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Objective To determine the incidence and risk factors of carotid stenosis progression in patients with asymptomatic moderate carotid artery stenosis (CAS). Methods Patients with asymptomatic moderate CAS in duplex ultrasound (DUS) were identified from 2003 to 2008, and only those with more than 1 DUS were included during a 5-year follow-up after index DUS. Study end-points were carotid stenosis progression to severe stenosis ≥70%, development of ipsilateral neurologic symptoms (INS), and death. Results One hundred twenty-nine carotid arteries in 124 patients were included in the study. Carotid stenosis progression occurred in 41 (31.8%) arteries, and 4 (3.2%) patients developed INS during a mean follow-up of 49 months (range, 2–128 months). The 5-year freedom from carotid stenosis progression and development of INS were 63.5% ± 5.3% and 98.1% ± 1.4%, respectively, with no difference from those of statin. There was no significant predictor of carotid stenosis progression, and it was not significantly associated with development of INS. The 5-year actuarial patient survival and symptom-free survival were 95.3% ± 2.7 and 93.4% ± 3.0%, respectively, with no difference from those of statin. The only independent predictor of death and INS/death was a remote history of INS (hazard ratio 18.166, P = 0.021, hazard ratio 4.840, P = 0.046). Conclusions The incidence of carotid stenosis progression in asymptomatic moderate CAS was high even in popular use of aspirin and statin. Although development of INS was not associated with carotid stenosis progression, it was a risk factor of long-term morbidity and survival.

We have examined the evolution of abnormal grain growth texture with increasing post-deposition annealing temperature in nanocrystalline Cu films (20 nm thick) deposited on an amorphous SiN x (20 nm)/Si substrate. Texture is analyzed by a TEM-based orientation and phase mapping technique based on precession electron diffraction. The as-deposited film, which has an initial grain size of ~12 nm in diameter, already shows a signature of abnormal grain growth, exhibiting a bimodal grain size distribution. Texture is analyzed by calculating area fractions of major components. The overall texture of the as-deposited film is identified to be 〈110〉, but 〈100〉 grains occupy the largest fraction in the abnormally grown grain areas, followed by 〈111〉 grains. After annealing at 398 K, 573 K, and 773 K (125 °C, 300 °C, and 500 °C), the overall texture turns to 〈112〉. After annealing at 398 K (125 °C), abnormally grown grains have a major 〈112〉 component. The situation is similar for the film annealed at 573 K (300 °C). After annealing at 773 K (500 °C), the abnormal grain growth texture evolved into major 〈111〉. The 〈100〉 component found in the abnormal grain growth texture for the as-deposited film is clearly explained by elastic strain energy minimization and the 〈111〉 component for the as-deposited film and the film annealed at 773 K (500 °C) is explained by surface energy minimization. The development of the 〈112〉 texture obtained after annealing at 398 K and 573 K (125 °C and 300 °C) is not explained by either elastic strain energy minimization or surface energy minimization. We suggest that it is clarified by assuming that the Cu film system is perfectly elastic–plastic, which is associated with the Taylor factors.

Purpose To find a significant predictive factor for the efficacy of endovascular treatment of peripheral arteriovenous malformations (AVMs). Materials and Methods One hundred seventy-six patients (73 male patients and 103 female patients; mean age, 29.4y) who underwent treatment for AVMs in the body or extremities were included. Per Schobinger classification, lesions in 31 patients (18%) were stage II, those in 136 (77%) were stage III, and those in nine (5%) were stage IV. AVMs were located in the extremities in 130 patients (74%) and in the trunk in 46 patients (26%). AVMs were angiographically classified as type I (n=1), type II (n=36), type IIIa (n=6), type IIIb (n=91), or complex type (n=42). Demographic factors, clinical data, and imaging data were analyzed to determine a statistically significant relationship with overall clinical outcomes. Results Overall, 68 patients (39%) were cured, 91 patients (52%) showed a partial response, nine patients (5%) showed no response, treatment failed in seven patients (4%), and treatment aggravated the condition in one patient (1%). The overall complication rate was 45% (79 of 176 patients). Minor complications developed in 62 patients (35%) and major complications developed in 17 (10%). Statistically, the extent of AVMs (odds ratio, 0.199) and angiographic classification (odds ratio, 0.162) were significant predictive factors for overall clinical outcome. Conclusions Endovascular treatment of peripheral AVMs, planned with consideration of anatomic extent and angiographic subtypes, is likely to yield good clinical results with low complication rates.

We assessed the utility of a 3-grade classification of photoplethysmography (PPG) with cold water provocation test in Raynaud phenomenon (RP). A total of 35 patients with RP and 38 healthy volunteers were recruited. In healthy volunteers, PPG was measured twice at intervals of 30 minutes for evaluating reproducibility of test. Percentage variation of the PPG amplitude in post- versus precold provocation was expressed on a 3-grade scale at 1, 3, and 5 minutes (reflection index: RI) in patients with RP. The improvement pattern of the PPG (IPPPG) was evaluated by summing the score differences from RI1 min to RI3 min and RI5 min. After a therapeutic period of 8 weeks with nifedipine, the decreases in posttherapeutic RI3 min and RI5 min were statistically significant ( P < .05). Subgroup analysis of IPPPG showed statistical significance in patients with negative fluorescent antinuclear antibody ( P < .05). The analysis of cold-provoked PPG waves demonstrated and quantified improvements in peripheral arterial circulation in RP.

We examined the corrosion behavior of Mg in Hanks’ solution to determine the potential of a biodegradable pure Mg implant. Abrupt corrosion, initiated by Fe impurity, was observed in the latter stage of experimentation in the form of preferred crystallographic pitting (PCP) propagating along the (0 0 0 1) basal plane in the grain. Herein, we report the mechanism behind PCP corrosion of Mg and evaluate potential solutions to suppress PCP corrosion. In particular, the addition of Mn inhibits PCP initiation by converting Fe impurities to Fe-Mn compounds, while refining the grain size by extrusion reduces PCP propagation.

Some cerebral cavernous malformations (CCMs) may be associated with vascular malformations that occur on the capillary-venous side of the cerebral circulation. The association between CCMs and dural arteriovenous shunts (DAVSs) is not well known. The purpose of this study is to investigate the relationship between CCMs and DAVSs. We retrospectively analyzed 179 patients diagnosed as intracranial DAVSs and performed with digital subtraction angiography (DSA). The DSA images were investigated for the location, cortical venous reflux (CVR), multiplicity, and treatment method/result of DAVS. MR images were investigated for the location, number, and size of CCMs and correlated with the DSA images. Six of the 179 patients with DAVSs presented with coexistent CCMs (3.4 %; M/F = 3:3; mean age, 38 ± 22 years). Five of the six DAVS patients with CCMs were associated with CVR (83 %). The total number of CCMs associated with DAVS was 20. Multiple CCMs (range, 2–7) were seen in four (66 %) of six patients. Eighteen (90 %) of the 20 CCMs were located on the ipsilateral hemisphere of the CVR (n = 10) or adjacent to the deep venous reflux (n = 8). Five de novo CCMs were detected in two patients. All de novo CCMs were located on the ipsilateral hemisphere of the DAVS with CVR or juxtapositioned to abnormally dilated deep vein. CCMs may develop in association to DAVSs. The relationship between CCMs and DAVSs suggests the venous pathogenic origin of CCMs and the role of venous hypertension in the de novo development of CCMs.

Purpose Axium™ coils were developed to improve the durability of coil-embolized cerebral aneurysms by increasing packing density. The purpose of this prospective multicenter registry was to evaluate the safety and durability of Axium™ coils. Materials and Methods One hundred twenty-six patients with 135 aneurysms of ≤ 15 mm in size underwent coil embolization using bare platinum coils, with Axium™ coils constituting over 50% of the total coil length. Immediate and short-term follow-up results were prospectively registered and retrospectively evaluated. Results Of the 135 aneurysms (83 unruptured and 52 ruptured), immediate post-embolization angiography revealed complete occlusion in 80 aneurysms (59.3%), neck remnants in 47 (34.8%), and incomplete occlusion in 8 (5.9%). The mean packing density was 42.8% (range, 9.5 - 90%) with Axium™ coil length constituting a mean of 87.9% of total coil length. The rate of procedure-related complications was 16.3%. Procedure-related permanent morbidity and mortality rates were 3.2% and 0.8%, respectively. Follow-up catheter or MR angiography, which was available in 101 aneurysms at 6 - 15 months (mean, 7.7 months), revealed stable or improved occlusion in 95 aneurysms and worsening in 6 aneurysms (5.9%). Lower packing density (< 30%) remained the only predictor for anatomical worsening on multivariable logistic regression analysis (P < 0.05). Conclusion In this registry, Axium™ coils showed a relatively low rate of anatomical worsening on short-term follow-up imaging with an acceptable periprocedural safety profile compared to reports of other platinum coils. These results may warrant further study of long-term durability with Axium™ coils in larger populations.

This study deals with the experiments of liquid dampers with multi cells whose vertical tubes are divided into several square columns for easily changing natural frequencies. Shaking table test is performed to verify control effectiveness of the dampers which are installed on a building structure. To design liquid dampers, a 64-story building structure is reduced to a SDOF structure with 1/20 of similitude laws based on acceleration. The structure model is made up to adjust its mass and stiffness easily, with separate mass and drive parts. Mass parts indicate real structure`s weights and drive parts indicate real structure`s stiffness with springs and LM guides. Manufactured liquid damper has 18 cells and its natural frequency ranges are 0.65Hz to 0.81Hz. Shaking table test is carried out with one way excitation to compare with only accelerations of a large-scale structure and a structure installed with liquid dampers. Control performance of the liquid damper is expressed by the transfer function from shaking table accelerations to the large-scale structure ones. Testing results show that the liquid damper reduced a large-scale structure`s response by tuned natural frequencies.

Background Hand arteriovenous malformations (AVMs) are difficult to treat because of the necessity to maintain function and the high complication rate of treatment. The purpose of this study was to review the treatment of hand AVMs with embolo/sclerotherapy and the surgical procedures at a single institute. Material and Methods We retrospectively reviewed the medical records and identified the patients who were referred to the vascular division owing to hand AVMs between 1995 and 2009. The lesions were classified according to their affected areas. The treatments used at the clinic included conservative treatment, amputation, and embolo/sclerotherapy. We investigated the clinical data and assessed the treatment results. Results Sixty-four patients were involved in this study. The median follow-up duration was 26.9 months (range: 3.5–141.8 months). The median age of the patients was 31.5 years (range: 0.3–75.0 years). All of the lesions were of the extratruncal (ET) form, and 37 cases (57.8%) were of the infiltrating type. Sixteen patients were treated conservatively. Primary amputation was performed in seven cases with previous complications such as ulcer, bleeding, or functional limitations. Embolo/sclerotherapy with ethanol was performed in 41 patients. Sixteen (39.0%) of them showed clinical improvement. The treatment of 20 (48.8%) of the 41 patients was interrupted owing to a variety of complications, and 2 (4.9%) of these patients failed with embolo/sclerotherapy. Skin necrosis was the major complication, and this occurred in 17 patients treated with embolo/sclerotherapy—14 of these cases were small and the skin necrosis healed with conservative treatment; 1 patient had autoamputation owing to necrosis; and 2 patients underwent amputation surgery owing to gangrene. The risk for skin necrosis was higher for the AVMs that involved the subcutaneous layer and the AVMs that extended diffusely ( P = 0.021, P = 0.011). Seven neuropathic complications developed after embolo/sclerotherapy, and all of them were transient. Conclusions The symptoms and characteristics of the lesions are important factors in devising a treatment plan for AVMs. AVM treatment, and especially embolo/sclerotherapy, is a long-term prospect, and it carries a potential risk for serious complications. After every treatment, the lesions must be reevaluated and new treatment plans must be made by the members of a multidisciplinary team.

Thin sheets of V 85 Al 10 Co 5 alloy were produced by a thermo-mechanical treatment consisting in successive hot rolling, cold rolling steps and annealing treatment at high temperature followed by either air cooling or water quenching. Though the values of hydrogen permeability measured for these sheets were significantly reduced as a consequence of the rolling process, the annealing treatment restored almost the hydrogen permeation properties to those of the alloy in the cast condition. EBSD analyses suggested that the post-annealing treatment performed at 1100 °C for 3 min after cold rolling induced a recrystallization of the grains resulting in a preferred orientation along the {002} planes. For the sample annealed and water quenched, the value of the hydrogen flux reached about 45 ml/cm 2 .min, which is more than twice the value of the flux obtained for thin foils of Pd alloys tested under identical conditions.

To evaluate initial radiologic findings of symptomatic intracranial vertebrobasilar dissections (VBDs) as well as the results at follow-up imaging of dissections that are conservatively managed.The respective institutional review boards approved this retrospective study and waived the need for informed consent. The initial radiologic findings of 210 patients with 230 symptomatic intracranial VBDs were retrospectively evaluated (48 ruptured, 182 unruptured). Those patients had undergone conventional angiography as well as magnetic resonance imaging and/or computed tomographic angiography, so that angiographic shapes and pathognomonic findings (eg, intramural hematoma, intimal flap) could be reviewed. The primary angiographic shapes of the symptomatic intracranial VBDs were subdivided into three groups: (a) dilatation without stenosis, (b) pearl-and-string, and (c) stenosis without dilatation. Furthermore, the radiologic evolution of conservatively managed symptomatic intracranial VBDs was evaluated. The respective frequencies of the radiologic findings at initial and follow-up imaging studies were compared by using χ2 tests.Primary shape differed significantly between ruptured and unruptured symptomatic intracranial VBDs. Most ruptured dissections presented with one of two main structures: dilatation without stenosis or pearl-and-string appearance. The primary shape of unruptured dissections was evenly distributed among the three types of findings. Intramural hematomas were most frequently found in the stenosis-without-dilatation group (42 of 60 [70%]), followed by the pearl-and-string group (27 of 90 [30%]). Intimal flap was most frequently found in the pearl-and-string group (21 of 90 [23%]), followed by the stenosis-without-dilatation group (eight of 60 [13%]). Follow-up results significantly differed by initial VBD shapes: Seventy-four percent (25 of 34) of the dilatation-without-stenosis group showed no change, whereas improvement was observed in 91% (39 of 43) of the stenosis-without-dilatation group (P.05). Intracranial VBDs with intramural hematoma showed improvement in 63% (34 of 54) of cases, progression occurred in 20% (11 of 54), and only 17% (nine of 54) exhibited no change (P.05).Primary angiographic shapes of symptomatic intracranial VBDs differed between ruptured and unruptured lesions. The stenosis-without-dilatation lesions most frequently exhibited radiologic improvement at follow-up imaging, followed by pearl-and-string and dilatation-without-stenosis lesions.

Background The objective of this study was to estimate the outcomes of surgical treatment for patients with venous malformations (VMs). Methods We retrospectively reviewed the data of 48 patients who underwent surgical management for VMs from 1994 to 2009 at our institute. The 1-year responses to surgeries were classified into three groups based on the results: “remission,” “improvement,” and “no change.” Results The indications of surgeries were mass or swelling in 48 patients (100%), intractable pain in 11 (23%), limb length discrepancy in seven (15%), bleeding in three (6%), and limitation of the range of motion in one (2%). The locations of the VMs were head and neck in 17 patients (35%), abdomen and pelvis in one (2%), perineum and genitalia in three (6%), upper extremities in 12 (25%), and lower extremities or buttocks in 15 (31%). Of the 48 surgeries for radical excision and debulking, 25 (52%) resulted in remission, 11 (23%) in improvement, and 12 (25%) in no change. During follow-up (mean: 44.8 ± 36.6 months, range: 0–111 months), recurrence after radical excision occurred in 10% (3 of 31) of the patients, and size increase after debulking surgery in 24% (4 of 17) of the patients. Conclusions Surgical treatment can be an option in patients with VMs, especially with symptoms that cannot be managed with conservative therapy or sclerotherapy. After excisional or debulking surgery in patient with VMs, remission or improvement can be observed in 75%.

Lanthanum silicates with different lanthanum concentrations La9.33+x(SiO4)6O2+1.5x were prepared by solid state reaction using milling procedures of different degrees and sintered at 1700°C or 1750°C. The phase composition and the microstructural evolution were shown to depend strongly on the heat-treatment temperature and history. The presence of the liquid phase in the lanthanum-rich compositions at sintering temperatures is clearly evidenced, which, however, is not in accordance with the known phase relations of the material. Exaggerated growth of plate-shaped grains in the c-axis direction was induced by the inhomogeneous presence of the liquid phase. The solid solution region with excess lanthanum appears to extend with increasing temperature, as evidenced by intragranular second phase precipitation on heat treatments at lower temperature as well as the X-ray powder diffraction results of differently treated samples. Lanthanum-deficient compositions were shown to exist as a two-phase mixture with La2Si2O7 in equilibrium, although the powders prepared by solid state reaction at 1300°C do not indicate the significant presence of a secondary phase, regardless of the composition. The groove profiles with both a maximum and minimum (or hump) indicate the surface diffusion mechanism controlled by bulk defect chemistry and defect migration in the material. This phenomenon can be explained by the transport anisotropy in La diffusion which controls the matter transport by the bulk ambipolar diffusion mechanism, supported by recent theoretical as well as experimental studies. Electron backscattered diffraction mapping clearly correlated the grains perpendicular to the c-axis with the strong development of thermal grooving and vice versa by the transport anisotropy. There is little indication of the surface and grain-boundary energy anisotropy regardless of the compositions.

To investigate the clinical course of patients with venous malformation (VM) treated conservatively. We reviewed retrospectively the database of our Congenital Vascular Malformation clinic and interviewed 207 patients with VM, who had been managed only conservatively. The questionnaires asked about changes in size (no change, increase in proportion to growth, increase greater than in proportion to growth, decrease) and changes in symptoms (markedly worse, moderately worse, no change, moderately improved, markedly much improved). Progression of VMs was defined as an increase greater than in proportion to growth or worsening symptoms. Fifty patients (24 %) reported an increase in size greater than in proportion to growth and 25 patients (12 %) reported symptoms worsening from their initial symptoms. Overall, sixty-six (32 %) of the patients reported evidence of progression of their VM. A binary logistic regression model identified VM combined with capillary malformation (CM) or lymphatic malformation (LM) as an independent predictor of VM progression (OR 2.67, 95 % CI 1.29–5.53). Based on responses to the questionnaire, the size and symptoms of VM progressed in 32 % of patients over the course of their life. VMs combined with CM or LM were the only independent predictor of progression of a VM after conservative management.

BACKGROUND AND PURPOSE: The pathogenesis and characteristics of multiple DAVSs are not well-known. The purpose of this study was to evaluate the angiographic and clinical characteristics of patients with multiple DAVSs with an emphasis on the pathomechanism. MATERIALS AND METHODS: One hundred seventy-nine patients with DAVS were reviewed. Patients with ≥2 fistulas at anatomically separate sites were included. Multiple DAVSs were categorized into synchronous (simultaneous multiplicity) or metachronous (temporal sequential development of multiplicity) types. The angiographic and clinical characteristics of these lesions were analyzed. RESULTS: Fourteen patients were diagnosed with multiple DAVSs (7.8%; synchronous, n = 7; metachronous, n = 7). Thirteen of the 14 patients showed CVR (93%, Borden type II/III). Multiple DAVSs were frequently associated with dural sinus thrombosis (71.4%, n = 10). Synchronous DAVSs developed in association with an occluded sinus (n = 5). De novo metachronous lesions developed in association with thrombosis of a previously patent dural sinus (n = 3) or reopening of an occluded sinus (n = 2). Multiplicity was associated with aggressive initial symptoms in 64.3% (n = 9). The newly developed lesions in the metachronous types were accompanied by hemorrhage (n = 1), neurologic deficit (n = 1), worsening of the initial benign symptoms (n = 2), and incidental detection (n = 3). The mean time interval between the initial diagnosis and de novo lesion detection was 31.3 ± 29.8 months (range, 12–92 months). CONCLUSIONS: Multiplicity of DAVSs is associated with poor angiographic and clinical prognosis, requiring an aggressive treatment and management strategy. Sinus thrombosis has a prominent role in the pathomechanism of DAVSs.

This article proposes a new method to fabricate the ionic polymer metal composite (IPMC) actuator with a preshaped form by a simple thermal treatment process. The effects of the thermal treatment process on the properties of the actuator such as stiffness, displacement, resonance, and generating force are analyzed. To verify the effect of the thermal treatment process on the generation force of the actuator, the four-fingered gripper using the proposed method is designed, fabricated, and compared with an unheated actuator. Experimental results show that thermally treated IPMC actuators have an improved generatingforce compared with that of unheated actuators. POLYM. ENG. SCI., 52:1991–1997, 2012. © 2012 Society of Plastics Engineers

ObjectiveThis study compared treatment outcomes of patients with supra-aortic arterial (SAA) occlusive disease due to Takayasu arteritis (TA) treated with bypass surgery or endovascular treatment.MethodsAll patients diagnosed with TA from September 1994 to November 2010 were identified using the hospital database. This retrospective study included 21 TA patients who underwent endovascular or surgical intervention due to SAA lesions and four patients who were referred from other hospitals after endovascular treatment of SAA lesions. Fifteen arterial lesions in 10 patients were treated with an endovascular technique, and 24 arteries in 15 patients were reconstructed using bypass surgery. We performed endovascular intervention for short (50%) or occlusion of the reconstructed arteries was observed in eight of 15 arteries (53.3%) in the endovascular treatment group vs three of 24 (12.5%) in the bypass surgery group (P = .01; Fisher exact test). More serious complications, such as intracerebral hemorrhage (n = 2) due to cerebral hyperperfusion syndrome or cardiac tamponade developed in the surgical bypass group. No operative deaths occurred in either group.ConclusionsSurgical or endovascular interventions were required in one of 10 TA patients with SAA occlusive lesions. Arteries reconstructed after surgical bypass had superior patency to those reconstructed by endovascular treatment. However, bypass surgery was more likely than endovascular treatment to be accompanied by serious early postoperative complications.

Background Optimal management of bilateral vertebral artery dissecting aneurysms (bi-VDAs) causing subarachnoid hemorrhage (SAH) remains unclear. Objective To investigate the treatment methods and outcomes of bi-VDA causing SAH. Methods Seven patients were treated endovascularly for bi-VDA causing SAH. Treatment methods and outcomes were evaluated retrospectively. Results Two patients were treated with 2 overlapping stents for both ruptured and unruptured VDAs, 2 with 2 overlapping stents and coiling for ruptured VDA and with conservative treatment for unruptured VDA, 1 with internal trapping (IT) for ruptured VDA and stent-assisted coiling for unruptured VDA, 1 with IT for ruptured VDA and 2 overlapping stents for unruptured VDA, and 1 with IT for ruptured VDA and a single stent for unruptured VDA. None had rebleeding during follow-up (range, 15-48 months). All patients had favorable outcomes (modified Rankin Scale score, 0-2). On follow-up angiography at 6 to 36 months, 9 treated and 2 untreated VDAs revealed stable or improved state, whereas 3 VDAs in 2 patients showed regrowth. Of the 3 recurring VDAs, 1 was initially treated with IT but recurred owing to retrograde flow to the ipsilateral posterior inferior cerebellar artery (PICA), the second was treated with single stent but enlarged, and the last was treated with 2 overlapping stents and coiling but recurred from the remnant sac harboring the PICA origin. All 3 recurred VDAs were retreated with coiling with or without stent insertion. Conclusion Bilateral VDAs presenting with SAH were safely treated with endovascular methods. However, endovascular treatment may be limited for VDAs with PICA origin involvement.

The microstructural evolution of Cu through-silicon vias (TSVs) during thermal annealing was investigated by analyzing the Cu microstructure and the effects of twin boundaries and stress in the TSV. The Cu TSV had two regions with different grain sizes between the center and the edge with a random Cu texture before and after annealing. The grain size of large grains was almost unchanged after annealing, and the abrupt grain growth was restricted by the twin boundaries due to their structural stability. However, microvoids and cracks in the Cu TSV were observed after annealing. These defects were formed by the stress concentration among Cu grains. After defects were formed, the stress level of the TSV was decreased after annealing.

A new method to fabricate ionic polymer metal composite (IPMC) actuators with a 3-dimensional preshaped form by a simple thermal treatment process is demonstrated. The effects of the thermal treatment process on the properties of the actuator are analyzed and the characteristics of the actuator, such as stiffness, displacement and resonance, generating force, and repeated motions, are compared with those of unheated IPMC actuators. The experimental results show that thermal-treated IPMC actuators have improved generating force as well as preshaping of the 3-dimensional form.

Purpose To describe the clinical features and treatment outcomes after combined endovascular and embolosclerotherapy treatment of pelvic arteriovenous malformations (AVMs). Methods From November 1996 to May 2011, we treated 12 patients (seven males, five females; mean age, 38.1 ±14.6 years; age range, 23-70 years) with pelvic AVMs. Our treatment strategy was coil embolization of a dilated draining vein of the AVM to reduce blood flow velocity in the AVM lesion and sclerotherapy of the residual arteriovenous fistulae with high-concentration ethanol to eradicate potential AVM recurrence. To ensure effective endovascular treatment, we used transarterial, transvenous, percutaneous, or combined access routes. Treatment outcomes were assessed with periodic computed tomography angiograms and clinical examinations. Results During the follow-up period (mean, 33.2 months; median, 21.3 months; range, 1-96 months) after embolosclerotherapy, we observed complete remission (no residual or recurrent AVM lesion on follow-up computed tomography and complete symptomatic relief) in 10 (83.3%) patients and partial remission in two (16.7%) patients. One major complication of focal bladder necrosis occurred (1/22 sessions, 4.5%, 1/12 patients, 8.3%), but this resolved with conservative treatment. As early procedure-related complications, transient pulmonary hypertension and/or hemoglobinuria developed in 54.5% (12/22 sessions) and 22.7% (5/22 sessions) of patients, respectively. Conclusions Combined embolosclerotherapy of pelvic AVMs with coils and ethanol was efficacious at achieving complete remission.

BACKGROUND AND PURPOSE: Fusiform aneurysms and ultrawide-neck circumferential aneurysms are still some of the most challenging lesions. The aim of this study was to investigate the efficacy and feasibility of the use of multiple overlapping Enterprise stents with coiling for the treatment of fusiform or ultrawide-neck circumferential aneurysms. MATERIALS AND METHODS: Twelve consecutive patients (9 men and 3 women; mean age, 56 years) with fusiform ( n = 5) or ultrawide-neck circumferential ( n = 7) aneurysms were treated with 2–3 overlapping Enterprise stents and coiling. The feasibility of this procedure and the clinical and angiographic outcomes of this technique were retrospectively evaluated. RESULTS: All patients were successfully treated by using this technique without any complications. Posttreatment angiographic results revealed grade 4 occlusion of the aneurysm in 6, grade 3 in 4, and grade 2 in 2 patients. Clinical follow-up was performed in all patients (mean, 16 months; range, 5–24 months). Nine patients had an mRS score of 0. Two had an mRS score of 1, one of whom had an initial mRS score of 2 due to the mass effect of a giant aneurysm; the other had a recurrent aneurysm presenting with SAH 5 years after clipping. Angiographic follow-up was performed in 10 patients at 6–20 months posttreatment. Nine had stable or improved occlusion, while 1 had a minor recurrence. CONCLUSIONS: In this small series, multiple overlapping Enterprise stents with coiling were a feasible and effective option for the treatment of fusiform and ultrawide-neck circumferential aneurysms. Further experience and follow-up are required to document the long-term efficacy of this treatment.

The effect of grain boundary characteristics on the oxidation of ferritic stainless steel was investigated using XRD, SEM, energy dispersive spectroscopy, and electron backscattered diffraction. Oxide crystals at special grain boundaries were compared with that of random boundaries. The spinel type oxide grew along the grain boundaries whereas both spinel and chromia grew at the grain interiors. Oxidation rate at special boundaries was slower than random boundaries. The resistance to oxidation of special boundaries is influenced by their angular deviation from the ideal coincidence site lattice (CSL) misorientation. The special boundaries near ideal CSL misorientation are more resistant to oxidation.

Objectives Optimal treatment of spontaneous isolated superior mesenteric artery dissection (SISMAD) has not been established in part because the natural history of this rare vascular disease is not well established. We attempted to determine the natural history of SISMAD by observing patients who underwent conservative treatment. Methods Among 58 consecutive patients with SISMAD, 46 who underwent conservative treatment and periodic follow-up of computed tomography (CT) angiography (CTA) were included for this study. Our first-line treatment for SISMAD patients was conservative (n = 53), reserving interventional treatment, either endovascular (n = 1) or surgical (n = 4), for patients with persistent abdominal pain despite conservative treatment or signs of bowel ischemia. We retrospectively investigated changes of the length, type, or remodeling of the dissection and superior mesenteric artery patency on multidetector CT scan. To evaluate clinical course, presence of persistent or recurrent abdominal symptoms was queried on an outpatient base. Results After 23.0 (median, range 6.5-74.2) months, follow-up CT angiograms showed diminished extent of the false lumen size in 19 (41.3%), no change in 20 (43.5%), diminished length of dissection in 11 (23.9%), and complete remodeling of dissection in seven (15.2%) patients. No patient showed dissection progression on follow-up angiogram. During the follow-up period, 10 (26.3%) patients reported nonspecific, mild abdominal discomfort, however, no patient developed recurrent abdominal pain following conservative treatment. There was no mortality related with SISMAD. Conclusions After conservative treatment of SISMAD, we have observed that the majority of patients showed improvement or no change on both angiogram and clinical examination. We believe this observation supports an approach of conservative treatment for patients with SISMAD.

The oxide layer formation of ferritic stainless steel (Crofer22APU) oxidized in an air furnace at 800°C was analysed by transmission electron microscopy (TEM) and electron back scattered diffraction (EBSD).EBSD analysis revealed that crystallographic orientation affects the oxidation behaviour of Crofer22APU. On {110} grains, most oxide granules had the same orientation but on {111} grains, they had random orientation.TEM analysis revealed that the oxide layer consisted of spinel- chromia-spinel multi layered structure on the {110} matrix grain but no sub spinel oxide layer on the {111} matrix grain. On the {110} closed packed plane of matrix, the chromia oxide formation with the direction of rhombohedral structure on the {001} closed packed plane parallels the direction on the {110} plane of BCC matrix was observed, which is known as Pitsch-Schrader orientation relationship. On the {111} plane grain, there was no specific orientation relationship. Energy dispersive spectroscopy (EDS) ...

Background and objectives The clinical benefits of stem cell therapy have been reported in patients with peripheral arterial occlusive disease. However, those studies had no standard reporting system to assess the outcomes, so we made a scoring system and assessed the outcomes of the limbs that underwent whole bone marrow stem cell (WBMSC) therapy. Methods and results Between July 4 and June 2009, 90 limbs of 67 patients with symptomatic thromboangiitis obliterans (TAO) were enrolled. Autologous whole bone marrow was implanted into the limb by intramuscular injections. The primary outcomes were defined by the clinical and angiographic improvement in all the limbs and the secondary outcomes were the clinical improvement and the amputation-free rates in the critical ischemic limbs (CILs). Clinical improvement and angiographic improvement was observed in 55.6% and 43.2% of all the limbs and in 50% and 50%of the CILs, respectively. The 1, 3 and 5-year amputation-free rates were 91.9%, 88.5% and 84.6% for all the limbs, respectively, and 83.9%, 77.5% and 70.4% for the CILs, respectively. A history of sympathectomy/sympathetic block was shown to be a negative prognostic factor for clinical improvement in all the limbs and in the CILs. In addition, a history of sympathetic block/sympathectomy and the smoking state were the major predictors of amputation for the CILs. Conclusions This study indicated that autologous WMBSC therapy improves the clinical status and reduces amputation factors in the limbs with symptomatic TAO and a history of sympathetic block/sympathectomy and the smoking state are useful prognostic factors.

Objective The aims of our study were to confirm the effectiveness via animal study and safety through clinical trials of using human cord blood-mononuclear cells (HCB-MNCs). Design We performed a dose–response animal study (HCB-MNCs: 4 × 106, 4 × 107 and 4 × 108) using a limb ischaemia model in dogs to assess angiogenic responses. Safety assessment in humans in terms of graft-versus-host-disease was also done by observing an uncontrolled case series. Materials and methods Twelve animal ischaemic limbs and seven patients with thromboangiitis obliterans were treated with HCB-MNCs. These cells (4 × 108) were injected into the ischaemic limb muscle of patients. The results were analysed at 8 weeks for the animal study and at 6 months for patients. Results In the animal ischaemic models, the number of capillaries, angiogenic gene expression and the angiogenic factors were increased after HCB-MNC injection. In the clinical study, the seven patients experienced no graft-versus-host-disease or cardiac/cerebral complications during the follow-up period. Conclusion This preliminary study suggests that HCB-MNC might be a safe source of stem cells for treating ischaemic limbs. However, further clinical studies are needed to establish the long-term safety and the clinical efficacy of HCB-MNC transplantation in patients with ischaemic limbs.

Objective: We aimed to evaluate the long-term clinical outcomes and prognostic factors of symptomatic intracranial unruptured vertebrobasilar artery dissection (siu-VBD). Methods: A total of 191 patients (M:F = 127:64; median age, 46 years) with siu-VBD were treated between January 2001 and December 2008. Presentations, treatments, outcomes, and prognostic factors were retrospectively analyzed. Results: Clinical manifestations were ischemic symptoms with headache (n = 97) or without headache (n = 13) and headache without ischemic symptoms (n = 81). Forty-six patients (24.1%) underwent endovascular treatment. The remaining 145 patients (75.9%) were medically treated with anticoagulants (n = 49), antiplatelets (n = 48), or analgesics alone (n = 48). Clinical follow-up data were available in 178 patients (102 ischemic and 76 nonischemic) at 15 to 102 months (mean, 46 months). None of the siu-VBD hemorrhaged. All 76 patients without ischemic presentation had favorable outcomes (modified Rankin Scale, 0–1). Of the 102 patients with ischemic presentation, outcomes were favorable in 92 and unfavorable in 10 patients. Four patients died; 3 died of causes unrelated to VBD, and one died as a result of basilar artery (BA) dissection. Old age (odds ratio [OR] 1.099; 95% confidence interval [CI] 1.103–1.204; p = 0.042) and BA involvement (OR 11.886; 95% CI 1.416–99.794; p = 0.023) were independent predictors of unfavorable outcomes in siu-VBD with ischemic presentation. Conclusions: Clinical outcomes for siu-VBD were favorable in all patients without ischemic symptoms and in most patients with ischemic presentation. None of the siu-VBD caused subarachnoid hemorrhage. Old age and BA involvement were independent predictors of unfavorable outcome in siu-VBD with ischemic presentation.

Transplantation of cord blood-derived mesenchymal stem cells (CBMSCs) into ischemic regions could be a potential therapy for the treatment of ischemic disease, but its efficacy is limited by poor cell survival. We hypothesized that local delivery of fibroblast growth factor 2 (FGF2) to the site of CBMSC transplantation would enhance the viability of CBMSCs transplanted to ischemic tissues. Human CBMSCs were loaded onto fibrin gel with or without FGF2 and transplanted intramuscularly into either normal or ischemic hindlimbs of athymic mice. CBMSC transplantation combined with FGF2 delivery resulted in significantly lower apoptosis and higher survival of transplanted CBMSCs. The enhanced cell survival could be due to the local delivery of FGF2 and the enhanced secretion of anti-apoptotic factor. CBMSC transplantation and FGF2 delivery enhanced the expression of host-derived, platelet-derived growth factor-β and NG2, which induce endothelial cell homing and pericyte recruitment, respectively, and more effectively protected muscles from ischemic degeneration when compared to CBMSC transplantation alone. FGF2 delivery to the site of CBMSC transplantation can enhance the survival of CBMSCs transplanted into ischemic tissues. This approach could be used to improve the angiogenic efficacy of CBMSC transplantation therapy for ischemic disease.

Purpose: Inflammatory cells are known to be associated with the progression of atherosclerosis and plaque rupture. However, the relation to inflammatory cells and apolipoproteins on the progression of atherosclerosis is unknown. This study was aimed at examining the different expressions of inflammatory cells and evaluate the effect of apolipoprotein (APO) C1 and APO E during the progression of atherosclerosis. Methods: Ten atherosclerotic tissues were compared with five non-atherosclerotic tissues. The presence of vascular smooth muscle cells (VSMCs), macrophages, T-cells, APO C1, and APO E were identified by Western blotting and immunohistochemical analysis with antibodies. The senescence was analyzed by senescence-associated β-galactosidase. Results: The protein expression and senescence of macrophages, APO C1 and APO E were significantly higher in the main atherosclerotic lesion than the non-atherosclerotic lesion. A high concentration of inflammatory cells and the paucity of VSMCs were present in the shoulder area. In addition, macrophage and T-cells are expressed in the early stage of atherosclerotic development and more expanded in advanced atherosclerotic plaques. APO C1 was expressed mainly within the necrotic core, and APO E existed mostly around the necrotic core and the fibrous cap in advanced atherosclerotic plaques. Conclusion: Our study indicated that the expression and the senescence of macrophage and T-cells may be closelyrelated to induction and deposition of APO C1 and APO E. This contributes to the development and progression of atherosclerotic plaque by expanding the necrotic core.

Background Since the International Subarachnoid Aneurysmal Trial, endovascular coiling has been increasingly used as primary treatment option for ruptured or unruptured aneurysms that are feasible for coiling. Objective To evaluate the feasibility and clinical and angiographic outcomes of coiling for unruptured middle cerebral artery aneurysms. Methods The records of 70 consecutive patients with 76 unruptured middle cerebral artery aneurysms who underwent coiling were retrospectively evaluated. Results Thirty-one aneurysms were treated by single-catheter, 18 by multicatheter, 11 by balloon-assisted, 13 by stent-assisted, and 3 by a combination of multicatheter and balloon-assisted techniques. Coiling was accomplished in 75 but failed in 1 aneurysm. One patient died of consequences of subarachnoid hemorrhage occurring 9 hours after coiling. One intraprocedural aneurysm rupture occurred, which was controlled by further coil insertions and left no sequelae. There were 1 cortical infarction and 1 basal ganglia infarction, both of which recovered completely. Treatment-related permanent morbidity and mortality rates were 0% and 1.4%, respectively. Postembolization control angiography revealed 40 complete, 30 neck remnant, and 5 incomplete occlusions. Clinical follow-up was available in all patients (mean, 25 months; range, 7-105 months). There was no subarachnoid hemorrhage during follow-up, but 1 death resulting from acute myocardial infarction occurred 3 months after coiling. None of the surviving patients had any neurological deterioration. Follow-up angiography was available in 69 aneurysms at 6 to 24 months (mean, 12 months). Three major and 6 minor recurrences were detected. All 3 major recurrent aneurysms were re-treated by coiling without any complications. Conclusion Most unruptured middle cerebral artery aneurysms could be safely treated by coiling with acceptable short-term to midterm outcomes. Our results warrant further study with a longer follow-up period in a larger population.

Object Treatment of arteriovenous malformations (AVMs) is problematic due to many factors, including lesion size, lesion location, unacceptable complications, and negative outcomes. To overcome the limitation imposed by a large nidus volume, neurosurgeons have used Gamma Knife surgery (GKS) in a variety of ways, including combined with other treatment modalities, as volume-staged radiosurgery, and as repeat radiosurgery. We performed repeat radiosurgeries in patients who harbored large AVMs (> 30 cm3) and analyzed the AVM obliteration rates and complications. Methods The authors reviewed the cases of 44 patients at a single institution who underwent GKS between 1992 and 2007 for treatment of an AVM whose nidus was 30 cm3 or larger. The mean age of the patients was 27 years (range 4.5–62.3 years), and the median duration of follow-up was 109.4 months (range 27–202 months). The mean AVM nidus volume was 48.8 cm3 (range 30.3–109.5 cm3), and the mean radiation dose delivered to the margin of the nidus was 13.9 Gy (range 8.4–17.5 Gy). The authors determined complete AVM nidus obliteration based on findings on both MR images and digital subtraction angiograms. When they did not detect complete obliteration after GKS, they performed 1 or more additional GKSs separated by a minimum interval of 3 years. Results The overall obliteration rate following repeat GKS was 34.1%, and the estimated obliteration rate at 120 months was 41.8%. Three patients (6.8%) experienced hemorrhages after GKS, and 2 patients (4.5%) developed cysts. One patient (2.3%) experienced a newly developed seizure following GKS, and another patient (2.3%) was found to have radiation necrosis. Conclusions Even though complete obliteration of the large AVMs after repeat GKS took a long time, the complication rate was quite acceptable. In addition, the estimated obliteration rate at long-term follow-up was respectable. Repeat GKS should be considered as a primary treatment option for symptomatic large AVMs to overcome the limitation imposed on successful obliteration by the large volume of the nidus.

Cyclic oxidation of austenitic steels (Fe–20Ni–14Cr–2.5Mo–2Mn–2.5Al-wt.%) dispersed with 0, 0.5 and 5 wt.% yttria was carried out at 800 °C in air. The scale surface and cross-section were characterized using X-ray diffraction, scanning electron microscopy (SEM), electron probe microanalysis (EPMA) and X-ray photoelectron spectroscopy (XPS). Yttria additions improve the resistance to spallation. The increase in the resistance to spallation appears to be related to the presence of mixed oxides between yttria and base metal oxides.

Computer-generated holograms (CGHs) are often used for testing of aspheric optical surfaces. The precision of CGH mainly depends on the errors of the fabrication machine. We have developed a cylindrical-type direct laser lithographic machine whose working area is up to 360 mm. In this paper, the performance evaluation results of the lithographic machine are given.

OBJECTIVE: To evaluate the postprocedural hemorrhagic complications associated with stent-remodeled coil embolization of intracranial aneurysms. METHODS: From the database of 163 cases of stent-remodeled therapy for wide-neck intracranial aneurysms, patients who showed intracranial hemorrhagic complications on follow-up brain imaging were selected. The initial presentation, antithrombotic medication, hemorrhagic type, location, amount, association with ventriculostomy, symptomatic involvement, and outcome were assessed. RESULTS: Ten patients (6.1 %) developed intracranial hemorrhagic complications (range; 0-422 days; mean; 56 days). The hemorrhagic complication rate was higher in patients with acute subarachnoid hemorrhage (20%, 6 of 30 patients) than in patients with unruptured aneurysms (3%, 4 of 133 patients). Nine of the 10 patients were on dual-antiplatelet therapy at the time of hemorrhage development. Seven of the hemorrhages developed in patients with ventriculostomies (intraparenchymal, n = 4; subdural hematoma, n = 3). Three patients who did not receive a ventriculostomy also developed intracranial hemorrhage (n = 1) or intraparenchymal hemorrhage (n = 2). Hemorrhagic transformation in the recently infarcted brain tissue seemed to be the cause of nonventriculostomy related intraparenchymal hemorrhage. The hemorrhages were accompanied by symptomatic aggravation in 6 of 10 cases, with 5 cases resulting in moribund clinical outcome. CONCLUSION: Postprocedural intracranial hemorrhage may be a risk of stent-remodeled therapy while the patient is on dual-antiplatelet medication. Extra caution is warranted especially in patients with acute subarachnoid hemorrhage requiring ventriculostomy or with underlying recent brain infarction.

Hot deformation behaviour of hypereutectoid steels (0·83–0·92%C) alloyed with 0–2%Al is investigated. Compression tests were carried out in the temperature range 1000–1100°C at 0·1–10 s–1 strain rates. The stress–strain curves are analysed using work hardening rate flow stress plots to determine the critical and peak stress and the corresponding strains associated with dynamic recrystallisation. The addition of Al increases the strain hardening rate and lowers the peak strain. There is an optimum content beyond which peak strain increases with Al addition. Phase diagram calculations show that the multiphase microstructure present during deformation is responsible for the non-linear effect of Al. The steady state stress is modelled using the sine hyperbolic constitutive equation, and the activation energy for deformation is determined.

Hypereutectoid steels with 0, 0.69, 1.29, and 1.95 wt pct aluminum were prepared. The samples were hot rolled at 1100 °C followed by cooling in air. The microstructure of the as-rolled samples was characterized using field emission–scanning electron microscopy (FE-SEM). The electron backscattered diffraction (EBSD) technique was used to identify the grain boundary phases. The steels have a pearlitic microstructure with different amounts of grain boundary cementite. A continuous grain boundary cementite network is present in the 0 wt pct Al steel. Grain boundary cementite formation is completely suppressed in the 1.29 wt pct Al steel. Phase diagram calculations show that aluminum increases the eutectoid temperature. However, the interlamellar spacing and pearlite colony size decrease with increase in aluminum content. Dilatometry measurements show that aluminum addition increases the undercooling below the eutectoid temperature. The yield strength increases with the decrease in interlamellar spacing and colony size. Very high ultimate tensile strengths (1200 to 1400 MPa) and improved elongations to failure (7 to 9 pct) are achieved in the as-rolled condition.

BACKGROUND AND PURPOSE: ICAD with hemodynamic insufficiency may present with either fulminant infarct or with progressive neurologic deterioration. The purpose of this study was to evaluate the safety and efficacy of emergent self-expanding stent placement for acute intracranial or extracranial ICAD with significant hemodynamic insufficiency. MATERIALS AND METHODS: Eight patients (7 men and 1 woman; age range, 20–55 years; NIHSS score, 5–21) underwent emergent self-expanding stent placement for treatment of significant hemodynamic insufficiency due to acute ICAD. The safety and efficacy of emergent self-expanding stent placement were retrospectively evaluated. RESULTS: All patients presented with progressive (n = 6) or fluctuating (n = 2) neurologic deficits and revealed markedly decreased perfusion on CT or MR perfusion studies. Conventional angiography revealed acute occlusion (n = 2) or critical stenosis (n = 6) in intracranial (n = 3) or extracranial (n = 5) carotid arteries with a lack of sufficient collaterals. Stent placement was successful in all patients without any procedure-related complications. In all patients, hemodynamic insufficiency was corrected immediately after stent placement, and neurologic symptoms were completely resolved during several days. Mean improvement of the NIHSS score between baseline and discharge was 11.6 (range, 5–21). All patients remained neurologically intact (mRS, 0) during clinical follow-up for a mean of 21 months (range, 8–50 months). Angiographic follow-up was available for 6 patients at 3–12 months. None of the 6 patients revealed residual or in-stent restenosis. CONCLUSIONS: Self-expanding stent placement is a safe and effective option for selected patients with significant hemodynamic insufficiency due to acute intracranial or extracranial ICAD.

Delirium is a common complication of vascular surgery. The protective effect of preoperative statins on delirium after vascular surgery is controversial. The authors hypothesized that preoperative statin administration would decrease the incidence of delirium after vascular surgery. From May 2010 to May 2015, 1,132 patients underwent vascular surgery. Postoperative delirium was diagnosed from patients’ medical records. The incidence of delirium was 11.5%. The preoperative statin exposure was not associated with reduced delirium in the univariate analysis. After adjusting for covariates, preoperative statin exposure was associated with reduced delirium (OR, 0.54; 95% CI, 0.33–0.87; p = 0.011). This favor effect of statin for delirium was observed after propensity matching (OR, 0.59; 95% CI, 0.34–1.02; p = 0.060). However, the median hospital lengths of stay and in-hospital mortality were not statistically different between the two groups. CRP(C-reactive protein) levels in the unmatched population were lower in the preoperative statin group compared with the other group (p

Ostium of vertebral artery (VA) is a common site of pseudostenosis on contrast-enhanced MR angiography (CE-MRA). The purpose of this study was to determine the diagnostic accuracy of CE-MRA at 3 T in the evaluation of ostial stenosis of VA and to find associated coincidental stenoses using logistic regression analysis. One hundred and thirty-five VA ostial regions from 72 patients who received CE-MRA of neck vessels, intracranial time of flight (TOF) MRA, and digital subtraction angiography (DSA) were retrospectively reviewed. The sensitivity and specificity of the CE-MRA in detection of ostial stenosis were calculated with reference standard of DSA. Ostial stenosis on MRA was correlated with coincidental lesions in intracranial and cervical arteries by logistic regression analysis. The sensitivity and specificity of the CE-MRA were 100% and 80.4% for detection of significant stenosis. In case of significant stenoses, CE-MRA showed a tendency of overestimation with a false-positive rate of 52.5%. Logistic regression analysis showed that the stenoses of middle cerebral artery (MCA) on TOF MRA was associated with significant stenoses of VA ostia (OR = 5.84, 95% confidence intervals 1.41–24.17). CE-MRA is sensitive in detection of VA ostial stenosis although it has high false-positive rate. True positive ostial stenosis should be considered in cases of coincidental stenoses of MCA on TOF MRA.

This study was designed to investigate the effects of repeat bolus absolute ethanol injections on cardiopulmonary hemodynamic changes during ethanol embolotherapy of inoperable congenital arteriovenous (AV) malformations in the extremities.Thirty adult patients (14 male, 16 female; age range, 22-51 years) who underwent ethanol embolotherapy of extremity AV malformations were enrolled in the study. A pulmonary artery catheter was used to measure hemodynamic profiles at baseline (T(baseline)), immediately before (T(pre)) and after (T(post)) a bolus injection of absolute ethanol, at the time of the maximum mean pulmonary arterial pressure (PAP) value during a session (T(highest)), 10 minutes after the final injection (T(final)), and after restoration of spontaneous breathing (T(resp)).The systolic, mean, and diastolic PAP (P.01, P.01, and P.01, respectively) and the systemic vascular resistance index (P.05) and pulmonary vascular resistance index (PVRI; P.05) of T(highest) and T(resp) were significantly higher than values for T(final). The volume of a single bolus injection of absolute ethanol from 0.023 to 0.175 mL/kg of body weight showed that the systolic PAP (P = .02), pulmonary capillary wedge pressure (P = .02), and PVRI (P.01) significantly increased in accordance with the increased single volume of absolute ethanol. A significant increase of the right ventricular end-diastolic volume index and right ventricular end-systolic volume index were observed at a dose of more than 0.14 mL/kg of body weight for a single bolus injection of absolute ethanol.During ethanol embolotherapy of extremity AV malformations, significant hemodynamic changes can arise during a bolus injection of absolute ethanol. Cardiopulmonary hemodynamic profiles should be monitored closely after a bolus injection of more than 0.14 mL/kg of body weight of absolute ethanol.

Objective This study aimed to determine the natural history of spontaneous isolated abdominal aortic dissection (SIAAD) and to establish an optimal management strategy for patients with SIAAD. Methods We searched the database of thoracoabdominal computed tomography (CT) performed at a single institution from January 2003 to July 2016 using the keywords "aortic dissection" and "dissection AND aorta." Once a diagnosis of SIAAD was made, we investigated the initial clinical and morphologic features and aorta-related events for all patients and morphologic changes of the aortic dissection (AD) during the follow-up period for the patients who underwent follow-up CT scans. We compared characteristics of the patients, frequencies of clinical events (aortic rupture, intervention, death), and morphologic changes (false lumen enlargement, progression of AD, remodeling of AD, and involvement of iliac or visceral artery) during the follow-up period according to the location of AD (infrarenal vs suprarenal), symptom status (symptomatic vs asymptomatic), and gender. Results There were 210 (10.7%) patients (median age, 69.4 years [interquartile range, 61.3-74.7]; male, 73.3%) who were diagnosed with SIAAD among 1958 patients with AD. SIAAD was most frequently located at the infrarenal aorta (86.2%), extended to the iliac (12.4%) or visceral artery (2.9%), and was symptomatic in 13.3% of patients. During the study period, aortic rupture developed in two patients (0.9%), aortic intervention was required in five (2.4%), and aorta-related deaths were identified in three (1.4%). Among 138 (65.7%) patients who underwent follow-up CT scans, 81.9% showed no morphologic change or remodeling during the follow-up period (median, 25 months; range, 1-158 months; interquartile range, 12.3-49.1 months). In the meantime, false lumen enlargement and longitudinal progression of AD developed in 8.7% and 6.5% of patients, respectively. However, newly developed visceral artery extension was not found in any of the patents. When characteristics of the patients and frequencies of clinical events or late morphologic changes of AD were compared on the basis of the location of AD, symptom status, and gender, female gender, presence of symptoms, and suprarenal SIAAD were more frequently associated with aorta-related mortality. False lumen enlargement was more frequent in the suprarenal AD group than in the infrarenal AD group. Conclusions Based on our observation, the majority of symptomatic and asymptomatic SIAAD patients can be managed conservatively unless they present with aortic rupture, concomitant large aortic aneurysm, or underlying connective tissue disease. However, a more proactive management strategy may be required for female, symptomatic patients or those with suprarenal SIAAD.

The influences of a stent on the outcome of embolized aneurysms are not well known. The purpose of this study is to assess and compare the angiographic follow-up (FU) results of stent-remodeled (StR) and non-remodeled (nonR) coil embolization of intracranial aneurysms. Thirty-seven StR patients with FU digital subtraction angiography (DSA) were matched with 37 nonR patients according to presentation (ruptured or unruptured), location of the aneurysm (sidewall or bifurcation), initial sac occlusion (complete/near complete or incomplete/failure), and the sac size (largest diameter/less than 2 mm difference). The baseline clinical and aneurysm characteristics, initial/FU treatment success rates, and FU DSA findings between the StR and nonR groups with regard to the morphologic features (size and location) of the aneurysms were assessed and compared. The StR group showed more frequent progressive thrombosis compared to the nonR group (56.8 vs. 27.0%; p

Asymmetric rolling of commercially pure magnesium was carried out at three different temperatures: room temperature, 200 degrees C and 350 degrees C. Systematic analysis of microstructures, grain size distributions, texture and misorientation distributions were performed using electron backscattered diffraction in a field emission gun scanning electron microscope. The results were compared with conventional (symmetric) rolling carried out under the same conditions of temperature and strain rate. Simulations of deformation texture evolution were performed using the viscoplastic self-consistent polycrystal plasticity model. The main trends of texture evolution are faithfully reproduced by the simulations for the tests at room temperature. The deviations that appear for the textures obtained at high temperature can be explained by the occurrence of dynamic recrystallization. Finally, the mechanisms of texture evolution in magnesium during asymmetric and symmetric rolling are explained with the help of ideal orientations, grain velocity fields and divergence maps displayed in orientation space.