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Percutaneous Radiofrequency Thermocoagulation in Trigeminal Neuralgia : Analysis of Early and Late Outcomes of 156 Cases and 209 Interventions

  • Gunduz, Hasan Burak;Cevik, Orhun Mete;Asilturk, Murad;Gunes, Muslum;Uysal, Mustafa Levent;Sofuoglu, Ozden Erhan;Emel, Erhan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.827-836
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    • 2021
  • Objective : Trigeminal neuralgia is one of the most common causes of facial pain. Our aim is to investigate the efficacy and borders of percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia. Methods : Between May 2007 and April 2017, 156 patients with trigeminal neuralgia were treated with radiofrequency thermocoagulation. These 156 patients underwent 209 procedures. In our study, we investigated the early and late results of percutaneous radiofrequency thermocoagulation under guiding fluoroscopic imaging in the treatment of trigeminal neuralgia. Barrow Neurological Institute (BNI) pain scale was used for grading the early results. In addition, Kaplan-Meier survival analysis was used to assess long-term outcomes. Of the 156 patients who underwent radiofrequency thermocoagulation for trigeminal neuralgia, 45 had additional disease. Patients with this condition were evaluated with their comorbidities. Early and late results were compared with those without comorbidity. Results : In 193 of 209 interventions BNI pain scale I to III results were obtained. Out of the 193 successful operation 136 patients (65.07%) were discharged as BNI I, 14 (6.70%) as BNI II, 43 (20.58%) as BNI III. Sixteen patients (7.65%) remained uncontrolled (BNI IV and V). While the treatment results of trigeminal neuralgia patients with comorbidity seem more successful in the early period, this difference was not observed in follow-up examinations. Conclusion : Finally, we concluded that percutaneous radiofrequency thermocoagulation of the Gasserian ganglion is a safe and effective method in the treatment of trigeminal neuralgia. However, over time, the effectiveness of the treatment decreases. Neverthless, the reapprability of this intervention gives it a distinct advantage.

Analysis of reported adverse events of pipeline stents for intracranial aneurysms using the FDA MAUDE database

  • Mokshal H. Porwal;Devesh Kumar;Sharadhi Thalner;Hirad S. Hedayat;Grant P. Sinson
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.3
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    • pp.275-287
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    • 2023
  • Objective: Flow diverting stents (FDS) are a validated device in the treatment of intracranial aneurysms, allowing for minimally invasive intervention. However, after its approval for use in the United States in 2011, post-market surveillance of adverse events is limited. This study aims to address this critical knowledge gap by analyzing the FDA Manufacturer and User Facility Device Experience (MAUDE) database for patient and device related (PR and DR) reports of adverse events and malfunctions. Methods: Using post-market surveillance data from the MAUDE database, PR and DR reports from January 2012-December 2021 were extracted, compiled, and analyzed with R-Studio version 2021.09.2. PR and DR reports with insufficient information were excluded. Raw information was organized, and further author generated classifications were created for both PR and DR reports. Results: A total of 2203 PR and 4017 DR events were recorded. The most frequently reported PR adverse event categories were cerebrovascular (60%), death (11%), and neurological (8%). The most frequent PR adverse event reports were death (11%), thrombosis/thrombus (9%) cerebral infarction (8%), decreased therapeutic response (7%), stroke/cerebrovascular accident (6%), intracranial hemorrhage (5%), aneurysm (4%), occlusion (4%), headache (4%), neurological deficit/dysfunction (3%). The most frequent DR reports were activation/positioning/separation problems (52%), break (9%), device operates differently than expected (4%), difficult to open or close (4%), material deformation (3%), migration or expulsion of device (3%), detachment of device or device component (2%). Conclusions: Post-market surveillance is important to guide patient counselling and identify adverse events and device problems that were not identified in initial trials. We present frequent reports of several types of cerebrovascular and neurological adverse events as well as the most common device shortcomings that should be explored by manufacturers and future studies. Although inherent limitations to the MAUDE database are present, our results highlight important PR and DR complications that can help optimize patient counseling and device development.

Pollution Research about Radiology radiographic laboratory (방사선 영상학 실습실 오염실태 조사 (D대학교 DR장비와 방사선 발생장치, Cassette 오염실태 조사))

  • Park, Chang-Hee
    • Korean Journal of Digital Imaging in Medicine
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    • v.15 no.2
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    • pp.69-76
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    • 2013
  • We checked the existence of bacteria at DR equipment, radiation generator and cassette in 'D university' to propose optimized management method for bacteria and disinfection at DR equipment, radiation generator and cassette at used in radiographic laboratory of the department of radiology. The infected region is treated by alcohol and cresol and compared before spraying and after spraying for 1, 3, 5 and 10 minutes. As time goes on, amount of bacteria colony decreases significantly. The Cresol is useful to disinfect the diminutive devices. However alcohol disinfection, at least 5 minutes later, and hand washing before practical training and shooting image is recommended due to the big and fixed radiography equipment which cause the soakage.

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Optical Characterization of Azo-dye Attached on Photonic Crystal: The Cause of Large Absorption Band Shift

  • Kim, Byoung-Ju;Kwon, Ki-Chul;Yu, A-Reum;Kang, Kwang-Sun
    • Current Photovoltaic Research
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    • v.5 no.2
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    • pp.43-46
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    • 2017
  • Large absorption band shift has been observed for the azo-dye (disperse red-13, DR-13) attached on the surface of silica spheres. Urethane linkage has been utilized to form covalent bond between azo-dye (-OH) and 3-isocyanatopropyltriethoxysilane (ICPTES, -N=C=O). The synthesized ICPTES-DR-13 (ICPDR) molecules were attached to the silica spheres by the hydrolysis and condensation reaction. Although the absorption peak of DR-13 in methanol is at 510 nm, the absorption peak of the ICPDR-silica spheres shifts to 788 nm. The large absorption peak shift is due to the formation of intramolecular charge-transfer band with large aggregated ICPDR.

Ultrasound Mediated, Sodium Bisulfite Catalyzed, Solvent Free Synthesis of 6-Amino-3-methyl-4-substitued-2,4-dihydropyrano[2,3-c]pyrazole-5-carbonitrile

  • Darandale, Sunil N.;Sangshetti, Jaiprakash N.;Shinde, Devanand B.
    • Journal of the Korean Chemical Society
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    • v.56 no.3
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    • pp.328-333
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    • 2012
  • A simple, convenient and practical green synthetic protocol for sodium bisulfite catalyzed multicomponent reaction of ethyl acetoacetate, hydrazine hydrate, malononitrile, and various aldehydes for the synthesis of 6-amino-4-phenyl-3-methyl-2,4-ihydropyrano[2,3-c]pyrazole-5-carbonitriles using ultrasound irradiations in solvent free condition. This method provides the advantage of operational simplicity, shorter reaction time and excellent yields making the protocol environment friendly and economically lucrative.

Relative Efficiency and Productivity Change of the Korean Non-Life Insurance Firms (국내 손해보험회사의 상대적 효율성 및 생산성 변화)

  • Kang, Ho-Jung
    • The Journal of the Korea Contents Association
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    • v.9 no.5
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    • pp.224-229
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    • 2009
  • This study measures the relative efficiency and productivity change of the Korean Non-Life Insurance Firms using DEA model and Malmquist Index for 2004-2007. The main results of this study can by summarized as follows. First, in case of efficiency of CCR for 2004-2007, the number of efficient firms(CCR value is one) are one firm, one firm, one firm, one firm respectively. Second, in case of efficiency of BCC for 2004-2007, the number of efficient firms(BCC value is one) are five firms, five firms, six firms, six firms respectively. Third, In case of return to scale for 2004-2007, DRS are five firms, DRS are five firms, DRS are six firms, DRS are six firms respectively, Fourth, Malmquist Index representing productivity change for 2004-2007 are 0.99 in 2004-2005, 1.04 in 2005-2006, 1.06 in 2006-2007.

Clinical Significance of Atypical Squamous Cells of Undetermined Significance in Detecting Preinvasive Cervical Lesions in Post-Menopausal Turkish Women

  • Tokmak, Aytekin;Guzel, Ali Irfan;Ozgu, Emre;Oz, Murat;Akbay, Serap;Erkaya, Salim;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6639-6641
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    • 2014
  • Background: To evaluate the clinical significance of atypical squamous cells of undetermined significance (ASCUS) in PAP test in post-menopausal women and compare with reproductive age women. Materials and Methods: A total of 367 patients who referred to our gynecologic oncology clinic were included to the study between September 2012 and August 2013. Data for 164 post-menopausal (group 1) and 203 pre-menopausal (group 2) women with ASCUS cytology were evaluated retrospectively. Immediate colposcopy and endocervical curettage was performed for both groups and conization for all women with a result suggestive of CIN2-3. Histopathological results and demographic features of patients were compared between the two groups. Results: Mean age of the patients was $54.6{\pm}6.5$ years in group 1 and $38{\pm}6.6$ years in group 2. Some 14 (8.5%) of post-menopausal women and 36 (17.7%) of pre-menopausal women were current smokers (p=011). Totals of 38 (23.2%) post-menopausal and 64 (31.5%) pre-menopausal women were assessed for HPV-DNA. High risk HPV was detected in 7 (4.3%) and 21 (10.3%), respectively (p=0.029). Final histopathological results recorded were normal cervix, low grade cervical intra-epithelial neoplasia (CIN 1), and high grade cervical intra-epithelial neoplasia (CIN2-3). In group 1 results were 84.8%, 12.2% and 1.8%, respectively, and in group 2 were 71.9%, 23.2% and 4.9%. There were no cases of micro invasive or invasive cervical carcinoma in either group. Two cases were detected as endometrial carcinoma in the menopausal group (1.2%). Conclusions: In current study we found that preinvasive lesions were statistically significantly higher in pre-menopausal women than post-menopausal women with ASCUS. Cervicitis was more common in menopausal women. Therefore, we think that in case of ASCUS in a post-menopausal woman there is no need for radical management.

Taxane and Anthracycline Based Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer : Institutional Experience

  • Gogia, Ajay;Raina, Vinod;Deo, Suryanarayan Vishnu;Shukla, Nootan Kumar;Mohanti, Bidhu Kalyan;Sharma, Daya Nand
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.1989-1992
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    • 2014
  • Background: The aim of this study was to assess the response rates (clinical and pathological ) with docetaxel and epirubicin combination chemotherapy and its effect on outcome. Materials and Methods: We retrospectively analysed locally advanced breast cancer (LABC) patients who received NACT from January 2008 to December 2012 in our tertiary care centre. LABC constituted 37% of all breast cancer cases and 120 patients fulfilled the eligibility criteria. The regimens used for NACT were, six cycles of DEC (docetaxel $75mg/m^2$, epirubicin $75mg/m^2$, cyclophosphamide $50mg/m^2$ on Day 1, 3 weekly) and a sequential regimen (4 cycles of FEC, 5-flurouracil $600mg/m^2$, epirubicin $75mg/m^2$, cyclophosphamide $600mg/m^2$ followed by 4 cycles of docetaxel $85mg/m^2$). Results: The median age was 47 years (range 23-72). Ninety six ( 80 %) had T4 disease and 90% had clinically palpable lymph nodes at diagnosis. The median size of primary tumor at presentation was 5.9 cm. Hormone receptor positivity was seen in 55% and HER2/neu positivity, in 25%. Triple negative breast cancers constituted 25 % of the cases. The overall clinical response rate (complete or partial ) was 85% and pathological complete responses were obtained in 15%. Four cases defaulted, 5 patients died of treatment related toxicity and 15% developed febrile neutropenia on DEC. The median duration of follow up was 22 months. The median time to relapse was 20 months and the 3 year relapse free and overall survival rates were 50% and 70% respectively. Conclusions: LABC constituted 37% of all breast cancer cases at our institute. With NACT, pCR was seen in 15% of the cases. Sequential chemotherapy was better tolerated than concurrent anthracyline and taxane chemotherapy with a similar pCR.