A boundary scan design with embedded time-to-digital converter (TDCBS) has been proposed for testing small delay faults. In this paper, the TDCBS is applied for testing TSVs in 3D IC. To reduce test ...application time of the TDCBS, we propose a modified TAP controller that utilizes the bypass mode for reducing unnecessary scan shifts during observation of the captured results. The simulation for an experimental circuit is shown to evaluate the effectiveness of the proposed method.
The influence of neuronal activity on cortical axon branching was studied by imaging axons of layer 2/3 neurons in organotypic slice cultures of rat visual cortex. Upper layer neurons labeled by ...electroporation of plasmid encoding yellow fluorescent protein were observed by confocal microscopy. Time-lapse observation of single-labeled axons showed that axons started to branch after 8-10 d in vitro. Over the succeeding 7-10 d, branch complexity gradually increased by both growth and retraction of branches, resulting in axon arbors that morphologically resembled those observed in 2- to 3-week-old animals. Electrophysiological recordings of neuronal activity in the upper layers, made using multielectrode dishes, showed that the frequency of spontaneous firing increased dramatically approximately 10 d in vitro and remained elevated at later stages. To examine the involvement of spontaneous firing and synaptic activity in branch formation, various blockers were applied to the culture medium. Cultures were silenced by TTX or by a combination of APV and DNQX but exhibited a homeostatic recovery of spontaneous activity over several days in the presence of blockers of either NMDA-type or non-NMDA-type glutamate receptors alone. Axonal branching was suppressed by TTX and AMPA receptor blockade but not by NMDA receptor blockade. We conclude that cortical axon branching is highly dynamic and that neural activity regulates the early developmental branching of upper layer cortical neurons through the activation of AMPA-type glutamate receptors.
We report a case in which a central venous catheter (CVC) misplaced in the vertebral artery during insertion was surgically removed. A 70-year-old man was suspected of having a pancreatic abscess ...based on computed tomography (CT). The patient was initially treated for it at another department. Moreover, as part of the treatment, the CVC was placed under echocardiographic guidance. However, while placing the CVC, the catheter was erroneously inserted into the vertebral artery; therefore, he was referred to our department for retrieval. Magnetic resonance imaging (MRI) showed right thalamic and occipital cerebral infarctions. CT angiography (CTA) demonstrated that the catheter was inserted approximately 5 mm distal to the bifurcation of the brachiocephalic and vertebral arteries, and the catheter tip was located in the brachiocephalic artery. Removing the catheter posed risks such as hemorrhage, cerebral embolism, and arteriovenous fistulas. Therefore, to prevent the aforementioned risks, we chose a surgical intervention to remove the catheter using a microscope. The postoperative course was uneventful, and no complications occurred. This case demonstrates that surgical removal of CVC is effective and should be considered to avoid the risk of complications.
During development, axon branching is influenced by sensory-evoked and spontaneous neural activity. We studied the molecular mechanism that underlies activity-dependent branch formation at ...horizontally elongating axons (horizontal axons) in the upper cortical layers, focusing on Rho family small GTPases. Axonal labeling with enhanced yellow fluorescent protein showed that horizontal axons formed several branches in organotypic slice cultures. This branch formation was considerably increased by introducing constitutively active RhoA and was slightly inhibited by dominant-negative RhoA. Activators and inhibitors of endogenous RhoA signaling also promoted and inhibited branching, respectively. Daily imaging of horizontal axon growth further demonstrated that constitutively active RhoA increased the dynamic addition and loss of branches. Moreover, the amount of active RhoA relative to the total amount of RhoA was examined by a pull-down assay in cortical slices treated with sodium channel or glutamate receptor blockers to reduce neural activity. Activity blockade significantly decreased active RhoA compared with normal culture conditions, in which spontaneous firing is prominent. These findings suggest that RhoA signaling acts as a positive regulator for activity-dependent axon branching in cortical neurons.
We report a rare case of a small-bowel lymphangioma causing massive gastrointestinal （GI） bleeding that we successfully diagnosed and treated using double-balloon enteroscopy （DBE）. An 81-year-old ...woman suffering from repeated GI bleeding of unknown origin underwent a capsule endoscopy at a previous hospital. She was suspected of having bleeding from the jejunum, and was referred to our department for diagnosis and treatment. An oral DBE revealed a 20 mm × 10 mm, regularly surfaced, white to yellowish, elongated, pedunculated jejunal polyp with small erosions at 10 cm distal to the ligament of Treiz. Since no other source of bleeding was identified by endoscopy in the deep jejunum, anendoscopic polypectomy （EP） was performed for this lesion. A subsequent histopathological examination of the resected polyp showed clusters of lymphatic vessels with marked cystic dilatation in the submucosa and the deep layer of the lamina propria mucosae. These characteristics are consistent with the typical features of small-bowel lymphangioma with erosions. Although clip-ping hemostasis was performed during EP, re-bleeding occurred. Finally, a complete hemostasis was achieved by performing an additional argon plasma coagulation.
This study investigated the frequency of poor outcome at discharge of acute subdural hematoma (SDH) patients with and without microbleeds. We retrospectively examined the records of 37 patients with ...acute SDH who were surgically treated with hematoma removal and received magnetic resonance (MR) imaging within 2 weeks of head injury onset. MR images were used to determine the presence or absence of microbleeds and contusional hemorrhage (CH). Patient outcome was categorized as good (moderate disability or good recovery) or poor (severely disability, vegetative state, or dead) according to the Glasgow Outcome Scale at discharge. Microbleeds were found in 23 patients (62%) and CH was found in 26 patients (70%). Fifteen patients (41%) had both microbleeds and CH. Poor outcome at discharge was more common in SDH patients with both microbleeds and CH than in SDH patients with neither microbleeds nor CH (14/15, 93% vs. 14/22, 64%; p = 0.04). Poor outcome at discharge was more common in SDH patients under 60 years of age with microbleeds (6/8, 75%) than patients under 60 years of age without microbleeds (0/4, 0%; p = 0.03). The location of the microbleed was not related to the outcome at discharge. These results suggest that the presence of microbleeds and CH on MR images may indicate poor prognosis in patients with acute SDH.
Objective: In this report, three patients with cervical internal carotid artery dissection (cICAD) successfully treated with stenting are presented, and the relevant literature is discussed.Case ...Presentations: Case 1: A 47-year-old man developed dysarthria, right facial palsy, right paresthesia, and left photophobia lasting for half an hour. MRI showed no new infarction, but angiography demonstrated a severe high cervical internal carotid artery (ICA) stenosis with a false lumen. He underwent stenting on the 9th day, and the lesion disappeared completely. His postoperative course was uneventful, and no recurrence has been observed to date. Case 2: A 34-year-old man noted episodes of mild headache and a transient left visual field defect and was brought to the hospital by ambulance. Initial diffusion-weighted MRI showed left ICA occlusion. Although his symptoms improved with iv rt-PA, global aphasia and right hemiparesis occurred after 4 h. Since his emergent DSA showed left cICAD with nearly complete occlusion, he underwent stenting. His symptoms improved dramatically, and he recovered fully in 3 months. Case 3: A 63-year-old man developed two transient episodes of mild right hemiparesis. Due to his recurrent symptoms, DSA was performed, and dissection was found at left cervical ICA of C1 level. Endovascular intervention with a stent was conducted, and no recurrence has been observed to date.Conclusion: Endovascular intervention using stent may play an important role in patients with cICAD having severe stenosis or recurrent ischemic stroke.
Background and Importance. Subependymoma occurs very rarely in the spinal cord. We report another case of spinal subependymoma along with a review of the literature and discussion of a radiological ...finding that is useful for preoperative diagnosis of this tumor. Clinical Presentation. A 51-year-old man presented with a 2-year history of progressive muscle weakness in the right lower extremity. Sagittal magnetic resonance imaging (MRI) showed spinal cord expansion at the Th7–12 vertebral level. Surgical resection was performed and the tumor was found to involve predominantly subpial growth. Histological diagnosis was subependymoma, classified as Grade I according to criteria of World Health Organization. We made an important discovery of what seems to be a characteristic appearance for spinal subependymoma on sagittal MRI. Swelling of the spinal cord is extremely steep, providing unusually large fusiform dilatation resembling a bamboo leaf. We have termed this characteristic MRI appearance as the “bamboo leaf sign.” This characteristic was apparent in 76.2% of cases of spinal subependymoma for which MRI findings were reported. Conclusion. The bamboo leaf sign on spinal MRI is useful for differentiating between subependymoma and other intramedullary tumors. Neurosurgeons encountering the bamboo leaf sign on spinal MRI should consider the possibility of subependymoma.
Objective: A case of iatrogenic dural arteriovenous fistula that occurred during embolization of a feeding artery for transverse sinus (TS) dural arteriovenous fistula is reported.Case Presentation: ...A 66-year-old woman suddenly noted pain of the left temporal region and nausea and was emergently transported to our hospital. CT of the head showed left subcortical hemorrhage, and DSA demonstrated a dural arteriovenous fistula at the left TS. Although embolization of the feeding artery was attempted via the middle meningeal artery (MMA), a middle meningeal arteriovenous fistula (MMAVF) developed as the MMA was damaged by intraoperative balloon inflation. The MMA was immediately embolized together with the fistulous opening using n-butyl-2-cyanoacrylate (NBCA) and coils, and no sequelae were observed postoperatively.Conclusion: We experienced dural arteriovenous fistula caused by injury of the feeding artery during endovascular treatment. It must be remembered that iatrogenic arteriovenous fistula is a complication of endovascular treatment that is rare but requires attention.
Background: Chronic encapsulated intracerebral hematoma (CEIH) is one type of intracerebral hematoma that sometimes grows progressively while forming a capsule and presenting with neurological ...deficits. Although many cases of CEIH have been reported, correct preoperative diagnosis is very difficult. Only around 20% of cases are diagnosed preoperatively. Case Description: We encountered three cases of CEIH in which causes were unidentified and difficult to diagnose. All three cases were treated surgically. In the first case, a 59-year-old male was diagnosed preoperatively with metastatic brain tumor. In the second case, a 62-year-old female was diagnosed preoperatively with glioblastoma. The third case involved a 58-year-old female diagnosed preoperatively with CEIH. Conclusion: We should keep in mind that CEIH is a differential diagnosis for intracerebral space-occupying lesions. This report describes these three cases and discusses imaging findings and characteristics of CEIH.
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