DWI-FLAIR mismatch guided thrombolysis in patients without large-vessel occlusion: real-world data from a comprehensive stroke centre

A significant proportion of ischaemic stroke patients present with unknown symptom onset time. DWI-FLAIR mismatch on MRI can help to identify those eligible for thrombolysis. We set out to analyse the short-term efficacy and safety of thrombolysis in a real-world setting.A retrospective single-centre observational study was conducted. We collected data between January 2017 and April 2020. Patients with a large vessel occlusion (LVO) were excluded. Outcomes were compared between thrombolysed patients and those who did not receive alteplase due to lack of DWI-FLAIR mismatch or other contraindications. We analysed baseline and discharge NIHSS scores for efficacy and defined good outcome as any neurological improvement (ANI) on the NIHSS. In terms of safety, the presence and severity of intracerebral haemorrhage on follow-up imaging was analysed, and mortality at 90 days assessed.Seventy-one patients were included in this study, of whom 29 received thrombolysis. Significantly more patients had ANI in the thrombolysed group (OR, 3.16; 95% CI, 1.178-8.479; p = 0.020). In a multivariable logistic regression analysis, only thrombolysis correlated with ANI (OR, 3.051; 95% CI, 1.135-8.206; p = 0.027). Two thrombolysed patients suffered intracerebral haemorrhage (6.90%), of whom one was symptomatic and eventually fatal. We did not find a significant difference in 90-day mortality between the two groups (OR, 0.81, 95% CI, 0.134-4.856; p = 1.000).Our real-world data demonstrate that thrombolysis based on DWI-FLAIR mismatch in patients without LVO has an early beneficial effect. The rate of intracerebral haemorrhage was similar to this complication reported in large thrombolysis trials with known onset times

Mozgásszervi zavarok mikrokeringési következményeinek vizsgálata és befolyásolása = Assessment and modification of the microcirculatory consequences of locomotor disorders

Új, objektív intravitális videomikroszkópos módszert dolgoztunk ki a csonthártya és a térdízületi felszín mikrokeringésének kísérletes megfigyelésére. Kimutattuk, hogy a végtag ischaemia által kiváltott periosteális mikrokeringési zavarok során a mikrokeringés effektivitása csökken, a leukocyta-endothelsejt interakciók fokozódnak, emellett nő a szöveti hízósejt degranuláció. A szisztémás gyulladásos aktivációt CD11b adhéziós molekula expresszió, TNF-alfa felszabadulás és mieloperoxidáz aktivitás fokozódás jellemzi. Több, azonos irányú vizsgálatot folytattunk e jelenségek befolyásolása céljából, és kimutattuk az exogén foszfatidilkolin, az ösztrogén és kolloid terápiák (különösen a hidroxietil-keményítő) hatékonyságát, valamint az ischaemiás prekondícionálás lehetséges előnyeit, utóbbi esetben a TRPV-1 pozitív neuronok inaktiválódásának szerepét. Az intravitális paraméterek változását carrageenan arthritisben is igazoltuk, és a foszfatidilkolin gyulladáscsökkentő hatását ebben a modellben is kimutattuk. Intravitális mikroszkópos módszerünkkel elsőként mutattuk ki a tibia velőűrbe helyezett implantátumok hatását a periosteális érképződésre, melyről feltételezzük, hogy kompenzáló reakció lehet behelyezett anyagok érregenerációt gátló hatásának ellensúlyozására. | We have developed a novel intravital method for the examination of the microcirculation of the periosteum and synovial membrane in rats. Periosteal microcirculatory disorders elicited by limb ischemia were traced by the examinations of the changes in the efficacy of microcirculatory perfusion, leukocyte-endothelial interactions and mast cell degranulation. The systemic inflammatory activation (CD11b adhesion molecule expression and TNF-alfa release, myeloperoxidase activity) was also characterized. These reactions could be effectively ameliorated by exogenous phosphatidylcholine, estrogen and colloid (hydroxyethyl starch) therapies and ischemic preconditioning (which appears to be mediated by the activation of TRPV-1 positive nerves). The intravital microscopic assessment of synovial inflammatory changes was assessed in carrageenan-induced arthritis also and the anti-inflammatory potential of oral phosphatidylcholine was established in this model, too. Intravital microscopy was also applied to assess the changes in periosteal vascular density in tibias with polyethylene or titanium implants were infixed. We described an increased periosteal vessel formation which may represent a compensatory mechanism against impaired endosteal regeneration caused by the implants

Histological evaluation of human intrabony periodontal defects treated with an unsintered nanocrystalline hydroxyapatite paste

Objectives: The aim of the study was to clinically and histologically evaluate the healing of human intrabony defects treated with open flap surgery (OFD) and application of a new, resorbable, fully synthetic, unsintered, nanocrystalline, phase-pure hydroxyapatite (nano-HA). Materials and methods: Six patients, each of them displaying very advanced intrabony defects around teeth scheduled for extraction due to advanced chronic periodontitis and further prosthodontic considerations, were included in the study. Following local anaesthesia, mucoperiosteal flaps were reflected; the granulation tissue was removed, and the roots were meticulously debrided by hand and ultrasonic instruments. A notch was placed at the most apical extent of the calculus present on the root surface or at the most apical part of the defect (if no calculus was present) in order to serve as a reference for the histological evaluation. Following defect fill with nano-HA, the flaps were sutured by means of mattress sutures to allow primary intention healing. At 7months after regenerative surgery, the teeth were extracted together with some of their surrounding soft and hard tissues and processed for histological analysis. Results: The postoperative healing was uneventful in all cases. At 7months following surgery, mean PPD reduction and mean CAL gain measured 4.0 ± 0.8 and 2.5 ± 0.8mm, respectively. The histological analysis revealed a healing predominantly characterized by epithelial downgrowth. Limited formation of new cementum with inserting connective tissue fibers and bone regeneration occurred in three out of the six biopsies (i.e. 0-0.86 and 0-1.33mm, respectively). Complete resorption of the nano-HA was found in four out of the six biopsies. A few remnants of the graft particles (either surrounded by newly formed mineralized tissue or encapsulated in connective tissue) were found in two out of the six biopsies. Conclusion: Within their limits, the present results indicate that nano-HA has limited potential to promote periodontal regeneration in human intrabony defects. Clinical relevance: The clinical outcomes obtained following surgery with OFD + nano-HA may not reflect true periodontal regeneratio

Földtudományi kutatások és geotechnikai alkalmazások kozmikus müonok mérésével

A kozmikus eredetű müon elemi részecskék a felső légkörből eljutnak a Föld felszínére, és akár több kilométeres mélységre is behatolnak a kéregbe. A müonok detektálásával feltérképezhető az általuk áthatolt szilárd, folyékony és lég nemű közeg sűrűségeloszlása hasonlóan a röntgen-radiográfi ához. A kozmikus müonok detektálásán alapuló, passzív és roncsolásmentes képalkotási eljárást müográfi ának nevezzük. Ez az újszerű képalkotási technika hozzájárulhat geológiai szerkezet feltárásához, a geofi zikai folyamatok jobb megértéséhez, a természeti veszélyek előrejelzéséhez és különböző geotechnikai alkalmazásokhoz

Az ökológiai gazdálkodás hazai helyzete - Trendek és kitörési pontok |Program|Összefoglalók|Résztvevők|

A kiadvány az ÖMKi 2012. február 2-án megrendezett első szakmai konferenciájának programját és előadásainak anyagát tartalmazza. Az ökológiai gazdálkodás hazai helyzete - Trendek és kitörési pontok c. rendezvényt minden várakozást felülmúló érdeklődés övezte, több mint 400-an regisztráltak. A rendezvény fővédnöke Fazekas Sándor vidékfejlesztési miniszter volt, aki megnyitó beszédében elmondta: „Háromszázezer hektárra szeretnénk növelni hazánkban a biogazdálkodás alá vont területek nagyságát 2020-ig, ezért a tárca ökológiai mezőgazdálkodási programot dolgoz ki. Kiemelten támogatjuk a biogazdálkodókat, segítséget nyújtunk az átálláshoz”. A konferencián jelen voltak az ágazat legfontosabb szervezeteinek képviselői, úgy a gazdák, a civil társadalom, mint a közigazgatás és a tudomány világából. Értékes párbeszéd alakult ki a résztvevők között, és lehetőség nyílt a vélemények ütköztetésére is, amit szervezőként kifejezetten hasznosnak tartunk, hiszen hozzátartozik az átlátható, demokratikus biomozgalom megteremtéséhez

Gaseous Tracking Detectors at the Sakurajima Muography Observatory

Muography is a novel imaging technology to reveal density structure of hill-sized objects. The cosmic muons predictably lose their energy and penetrate hundreds of meters into the ground, thus their differential local flux correlates with the crossed density-length. The Sakurajima Muography Observatory in Kagoshima, Japan, is the largest muography experiment targeting an active volcano. A set of multilayered gaseous detectors are used to reconstruct the muon tracks, thus by measuring the flux, imaging of the inner part of the volcano become possible. The paper focuses on the technical challenges of such a particle tracking system, the designed multi-wire proportional chambers, and the recent results from the measurements

Underground Muography with Portable Gaseous Detectors

Muography is a novel imaging technology based on particle physics instrumentation to reveal density structure of hill-sized objects. The cosmic muon flux is attenuated while penetrating into the ground, thus the differential local flux correlates with the overburden density-length. Underground muography exploits the close-to-zenith flux, while main challenges became portability, low power consumption, and robustness against the out-of-the-laboratory environment. Various fields could benefit from this non-invasive imaging, eg. speleology, mining, archeology, or industry. Portable gaseous tracking detector systems have been designed, built, and successfully used in several underground locations. This paper presents the designed portable muography systems, the main requirements, and measurement campaigns for calibration, natural caves, and cultural heritage