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To evaluate embolization efficacy of pulmonary arteriovenous malformations (PAVM) using Amplatzer vascular plugs (AVP) and coils. Eighty-eight embolized simple PAVMs in 38 patients were retrospectively analyzed by follow-up CT. Mean age was 50.2 ± 15.6 years and 22 (57.9%) patients were females. Mean follow-up interval was 38.2 ± 28.4 months (median 29.9 months). Embolization devices included AVP I, AVP II, AVP 4, and coils. Technical success was defined as no visualization of an early draining vein at angiography after embolization. Treatment success was defined as complete disappearance or decrease in size of the venous aneurysm ≥ 70% at follow-up CT. Technical success rate was 100% and treatment success rate evaluated by CT for the various embolization strategies was 100% for AVP I (n = 6), 100% for AVP I + coils (n = 5), 83.3% for AVP II (n = 6), 40.0% for AVP II + coils (n = 5), 87.5% for AVP 4 (n = 8), 50.0% for AVP 4 + coils (n = 8), and 78.0% for coils alone (n = 50). No statistically significant difference in embolization efficacy was seen between different devices (P = 0.083). Although not statistically significant, combination use of coils with AVPs demonstrated lower rates of clinical embolization success (P = 0.053). Embolization of PAVMs demonstrated high technical and treatment success rates with available embolic devices. No significant statistical differences were demonstrated between AVPs. However, the need for both coils and AVPs may suggest a more complicated underlying lesion at risk for recurrence.

Pulmonary embolism (PE) is a cause of significant morbidity and mortality, with an estimated 600,000 cases of clinically significant PE in the United States annually, and roughly 200,000 deaths per annum directly attributable to PE. By far the most frequent cause of PE is deep vein thrombosis originating in the lower extremities, which travels to the pulmonary vasculature. The mainstay of treatment is anticoagulation, but multiple additional treatments exist for patients in whom anticoagulation is inadequate or contraindicated. The absolute indications for inferior vena cava (IVC) filtration are narrow, but many filters are placed in patients with relative indications. There is growing concern for overuse of IVC filters, with a relatively low rate of retrieval. It is essential for interventional radiologists to understand the appropriate and correct use and retrieval of IVC filters. Familiarity with placement techniques, protocols and techniques for retrieval, current and emerging technologies, and the clinical model for management of venous thromboembolism, will ensure that interventional radiologists remain an integral member of the care team for these often complex patients.

There are many possible mechanisms for innovation and bringing new technology into the marketplace. The Stanford Biodesign innovation process is based in a deep understanding of clinical unmet needs as the basis for focused ideation and development. By identifying and vetting a compelling unmet need, the aspiring innovator can "derisk" a project and maximize chances for successful development in an increasingly challenging regulatory and economic environment. As a specialty founded by tinkerers, with a history of disruptive innovation that has yielded countless new ways of delivering care with minimal invasiveness, lower morbidity, and lower cost, interventional radiologists are uniquely well positioned to identify unmet needs and develop novel solutions free of dogmatic convention.

Pulmonary embolism (PE) is a common and feared result of deep vein thrombosis. While anticoagulation is the mainstay of management, interruption of flow of thrombus from leg veins to the pulmonary circulation is frequently desired either in lieu of or in addition to anticoagulation. Inferior vena cava filters have become frequently used to prevent PE despite a paucity of evidence for efficacy and increasing concerns about the long-term complications of indwelling filters.

Twenty-five years ago, when this journal was initiated, imaging of movement disorders was in its infancy. Since that time, magnetic resonance imaging has become a standard technique that is routinely performed in patients with movement disorders in order to exclude secondary causes and in some instances to provide specific information that aids in making the diagnosis of a neurodegenerative condition. Transcranial sonography is a more recent advance and is now widely employed to aid in the diagnosis of Parkinson's disease and possibly in detecting individuals in the premotor phases of the disease. Investigations are currently under way to evaluate the value of this technique in other movement disorders.

I. INTRODUCTION Partnered lesbian women have substantially higher labor supply than married women (Leppel 2008; Tebaldi and Elmslie 2006). What might account for the sexual orientation gap in partnered female labor supply? Everyday conversation and casual empiricism suggests that partnered lesbian women have a stronger attachment to the labor market relative to married women because of their choice to have fewer children than their married counterparts; yet this has not been formally analyzed. The primary goal of this study is to determine the role observable characteristics, particularly children, play in explaining the differences in labor supply between partnered lesbian women and married women. While empirical research on the determinants of partnered lesbian women's labor supply is limited, (1) the determinants of married women's labor supply have been studied in great detail (see Blundell and MaCurdy 1999 for a survey of the literature). In general, married women's labor supply is found to be positively related to own wages, negatively related to spouse wages and nonlabor income, and negatively related to the presence of children, particularly young children, in the household. (2) Importantly, the same control variables are not found to have the same effect on married men's labor supply. In particular, men are not responsive to their wife's earnings and tend to have higher labor supply because of the presence of children. These findings are consistent with a traditional division of labor into market and household work which results in married men being viewed as the primary earners and married women being viewed as the secondary earners. (3) In particular, Becker (1981) argues that increasing returns from investments in specific human capital encourages a division of labor in market work and household work among household members. The sexual division of labor, however, arises from intrinsically different comparative advantages of men and women (e.g., in the production of children) which would determine the direction of the division of tasks by gender. This in turn leads to differences in specific human capital accumulation which reinforces the intrinsically different comparative advantages of men and women. Even in the face of rising female labor force participation, increased divorce rates, and lower fertility, male and female earnings would not be equalized (Becker 1985). Specifically, Becker argues that married women with household responsibilities (e.g., child care and food preparation) would expend less energy on market work, make lower investments in market-oriented human capital, face lower hourly earnings, and choose less demanding jobs/ occupations than married men (even when they work the same number of hours) because household responsibilities are time and effort intensive relative to leisure and other nonmarket uses of time by men. Moreover, married women would have lower labor force participation than their husbands because of the lower earnings they would face (because of less energy expended on market work and lower investments in market-oriented human capital) and a full equilibrium could involve complete specialization by married women in household production. Although married men have increased their time spent on child-care production, there is strong evidence that married women continue to spend more time on child-care production than their spouses (Bianchi, Robinson, and Milkie 2006; Drago and Lee 2008a, 2008b; Kalenkoski, Ribar, and Stratton 2005, 2007; Lundberg, Pabilonia, and Ward-Batts 2007). In addition, the sociology literature argues that married women are more likely to identify themselves in the context of family and market work while married men are more likely to identify themselves in the context of market work alone (see, e.g., Bielby and Bielby 1989). Finally, there is a large literature that tests the specialization hypothesis (Bardasi and Taylor 2008; Daniel 1992; Gray 1997; Hersch and Stratton 2000; Kenny 1983; Loh 1996; Stratton 2002). …

Using data from the 2000 U.S. Census, the authors explore two alternative explanations for the sexual orientation wage gap: occupational sorting, and human capital differences. They find that lesbian women earned more than heterosexual women irrespective of marital status, while gay men earned less than their married heterosexual counterparts but more than their cohabitating heterosexual counterparts. Results of a Oaxaca-Blinder decomposition indicate that the relative wage advantages observed for some groups of lesbians and gay men were mainly owing to greater levels of human capital accumulation (particularly education), while occupational sorting had little or no influence. The relative wage penalties that were observed in other cases, however, cannot be attributed either to differences in occupational sorting or to human capital. An analysis employing a DiNardo, Fortin, and Lemieux decomposition, which allows for variation in the wage gap at different points along the wage distribution, broadly confirms these results.

Large-caliber access to the arterial system is more frequently required in the age of thoracic endovascular aneurysm repair, endovascular aneurysm repair, and transaortic valve implantation. Frequently either anatomical or vessel size constraints preclude use of common access points such as the common femoral, radial, and brachial arteries. Alternative approaches include percutaneous access at alternate sites (subclavian, axillary, and carotid), open surgical access to the heart (left ventricular apex), open surgical access to large-caliber vessels (ascending aorta, subclavian, and axillary arteries, retroperitoneal access to the iliac artery or distal aorta), and novel percutaneous approaches (transvenous). Such approaches require additional skill sets, equipment, and, frequently, multidisciplinary teams to ensure safety and success. The techniques and approaches outlined in this article may allow expansion of endovascular treatments to greater patient populations and disease states than previously thought feasible.

Das Apert-Syndrom ist mit einer Pravalenz von 1:65.000 Lebendgeborenen eine seltene Erkrankung aus der Gruppe der Kraniosynostosesyndrome. Dem Apert-Syndrom liegt eine Mutation des fgfr2-Gens zugrunde. Eine pranatale Verdachtsdiagnose lasst sich bereits im 1. Trimester im Rahmen einer ausfuhrlichen Ultraschalldiagnostik gemas DEGUM (Deutsche Gesellschaft fur Ultraschall in der Medizin) Stufe II–III anhand der typischen Sonomorphologie stellen. An einer Kasuistik werden die typischen pranatalen Ultraschallbefunde, die molekulargenetische Diagnostik und die moglichen Probleme des postnatalen Verlaufs diskutiert. Die pranatale Diagnosesicherung tragt zu einer umfassenden Vorbereitung der Eltern auf die spater notwendige multidisziplinare Therapie bei.

We report a female newborn with characteristic signs of Antley-Bixler syndrome (ABS) such as midface hypoplasia, radiohumeral synostosis and multiple joint contractures. The newborn also presented ambiguous genitalia, stage Prader V, and congenital adrenal hyperplasia. The mother experienced midterm virilization due to a pregnancy luteoma. Her elevated androgen levels and virilization symptoms normalized post partum without treatment. The newborn had elevated serum testosterone and 17-OH-progesterone levels which remained elevated because of a 21-hydroxylase deficiency. The child's treatment in order of priority was: hydrocortisone substitution, craniofacial/skeletal anomaly management and surgical correction of the external genitalia. Mutations in the genes for fibroblast growth factor (FGF) 8 and receptors FGFR1, FGFR2, and FGFR3 were not detected. Conclusion A newborn girl with manifestations of the Antley-Bixler syndrome showed severe virilization probably caused by the association of a mild 21-hydroxylase deficiency and maternal hyperandrogenism due to a pregnancy luteoma. Abnormalities of androgen metabolism may be responsible for virilization reported in other cases of the Antley-Bixler syndrome.

Heterocyclic aromatic amines (HAs) are mutagenic compounds that are formed during heating of meat and fish. These substances are reaction products of creatine with amino acids and carbohydrates. It is recommended that exposure to these probable human carcinogens should be minimised. Five heterocyclic aromatic amines which occur in beef were investigated: 2-amino-3-methyl-imidazo[4,5-f]quinoline (IQ), 2-amino-3,4-dimethyl-imidazo[4,5-f]quinoline (MeIQ), 2-amino-3,8-dimethyl-imidazo[4,5-f]quinoxaline (MeIQx), 2-amino-3,4,8-trimethyl-imidazo[4,5-f]quinoxaline (4,8-DiMeIQx), and 2-amino-1-methyl-6-phenyl-imidazo[4,5-b]pyridine (PhIP). Clean-up was done by acid-base partition followed by SPE using blue cotton. HPLC analysis was carried out by using electrochemical detection for IQ- and IQx-type compounds and fluorescence detection for PhIP. The concentrations of the aromatic amines were as follows: IQ, 10.2 μg/kg; MeIQ, 2.46 μg/kg; MeIQx, 13.2 μg/kg; 4,8-DiMeIQx, 2.26 μg/kg; and PhIP, 5.48 μg/kg. The application of spices (rosemary, thyme sage, garlic, brine) reduced the content of the HAs below 60% of the amount found in the control.

Purpose: To determine efficacy and safety of latanoprost, a prostaglandin analog for glaucoma, during 1 year of treatment. Methods: After baseline measurements, 0.005% latanoprost was topically applied once daily for 12 months in patients from Scandinavia, the United Kingdom, and the United States who had elevated intraocular pressure (IOP). Diagnoses included ocular hypertension, chronic open-angle glaucoma, exfoliation syndrome, and pigment dispersion syndrome. Treatment was masked for the first 6 months and open-label during the second 6 months. Results: Of the 272 patients initially enrolled, withdrawals were due to inadequate IOP control (1 %), increased iris pigmentation (5%), other ocular problems (3%), systemic medical problems (3%), and nonmedical reasons (14%). Latanoprost significantly ( P Conclusion: Latanoprost safely and effectively reduces IOP for 1 year in patients of diverse nationalities, providing further evidence for its usefulness in chronic glaucoma therapy.

In this chapter we provide a brief overview of the main empirical tools used by economists to study international migration. We begin by exploring the three broad research areas that economists examine when researching immigration. We then explore the strengths and shortcomings of the standard methods, and highlight new methods that will likely become more common in future work in the field. We divide the most common tools used in the empirical literature into four broad categories: (1) Ordinary Least Squares and Inference, (2) Difference-in-Difference Estimation, (3) Instrumental Variables Techniques, and (4) Recent Developments and Distributional Estimators. We use recent empirical work to highlight and explain each method, and provide sources for researchers interested in further information on each topic.

The human cytomegalovirus (HCMV) is suspected to increase tumour malignancy by infection of cancer and/or stroma cells (oncomodulation). So far, oncomodulatory mechanisms have been attributed to the presence of HCMV and direct action of its gene products on cancer cells. Here, we investigated whether the prolonged presence of HCMV can result in the irreversible selection of a cancer cell population with increased malignancy. The neuroblastoma cell line UKF-NB-4 was long-term (200 passages) infected with the HCMV strain Hi91 (UKF-NB-4(Hi)) before virus eradication using ganciclovir (UKF-NB-4(HiGCV)). Global gene expression profiling of UKF-NB-4, UKF-NB-4(Hi) and UKF-NB-4(HiGCV) cells and subsequent bioinformatic signal transduction pathway analysis revealed clear differences between UKF-NB-4 and UKF-NB-4(Hi), as well as between UKF-NB-4 and UKF-NB-4(HiGCV) cells, but only minor differences between UKF-NB-4(Hi) and UKF-NB-4(HiGCV) cells. Investigation of the expression of a subset of five genes in different chronically HCMV-infected cell lines before and after virus eradication suggested that long-term HCMV infection reproducibly causes specific changes. Array comparative genomic hybridisation showed virtually the same genomic differences for the comparisons UKF-NB-4(Hi)/UKF-NB-4 and UKF-NB-4(HiGCV)/UKF-NB-4. UKF-NB-4(Hi) cells are characterised by an increased invasive potential compared with UKF-NB-4 cells. This phenotype was completely retained in UKF-NB-4(HiGCV) cells. Moreover, there was a substantial overlap in the signal transduction pathways that differed significantly between UKF-NB-4(Hi)/UKF-NB-4(HiGCV) and UKF-NB-4 cells and those differentially regulated between tumour tissues from neuroblastoma patients with favourable or poor outcome. In conclusion, we present the first experimental evidence that long-term HCMV infection can result in the selection of tumour cell populations with enhanced malignancy.

Using 2000 U.S. Census data we illustrate the importance of accounting for household specialization in lesbian couples when examining the sexual orientation gap in female labor supply. Specifically, we find the labor supply gap is substantially larger between married women and partnered lesbian women who specialize in market production (primary earners) than between married women and partnered lesbian women who specialize in household production (secondary earners). Using a semi-parametric decomposition approach, we further show that the role of children in explaining the mean labor supply gap by sexual orientation is greatly understated if the household division of labor between household and market production is not taken into account. Finally, we illustrate that controlling for children significantly reduces differences between married women and secondary lesbian earners both in terms of the decision to remain attached to the labor market (the extensive margin), as well as in terms of annual hours of work conditional on working (the intensive margin). Further, the effect of controlling for children is not uniform across the distribution of conditional annual hours; instead it primarily reduces the percentage of secondary lesbian earners working extremely high annual hours.

Using 2000 U.S. Census data we illustrate the importance of accounting for household specialization in lesbian couples when examining the sexual orientation gap in female labor supply. Specifically, we find the labor supply gap is substantially larger between married women and partnered lesbian women who specialize in market production (primary earners) than between married women and partnered lesbian women who specialize in household production (secondary earners). Using a semi-parametric decomposition approach, we further show that the role of children in explaining the mean labor supply gap by sexual orientation is greatly understated if the household division of labor between household and market production is not taken into account. Finally, we illustrate that controlling for children significantly reduces differences between married women and secondary lesbian earners both in terms of the decision to remain attached to the labor market (the extensive margin), as well as in terms of annual hours of work conditional on working (the intensive margin). Further, the effect of controlling for children is not uniform across the distribution of conditional annual hours; instead it primarily reduces the percentage of secondary lesbian earners working extremely high annual hours.

BACKGROUND AND PURPOSE: Jugular foraminal stenosis (JFS) or atresia (JFA) with collateral emissary veins (EV) has been documented in syndromic craniosynostosis. Disruption of EV during surgery can produce massive hemorrhage. Our purpose was to describe the prevalence of prominent basal emissary foramina (EF), which transmit enlarged EV, in syndromic craniosynostosis. Our findings were correlated with phenotypic and molecular diagnoses. METHODS: We reviewed the medical records and imaging examinations of 33 patients with syndromic craniosynostosis and known fibroblast growth factor receptor (FGFR) mutations. All patients underwent CT and 14 MR imaging. The cranial base was assessed for size of occipitomastoid EF and jugular foramina (JF). Vascular imaging studies were available from 12 patients. A control group (n = 76) was used to establish normal size criteria for JF and EF. RESULTS: Phenotypic classification included Crouzon syndrome (n = 10), crouzonoid features with acanthosis nigricans (n = 3), Apert syndrome (n = 10), Pfeiffer syndrome (n = 4), and clinically unclassifiable bilateral coronal synostosis (n = 6). EF ≥ 3 mm in diameter and JFS or JFA were identified in 23 patients with various molecular diagnoses. Vascular imaging in patients with JFS or JFA and enlarged EF revealed atresia or stenosis of the jugular veins and enlarged basal EV. JFA was seen in all patients with the FGFR3 mutation with crouzonoid features and acanthosis nigricans. Four patients had prominent EF without JFS. Six patients had normal JF and lacked enlarged EF. CONCLUSION: Enlarged basal EF are common in syndromic craniosynostosis and are usually associated with JFS or JFA. Bilateral basilar venous atresia is most common in patients with the FGFR3 ala391glu mutation and crouzonoid features with acanthosis nigricans, but may be found in patients with FGFR2 mutations. Skull base vascular imaging should be obtained in patients with syndromic craniosynostosis with enlarged EF.

A 26 year old woman with dopa responsive dystonia and cytogenetically confirmed Turner’s syndrome had bilateral globus pallidus hypointensity on brain MRI. Among the living members of a five generation pedigree the patient’s mother and the mother’s sister also had dopa responsive dystonia; a maternal grandfather had senile parkinsonism, his niece isolated postural tremor. No other family member had Turner’s syndrome. A new missense mutation in exon I of the gene of GTP-cyclohydrolase I was found in the three family members with dopa responsive dystonia. With levodopa substitution the patients with dopa responsive dystonia improved clinically as well as in quantitative tests on hand tapping, verbal and performance IQ, concept formation, and set shifting abilities. (J Neurol Neurosurg Psychiatry 1998;64:806‐808)

We performed a clinical and molecular genetic analysis in members of five families with dopa-responsive dystonia. Four mutations were detected in the gene GCH1 that codes for GTP cyclohydrolase I. Two of these mutations, a delG309 in exon 1 and a C544T transition in exon 5, have not been described before. They result in inactivation of the enzyme by truncation. The remaining two mutations, both A to G transitions, a(-2)g in intron 1 and a(-2)g in intron 2, cause truncation by abnormal splicing. The genotype of family members was correlated to their clinical phenotype (obtained before molecular analysis). Clinical symptoms observed in the families included generalized and focal dystonia, abnormal gait, and subtle signs such as an abnormal writing test. High penetrance (0.8-1.0) was observed in four of five families if minor symptoms and signs were considered. A given mutation was more likely to cause symptoms in females than in males, thus confirming the well-established higher incidence of dopa-responsive dystonia in females than in males.

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Introduction: Fetal subdural hematoma (SDH) is a rare event. With advances in obstetric ultrasound however it has been recognized that SDH may occur in utero before the onset of labor. We present a unique case of atraumatic SDH diagnosed in the second trimester. Case Report: A 31-year-old woman was referred to our institution for the investigation of a brain anomaly detected in an anomaly scan, at 22 weeks and 4 days of gestation. The woman had an uneventful pregnancy so far. A rounded hyperechogenic mass was detected in the posterior fossa, measuring about 2 cm, between the skull and the brain producing only a mild midline shift to the right. A strong suspicion of a fetal subdural hematoma was brought to mind among others. We suggested fetal brain MRI and this confirmed our suspicion of atraumatic spontaneous subdural hematoma of the posterior fossa. Medical consultation was given to the parents stating the scarcity of the condition and the poor prognosis that is referred to the literature. The parents chose the termination of the pregnancy, which took place with misoprostol leading to the delivery of a dead female fetus weighing 596 gr. The pathology report, confirmed the ultrasonographic and MRI diagnosis. Conclusion: Spontaneous fetal subdural hematoma is an extremely rare condition with a poor prognosis and it has never been reported before in literature to occur and be diagnosed at the time of the midtrimester scan. Ultrasound and other imaging techniques such as CT and MRI, and use of Doppler techniques for detecting cerebral hemodynamic abnormalities, might help in earlier diagnosis and perhaps lead to more accurate management and prognosis.

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A variety of retinal disease lead to a decrease in the sensitivity of the S (blue) cone pathways. To determine the possible sites and mechanisms of this loss we compared the sensitivities of an S (blue/pi-1) and an M (green/pi-4) cone pathway in patients with retinal diseases that differ as to their primary locus of sensitivity loss. The sensitivities of an S and an M cone pathway were assessed in patients with retinitis pigmentosa, insulin-dependent diabetes mellitus and open-angle glaucoma using Stiles two-color increment threshold technique. A greater loss in sensitivity of an S than an M cone pathway was found for all three disease groups; however, the diabetic patients showed a more selective loss. The results suggest that multiple sites are involved and that the combined effects of metabolic abnormalities and hypoxia contribute to the selective loss.

Covering both qualitative and quantitative topics, the expert contributors in this Handbook explore fundamental issues of scientific logic, methodology and methods, through to practical applications of different techniques and approaches in migration research.