Of medicine and machines

Some important legislation has been introduced that will make it easier for medical students to repay their educational loans. You can support this effort by going to:
http://capwiz.com/aoa-aoia/mail/oneclick_compose/?alertid=7742211
Although the form letter is written for osteopathic medical residents, you can easily modify it to your own situation. The website will then send an email on your behalf.

Today, I saw an interesting case - coiling of a left MCA aneurysm. First we shot an angio of the anterior circulation by selective catheterization of the involved MCA side branch. We then performed intracarotid sodium amobarbital test, or Wada test, in order to lateralize speech and assess memory function. We also had a neurologist come in and administer an exam to test the patient's language skills. After all that, a balloon was inflated to temporarily occlude the artery and determine the area supplied by it (the "wedge"). It looked like there were sufficient collaterals supplying the wedge from the anterior circulation, but it was decided to see whether or not the wedge was also supplied by the posterior circulation (i.e. branches of the PCA). The angio confirmed this and the decision was made to treat the aneurysm by coiling it. Before doing that, however, we also delivered a dose of radiotracer for the SPECT scan which we would obtain two hours later, after the procedure. Anyway, the branch of the MCA was again accessed, and first a "mesh" was delivered into the aneurysm followed by the coils. I think we used 5 sets of the coils in order to fill it properly. Afterwards, we shot another angio which showed obliteration of the aneurysm (good thing) and good filling of the wedge from surrounding collaterals (a very good thing). Clinically, the patient did real well w/no neurological deficits after the procedure. We are still waiting for the nuc study to get read but, thank God, it looks like it all went really well for the patient. Cool procedure, done by the neuroradiologist...

In totally unrelated news, Lexus has put up a preview site for the 2006 IS which looks tight, may replace the Acura TL as my current favorite. You can check it out here:
http://lexus.com/2006is_preview/?s_ocid=20117
I don't know what the Germans are doing to their cars, but I really think Audi and VW are going in the wrong direction and I can't say I like any of the new BMW designs except for the 3 series. Mercedes has some saving grace with the redesign of its SUV (2005 M-class) and the 4-door CLS500 coupe, but all that is almost cancelled out by its plan to introduce the R-class, a strange looking cross between a mini-van and station wagon...