• 제목/요약/키워드: Symptomatic

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Risk of Stroke with Temporary Arterial Occlusion in Patients Undergoing Craniotomy for Cerebral Aneurysm

  • Ha, Sung-Kon;Lim, Dong-Jun;Seok, Bong-Gil;Kim, Se-Hoon;Park, Jung-Yul;Chung, Yong-Gu
    • Journal of Korean Neurosurgical Society
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    • 제46권1호
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    • pp.31-37
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    • 2009
  • Objective : This study was performed to elucidate the technical and patient-specific risk factors for postoperative ischemia in patients undergoing temporary arterial occlusion (TAO) during the surgical repair of their aneurysms. Methods : Eighty-nine consecutive patients in whom TAO was performed during surgical repair of an aneurysm were retrospectively analyzed. The demographics of the patients were analyzed with respect to age. Hunt and Hess grade on admission, Fisher grade of hemorrhage, aneurysm characteristics, timing of surgery, duration of temporary occlusion, and number of temporary occlusive episodes. Outcome was analyzed at the 3-month follow-up, along with the occurrence of symptomatic and radiological stroke. Results : In overall, twenty-seven patients (29.3%) had radiologic ischemia attributable to TAO and fifteen patients (16.3%) had symptomatic ischemia attributable to TAO. Older age and poor clinical grade were associated with poor clinical outcome. There was a significantly higher rate of symptomatic ischemia in patients who underwent early surgery (p=0.007). The incidence of ischemia was significantly higher in patients with TAO longer than 10 minutes (p=0.01). In addition, patients who underwent repeated TAO, which allowed reperfusion, had a lower incidence of ischemia than those who underwent single TAO lasting for more than 10 minutes (p=0.011). Conclusion : Duration of occlusion is the only variable that needs to be considered when assessing the risk of postoperative ischemic complication in patients who undergo temporary vascular occlusion. Attention must be paid to the patient's age, grade of hemorrhage, and the timing of surgery. In addition, patients undergoing dissection when brief periods of temporary occlusion are performed may benefit more from intermittent reperfusion than continuous clip application. With careful planning, the use of TAO is a safe technique when used for periods of less than 10 minutes.

증상이 동반된 소아 유연성 편평족 치료에서의 Calcaneo-stop 술식 (Calcaneo-stop Procedure for Management of Pediatric Symptomatic Flexible Flatfoot)

  • 이강;남영준
    • 대한족부족관절학회지
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    • 제19권4호
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    • pp.176-180
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    • 2015
  • Purpose: The aim of the current study is to report on the clinical and radiographic results after calcaneo-stop procedure in Korean children with symptomatic flexible flatfoot. Materials and Methods: Twenty-two children suffering pain along the medial aspect of midfoot with flexible flatfoot whose symptoms did not improve with conservative measures and therefore underwent calcaneo-stop procedure were identified retrospectively. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analogue scale (VAS) were evaluated. Radiographically, standing anteroposterior and lateral radiographs of the foot and Saltzman's alignment views were taken and talonavicular coverage angle, lateral talo-first metatarsal angle, and hindfoot alignment angles were measured and analyzed. Results: Clinically, AOFAS ankle-hindfoot scale improved from $70.3{\pm}5.6$ to $97.3{\pm}2.5$ and VAS improved from $6.4{\pm}1.6$ to $0.2{\pm}0.4$. Radiographically, talonavicular coverage angle improved from $28.3^{\circ}{\pm}12.3^{\circ}$ to $10.9^{\circ}{\pm}8.1^{\circ}$, lateral talo-first metatarsal angle improved from $-19.3^{\circ}{\pm}9.0^{\circ}$ to $-2.4^{\circ}{\pm}8.1^{\circ}$, and hindfoot alignment angle improved from valgus $11.9^{\circ}{\pm}10.0^{\circ}$ to $3.5^{\circ}{\pm}4.3^{\circ}$ at minimum 2-year follow-up. No complications occurred postoperatively. Conclusion: Calcaneo-stop procedure is a simple and very effective procedure for management of pediatric symptomatic flexible flatfoot that does not respond to conservative treatment.

Double membrane-bound particles associated with eriophyid mite-borne plant diseases of unknown etiology : a potentially new group of plant viruses\ulcorner

  • Ahn, Kyung-Ku;Kim, Kyung-Soo
    • 한국식물병리학회:학술대회논문집
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    • 한국식물병리학회 1997년도 Proceedings of special lectures on Recent Research Trend of Plant Pathology
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    • pp.5-21
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    • 1997
  • Unique virus-like particles were associated with five eriophyid mite-borne plant diseases of unknown etiology; fig mosaic, redbud yellow ringspot, rose orsette, thistle mosaic, and high plains disease of corn and wheat. Quasi-spherical, double membrane-bound particles (DMPs), 120 - 200 nm in diameter, were observed in the cytoplasm of all cell types in symptomatic leaves of infected plants. No DMPs were observed in symptomless plants. The DMPs in symptomatic thistles were associated with two types of inclusions, electron-dense amorphous material and tubular aggregates. Similar amorphous inclusions were also found in corn and wheat with high plains disease, while tubular inclusions were observed in figs with mosaic symptoms. The particles and inclusions were similar in some aspects to immature particles associated with viroplasms of animal and insect poxviruses and also to the double-enveloped particles of tomato spotted wilt virus associated with viroplasms during early stages of infection, but were unique and unlike any known plant viruses. The DMPs and associated viroplasm-like inclusions in the high plains disease were specifically immunogold labeled in situ with the disease-specific antiserum. Thread-like structures, similar to tenuivirus particles, present in the partially purified virus preparations were also immunogold labeled with the antiserum. It is suggested that the thread-like structures are derived from the DMP. In many cells of symptomatic corn and wheat samples, DMPs occurred together with flexuous rod-shaped particles and cylindrical inclusions of wheat streak mosaic potyvirus (WSMV), suggesting that the disease is caused by a mixed infection of WSMV and the agent represented by the DMPs. Based on cytopathology, symptomatology and mite and/or graft-transmissibility, the five diseases described in this paper are potentially caused by virus(es) and the DMPs associated with these diseases may represent virus particles. If the DMPs are indeed viral in nature, they would comprise a new group of plant viruses.

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High-Dose Simvastatin Is Effective in Preventing Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage : A Prospective Cohort Study in Korean Patients

  • Woo, Sung Woong;Kim, Jae Hoon;Kang, Hee In;Kim, Deok Ryeong;Moon, Byung Gwan;Kim, Joo Seung
    • Journal of Korean Neurosurgical Society
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    • 제58권4호
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    • pp.328-333
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    • 2015
  • Objective : The goal of this study was to assess the effect of high-dose simvastatin on cerebral vasospasm and its clinical outcome after aneurysmal subarachnoid hemorrhage (SAH) in Korean patients. Methods : This study was designed as a prospective observational cohort study. Its subjects were aneurysmal SAH patients who had undergone aneurysm clipping or coiling. They were assigned to 1 of 3 groups : the 20 mg, 40 mg, and 80 mg simvastatin groups. The primary end-point was the occurrence of symptomatic vasospasm. The clinical outcome was assessed with the modified Rankin Scale (mRS) score after 1 month and 3 months. The risk factors of the development of vasospasm were assessed by logistic regression analysis. Results : Ninety nine patients with aneurysmal SAH were treated and screened. They were sequentially assigned to the 20 mg (n=22), 40 mg (n=34), and 80 mg (n=31) simvastatin groups. Symptomatic vasospasm occurred in 36.4% of the 20 mg group, 8.8% of the 40 mg group, and 3.2% of the 80 mg group (p=0.003). The multiple logistic regression analysis showed that poor Hunt-Hess grades (OR=5.4 and 95% CI=1.09-26.62) and high-dose (80 mg) simvastatin (OR=0.09 and 95% CI=0.1-0.85) were independent factors of symptomatic vasospasm. The clinical outcomes did not show a significant difference among the three groups. Conclusion : This study demonstrated that 80 mg simvastatin treatment was effective in preventing cerebral vasospasm after aneurysmal SAH, but did not improve the clinical outcome in Korean patients.

다발성 요추간반 탈출증에서 추간반조영술의 진단적 의의 (Diagnostic Significance of Discography on Multiple Lumbar Disc Herniation)

  • 이상원;김긍년;진동규;김영수;조용은;진병호
    • Journal of Korean Neurosurgical Society
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    • 제29권5호
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    • pp.628-634
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    • 2000
  • Objective : The introduction of MRI makes it easy to detect multiple lumbar disc herniation. However, MRI is not a physiologic test for detecting the symptomatic level. For the surgical plan, it is very important to determine the symtomatic level among the multiple lumbar disc herniation. In this regard, we studied diagnostic significance of discography on multiple lumbar disc herniation in determining the symptomatic level. Method and Material : We retrospectvely analyzed the discographic and clinical findings of 121 patients with multiple lumbar disc herniation for investigating the diagnostic availability of discography. All were surgically treated from January 1995 through May 1998. Result : Discography provocated the same pain as usual symptom in 99 out of 121 patients(81.8%). Compared with surgical findings, the diagnostic accuracy of the discography in multiple lumbar disc herniation was 75.6%, sensitivity was 64.6%, and specificity 87.2%. There was no correlation between the pain provocation of discography and the extent of annular degeneration on CT/discogram. The pain provocation showed good correlation with the extent of annular disruption on CT/discogram. The rate of same result(correlation rate) between the discography and D.I.T.I was 81.4% in multiple lumbar disc herniation patients with unilateral leg pain. Conclusion : These results indicate that in multiple lumbar disc herniation, the discography is considered useful diagnostic tool to determine the symptomatic level and to decide the surgical plan.

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Surgical Results of Unruptured Intracranial Aneurysms

  • Kim, Sung-Ho;Choi, Byung-Yon;Chang, Chul-Hoon;Kim, Sang-Woo;Kim, Seong-Ho;Cho, Soo-Ho
    • Journal of Korean Neurosurgical Society
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    • 제40권2호
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    • pp.99-102
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    • 2006
  • Objective : To document surgical mortality and morbidity for the treatment of unruptured intracranial aneurysms, and to identify optimal treatment modalities, the authors reviewed and analyzed the surgical results. Methods : The authors reviewed 49 cases of unruptured intracranial aneurysm without a previous history of subarachnoid hemorrhage from March 1984 through December 2003. Unruptured intracranial aneurysms were categorized as asymptomatic and symptomatic, and operative results were assessed using the Karnofsky scale at 3 months postoperatively. Outcomes were defined as 'excellent' for a Karnofsky scale score of 100, 'good' for a score of $80{\sim}90$, 'fair' for $50{\sim}70$, 'poor' for $10{\sim}40$, or as 'death'. Excellent and good results were defined as a 'favorable' outcome and others as 'unfavorable' outcome. Results : Of the 49 study subjects, 45 had a favorable outcome and 4 an unfavorable outcome. Surgical mortality was 6.1% and surgical morbidity was 2.0% for all subjects. And the symptomatic group had more complications. Conclusion : There were no significant relationships between aneurysmal size, location, and preoperative symptoms with surgical results. And we believe that the reasons for morbidity and mortality are attributable to strokes, thus more attention should be paid to peri- and post-operative patients care with a focus on strokes prevention in the symptomatic group.

성인의 유연성 편평족에 대한 종골 연장술 (Calcaneal Lengthening Osteotomy for the Symptomatic Flexible Flatfoot in Adults)

  • 최홍준;조재호;왕배건
    • 대한족부족관절학회지
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    • 제17권2호
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    • pp.115-120
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    • 2013
  • Purpose: Calcaneal lengthening osteotomy is one option for the treatment of symptomatic flexible flatfoot in adults. The aim of the study was to evaluate the short term clinical and radiologic results and analyze its complications. Materials and Methods: Twelve feet who had undergone calcaneal lengthening osteotomy without flexor digitorum longus transfer between December 2009 and July 2011 were included. The mean age was 40.6 years (23~75 years). The mean followup was 17.3 months (13~25 months). Clinical outcome were assessed using American Orthopadics Foot ans Ankle Society (AOFAS) score and visual analogue scale (VAS) for pain. Four radiologic parameters were measured from weightbearing radiographs to evaluate the difference between preoperatively and postoperatively measures. To analyze the complications, calcaneocuboid joint subluxation and degenerative change were measured postoperatively. Results: The mean AOFAS score improved from 55.3 points preoperatively to 82.2 points at lastest follow-up (p=0.000). The mean VAS improved from 6.3 points preoperatively to 3.2 points postoperatively (p=0.002).All radiologic parameters, the mean talonavicular coverage angle on AP view, the mean talo-1st metatarsal angle on AP and lateral view and the mean calcaneal pitch angle, significantly improved after calcaneal lengthening osteotomy. Nine feets (75%) were shown the degenerative change in the calcaneocuboid joint at latest follow-up radiographs. Conclusion: Calcaneal lengthening osteotomy for the symptomatic flexible flatfoot in adults produced significant improvement in clinical and radiologic parameters, but calcaneocuboid joint osteoarthritis occurred postoperatively remained a major problem.

Different Clinical Outcomes of Entamoeba histolytica in Malaysia: Does Genetic Diversity Exist?

  • Anuar, Tengku Shahrul;Al-Mekhlafi, Hesham M.;Abdul Ghani, Mohamed Kamel;Azreen, Siti Nor;Salleh, Fatmah Md.;Ghazali, Nuraffini;Bernadus, Mekadina;Moktar, Norhayati
    • Parasites, Hosts and Diseases
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    • 제51권2호
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    • pp.231-236
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    • 2013
  • The present study was conducted to investigate the clinical outcomes of Entamoeba histolytica infection in symptomatic and asymptomatic Orang Asli (aborigine) communities in Malaysia. Examination was performed on 500 stool samples obtained from Orang Asli communities in 3 different states using formalin-ether concentration, trichrome staining, and single-round PCR techniques. Out of 500 stool samples, single infection of E. histolytica, Entamoeba dispar, and Entamoeba moshkovskii was identified in 3.2%, 13.4%, and 1%, respectively. In addition, 10 samples had mixed infections with E. histolytica and E. dispar. Six samples containing E. dispar were also positive for E. moshkovskii, and only 2 samples had E. histolytica in association with E. dispar and E. moshkovskii. Seventeen E. histolytica-positive samples were from symptomatic subjects, whereas the remaining 11 samples came from asymptomatic subjects. These findings suggest a predominant distribution of pathogenic potential of E. histolytica strains in this community. Therefore, further studies on genotyping of E. histolytica is required, to find out association between E. histolytica genotype and the outcome of the infection.

거리환경미화원의 근골격계 증상의 특징 및 인간공학적 평가 (Ergonomic Workload Evaluation and Musculo-skeletal Symptomatic Features of Street Cleaners)

  • 이향기;명준표;정은희;정혜선;구정완
    • 대한인간공학회지
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    • 제26권4호
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    • pp.147-152
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    • 2007
  • The aim of this study was to evaluate the musculo-skeletal symptomatic features of municipal sanitation workers and to compare differences of the musculo-skeletal symptoms by work types. We conducted descriptive cross-sectional survey concerning the musculo-skeletal symptomatic features of 315 street cleaners in Seoul and GyeongGi Province, Korea, during 2 weeks of September 2006. Questionnaires were consisted of general characteristics, occupational characteristics and musculo-skeletal symptoms. And we observed their works and evaluated their movement and posture by REBA. For work types, tools and subjective physical work loading, there were statistical difference whether or not NIOSH symptom positive on upper limb. Musculo-skeletal symptoms on upper limb were claimed from 43.2% of street cleaners, more than in 32.4% of cleaners. Musculo-skeletal symptoms on upper limb were reported higher in the group who felt their subjective physical work loading severe than in the otherwise group. The REBA results were over 'high risk stage' in street cleaners. Street cleaners had more repetitive motions than solid waste collectors on upper limbs. Works according to the criteria of musculoskeletal burdened work by the Ministry of Labor results were over 'high risk stage' of No. 2 and No. 4 in street cleaners. We found that street cleaners complained musculo-skeletal symptoms on upper limb more than solid waste collectors. This study suggests that it is necessary for street cleaners to carry out the prevention program of musculo-skeletal diseases. For street cleaner, the measure plans such as job rotation, automatic street sweepers, reducing work hours are helpful in preventing musculoskeletal symptoms on the upper limb.