• Title/Summary/Keyword: pre-symptomatic

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Comparison of the Indications and Treatment Results of Burr-Hole Drainage at the Maximal Thickness Area versus Twist-Drill Craniostomy at the Pre-Coronal Point for the Evacuation of Symptomatic Chronic Subdural Hematomas

  • Kim, Gi Hun;Kim, Bum-Tae;Im, Soo-Bin;Hwang, Sun-Chul;Jeong, Je Hoon;Shin, Dong-Seong
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.243-247
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    • 2014
  • Objective : To analyze the clinical data and surgical results from symptomatic chronic subdural hematoma (CSDH) patients who underwent burr-hole drainage (BHD) at the maximal thickness area and twist-drill craniostomy (TDC) at the precoronal point. Methods : We analyzed data from 65 symptomatic CSDH patients who underwent TDC at the pre-coronal point or BHD at the maximal thickness area. For TDC, we defined the pre-coronal point to be 1 cm anterior to the coronal suture at the level of the superior temporal line. TDC was performed in patients with CSDH that extended beyond the coronal suture, as confirmed by preoperative CT scans. Medical records, radiological findings, and clinical performance were reviewed and analyzed. Results : Of the 65 CSDH patients, 13/17 (76.4%) with BHD and 42/48 (87.5%) with TDC showed improved clinical performance and radiological findings after surgery. Catheter failure was seen in 1/48 (2.4%) cases of TDC. Five patients (29.4%) in the BHD group and four patients (8.33%) in the TDC group underwent reoperations due to remaining hematomas, and they improved with a second operation, BHD or TDC. Conclusion : Both BHD at the maximal thickness area and TDC at the pre-coronal point are safe and effective drainage methods for symptomatic CSDHs with reasonable indications.

Peroxidase Activity during Leaf Infection of Mulberry (Morus alba L.) with Brown Leaf Spot Fungus Myrothecium roridum

  • Chattopadhyay Soumen;Krishnan Natraj;Maji Manas D.
    • International Journal of Industrial Entomology and Biomaterials
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    • v.12 no.1
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    • pp.21-28
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    • 2006
  • Peroxidase activity was measured in brown leaf spot pathogen (Myrothecium roridum) inoculated potted mulberry (Morus alba) during pre-symptomatic to various symptom development stages and compared with corresponding healthy leaf tissues. The enzyme showed a pH optimum of 7.0 and the activity was linearly increased up to 15 min of incubation. The peroxidase had a broad substrate specificity and the rates of oxidation were in the rank of pyrogallol> guaiacol> ascorbate at pH 7.0. Catechol at 10 mM inhibited 89% of guaiacol-peroxidase and 76% pyrogallol-peroxidase activities, indicated higher non-specific peroxidation in pyrogallol dependent assay system in mulberry than guaiacol. The optimum requirement for the guaiacol dependent assay was 0.2 ml (${\approx}40-60{\mu}g$ equivalent of protein) of crude enzyme source. Excepting the 8th leaf from the apex, the peroxidase activity did not vary appreciably in different leaf positions. In pre-symptomatic phases, an initial (1 to 5 min) rise of peroxidase activity was noticed in inoculated leaves, and then maintained a plateau up to 300 min. In contrary, non-infected tissue showed a slightly increased trend of enzyme level up to 420 min. In infected tissue, a sharp transient increase (3.1 fold) of peroxidase activity appeared between 300 - 420 min post infections. Afterwards, significantly different but steady maintenance of enzyme levels were observed in two treatments. On the other hand, during symptom development, a sharp increase in peroxidase activity was noticed up to 4th grade of lesion appearance (25.1 % to 50% of leaf area infection), and then declined slightly. However, in non-infected but same age healthy leaves, such huge fluctuations of enzyme level did not apparent. A high positive correlation $(R^2=0.92)$ between peroxidase activity and leaf spot development grades was also marked. The result implies that pre-symptomatic burst (between 1 - 5 and 300 - 420 min) and subsequent increased trend of guaiacol peroxidase activity may require for the symptomatic manifestation of Myrothecium leaf spot in mulberry.

Effect of the Intra-arterial Papaverine Infusion on the Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage (뇌지주막하 출혈 후 뇌혈관 연축에 대한 동맥내 Papaverine 주입의 치료효과)

  • Shin, Jun Jae;Lee, Jae Whan;Shin, Yong Sam;Huh, Seung Kon;Kim, Dong Ik;Lee, Kyu Chang
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.325-333
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    • 2001
  • Objective : To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods : A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups : deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results : The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0%-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion : Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.

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Indications and Surgical Results of Twist-Drill Craniostomy at the Pre-Coronal Point for Symptomatic Chronic Subdural Hematoma Patients

  • Lee, Jin-Young;Kim, Bum-Tae;Hwang, Sun-Chul;Im, Soo-Bin;Shin, Dong-Seong;Shin, Won-Han
    • Journal of Korean Neurosurgical Society
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    • v.52 no.2
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    • pp.133-137
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    • 2012
  • Objective : Twist-drill craniostomy (TDC) with closed-system drainage and burr-hole drainage (BHD) with a closed system are effective treatment options for chronic subdural hematoma (CSDH). The aim of this study was to analyze clinical data and surgical results from symptomatic CSDH patients who underwent TDC with closed-system drainage at the pre-coronal point (PCP). Methods : We analyzed data for 134 symptomatic CSDH patients who underwent TDC at the PCP with closed-system drainage. We defined the PCP for TDC to be 1 cm anterior to the coronal suture at the level of superior temporal line. TDC at the PCP with closed-system drainage was selected in patients with CSDH that extended beyond the coronal suture, confirmed by preoperative CT scans. Medical records, radiological findings, and clinical performance were reviewed retrospectively. Results : Of the 134 CSDH patients, 114 (85.1%) showed improved clinical performance and imaging findings after surgery. Catheter failures were seen in two cases (1.4%); the catheters were inserted in the epidural space. Recurrent cases were seen in eight patients (5.6%), and they were improved with a second BHD with a closed-system operation. Conclusion : TDC at the PCP with closed-system drainage is safe and effective for patients with symptomatic CSDH whose hematomas extend beyond the coronal suture.

A Best Effort Classification Model For Sars-Cov-2 Carriers Using Random Forest

  • Mallick, Shrabani;Verma, Ashish Kumar;Kushwaha, Dharmender Singh
    • International Journal of Computer Science & Network Security
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    • v.21 no.1
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    • pp.27-33
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    • 2021
  • The whole world now is dealing with Coronavirus, and it has turned to be one of the most widespread and long-lived pandemics of our times. Reports reveal that the infectious disease has taken toll of the almost 80% of the world's population. Amidst a lot of research going on with regards to the prediction on growth and transmission through Symptomatic carriers of the virus, it can't be ignored that pre-symptomatic and asymptomatic carriers also play a crucial role in spreading the reach of the virus. Classification Algorithm has been widely used to classify different types of COVID-19 carriers ranging from simple feature-based classification to Convolutional Neural Networks (CNNs). This research paper aims to present a novel technique using a Random Forest Machine learning algorithm with hyper-parameter tuning to classify different types COVID-19-carriers such that these carriers can be accurately characterized and hence dealt timely to contain the spread of the virus. The main idea for selecting Random Forest is that it works on the powerful concept of "the wisdom of crowd" which produces ensemble prediction. The results are quite convincing and the model records an accuracy score of 99.72 %. The results have been compared with the same dataset being subjected to K-Nearest Neighbour, logistic regression, support vector machine (SVM), and Decision Tree algorithms where the accuracy score has been recorded as 78.58%, 70.11%, 70.385,99% respectively, thus establishing the concreteness and suitability of our approach.

Usefulness of Three Dimensional Proset MR Images for Diagnosis of Symptomatic L5-S1 Foraminal and Extraforaminal Stenosis

  • Kim, Sang Woo;Kim, Chang Hwan;Kim, Min Su;Jung, Young Jin;Byun, Woo Mok
    • Journal of Korean Neurosurgical Society
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    • v.54 no.1
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    • pp.30-33
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    • 2013
  • Objective : To suggest a new useful diagnostic technique, principles of the selective excitation technique-magnetic resonance images (Proset-MRI), and to know the precise radiologic findings that can prove symptomatic foraminal and extraforaminal stenosis at L5-S1. Methods : Nineteen patients with symptomatic L5-S1 stenosis were checked by Proset-MRI. Four patients were performed decompressive surgery and 15 patients were performed selective nerve root block (SNRB) at L5. The pain scale of patients was checked by Visual Analogue Scale (VAS) scores at the pre- and post-treatment state. Results : Proset-MRI findings of patients with symptomatic stenosis are root swelling (RS) and indentation. The comparisons with VAS scores had a meaningful statistical result at each RS (p<0.01) and indentation (p<0.01). However, the findings of RS combined with indentation lacked statistical significance (p=0.0249). In addition, according to a comparison with the treatment modalities, reducing of VAS scores had statistical meaningful significance in decompressive surgery cases (p<0.01), and also in SNRB cases (p<0.01) after a 3-month follow-up period. Conclusion : The three dimensional Proset-MRI is very useful and sensitive technique to diagnose the symptomatic foraminal and extraforaminal stenosis at L5-S1.

Clinical features of children's brain tumors according to location (소아 뇌종양 발생위치에 따른 임상양상 고찰)

  • Han, Seung Jeong;Kim, Yun Hee;Kwon, Young Se;Jun, Yong Hoon;Kim, Soon Ki;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.76-81
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    • 2006
  • Purpose : This study evaluated the clinical characteristics of brain tumors in children according to their location, the parental delay and the doctor's delay between the onset of symptoms and the diagnosis of a pediatric brain tumor. In addition, this study compared the relationship between the pre-diagnostic symptomatic interval and the tumor location. Methods : A retrospective study was undertaken of 45 children with primary brain tumors admitted to Inha Hospital from July, 1986 to June, 2004. A diagnosis of the tumor location was made using brain MRI. Results : The male to female ratio was 1 : 0.67. The median age at diagnosis was 6.0 years in supratentorial tumors, 7.0 years in infratentorial tumors. Twenty four cases(53.3 percent) were located in the supratentorial area, 21 cases(46.6 percent) were located in the infratentorial area. The distribution of supratentorial tumors were 14(58.3 percent) in the cerebral hemisphere and temporal lobe, seven (29.1 percent) in the suprasellar area, and three(12.5 percent) in the pineal gland and posterial lateral ventricle. The distributions of the infratentorial tumors were 12(57.1 percent) in the cerebellar vermis and fourth ventricle, four(19.1 percent) in the brain stem, and five(23.8 percent) in the cerebellar hemisphere. The most common initial symptom was seizure(37.5 percent) in the supratentorial tumor and headache(38.0 percent) in infratentorial tumors. The median pre-diagnostic symptomatic interval (PSI) was 21 days(range 0-240 days). The median PSI with a parental delay in supratentorial tumor was six days(range 1-240 days), and 30 days(range 1-40 days) in the infratentorial tumor. We immediately diagnosed most cases after visiting the hospital. There was no significant relationship between the tumor location and the pre-diagnostic symptomatic interval. Conclusion : The most common symptom of supratentorial tumors and infratentorial tumors was seizure and headache, respectively. Although, the median pre-diagnostic symptomatic interval was shorter than in previous studies, a detailed medical history and a correctly interpreted neurological examination should lead to an earlier diagnosis of pediatric brain tumors.

Treatment of Bunionette Deformity with Diaphyseal Oblique Osteotomy (간부 사형 절골술을 이용한 소건막류의 수술적 치료)

  • Kim, Sang Kil;Kim, Jihyeung;Lee, Jeong Ik;Rhee, Seung Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.19-23
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    • 2014
  • Purpose: The purpose of this study is to evaluate the clinical and radiographic results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. Materials and Methods: We retrospectively reviewed 12 feet of nine patients diagnosed as symptomatic bunionette and treated with diaphyseal oblique osteotomy. All patients were female and the average age at the time of surgery was 48 years. We checked the foot standing anteroposterior, oblique, and lateral images pre- and post-operatively. We measured the fourth intermetatarsal angle and fifth metatarsophalangeal angle and evaluated the clinical results using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scale preoperatively and six months postoperatively. Results: Of the nine patients, hallux valgus was combined with symptomatic bunionette in seven feet of five patients. In all of our cases, the average AOFAS lesser MTP-IP scale showed improvement after surgery. Painful callosity around the fifth metatarsophalangeal joint disappeared after surgery in all of our cases. The fourth intermetatarsal angle improved from $12.7^{\circ}$ to $3.1^{\circ}$ and the fifth metatarsophalangeal angle improved from $16.6^{\circ}$ to $2.3^{\circ}$. Conclusion: Diaphyseal oblique osteotomy of the fifth metatarsal appears to be a safe and satisfactory surgical procedure for treatment of symptomatic bunionette.

Delayed Cancer Diagnosis in Thyroid Nodules Initially Treated as Benign With Radiofrequency Ablation: Ultrasound Characteristics and Predictors for Cancer

  • Myoung Kyoung Kim;Jung Hee Shin;Soo Yeon Hahn;Haejung Kim
    • Korean Journal of Radiology
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    • v.24 no.9
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    • pp.903-911
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    • 2023
  • Objective: Regrowth after radiofrequency ablation (RFA) of symptomatic large thyroid nodules, initially treated as benign, sometimes turns out to be malignancies. This study aimed to assess the ultrasound (US) characteristics of thyroid nodules initially treated as benign with RFA and later diagnosed as cancers, predictive factors for cancers masquerading as benign, and methods to avoid RFA in these cancers. Materials and Methods: We reviewed the medical records of 134 consecutive patients with 148 nodules who underwent RFA between February 2008 and November 2016 for the debulking of symptomatic thyroid nodules diagnosed as benign using US-guided biopsy. We investigated the pre-RFA characteristics of the thyroid nodules, changes at follow-up after RFA, and the final surgical pathology. Results: Nodule regrowth after RFA was observed in 36 (24.3%) of the 148 benign nodules. Twenty-two of the 36 nodules were surgically removed, and malignancies were confirmed in seven (19.4% of 36). Of the 22 nodules removed surgically, pre-RFA median volume (range) was significantly larger for malignant nodules than for benign nodules: 22.4 (13.9-84.5) vs. 13.4 (7.3-16.8) mL (P = 0.04). There was no significant difference in the regrowth interval between benign and malignant nodules (P = 0.49). The median volume reduction rate (range) at 12 months was significantly lower for malignant nodules than for benign nodules (51.4% [0-57.8] vs. 83.8% [47.9-89.6]) (P = 0.01). The pre-RFA benignity of all seven malignant nodules was confirmed using two US-guided fine-needle aspirations (FNAs), except for one nodule, which was confirmed using US-guided core-needle biopsy (CNB). Regrown malignant nodules were diagnosed as suspicious follicular neoplasms by CNB. Histological examination of the malignant nodules revealed follicular thyroid carcinomas, except for one follicular variant, a papillary thyroid carcinoma. Conclusion: Symptomatic large benign thyroid nodules showing regrowth or suboptimal reduction after RFA may have malignant potential. The confirmation of these nodules is better with CNB than with FNA.

Diaphragmatic eventration: a case report (횡경막 이완증 1례 보)

  • 김송명
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.144-149
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    • 1984
  • Diaphragmatic eventration is a rare condition in primary diaphragmatic diseases and is found rarely in clinical experience. Diaphragmatic eventration means abnormally high position of diaphragm, which is caused acquired, paralytic or congenital, nonparalytic etiologic origins. This report is presented a symptomatic diaphragmatic eventration of 50 years old woman, who had complained coughing and left chest pain since I year ago prior to admission in Kosin Medical College, Gospel Hospital. A patient who had established accurate diagnosis at pre-operative period. There had been post-operative course uneventfully.

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