Carson P. McCann;Michael G. Brandel;Arvin R. Wali;Jeffrey A. Steinberg;J. Scott Pannell;David R. Santiago-Dieppa;Alexander A. Khalessi
Journal of Cerebrovascular and Endovascular Neurosurgery
/
v.25
no.4
/
pp.380-389
/
2023
Objective: Middle meningeal artery embolization (MMAe) has burgeoned as a treatment for chronic subdural hematoma (cSDH). This study evaluates the safety and short-term outcomes of MMAe patients relative to traditional treatment approaches. Methods: In this retrospective large database study, adult patients in the National Inpatient Sample from 2012-2019 with a diagnosis of cSDH were identified. Cost of admission, length of stay (LOS), discharge disposition, and complications were analyzed. Propensity score matching (PSM) was utilized. Results: A total of 123,350 patients with cSDH were identified: 63,450 without intervention, 59,435 surgery only, 295 MMAe only, and 170 surgery plus MMAe. On PSM analysis, MMAe did not increase the risk of inpatient complications or prolong the length of stay compared to conservative management (p>0.05); MMAe had higher cost ($31,170 vs. $10,768, p<0.001) than conservative management, and a lower rate of nonroutine discharge (53.8% vs. 64.3%, p=0.024). Compared to surgery, MMAe had shorter LOS (5 vs. 7 days, p<0.001), and lower rates of neurological complications (2.7% vs. 7.1%, p=0.029) and nonroutine discharge (53.8% vs. 71.7%, p<0.001). There was no significant difference in cost (p>0.05). Conclusions: MMAe had similar LOS and decreased odds of adverse discharge with a modest cost increase compared to conservative management. There was no difference in inpatient complications. Compared to surgery, MMAe treatment was associated with decreased LOS and rates of neurological complications and nonroutine discharge. This nationwide analysis supports the safety of MMAe to treat cSDH.
Proceedings of the Korean Institute of Navigation and Port Research Conference
/
2004.04a
/
pp.5-9
/
2004
In this paper, we studied the OCT(Optical Coherence Tomography) system which it has been extensively studied because of having some advantages such as high resolution cross-sectional images, low cost, and small size configuration. A basic principle of OCT system is Michelson interferometer. The characteristics of light source determine the resolution and the transmission depth. As a results, the light source have a commercial SLD with a central wavelength of 1,285 nm and FWHM(Full Width at Half Maximum) of 35.3 nm. The optical delay line part is necessary to equal of the optical path length with scattered light or reflected light from sample. In order to equal the optical path length, the stage which is attached to reference mirror is moved linearly by step motor And the interferometer is configured with the Michelson interferometer using single mod fiber, the scanner can be focused of the sample by using the reference arm. Also, the 2-dimensional cross-sectional images were measured with scanning the transverse direction of the sample by using step motor. After detecting the internal signal of lateral direction at a paint of sample, scanner is moved to obtain the cross-sectional image of 2-demensional by using step motor. Photodiode has been used which has high detection sensitivity, excellent noise characteristic, and dynamic range from 800 nm to 1,700 nm. It is detected mixed small signal between noise and interference signal with high frequency After filtering and amplifying this signal, only envelope curve of interference signal is detected. And then, cross-sectional image is shown through converting this signal into digitalized signal using A/D converter. The resolution of the OCT system is about 30$\mu\textrm{m}$ which corresponds to the theoretical resolution. Also, the cross-sectional image of ping-pong ball is measured. The OCT system is configured with Michelson interferometer which has a low contrast because of reducing the power of feedback interference light. Such a problem is overcomed by using the improved inteferometer. Also, in order to obtain the cross-sectional image within a short time, it is necessary to reduce the measurement time for improving the optical delay line.
Purpose: The incidence and prevalence of inflammatory bowel disease (IBD) are increasing along with an increasing number of patients with comorbid conditions like psychiatric and behavioral disorders, which are independent predictors of quality of life. Methods: Non-overlapping years (2003-2016) of National Inpatient Sample and Kids Inpatient Database were analyzed to include all IBD-related hospitalizations of patients less than 21 years of age. Patients were analyzed for a concomitant diagnosis of psychiatric/ behavioral disorders and were compared with IBD patients without psychiatric/behavioral disorder diagnoses for outcome variables: IBD severity, length of stay and inflation-adjusted hospitalization charges. Results: Total of 161,294 IBD-related hospitalizations were analyzed and the overall prevalence rate of any psychiatric and behavioral disorders was 15.7%. Prevalence rate increased from 11.3% (2003) to 20.6% (2016), p<0.001. Depression, substance use, and anxiety were the predominant psychiatric disorders. Regression analysis showed patients with severe IBD (odds ratio [OR], 1.57; confidence interval [CI], 1.47-1.67; p<0.001) and intermediate IBD (OR, 1.14; CI, 1.10-1.28, p<0.001) had increased risk of associated psychiatric and behavioral disorders than patients with a low severity IBD. Multivariate analysis showed that psychiatric and behavioral disorders had 1.17 (CI, 1.07-1.28; p<0.001) mean additional days of hospitalization and incurred additional $8473 (CI, 7,520-9,425; p<0.001) of mean hospitalization charges, independent of IBD severity. Conclusion: Prevalence of psychiatric and behavioral disorders in hospitalized pediatric IBD patients has been significantly increasing over the last two decades, and these disorders were independently associated with prolonged hospital stay, and higher total hospitalization charges.
PURPOSE. The purpose of this study was to compare the width ratio of maxillary anterior teeth according to age in the Korean population and to evaluate the maxillary central incisor width-to-length (W/L) ratio, given differences in age and gender. MATERIALS AND METHODS. Ninety-three Korean adults were divided into 3 groups (n = 31) by age. Group I was 20 - 39 years old, Group II was 40 - 59 years old, and Group III was over 60 years of age. After taking an impression and a cast model of the maxillary arch, the anterior teeth width ratio and central incisor W/L ratio were calculated from standard digital images of the cast models using a graph paper with a digital single lens reflex (DSLR) camera. The calculated ratios were compared among all groups and central incisor W/L ratio were analyzed according to age and gender. All comparative data were statistically analyzed with one-sample t-tests, one-way ANOVAs with Tukey tests, and independent t-tests. RESULTS. No significant differences in maxillary anterior teeth ratios were found among the age groups. The maxillary central incisor W/L ratios in Group III were the greatest and were significantly higher than those in the other groups. The central incisor W/L ratio of men was higher than that of women in Group II. CONCLUSION. Maxillary anterior teeth width ratios were similar in all age groups in the Korean population. The maxillary central incisor was observed as worn teeth in the group over 60 years of age, and a significant difference between genders was found in 40 to 50 year olds.
Among larger species of fish found in Punatsang chhu, Brown trout (Salmo trutta) and Snow trout (Schizothorax richardsonii) are notable species. Snow trout is a native species, whereas Brown trout is an introduced species. Brown trout is noted to have a negative impact on the population of native species worldwide. This study studied the population dynamics and structure of these species to detect if the introduced species affected the native species adversely. The study was conducted on a 30 km stretch of Punatsang chhu including its major and minor tributaries at about their confluences. In total, 56 sample plots of a 200 m sampling stretch were studied with a 200 m distance between each stretch. Length, weight, maturity, and sex data for both species were collected along with the habitat and water parameters. The two species were found to prefer different areas within a single stretch with a rare overlap. Snow trout were found to be distributed widely within the basin whereas Brown trout were only found in altitudes higher than 1,000 masl ($\overline{x}$ = 1,231.77) and in turbid waters (p = 0.009). Recruitment of Snow trout was not good whereas recruitment of Brown trout was good. Length-frequency graphs indicated good inverse J distribution for the Snow trout population and sporadic for Brown trout. There is an effect of Brown trout introduction to the Snow trout living in the study area. Places invaded by Brown trout have a lesser presence of Snow trout compared to places not invaded by these species.
Hong, Sung-Bin;Kusnoto, Budi;Kim, Eun-Jeong;BeGole, Ellen A;Hwang, Hyeon-Shik;Lim, Hoi-Jeong
The korean journal of orthodontics
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v.46
no.2
/
pp.111-126
/
2016
Objective: To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. Methods: Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. Results: Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ${\geq}20$ years of age, and for long MIs (${\geq}8mm$) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). Conclusions: When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.
Kim, Tackeun;Lee, Chang-Hyun;Hyun, Seung-Jae;Yoon, Sang Hoon;Kim, Ki-Jeong;Kim, Hyun-Jib
Journal of Korean Neurosurgical Society
/
v.52
no.6
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pp.523-527
/
2012
Objective : The incidence of spontaneous spinal epidural hematoma (SSEH) is rare. Patients with SSEH, however, present disabling neurologic deficits. Clinical outcomes are variable among patients. To evaluate the adequate treatment method according to initial patients' neurological status and clinical outcome with comparison of variables affecting the clinical outcome. Methods : We included 15 patients suffered from SSEH. Patients were divided into two groups by treatment method. Initial neurological status and clinical outcomes were assessed by the American Spinal Injury Association (ASIA) impairment scale. Also sagittal hematoma location and length of involved segment was analyzed with magnetic resonance images. Other factors such as age, sex, premorbid medication and duration of hospital stay were reviewed with medical records. Nonparametric statistical analysis and subgroup analysis were performed to overcome small sample size. Results : Among fifteen patients, ten patients underwent decompressive surgery, and remaining five were treated with conservative therapy. Patients showed no different initial neurologic status between treatment groups. Initial neurologic status was strongly associated with neurological recovery (p=0.030). Factors that did not seem to affect clinical outcomes included : age, sex, length of the involved spinal segment, sagittal location of hematoma, premorbid medication of antiplatelets or anticoagulants, and treatment methods. Conclusion : For the management of SSEH, early decompressive surgery is usually recommended. However, conservative management can also be feasible in selective patients who present neurologic status as ASIA scale E or in whom early recovery of function has initiated with ASIA scale C or D.
The right hip adbuctor musculature has been reported to demonstrate 'stretch weakness' attributable to chronic elongation imposed by standing posture common to right-handed healthy persons. Kendall and associates have described the concept of 'stretch weakness'. The purpose of this study was to assess isometric hip abduction torque and surface electro-myographic activity (using MYOMED 432) in a sample of 40 healthy right-handed persons (20 male, 20 female), all of whom agreed to participate in the study, and compare side difference in the hip abductor musculature. In order to assure the statistical significance of the results, the paired t-test was applied at the .05 level of significance. The results were as follows : 1. The difference in apparent leg length of right and left legs was significant at the .05 leve1. 2. There was a significant difference between right and left pelvic height (standing position) at the .005 level measurements, and scapula height at the .05 level. 3. Power measurements and action potentials of right hip adbuctor were greater than the left hip adbuctor regardless of the range of joint motion (inner range, outer range). 4. The difference in muscle power and action potentials according to inner or outer range of both hip abductor were significant at the .05 level. 5. In supine during active left hip abduction, the appearance of action potentials in the right hip abductors is indicative of contra-lateral effect (p<.005). These results suggest : In healthy right-handed persons. the apparent leg length on the right is longer than on the left, and pelvic height is elevated on the right side. Muscle torque and muscle action potentials of the right hip adbuctor art higher than those of the hip abductor in the lengthened position. Therefore, the results in this study are contrary to Kendall's. This type of study should be carried out in many physical therapy departments.
Objectives : This study was carried out to investigate the effects of Soyumjungjang-tang(SJT) on the experimental ulcerative colitis induced by dextran sulfate sodium(DSS) in mice. Methods : Ulcerative colitis was induced through supplying 4% DSS solution as the drinking water for 7 days in 6-week-old male ICR mice. The colitic mice were divided into three groups: the sample groups were orally administered SJT in doses of 25mg/kg(S25 group) or 100mg/kg(S100 group) once a day for 10 days, from 3 days before starting drinking the DSS solution, and the control(C) group was administered normal saline instead of SJT. The DSS solution or SJT was not administered to the normal(N) group. The length of colon, histologic finding, the activities of myeloperoxidase(MPO) and alkaline phosphatase(AP), and the expressions of $IL-1{\beta}$, IL-6, COX-2, $NF-{\kappa}B$, and $I{\kappa}B$ in colonic mucosa was checked using immunoblot, ELISA, etc. The activities of chondroitinase, tryptophanase, ${\beta}-glucuronidase$ and ${\beta}-glucosidase$ in stool were also measured. Results : The length of colon shortened, histologic finding deteriorated, the activities of MPO, AP, chondroitinase, tryptophanase, ${\beta}-glucuronidase$ and ${\beta}-glucosidase$, and the expressions of $IL-1{\beta}$, IL-6, COX-2, $NF-{\kappa}B$ increased, and the expression of $I{\kappa}B$ decreased in the C group. All measures, except $NF-{\kappa}B$, were restored in S25 group, but some measures deteriorated more in the S100 group than in the C group. Conclusions : According to the above results, it is supposed that SJT has a potential therapeutic effect on ulcerative colitis.
The right hip abductor musculature has been reported to demonstrate "stretch weakness" attributable to chronic elongation imposed by standing posture common to right-handed healthy persons. Kendall and associates have described the concept of "stretch weakness",. The purpose of this study was to assess isometric hip abduction torque and surface electromyographic activity (using MYOMED 432) in a sample of 40 healthy right-handed persons (20 male, 20 female), all of whom agreed to participate in the study, and compare side difference in the hip abductor musculature. In order to assure the statistical significance of the results, the paired t test was applied at the .05 level of significance. The results were as follows: 1) The difference in apparent leg length of right and left legs was significant at the .05 level. 2) There was a significant difference between right and left pelvic height (standing position) at the 05 level measurements, and scapula height at the .05 level. 3) Power measurements and action potentials of right hip abductor were greater than the left hip abductor regardless of the range of joint motion (inner range, outer range) 4) The difference in muscle power and action potentials according to inner or outer range of both hip abductor were significant at the .05 level. 5) In supine during active left hip abduction, the appearance of action potentials in the right hip abductors is indicative of contra-lateral effect (p<.05) These results suggest: In healthy right-handed persons, the apparent leg length on the right is longer than on the left, and pelvic height is elevated on the right side. Muscle those and muscle action potentials of the right hip abductor are higher than those of the left hip abductor in the lengthened position. Therefore, the results in this study are contrary to Kendall's. This type of study should be carried out in many physical therapy departments.
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