Brain parenchymal signal abnormalities associated with developmental venous anomalies: detailed MR imaging assessment.

BACKGROUND AND PURPOSE: The occurrence of brain parenchymal signal-intensity changes within the drainage territory of developmental venous anomalies (DVAs) in the absence of cavernous malformations (CMs) has been incompletely assessed. This study was performed to evaluate the prevalence of brain parenchymal signal-intensity abnormalities subjacent to DVA, correlating with DVA morphology and location. MATERIALS AND METHODS: One hundred sixty-four patients with brain MR imaging with contrast studies performed from July 2005 through June 2006 formed the study group. The examinations were reviewed and data were collected regarding the following: location, depth, size of draining vein, associated increased signal intensity on fluid-attenuated inversion recovery and T2-weighted images, associated CMs, and associated signal intensity on gradient recalled-echo sequences. RESULTS: Of the 175 DVAs identified, 28 had associated signal-intensity abnormalities in the drainage territory. Seven of 28 DVAs with signal-intensity abnormalities were excluded because of significant adjacent white matter signal-intensity changes related to other pathology overlapping the drainage territory. Of the remaining DVAs imaged in this study, 21/168 (12.5%) had subjacent signal-intensity abnormalities. An adjusted prevalence rate of 9/115 (7.8%) was obtained by excluding patients with white matter disease more than minimal in degree. Periventricular location and older age were associated with DVA signal-intensity abnormality. CONCLUSION: Signal-intensity abnormalities detectable by standard clinical MR images were identified in association with 12.5% of consecutively identified DVAs. Excluding patients with significant underlying white matter disease, we adjusted the prevalence to 7.8%. The etiology of the signal-intensity changes is unclear but may be related to edema, gliosis, or leukoaraiosis secondary to altered hemodynamics in the drainage area.

[Plasma and urinary fibrin fibrinogen degradation products in a case of renal thromboembolism]. / Prodotti di degradazione della fibrina-fibrinogeno plasmatici ed urinari in un caso di tromboembolia renale.

The authors examined the trend of plasma (FDPp) and urine (FDPu) fibrin-fibrinogen degradation products in a case of renal thromboembolism during atrial fibrillation. No alterations of FDP are reported in the literature for this renal pathology. This raises the question of whether this laboratory parameter is of diagnostic value during the course of renal embolism. The case concerned a patient who was admitted to the emergency ward with painful symptoms in his right flank. He was initially hospitalised with a diagnosis of right renal colic. A few days later multiple thromboembolism of the right kidney was diagnosed using CAT with i.v. infusion of contrast medium and renal scintigraphy with 99Tc DTPA. From day 6 to day 17 after the start of painful symptoms, a number of assays were made of FDPp and FDPu using the rapid latex test for FDP which uses specific anti-fragment D and E antiserum (Thrombo-Wellcotester). Alterations of plasma and urine FDP were found which also showed an opposite trend: an inversion of the changes was noted on day 8 with normalisation of FDPp and a persistent increase in FDPu by day 17. Earlier tests may confirm the trend of FDP and their value in diagnostic screening for cases of renal thromboembolism.

[Treatment with human tetanus immunoglobulins in the Emergency Department. Effects of informed consent]. / Trattamento con immunoglobuline umane antitetaniche in Pronto Soccorso. Effetti del consenso informato.

BACKGROUND: The impact of informed consent to tetanus prophylaxis with human immunoglobulins on patients treated in the Emergency Department has been evaluated. METHODS: Tetanus vaccination history was investigated in 1435 patients in 1995 and in 1300 patients in 1996 with post-traumatic skin lesions. RESULTS: The study has shown that in 1995, 55% and in 1996 49.5% of the total patients studied had not received vaccine for tetanus or boosters for over 10 years. These patients had been proposed the treatment with human tetanus immunoglobulins (TIG). The research was performed comparing the consent obtained before (from 17/5 to 15/7/1995) and after (from 17/5 to 15/7/1996) the introduction of the informed consent. The survey was divided into 15-day periods. In 1995 prophylaxis with human immunoglobulins was refused by 42 patients out of 831 (5%) while, in the following year, by 284 out of 641 (44.3%). Every period examined has shown highly significant differences (p < 0.000). CONCLUSIONS: Informing the patients that tetanus prophylaxis with human immunoglobulins can expose them to the risk, at present remote, of transmission of viral infections, has caused a heavy rise of denials to the suggestion of treatment with human immunoglobulins. The amount of the treated patients and the time that was devoted to informed consent would make Emergency Department one of the main places for effective and widespread tetanus prophylaxis. However a greater activity of outer structures would also be hoped for.

Rationale for a community strategy in the field of information and communications technologies applied to health care.

The challenge for Europe in the field of information and communications technologies applied to health care is that of addressing positively the problem of the widening gap between the expectations of the citizens of the type of care that can be made available and the limited resources to provide that care. If the expectations of the population are to be fulfilled, it will be necessary to find innovative ways of delivering health services and to do it more efficiently than has yet been the case. Advanced information and communications technologies will be important tools for Member States to achieve the levels of efficiency required. Based on the results of the Community AIM Exploratory Action, further collaborative work is required at EEC level to create an Integrated Health Information Environment (IHE) allowing essentially for integration, modularity and security.

[A new evaluation system of 3D vision]. / Nouveaux systèmes d'évaluation de la vision 3 D.

3D vision assessment depends on monocular and binocular factors. In ophthalmology, it is clinically evaluated through the optometric examination which is not exhaustive according to the monocular elements and doesn't take on the visual stimulus quantification. The video and electro-optic displays can meet all these exigencies. The basic principles they share are exposed and then an illustration is given of their performance and their adaptation to the physiologic mechanisms. So is presented a study on the fusion area of heterophoric subjects depending on the stimulus spatial frequencies (the synthetic precisely quantified images shown were circular DOGs). This area is greatly modified following the variety of subject's heterophoria.

[Evoked potentials and structured and colored stimuli]. / Potentiels evoqués et stimulations structurées et colorées.

After a historical account and a brief description of the techniques of signal analysis used in their laboratory (visual evoked potentials (VEPs) with statistical calculations, Fast Fourier Transform, correlation function), the authors present the experiments they undertook concerning colored stimulations. These experiments were carried out in 3 steps: colored stimulations on a cathode-ray screen, with constant luminance, concerning 8 healthy volunteers (72 VEPs analyzed); colored stimulations on a 'structured' screen (pattern reversal), concerning 31 healthy volunteers (186 VEPs analyzed); colored and pattern stimulations on a new cathode-ray stimulator built in the 'Centre National des Arts et Métiers' enabling both preceding types of stimulations with increased reliability and offering new possibilities of stimulation (variation of contrast, luminance or chromaticity precisely controlled) with various patterns in the background. The results evidence two different groups of electrophysiological responses, distinctly related to the presence or absence of a morphological structure in the stimulation. As well as this, a significant increase in latencies is observed with blue stimulations.

Visual acuity in color contrast on cathode ray tubes: role of luminance, hue, and saturation contrasts.

Three experiments were conducted on 90 flying personnel to determine the role of luminance, hue, and saturation contrasts on angular visual acuity measured on a CRT system. A Snellen E test object was displayed under various visual acuity conditions on a TV screen, in color contrast, using red, yellow, green, cyan, blue, purple, white, and black. The response system gives response times and quality. The three photocolorimetric parameters are classified through data processing. All other things being equal, the best visual acuity is obtained under a luminance contrast. Two groups of colors can be differentiated under a hue contrast. The first group (red, blue, purple) is better perceived than the second (green, cyan, yellow, white) whatever the other color in simultaneous contrast may be. Higher saturation enhances visual acuity. A curve of mean response time vs. test object sizes is established for the various color couples. The obtained results are of interest for aerospace ergonomics.

Pickup of visual information by the pilot during a ground control approach in a fighter aircraft simulator.

Before providing the new single-seat fighter aircraft with selective visual information display systems, it is necessary to conduct new studies of the visual behavior of pilots flying these aircraft in order to determine the nature of information to be displayed. The authors describe a modified NAC Eye Mark recorder which can be used in tight spaces without any interfering light source and given an example of its use in an experiment conducted in a Mirage III R training simulator. The reported experiment was designed to analyse the visual behavior of 12 pilots of four different qualification levels who flew a ground control approach (GCA) test each day for five consecutive days. The results show that the pilot's visual behavior is stable, both on an intra- and inter-individual basis. In addition, it is possible to classify the control panel instruments as a function of the number of times and length of time they are checked.