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2012

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Articles 181 - 210 of 1392

Full-Text Articles in Medical Specialties

Activation Of Amp-Activated Protein Kinase By 3,39-Diindolylmethane (Dim) Is Associated With Human Prostate Cancer Cell Death In Vitro And In Vivo, Di Chen, Sanjeev Banerjee, Qiuzhi C. Cui, Dejuan Kong, Fazlul H. Sarkar, Q. Ping Dou Oct 2012

Activation Of Amp-Activated Protein Kinase By 3,39-Diindolylmethane (Dim) Is Associated With Human Prostate Cancer Cell Death In Vitro And In Vivo, Di Chen, Sanjeev Banerjee, Qiuzhi C. Cui, Dejuan Kong, Fazlul H. Sarkar, Q. Ping Dou

Oncology Faculty Publications

There is a large body of scientific evidence suggesting that 3,39-Diindolylmethane (DIM), a compound derived from the digestion of indole-3-carbinol, which is abundant in cruciferous vegetables, harbors anti-tumor activity in vitro and in vivo. Accumulating evidence suggests that AMP-activated protein kinase (AMPK) plays an essential role in cellular energy homeostasis and tumor development and that targeting AMPK may be a promising therapeutic option for cancer treatment in the clinic. We previously reported that a formulated DIM (BR-DIM; hereafter referred as B-DIM) with higher bioavailability was able to induce apoptosis and inhibit cell growth, angiogenesis, and invasion of prostate cancer cells. …


Librarians Collaborate To Touch The Lives Of Patients Through Community Pediatricians, Keri Swaggart, Nancy Allen Oct 2012

Librarians Collaborate To Touch The Lives Of Patients Through Community Pediatricians, Keri Swaggart, Nancy Allen

Posters

MCMLA 2012 Annual Meeting Presentation


Enhancing Resident Education By Empowering The Learner Through The Creation Of Smartphone Applications, Christine W. Du Md, Dale A. Dangleben Md, Judith A. Olenwine Ms, C-Tagme, Michael M. Badellino Md Oct 2012

Enhancing Resident Education By Empowering The Learner Through The Creation Of Smartphone Applications, Christine W. Du Md, Dale A. Dangleben Md, Judith A. Olenwine Ms, C-Tagme, Michael M. Badellino Md

Department of Surgery

No abstract provided.


Radiation Therapy For Locally Recurrent Breast Cancer., Joshua Siglin, Colin E Champ, Yelena Vakhnenko, Pramila R Anne, Nicole L Simone Oct 2012

Radiation Therapy For Locally Recurrent Breast Cancer., Joshua Siglin, Colin E Champ, Yelena Vakhnenko, Pramila R Anne, Nicole L Simone

Department of Radiation Oncology Faculty Papers

Approximately one-third of all breast cancer patients experience local recurrence of their tumor after initial treatment. As initial treatment often employs the use of radiation therapy (RT), the standard of care for local breast cancer recurrence after initial breast conserving therapy has traditionally been surgical intervention with mastectomy. However, recent attempts to preserve the intact breast after recurrence with local excision have revealed a potential need for RT in addition to repeat breast conserving surgery as rates of local failure with resection alone remain high. Additionally, local recurrence following initial mastectomy and chest wall RT can be treated with reirradiation …


Prevalence And Determinants Of Human Papillomavirus Infection And Cervical Lesions In Hiv-Positive Women In Kenya, H De Vuyst, N R. Mugo, M H. Chung, K P. Mckenzie, E Nyongesa-Malava, V Tenet, J W. Njoroge, S R. Sakr, C Jlm Meijer, P Jf Snijders, Farzana Rana, S Franceschi Oct 2012

Prevalence And Determinants Of Human Papillomavirus Infection And Cervical Lesions In Hiv-Positive Women In Kenya, H De Vuyst, N R. Mugo, M H. Chung, K P. Mckenzie, E Nyongesa-Malava, V Tenet, J W. Njoroge, S R. Sakr, C Jlm Meijer, P Jf Snijders, Farzana Rana, S Franceschi

Pathology, East Africa

Background: We assessed the association of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) with various characteristics, CD4 count and use of combination antiretroviral therapy (cART) among HIV-positive women.

Methods: Cross-sectional study of 498 HIV-positive women who underwent HPV PCR-based testing, cytology, and systematic cervical biopsy.

Results: In all, 68.7% of women were HPV-positive, 52.6% had high-risk (hr) HPV, and 40.2% multiple type infections. High-risk human papillomavirus-positivity did not vary significantly by age but it was negatively associated with education level. The most frequent types in 113 CIN2/3 were HPV16 (26.5%), HPV35 (19.5%), and HPV58 (12.4%). …


Clostridium Septicum Growth From A Total Knee Arthroplasty Associated With Intestinal Malignancy: A Case Report, Demetri M. Economedes, Jerome Santoro, Carl A. Deirmengian Oct 2012

Clostridium Septicum Growth From A Total Knee Arthroplasty Associated With Intestinal Malignancy: A Case Report, Demetri M. Economedes, Jerome Santoro, Carl A. Deirmengian

PCOM Scholarly Works

BACKGROUND: Previous reports of infection with Clostridium septicum have identified an unexpected association with concurrent malignancy. The reported rate of associated malignancy has been found to be as high as 81 percent. The purpose of this case report was to present a case of a total knee arthroplasty infected with C. septicum and the subsequent finding of an occult colonic malignancy.

CASE PRESENTATION: A 74 year-old man underwent uneventful bilateral total knee arthroplasties. Two weeks post-operatively, he presented with acute swelling, redness and pain of the left knee. Aspiration of the knee was sent for cell count and …


A Descriptive Study Of Childhood Cancer Statistics: Montgomery County, Jamie L. Hartig Oct 2012

A Descriptive Study Of Childhood Cancer Statistics: Montgomery County, Jamie L. Hartig

Master of Public Health Program Student Publications

Objective: This research describes childhood cancer and identifies variances in childhood cancer statistics in the United States, Ohio, and Montgomery County.

Methods: This is a descriptive analysis of childhood cancer statistics using the Ohio Cancer Incidence Surveillance System (OCISS) (Ohio Department of Health, 2010) and CDC Wonder database (United States Department of Health and Human Services [USDHHS], Centers for Disease Control and Prevention [CDC], & National Cancer Institute [NCI], 2008 & 2011.) Cancer incidences between white children and black children were compared for the years 1999-2009. The OCISS database was also used to compare vital status by race, cancer stage …


Invisible Chronic Illness: Invisible Is Not Imaginary, Rebecca L. Tadlock-Marlo Oct 2012

Invisible Chronic Illness: Invisible Is Not Imaginary, Rebecca L. Tadlock-Marlo

Faculty Research & Creative Activity

The need for counselors to be versed in various areas of multicultural counseling is a requirement to the profession (ACA Code of Ethics, 2005). Providing a basis of counselor knowledge in dealing with the various areas of multiculturalism is necessary to revolutionize how we are able to help clients with various life stories. One of the goals within the ACA standards is to help navigate a sense of empowerment for such clients. Counselors must promote holistic wellness in the often challenging social, emotional, cognitive, and spiritual path of comeback. With the rise in invisible chronic physical conditions, the importance of …


Mongolian Women's Voices: A Case Study On Maternal Healthcare, Pregnancy, And Birth In Ulaanbaatar's Public Hospitals, Amelia Olmsted Oct 2012

Mongolian Women's Voices: A Case Study On Maternal Healthcare, Pregnancy, And Birth In Ulaanbaatar's Public Hospitals, Amelia Olmsted

Independent Study Project (ISP) Collection

Mongolia is a country undergoing an incredible amount of change. Last year, in 2011, they had the fastest growing economy in the world, with a 17.2% increase in their GDP, according to the World Bank. A mere 22 years ago, Mongolia was a communist country, and today they are a parliamentary democracy. The country has opened itself up to the rest of the world and a free market economy, and experienced a very drastic shift in this direction in the early 1990's. Many Mongolians will tell you that the mindset of Mongolia's citizens has made a drastic shift since communism …


Awareness Of Type Ii Diabetes In The Developing World: Case Study In Binh Du’O’Ng, Vietnam, Anna Hong Le Oct 2012

Awareness Of Type Ii Diabetes In The Developing World: Case Study In Binh Du’O’Ng, Vietnam, Anna Hong Le

Independent Study Project (ISP) Collection

Vietnam’s rapid economic development after 1986 forever changed the lifestyle of the Vietnamese. Economic development has highly impacted behavior, “changing from a traditional lifestyle to an industrial lifestyle [increasing] noncommunicable diseases (NCDs) : diabetes, overweight, high blood pressure, and high cholesterol disorders” (Danh, Personal Interview). With the increase of NCDs within the country, it is important to focus on awareness education that motivates the population especially those living in the urban sector to practice healthy behaviors. This study project focuses on the evaluating the reach and effectiveness of current diabetes awareness educational materials. One week was spent in Ha Noi, …


Com Outlook Fall 2012, College Of Osteopathic Medicine Oct 2012

Com Outlook Fall 2012, College Of Osteopathic Medicine

COM Outlook

No abstract provided.


Gender Differences In The Developmental Outcomes Of Children With Congenital Cardiac Defects, Annette Majnemer, Catherine Limperopoulos, Michael Shevell, Charles Rohlicek, Bernard Rosenblatt, Chirsto Tchervenkov Oct 2012

Gender Differences In The Developmental Outcomes Of Children With Congenital Cardiac Defects, Annette Majnemer, Catherine Limperopoulos, Michael Shevell, Charles Rohlicek, Bernard Rosenblatt, Chirsto Tchervenkov

Pediatrics Faculty Publications

Objective: This study compares the developmental and functional outcomes at school entry between boys and girls born with a congenital cardiac defect who required early surgical correction.

Study design: A prospective cohort of 94 children, including 49 percent boys, were followed up to 5 years of age and assessed for developmental progress. Developmental measures included Wechsler Preschool and Primary Scale of Intelligence – cognitive; Peabody Picture Vocabulary Test – receptive language; Peabody Developmental Motor Scale – motor; and Child Behaviour Checklist – behaviour. Measures of function included the Vineland Adaptive Behavior Scale and Functional Independence Measure for Children (WeeFIM).

Results: …


Civilian Trauma Care - Learning From The Military Experience, Vivian Mcalister Oct 2012

Civilian Trauma Care - Learning From The Military Experience, Vivian Mcalister

Data and Test Instruments

In the 21st century, military and civilian trauma surgeons bring similar solutions to similar problems, learning one from another. The objective of this presentation is to review military trauma care in Afghanistan for aspects that may influence civilian practice at home. • Comprehensive trauma care system: guidelines, registry, review • Protocols for care: damage control; massive blood transfusion policy; mass casualty care • Techniques: resuscitative thoracotomy; decompressive craniectomy; pelvic-gluteal hemorrhage control • Rehabilitation: Mild traumatic brain injury • Delegated medical acts: medics / PAs


Achieving Consensus On Measure-Driven Child Health Quality: Maine’S Improving Health Outcomes For Children Initiative, Martha Elbaum Williamson Mpa, Nargiza Fuzailova Md, Mph, Kimberley S. Fox Mpa Oct 2012

Achieving Consensus On Measure-Driven Child Health Quality: Maine’S Improving Health Outcomes For Children Initiative, Martha Elbaum Williamson Mpa, Nargiza Fuzailova Md, Mph, Kimberley S. Fox Mpa

Population Health & Health Policy

This brief describes Maine’s process for selecting child health quality measures, including identified strengths and limitations of the CHIPRA core measures that led to the inclusion of additional state-specific measures and the factors considered for selection. Subsequent articles will describe how measures have been implemented and used to improve child health quality and how they have been integrated into systems of care (e.g. health information technology systems, policy changes).


Laparoscopic Splenectomy For Haematological Disorder: Our Experience, Hasnain Zafar, Aamir Hameed, Amyn Pardhan, Ghulam Murtaza, Samia Mazahir Oct 2012

Laparoscopic Splenectomy For Haematological Disorder: Our Experience, Hasnain Zafar, Aamir Hameed, Amyn Pardhan, Ghulam Murtaza, Samia Mazahir

Section of General Surgery

Laparoscopic splenectomy has universal acceptance due to less morbidity and decreased incidence of per-operative and postoperative complication. It is not a popular procedure in Pakistan due to technical challenges. Here, we are presenting our experience of laparoscopic splenectomy for haematological disorders at Aga khan university hospital. A total of seven cases, underwent elective laparoscopic splenectomy for haematological disorders. The operative time was less than 3 hours with minimal blood loss with rapid and uneventful recovery. There was no procedure related morbidity or mortality; however, one patient expired due to overwhelming post splenectomy sepsis.Our initial report highlights the safety of laparoscopic …


Early Abnormal Sponteneous Activity Findings In Axonal Variant Of Guillain Barre Syndrome: Is This A New Variant Of Guillain Barre Syndrome?, Ghulam Shabbir Dr., Asad Ullah Dr., M.A. Lakhair Dr., Ali Majid Dr., Emran Rashid Dr. Oct 2012

Early Abnormal Sponteneous Activity Findings In Axonal Variant Of Guillain Barre Syndrome: Is This A New Variant Of Guillain Barre Syndrome?, Ghulam Shabbir Dr., Asad Ullah Dr., M.A. Lakhair Dr., Ali Majid Dr., Emran Rashid Dr.

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.


Acute Quadriparesis Due To Acute Demyelinating Polyneuropathy In A Patient Newly Diagnosed As Acase Of B -Cell Lymphoma- An Unusual Presentation. A Case Report With Review Of Literature, Anjum Akhtar, Sarwar Jamil Siddiqui Oct 2012

Acute Quadriparesis Due To Acute Demyelinating Polyneuropathy In A Patient Newly Diagnosed As Acase Of B -Cell Lymphoma- An Unusual Presentation. A Case Report With Review Of Literature, Anjum Akhtar, Sarwar Jamil Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.


Transfusion Therapy As A Sole Treatment Option In A Thalassemia Patient With Acute Paraplegia – A Case Report And Review Of Literature, Sana Rashid Oct 2012

Transfusion Therapy As A Sole Treatment Option In A Thalassemia Patient With Acute Paraplegia – A Case Report And Review Of Literature, Sana Rashid

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.


The Effects Of Supplemental Fish Oil On Blood Pressure And Morning Cortisol In Normotensive Adults: A Pilot Study, Eric E. Noreen, Josef Brandauer Oct 2012

The Effects Of Supplemental Fish Oil On Blood Pressure And Morning Cortisol In Normotensive Adults: A Pilot Study, Eric E. Noreen, Josef Brandauer

Health Sciences Faculty Publications

Purpose: To determine the effects of 6wk of supplementation with fish oil (FO) on blood pressure and the morning salivary cortisol concentration in normotensive adults.

Methods: Testing was performed following an overnight fast. Subjects (n=40; 35+/-13y, mean+/-SD) rested supine for 40 min, at which time blood pressure and heart rate were measured. Saliva was collected and analyzed for cortisol. Subjects were then randomly assigned to either: 4g/d of Safflower Oil (SO); pr 4g/d of FO supplying 1,600mg/d eicosapentaenoic acid and 800mg/d docosahexaenoic acid. Testing was repeated following 6wk treatment.

Results: Compared to SO, there was a significant decrease …


Nucleic Acid And Non-Nucleic Acid-Based Reprogramming Of Adult Limbal Progenitors To Pluripotency, Sowmya Parameswaran, Sudha Balasubramanian, Norbert Babai, Carolina B. Deldebbio, Donald W. Harms, Channabasavaiah B. Gurumurthy, Mahendra S. Rao, J. Graham Sharp, Iqbal Ahmad Oct 2012

Nucleic Acid And Non-Nucleic Acid-Based Reprogramming Of Adult Limbal Progenitors To Pluripotency, Sowmya Parameswaran, Sudha Balasubramanian, Norbert Babai, Carolina B. Deldebbio, Donald W. Harms, Channabasavaiah B. Gurumurthy, Mahendra S. Rao, J. Graham Sharp, Iqbal Ahmad

Journal Articles: Ophthalmology

Reprogramming somatic cells to a pluripotent state by nucleic acid based (NAB) approaches, involving the ectopic expression of transcription factors, has emerged as a standard method. We recently demonstrated that limbal progenitors that regenerate cornea are reprogrammable to pluripotency by a non-NAB approach through simple manipulation of microenvironment thus extending the possible therapeutic use of these readily accessible cells beyond the proven treatment of corneal diseases and injury. Therefore, to determine the validity and robustness of non-cell autonomous reprogramming of limbal progenitors for a wider clinical use, here, we have compared their reprogramming by non-NAB and NAB approaches. We observed …


Evaluation Of A Mechanical Ventilator Education Program For Intern Physicians In An Intensive Care Nursery, William Bucher, Brian Glynn Oct 2012

Evaluation Of A Mechanical Ventilator Education Program For Intern Physicians In An Intensive Care Nursery, William Bucher, Brian Glynn

Division of Pulmonary, Allergy, and Critical Care Medicine Posters

Background: Thomas Jefferson University Hospital is a large urban Academic Medical Center with a level III Intensive Care Nursery (ICN). A new group of pediatric interns rotate through the ICN every year and receive limited education on mechanical ventilation. We developed a live, one hour training session performed by a Respiratory Therapist and a Respiratory Challenge Test to be completed by the physicians before and after each session. Clinical training was defined as routine training acquired during daily rotation in the ICN. We hypothesized that classroom and clinical training would be more effective than clinical training alone.

Method: After a …


Experience Of Caregivers With The Survivors Of Hepatitis C, Noureen Shehzad Jiwani, Raisa B. Gul, Rubina Sultan Oct 2012

Experience Of Caregivers With The Survivors Of Hepatitis C, Noureen Shehzad Jiwani, Raisa B. Gul, Rubina Sultan

School of Nursing & Midwifery

Objectives: To assess and describe the experiences of those caring for hepatitis C patients in Karachi, Pakistan.

Methods: Using a qualitative approach, the study adopted a descriptive exploratory design for which 8 caregirers were selected through snowball sampling technique from different parts of Karachi. Data was collected between May and July 2010 through semi-structured interviews from the caregivers. The interviews were recorded on tape and were transcribed verbatim. The data was manually analysed for extracting themes and categories.

Results: The analyses of data led to one theme - \'deadly, dangerous, and devastating. Two associated categories could also be noted: \'perceptions …


Real-Time Analysis Of Brain Tumor Cell Dynamics: Novel Thermoelectric Detection Of L-Glutamate And Cell Metabolism Using Microfluidics, Siva Mahesh Tangutooru Oct 2012

Real-Time Analysis Of Brain Tumor Cell Dynamics: Novel Thermoelectric Detection Of L-Glutamate And Cell Metabolism Using Microfluidics, Siva Mahesh Tangutooru

Doctoral Dissertations

This study describes the design, fabrication and applications of a novel thermoelectric microfluidic bio-sensor. The bio-sensor is used for real time detection of the L-glutamate (L-glu) dynamics and metabolism for brain tumor cells immobilized in a microfluidic device. The microfluidic device is fabricated using a polymer/glass laminating technique (Xurography). An antimony-bismuth thin-film thermopile (primary sensing element) is integrated to the microfluidic device. The brain tumor cells are immobilized over the thermopile covering measuring and reference junctions of the thermopile using a poly-l-lysine coating layer. L-glutamate oxidase (L-GLOD) is immobilized over the measuring junctions of the thermopile prior to the immobilization …


The Cutting Edge Fall 2012, Wright State University Department Of Surgery Oct 2012

The Cutting Edge Fall 2012, Wright State University Department Of Surgery

The Cutting Edge Newsletter

An eight page newsletter created by the Department of Surgery documenting current affairs of the department. This issue highlights the arrival of two new faculty members, upcoming special lectures, alumni news, and more.


Infliximab Dose Rounding Pratices In Pediatric Inflammatory Bowel Disease, Kelly C. Sandberg, Benjamin H. Shpeen, Sally J. Eder, Muhammad Dhanani, Sarah J. Clark, Gary L. Freed, Jeremy Adler Oct 2012

Infliximab Dose Rounding Pratices In Pediatric Inflammatory Bowel Disease, Kelly C. Sandberg, Benjamin H. Shpeen, Sally J. Eder, Muhammad Dhanani, Sarah J. Clark, Gary L. Freed, Jeremy Adler

Pediatrics Faculty Publications

Infliximab (IFX) is commonly used to treat Inflammatory Bowel Disease (IBD). IFX is supplied in 100mg vials and remains expensive. Dosing usually starts at 5mg/kg, and is commonly rounded up or down. The scope of dosing practices is unknown. Under-dosing may place patients at risk for exacerbation of IBD. Over-treatment potentially carries increased risk of infectious and malignant complications. We aimed to characterize IFX dosing practices among pediatric IBD practitioners participating in the ImproveCareNow Network.


Building A Computer Program To Support Children, Parents, And Distraction During Healthcare Procedures, Kirsten Hanrahan, Ann Marie Mccarthy, Charmaine Kleiber, Kaan Ataman, W. Nick Street, M. Bridget Zimmerman, Annel L. Ersig Oct 2012

Building A Computer Program To Support Children, Parents, And Distraction During Healthcare Procedures, Kirsten Hanrahan, Ann Marie Mccarthy, Charmaine Kleiber, Kaan Ataman, W. Nick Street, M. Bridget Zimmerman, Annel L. Ersig

Business Faculty Articles and Research

This secondary data analysis used data mining methods to develop predictive models of child risk for distress during a healthcare procedure. Data used came from a study that predicted factors associated with children's responses to an intravenous catheter insertion while parents provided distraction coaching. From the 255 items used in the primary study, 44 predictive items were identified through automatic feature selection and used to build support vector machine regression models. Models were validated using multiple cross-validation tests and by comparing variables identified as explanatory in the traditional versus support vector machine regression. Rule-based approaches were applied to the model …


Non-Compaction Of The Left Ventricle And Associated Ventricular Septal Defect., Abid Laghari, Javed Tai, Sumaira Saleem Oct 2012

Non-Compaction Of The Left Ventricle And Associated Ventricular Septal Defect., Abid Laghari, Javed Tai, Sumaira Saleem

Department of Medicine

A case report of a 28-year-old patient, who presented with symptoms and signs of congestive heart failure and had clinical signs of ventricular septal defect as well. On further work-up echocardiogram showed non-compaction of the left ventricle with severe left ventricular systolic dysfunction and a ventricular septal defect. He was treated with standard treatment of heart failure and is doing well.


Cabergoline Therapy For Macroprolactinoma During Pregnancy: A Case Report., Hira Shahzad, Aisha Sheikh, Lumaan Sheikh Oct 2012

Cabergoline Therapy For Macroprolactinoma During Pregnancy: A Case Report., Hira Shahzad, Aisha Sheikh, Lumaan Sheikh

Department of Medicine

Background: We assessed the safety of Cabergoline therapy during pregnancy in a lady with hyperprolactinemia intolerant to Bromocriptine.

Case presentation: We report the case of a 31 year old lady who presented to us with uncontrolled hyperprolactinemia. A pituitary Macroadenoma was demonstrated by MRI. Due to intolerance to Bromocriptine, Cabergoline was started. The patient improved and subsequently conceived. MRI in the second trimester demonstrated further reduction in the tumor size. It was decided to continue Cabergoline throughout pregnancy to ensure further reduction in tumor size until delivery and to hold Cabergoline during postpartum period to allow for an adequate interval …


Are Robots Any Better In Stroke Rehabilitation?, Muhammad Faisal Wadiwala, Ayeesha Kamran Kamal Oct 2012

Are Robots Any Better In Stroke Rehabilitation?, Muhammad Faisal Wadiwala, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.


Recurrent Non-Aneurysmal, Metastatic Intraparenchymal Haemorrhages Following Resection Of Atrial Myxoma - Case Report And Literature Review., Emmon Raza, Ayeesha Kamran Kamal Oct 2012

Recurrent Non-Aneurysmal, Metastatic Intraparenchymal Haemorrhages Following Resection Of Atrial Myxoma - Case Report And Literature Review., Emmon Raza, Ayeesha Kamran Kamal

Department of Medicine

Atrial myxomas are the commonest cardiac neoplasms. The most common extra-cardiac manifestations are embolic infarcts from tumour embolisation. Infrequently, aneurysm formation and intracranial haemorrhages also occur. Incredibly rare are space-occupying lesions and malignant transformation. The authors report a case of a previously healthy middle-aged lady who developed recurrent and expanding intraparenchymal haemorrhages following resection of a left atrial myxoma without any primary disease recurrence. The case described is completely different from the described literature in that her intracranial vasculature was free of aneurysms on angiography despite central nervous system haemorrhage and no myxomatous or malignant features were seen on histology …