Methods This retrospective study initially analyzed data on 94 patients with T2DM. Visit-to-visit HbA1c variability was evaluated using the intrapersonal coefficient of variation (CV), standard deviation (SD), and adjusted SD of 8 or more serial measurements of HbA1c during a 2-year period. The BRS was analyzed using the sequence method. Short-term GV was assessed by measuring the glucose CV during 24-h continuous glucose monitoring (CGM). The primary objective was to determine if there was a relationship between visit-to-visit HbA1c variability (HbA1c CV) and BRS. Secondary objectives were to examine the relationship between other variables and BRS and the respective and combined effects of long-term GV (HbA1c CV) and short-term GV (CGM CV) on BRS. Results A total of 57 patients (mean age 67.2 ± 7.7 years, mean HbA1c 7.3 ± 1.0%) who met this study’s inclusion criteria were finally analyzed. In the univariate analysis, HbA1c CV (r = − 0.354, p = 0.007), HbA1c SD (r = − 0.384, p = 0.003), and adjusted HbA1c SD (r = − 0.391, p = 0.003) were significantly related to low levels of BRS. Multiple regression analysis showed that HbA1c CV, HbA1c SD, and adjusted HbA1c SD were inversely related to BRS. Furthermore, although the increase in either long-term GV (HbA1c CV) or short-term GV (CGM CV) as determined by 24-h CGM was inversely correlated with BRS, additional reductions in BRS were not shown in participants with both HbA1c CV and CGM CV values above the median. Conclusions Visit-to-visit HbA1c variability was inversely related to BRS independently of the mean HbA1c in patients with T2DM. Therefore, visit-to-visit HbA1c variability might be a marker of reduced BRS in T2DM