Imaging-anatomic Measurements of Carotid Artery Bifurcation

ABSTRACT Objective: To have anatomic measurements of carotid artery bifurcation (CAB) with 64-spiral computed tomography angiography (64-SCTA), and provide anatomic basis for related research. Methods: Imaging data of 92 subjects (45 males, 47 females, the age range 20-82 years and mean age 48.4 ± 6.1 years) without pathology of CAB, who underwent 64-SCTA in head and neck from June 1, 2008 to June 30, 2010, were selected from the Picture Archiving and Communication Systems in Zhongshan Hospital of Xiamen University, Fujian, China. On the 3D images, the angle and size of CAB were measured, and the statistical comparisons of measurements were made between the bilateral, sex and age groups. Results: The measurements of CAB were divided into young (≤ 40 years) and older (> 40 years) groups: bifurcation angle is 36.206° ± 10.210° and 49.343° ± 16.489°, respectively; the inner diameter of common carotid artery (CCA) is 6.820 ± 0.635 and 6.845 ± 0.838 mm, respectively; the proximal inner diameter of internal carotid artery (ICA) is 7.143 ± 0.992 and 7.476 ± 1.630 mm, of the enlargement is 7.568 ± 1.069 and 8.554 ± 1.733 mm, of the distal is 4.897 ± 0.508 and 5.123 ± 0.699 mm, respectively; the inner diameter of external carotid artery (ECA) is 4.324 ± 0.580 and 4.104 ± 0.638 mm, respectively. There were statistically significant differences in all the measurements between male and female groups, in the bifurcation angle, inner diameters of ICA and ECA between young and older groups, and in the bifurcation angle between the left and right (p < 0.05). Conclusion: A 64-SCTA with 3D image post-processing technique can clearly observe and show the CAB. All CAB measurements will provide the objective basis for applied anatomy, imaging diagnosis and surgery treatment.

Experimental study on the atlanto-axial joint and related structures with regional anatomy and medical imaging / Estudio experimental de la articulación atlanto-axial y las estructuras relacionadas con la anatomía regional y la imagen médica

OBJECTIVE: To evaluate the anatomy and medical imaging characteristics in a study observing the atlanto-axial joint (AAJ) and related structures. METHODS: Eight cadaveric specimens of the AAJ segment were studied with both anatomical and imaging methods. The vertebral arteries of the AAJ segment (VA-A), the first and second cervical nerves (CN1, CN2) and synovial fold (SF) of the AAJ were observed and measured. RESULT: After extending from the vertebral canal, the CN1 goes between the posterior arch of the atlas and VA-A, and the CN2 passes between the posterior arch of the atlas and axis, and is posterior to VA-A. Among the eight cases, six were found in the SF in the central anterior AAJ and five in lateral. The vertebral arteries of the AAJ segment go along the AAJ with four curves, of which the second and fourth are away from the bone structure of the AAJ. The distance from CN1, CN2 to VA-A and that from the second, fourth curve of VA-A to AAJ is 0.0-2.2 mm, 0.0-3.6 mm and 0.0-4.8 mm, 2.0-7.9 mm respectively. There is no significant difference between the measurements made anatomically and those by the imaging method (p > 0.05). CONCLUSION: The anatomical method has advantages in observing the CN and SF, while the imaging method shows clearly and directly the VA-A and AAJ. Both are mutually complementary with consistent measurements. The combined use of the two provides a new way to study the complicated anatomy in this region.

OBJETIVO: Evaluar las características del método anatómico y el uso de la imagen médica en un estudio de observación de la articulación atlanto-axial (AAA) y estructuras relacionadas. MÉTODOS: Se estudiaron ocho especimenes cadavéricos del segmento de la AAA tanto con métodos anatómicos como con métodos de imaginología médica. Las arterias vertebrales del segmento de AAA (AV-A), el primer y el segundo nervios cervicales (NC1, NC2) y los pliegues sinoviales (PS) fueron observados y medidos. RESULTADO: Tras de extenderse desde el canal vertebral, el NC1 se extiende entre el arco posterior del atlas, y el NC2 pasa entre el arco posterior del atlas y el axis, y es posterior a las AV-A. Entre los ocho casos, se encontraron seis en los PS en la AAA anterior central, y cinco en la lateral. Las arterias vertebrales del segmento AAA van junto con la AAA con cuatro curvas, de las cuales la segunda y la cuarta están separadas de la estructura ósea de la AAA. La distancia del NC1 y NC2, a las AV-A, y la de la segunda y cuarta curvas de las AV-A a la AAA es 0.0-2.2 mm, 0.0-3.6 mm y 0.0-4.8 mm, 2.0-7.9 mm respectivamente. No hay ninguna diferencia significativa entre las mediciones realizadas anatómicamente y las hechas mediante métodos de imaginología (p > 0.05). CONCLUSIÓN: El método anatómico tiene ventajas al observar el NC y los PS, mientras que el método imaginológico muestra clara y directamente las AV-A y la AAA. Ambos son mutualmente complementarios con las mediciones. El uso combinado de los dos proporciona una nueva manera de estudiar la complicada anatomía de esta región.

International clinical trials of HIV vaccines: II. phase I trial of an HIV-1 synthetic peptide vaccine evaluating an accelerated immunization schedule in Yunnan, China.

A Phase 1, double-blind, placebo controlled trial was conducted in Longchuan County, China, to evaluate the safety and immunogenicity of a prototype HIV-1 synthetic peptide vaccine in a target population at risk for HIV infection, and to establish the infrastructure for future large-scale HIV vaccine efficacy trials. Subjects were randomly assigned to receive 100 microg or 500 microg of vaccine or alum placebo, and were given three injections at an accelerated 0, 1, and 2 month schedule. The vaccine was well tolerated with no significant local or systemic reactions observed in any subjects. Fifty-five percent (100 microg dose) and 64% (500 microg dose) of subjects who received the vaccine produced binding antibody to the immunogen as determined by ELISA. However, HIV-1 (MN) neutralizing antibody was detected in only 23% (3/13) of subjects with detectable HIV-1 specific binding antibody. It was concluded that this prototype HIV-1 synthetic peptide vaccine was well tolerated, safe and immunogenic, and that a 0, 1, 2 month schedule was not as effective in stimulating HIV-1 specific neutralizing antibodies compared with previous trials utilizing a 0, 1, 6 month schedule. Finally, this trial demonstrated that well-designed HIV vaccine trials can be performed at this clinical trials site in Yunnan, China, and that this site should be considered for conducting larger safety, immunogenicity and efficacy trials of candidate HIV vaccines.