Sequential computed tomography (CT) scans were obtained in 30 patients with acute cerebral infarction. In some cases, infarction was seen on the scans as early as three to six hours after onset of symptoms. Although small areas of petechial hemorrhagic infarction are not easily detected by currently available equipment, positive contrast enhancement helps locate petechial hemorrhagic infarction, which is usually in the cortical gray matter of the cerebral mantle and the central gray matter of the deep central gray matter. Contrast-enhanced CT scans are a useful method for detecting small infarctions. However, when a CT scan is performed within five days of ictus, contrast enhancement is usually not required.
Time-resolved computed tomography angiography (4D-CTA) using a 320-row area detector CT scanner has recently been applied in the evaluation of cranial vascular disorders. However, application of 4D-CTA to spinal vascular disorder evaluation has never before been described. The authors herein report their initial experience of 4D-CTA in the evaluation of spinal arteriovenous fistulas (AVFs) and compare this novel modality with other imaging modalities. Four consecutive patients with spinal AVF underwent time-resolved contrast-enhanced magnetic resonance angiography (trMRA), 4D-CTA, and selective catheter angiography (CA). In 4D-CTA, volume data was transformed into 3D volume-rendered images and maximum intensity projection. These images were also evaluated by time-resolved serial phases. Then, images of each modality were compared, focusing on the detection of perimedullary draining veins and the prediction of AVF location and drainage flow direction. All modalities successfully detected perimedullary draining veins in all cases. Location of the AVF was detected in all cases by CA. trMRA and 4D-CTA detected the AVF in three out of the four cases. With regard to flow direction, while 4D-CTA successfully depicted ascending or descending drainage flow in the spinal canal, CA failed to detect the flow direction in one case while trMRA failed in two cases. In the case with epidural AVF, 4D-CTA was the only technique to detect the flow direction of perimedullary drainage. Although this is only an initial experience of the application of 4D-CTA to spinal vascular diseases, 4D-CTA was capable of detecting the dynamic vascular flow of spinal AVFs. The authors believe that 4D-CTA can be a useful option in the evaluation of spinal AVFs.
Our previous study showed that the sorption coefficient of certain polar pharmaceuticals to river sediment, especially particular amines, was unexpectedly high. Thus, we conducted sorption experiments of selected polar pharmaceuticals and pyrene derivatives, including amines, carboxylic acids, and neutral compounds, to model clay minerals, i.e., montmorillonite and kaolin, in addition to silica sands and humic substances. The contribution of each component was roughly estimated by simple fractionation of the individual sorption coefficients. Relatively high sorption coefficients (K values) were found, especially for amines on clay minerals, which suggest that electrochemical affinity may play an important role. The estimated contribution percentage suggests a relatively large contribution from inorganic constituents, such as clay minerals, for silt loam soil; in contrast, organic components predominantly contribute for sandy river sediments. These findings could be the key to understanding not only the fate and transport but also bioavailability and environmental risks of pharmaceuticals, which are mostly polar and/or ionizable.
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