Morphometry of cerebral arterial bifurcations harbouring aneurysms: a case-control study.

BACKGROUND: Conclusions from studies evaluating vessel dimensions and their deviations from values resulting from the principle of minimum work (PMW) on the formation of intracranial aneurysms (IAs) are still inconclusive. Our study aimed to perform a morphometric analysis of cerebral arterial bifurcations harbouring aneurysms. METHODS: The study comprised 147 patients with basilar artery (BA) and middle cerebral artery (MCA) aneurysms and 106 patients constituting the control group. The following morphometric parameters were evaluated: the radii of vessels forming the bifurcation, the junction exponent, the values of the bifurcation angles (Φ1 and Φ2 angles between the parent vessel trunk axis and the larger or smaller branches, respectively; α angle, the total bifurcation angle) and the difference between the predicted optimal and observed branch angles. RESULTS: The analysed parameters for internal carotid artery (ICA) bifurcations were not significantly different among the groups. The MCA and BA bifurcation angles and the radii of the parent MCA and BA vessels with aneurysms were significantly higher than those of the control group. The differences between the predicted optimal and observed branch angles were significantly higher for BA and MCA bifurcations with aneurysms compared to the control group. The mean junction exponent for bifurcations in the circle of Willis (i.e., ICA and BA bifurcations, respectively) and MCA bifurcations with aneurysms was significantly lower than the theoretical optimum and did not significantly differ among the groups. In a multilevel multivariate logistic regression analysis, the branch angles and the radius from the parent vessel were significant independent predictors of the presence of an IA. The ROC analysis indicated that the α angle was the best performer in discriminating between aneurysmal and nonaneurysmal bifurcations. CONCLUSIONS: The dimensions of the arteries forming the circle of Willis do not follow the PMW. Deviation from the energetically optimum geometry for bifurcations beyond the circle of Willis (particularly, a larger radius of the parent artery and a wider total bifurcation angle) may lead to the formation of IAs. Further studies are warranted to investigate the significance of vessel dimensions and the bifurcation angle on the magnitude of shear stress in the walls of arterial bifurcations.

Markers of angiogenesis (CD31, CD34, rCBV) and their prognostic value in low-grade gliomas.

BACKGROUND AND PURPOSE: Antigens CD31 and CD34 and relative cerebral blood volume (rCBV) in gliomas reflect in different ways neoangiogenesis of the tumour. Thus, we decided: (1) to estimate the correlation between the values of CD31 and CD34 and the value of rCBV in low-grade gliomas (LGG), and (2) to establish the prognostic value of these markers. MATERIAL AND METHODS: The investigated group consisted of 53 patients with LGG who were operated on in the Neurosurgical Department at Sosnowiec between 2005 and 2011. On the basis of perfusion-weighted imaging (PWI-MRI) in the tumour texture, rCBV was calculated. The values of CD31 and CD34 were estimated on the basis of immunohistochemical investigation. Three outcome measures were assessed: (1) overall survival, (2) progression-free survival, and (3) malignant-free survival. Statistical analyses were done using the STATISTICA 9.0 program. RESULTS: Higher value of rCBV in the texture of LGG significantly correlated with higher CD31 (p = 0.0006) and CD34 values (p = 0.0043). Progression-free survival was significantly longer in patients with rCBV < 1.75 than for persons with rCBV > 1.75 (p = 0.015). Lower expression of CD31 correlated with probability of longer survival of the patients after the operation of LGG (p = 0.068). CONCLUSIONS: Density of microvessels as assessed immunohistochemically with CD31+ and CD34+ in LGG correlated with the value of rCBV in the tumour. The value of 1.75 for rCBV may be the threshold for better or poorer outcome of these patients. Expression of CD31 antigen is an important prognostic factor for the time of survival for patients with LGG.

Communicating a clinical problem to the engineers: towards a common methodology.

The purpose of this article is to present a method for communicating a clinical problem to a group of engineers. The seven-step design process described has been used for this type of communication and audience. A research project focusing on improvement of orthognathic surgery planning, including transfer of information to the operating room, is used as an example. The adoption of the seven-step design process, positioned within the symmetrical problem/solution model, could be the first step in facilitating communication between clinicians and engineers in translational research, and assisting in group focus on the development of a device (system) intended to solve a specific clinical problem.

[Hypertension--diagnosis, treatment and the effectiveness of the treatment of Polish population participating in the POL-MONICA program]. / Nadcisnienie tetnicze--wykrywalnosc, leczenie oraz efektywnosc leczenia w populacji polskiej objetej programem POL-MONICA.

According to the POL-MONICA program basing on screening studies of random population samples of two Warsaw districts and the Tarnobrzeg provinceip the detectability of arterial hypertension (AH), the AH treatment fact, the effectiveness+ of AH treatment and the populational control of AH has been evaluated. The AH control was better in Warsaw (men 55%, women 73%) than in the Tarnobrzeg province (men 44%, women 65%). In both populations the control was better among women than among men and increased with the age of subjects investigated. In both populations the treatment was introduced only in half of detected AH and increased also with the age of subjects studied. Only 20% men and 25% of women in Warsaw and 35% of men and 42% of women in the Tarnobrzeg province was effectively treated. The AH control in the Warsaw population was twice a lower than in the Tarnobrzeg province (Warsaw: men 5%, women 10%, Tarnobrzeg: men 7%, women 16%). Exceptionally bad control of HT has been stated in the youngest and the middle age men group in Warsaw (2.9%). The patterns studied with the use of MLF functions in both population studied have significant influence on the detectability and the AH treatment fact and remain without the influence of effectivity of treatment.

[Beclobrate (Turec) in the treatment of primary hyperlipoproteinemia. II. Results of the treatment in relation to the type of hyperlipoproteinemia]. / Beklobrat (Turec) w leczeniu pierwotnej hiperlipoproteinemii. Czesc II: Zaleznosc wyników leczenia od postaci hiperlipoproteinemii.

After three months of beclobrate treatment (100 mg once daily) of 63 patients with primary hyperlipoproteinemia (HLP) significant decrease of total cholesterol concentration was found in type IIa by 12.9%, IIb by 23.7%, IV by 20.8%. LDL cholesterol concentration decreased in type IIa by 15.4%, IIb by 8.3%, in type IV non significant increase of LDL cholesterol by 21.6% was observed. Decrease of initial triglyceride level in type IIa by 36.1%, IIb by 41.2%, in type IV by 56.6% was found. HDL-cholesterol concentration increased in all examined HLP types in IIa by 19.5%, IIb by 19.3%, IV by 14.5%. Also initial apolipoprotein A1 and A2 levels increased in all HLP types examined, namely in type IIa respectively by 21.2% and 12.4%, IIb by 25.1% and 11.0%, in type IV by 23.6% and 34.9%. Serum apolipoprotein B concentration decreased significantly in type IIa by 20.5%, IIb by 28.4%, however in type IV a slight increase of apoprotein B level was observed. Comparison of HLP types response to beclobrate treatment revealed that the HLP types examined are significantly different in change size of LDL cholesterol concentration, triglyceride concentration and apoprotein B concentration after treatment.