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Federico Russo, Marco Valentini, Daniele Sabatino, Michele Cerati, Carla Facco, Paolo Battaglia, Mario Turri-Zanoni, Paolo Castelnuovo, and Apostolos Karligkiotis

manipulate respiratory mucosal surfaces, where the patient’s upper respiratory secretions are present 5 with a high viral load. 6 In particular, clinical examination of and diagnostic or surgical invasive procedures for the upper aerodigestive tract expose healthcare workers to direct transmission of SARS-CoV-2 via inhalation or ocular instillation of contaminated droplets, as well as to indirect transmission via contact with contaminated hands or surfaces. 7 The primary mode of viral transmission is droplet transmission, which refers to the spread of infection through

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Ajay K. Wakhloo, Baruch B. Lieber, Stephen Rudin, Mary Duffy Fronckowiak, Robert A. Mericle, and L. Nelson Hopkins

requirements. 17, 25 By substituting Ethiodol, a discrete droplet tracer, for the standard soluble angiographic contrast agent and by implementing high-speed biplane DSA we expect to improve the resolution of the AVM complex and the quantification of hemodynamic parameters, and ultimately to improve the precision, reproducibility, and success of AVM embolizations. Our preliminary results are summarized here. Clinical Material and Methods Patient Population Angiograms and embolizations were performed in 13 patients, eight females and five males aged 12 to 60 years

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Ajay K. Wakhloo, Baruch B. Lieber, Stephen Rudin, Mary Duffy Fronckowiak, Robert A. Mericle, and L. Nelson Hopkins

Successful therapeutic embolization of arteriovenous malformations (AVMs) of the brain with liquid polymers (glues) requires precise knowledge of highly variable AVM structure and flow velocities and transit times of blood through the AVM nidus. The goal of this study was to improve AVM flow measurement and visualization by the substitution of the insoluble Ethiodol (ethiodized oil) contrast agent for the soluble contrast media normally used in angiographic studies.

Before enbucrilate embolization of 24 AVM feeding pedicles in 13 patients, standard contrast medium was superselectively injected into each target pedicle, followed by infusion of 20 μl of Ethiodol microdroplets. Transport of contrast material was assessed using high-speed biplane pulsed digital subtraction angiography (DSA) operating at 15 frames per second.

The mean blood flow transit times through AVMs after administration of Ethiodol were found to be approximately half as long as in those measured after injection of soluble contrast materials (0.22 ± 0.10 seconds compared with 0.46 ± 0.19 seconds [mean ± standard deviation]; p < 0.0001). The discrete Ethiodol microdroplets travel with the core flow, more closely approximating the dynamic behavior of enbucrilate, allowing the AVM structure to be traced with high spatial and temporal resolution. There were no inadvertent vessel occlusions or pulmonary complications related to the use of Ethiodol for DSA.

Because of diffusion and convection, forces that decrease concentration, visualization of the contrast front is reduced, often resulting in deceptively long transit times when soluble contrast materials are used. Overestimation may prove dangerous when planning embolizations. The Ethiodol droplet DSA method provides accurate transit time measurements and precise, detailed, and dynamic AVM visualization. Further development of this method will improve the safety and precision of AVM treatments.

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Kanwaljeet Garg and Rajinder Kumar

D ermoid cysts represent a rare group of tumors manifesting predominantly in adulthood. Rupture is well described in intracranial dermoid tumors. However, rupture of an intraspinal dermoid into the central canal is uncommon and in most cases asymptomatic. 4 , 12 We report 3 unusual cases of lumbar spinal dermoid cysts with asymptomatic rupture and migration of free fat droplets into the central canal. Case Reports Case 1 History and Presentation This 19-year-old male patient, who had undergone surgery for treatment of a lumbosacral

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Thomas H. Milhorat, Fariborz Nobandegani, John I. Miller, and Chandrakant Rao

kaolin injection showing flattening of the ependymal epithelium and spongy changes with vacuolization in the subependymal glial sheath characteristic of edema. Right: Section obtained at 6 weeks showing marked flattening and denuding of the ependymal epithelium. Spongy changes are prominent in the subependymal glial sheath. After 3 weeks, there was increasing compression of the periependymal tissues associated with stretching of axons, fragmentation of myelin sheaths, and the formation of myelin droplets ( Fig. 7 ). These changes appeared to be confined to

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Sen Gao, Jeffrey Nelson, Shantel Weinsheimer, Ethan A. Winkler, Caleb Rutledge, Adib A. Abla, Nalin Gupta, Joseph T. Shieh, Daniel L. Cooke, Steven W. Hetts, Tarik Tihan, Christopher P. Hess, Nerissa Ko, Brian P. Walcott, Charles E. McCulloch, Michael T. Lawton, Hua Su, Ludmila Pawlikowska, and Helen Kim

functional network HumanNet. Evaluation of Sequencing Coverage We used ExomeCQA 33 to assess the coverage distributions of the sequencing reads in the study cohort, and we used bedtools to calculate the coverage files required. Cohort Coverage Sparseness was used to assess the coverage of all exons across the genome, and Unevenness was used to evaluate the coverage of a given exon across all samples. Digital Droplet Polymerase Chain Reaction For validation and replication, we assayed KRAS G12V and G12D by using commercially available digital droplet

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Sumio Uematsu

nerve was transplanted to repair the radial nerve. The chain of cold glue droplets outlines the area of total loss of sensation. The thermographic image and the blue glue droplets matched particularly well in the area of the heel of the foot, and less well toward the ankle joint.”

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Jeroen R. Coppens and Joseph E. Sherrill II

and subarachnoid fat droplets were present ( Fig. 1 ). Examination of computed tomography findings ruled out the diagnosis of spinal dysraphism. F ig . 1 Unenhanced T 1 -weighted sagittal MR images obtained in the cervical (A), thoracic (B), and lumbar (C) spine, demonstrating a conus medullaris lesion as well as multiple fat droplets in the subarachnoid spaces and in the intramedullary cervical region. F ig . 2 Unenhanced T 1 -weighted axial MR image obtained in the cervical spine, revealing an intramedullary fat droplet. A combined L-1

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James M. Powers, Stephen E. Rawe, and Garnett R. Earlywine

parietal lobes ( Fig. 1 ). There was blurring of the gray-white junction. The subcortical white matter also demonstrated petecchial hemorrhages and greenish discoloration. The left lateral ventricle was partially compressed; the basal ganglia were unremarkable. A single secondary hemorrhage (Duret) was also noted in the upper midbrain at the level of the red nucleus. The microscopic features of the edematous left cortical mantle consisted of perivascular, inspissated protein droplets, a few microglial cells, many reactive astrocytes, petecchial hemorrhages, acute

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Mark Lee, Hazel T. Rivera-Rosario, Matthew H. Kim, Gregory P. Bewley, Jane Wang, Zellman Warhaft, Bradley Stylman, Angela I. Park, Aoife MacMahon, Ashutosh Kacker, and Theodore H. Schwartz

need for appropriate personal protective equipment (PPE), which itself is not impervious. However, in conjunction with appropriate PPE, the antechamber described herein may significantly reduce the risk of intraprocedural infection of healthcare workers. The transmission of the novel coronavirus, SARS coronavirus 2 (SARS-CoV-2), by droplets is generally accepted. 19 Aerosol transmission, particularly in the context of aerosol-generating procedures, remains incompletely understood. Historically, many viruses do not behave in the simple dichotomous taxonomy of