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Arterial Spin Labeling (ASL) allows for the non-invasive visualization of brain perfusion to detect abnormalities. In unilateral carotid artery stenosis, one hemisphere is less supplied with blood which results in a lower cerebral blood flow (CBF) compared to the healthy side. ASL can be performed time-resolved using multiple post labeling delay (PLD) times after labeling or static with a single delay, the latter allowing for a faster and more robust acquisition while bearing the risk of a falsely set delay resulting in unusable images. The purpose of this study is to compare the performance of multi-PLD and single-PLD ASL in patients with unilateral carotid artery stenosis both as means of diagnosis and therapeutic follow-up examination. ASL perfusion data of 17 patients with known unilateral carotid artery stenosis was used to compare the diagnostic performance of the multi-PLD and single-PLD approach. Comparisons were made based on the CBF values and the added benefit of arrival time maps showing slower blood flow in multi-PLD ASL which might be overlooked in the individual delay images both before and after therapy. Both the multi-PLD and the single-PLD data could identify the side of the stenosis with hemispheric differences in each approach (p < 0.001) and depict the normalization of CBF after therapy (p > 0.05). There were no differences between the individual methods (p > 0.05). In this work, we could show that multi-PLD ASL in patients with unilateral carotid artery stenosis is beneficial as it provides both CBF and arrival time maps, however when only a single-PLD acquisition is available, this appears sufficient in a clinical setting to investigate the presence of a unilateral stenosis. [ABSTRACT FROM AUTHOR]

Abstract: Aim of the study: Out-of-hospital cardiac arrest (OHCA) accounts for many unexpected deaths in Europe and the survival rates in different regions vary considerably. We have previously reported excellent survival to discharge rates in the Stavanger region. We now describe the long-term outcome of OHCA victims in our region. Methods: In this retrospective observational study, we followed all OHCA hospital discharge survivors between 01.07.2002 and 30.06.2011 (n =213) for a minimum of 1 year and up to 10 years. Based on the national death statistics stratified for gender and age, we could calculate the potential life years saved, standardised mortality rates (SMR) and delineate the causes of death after hospital discharge. Results: Of the 213 patients who were discharged from the hospital, 91% had a cardiac origin of their OHCA. The mean potential life years saved per patient was 22.8 years. The observed five-year survival rate was 76%. The overall SMR in our study cohort was 2.3 when compared to the age- and gender-matched population. Cardiac disease was a prominent cause of late deaths, with the specific SMR for cardiac disease-related deaths being as high as 42 in males and 140 in females. Conclusion: Resuscitation of OHCA victims lead to a significant long-term benefit with respect to life years saved. Cardiac disease was the main cause of death after hospital discharge. More studies are needed to identify the potential of therapeutic interventions and rehabilitation efforts that may further enhance the long-term outcomes in OHCA hospital discharge survivors. [Copyright &y& Elsevier]

Alveolar soft part sarcoma (ASPS) is a rare tumour. Published series about treatment and outcome are scarce. Conclusive data about the response to chemotherapy are not available. The aim of this study was to analyse the efficacy of palliative chemotherapeutic treatment options and the incidence and mode of presentation of brain metastases. We retrospectively analysed our own sarcoma data-base and reviewed the literature. From our registry containing 757 patients, we identified 8 patients with ASPS. From the literature, 47 cases of adult patients and 13 children with sufficient data about chemotherapy were identified. Response to first-line chemotherapy in 68 patients was: complete remission (CR) 4%, partial remission (PR) 3%, stable disease (SD) 41%, progressive disease (PD) 51%. 285 patients with stage IV disease were evaluable for the analysis of metastatic sites. The incidence of brain metastases was 30.5% (87/285). Brain metastases were detected at a median interval of 48 months (range 0–396 months) after the primary diagnosis. Median survival after the diagnosis of brain metastases was 12 months. The median survival for patients with stage IV disease treated by chemotherapy was 36+ months (range 10–132 months) (31 patients evaluable) with a median follow-up of 46 months (range 10–135 months). ASPS shows a high incidence of brain metastases, at least 3 times higher than that of other soft tissue sarcomas. Chemotherapeutic regimens used for the treatment of other soft tissue sarcomas lack efficacy in ASPS. Staging investigations for ASPS should routinely include imaging of the brain. ASPS patients should not be treated with chemotherapy outside of controlled clinical trials. New targets for specific biologically-directed therapies need to be developed. [Copyright &y& Elsevier]

Summary: Allograft is frequently used in orthopaedic and trauma surgery. On top of safety issues its biological activity is limited also due to processing. Consequently, the combination of allograft with osteoinductive substances may increase its effectiveness and decrease failure rates. In particular Bone Morphogenetic Proteins (BMPs) seem to be a promising partner for clinical applications. This overview focuses on the combined application of allograft/BMPs. Current points of view from available literature are summarized. [Copyright &y& Elsevier]

Abstract: Background: Despite continuous innovation in trauma care, fatal trauma remains a significant medical and socioeconomic problem. Traumatic cardiac arrest (tCA) is still considered a hopeless situation, whereas management errors and preventability of death are neglected. We analyzed clinical and autopsy data from tCA patients in an emergency-physician-based rescue system in order to reveal epidemiologic data and current problems in the successful treatment of tCA. Material and methods: Epidemiological and autopsy data of all unsuccessful tCPR cases in a one-year-period in Berlin, Germany (n =101, Group I) and clinical data of all cases of tCPR in a level 1 trauma centre in an 6-year period (n =52, Group II) were evaluated. Preventability of traumatic deaths in autopsy cases (n =22) and trauma-management failures were prospectively assessed. Results: In 2010, 23% of all traumatic deaths in Berlin received tCPR. Death after tCPR occurred predominantly prehospital (PH;74%) and only 26% of these patients were hospitalized. Of 52 patients (Group II), 46% required tCPR already PH and 81% in the emergency department (ED). In 79% ROSC was established PH and 53% in the ED. The survival rate after tCPR was 29% with 27% good neurological outcome. Management errors occurred in 73% PH; 4 cases were judged as potentially or definitive preventable death. Conclusion: Trauma CPR is beyond routine with the need for a tCPR-algorithm, including chest/pericardial decompression, external pelvic stabilization and external bleeding control. The prehospital trauma management has the highest potential to improve tCPR and survival. Therefore, we suggested a pilot prehospital tCPR-algorithm. [Copyright &y& Elsevier]

Abstract: The calorimeter, range detector and active target elements of the T2K near detectors rely on the Hamamatsu Photonics Multi-Pixel Photon Counters (MPPCs) to detect scintillation light produced by charged particles. Detailed measurements of the MPPC gain, afterpulsing, crosstalk, dark noise, and photon detection efficiency for low light levels are reported. In order to account for the impact of the MPPC behavior on T2K physics observables, a simulation program has been developed based on these measurements. The simulation is used to predict the energy resolution of the detector. [Copyright &y& Elsevier]

The article describes the case of a 21-year-old woman who presented with the suspected diagnosis of a lumbar disc herniation. A thrombosis of the anterior tibial vein was diagnosed based on the clinical history and the magnetic resonance imaging (MRI) data. The case is considered peroneal nerve palsy due to thrombosis of a crural vein.