• Title/Summary/Keyword: Symptomatic approach

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Symptomatic Post-Discectomy Pseudocyst after Endoscopic Lumbar Discectomy

  • Kang, Suk-Hyung;Park, Seung-Won
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.31-36
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    • 2011
  • Objective: The objectives of this study were to determine the frequency of symptomatic postdiscectomy pseudocyst (PP) after endoscopic discectomy and to compare the results of surgical and conservative management of them. Methods: Initial study participants were 1,503 cases (1,406 patients) receiving endoscopic lumbar discectomy by 23-member board of neurosurgeons from March 2003 to October 2008. All patients' postoperative magnetic resonance imaging (MRI) scans were evaluated. On the postoperative MRI, cystic lesion of T2W high and T1W low at discectomy site was regarded as PP. Reviews of medical records and radiological findings were done. The PP patients were divided into two groups, surgical and conservative management by treatment modality after PP detection. We compared the results of the two groups using the visual analogue scale (VAS) for low back pain (LBP), VAS for leg pain (LP) and the Oswestry disability index (ODI). Results: Among 1,503 cases of all male soldiers, the MRls showed that pseudocysts formed in 15 patients, about 1.0% of the initial cases. The mean postoperative interval from surgery to PP detection was 53.7 days. Interlaminar approach was correlated with PP formation compared with transforaminal approach. (p=0.001).The mean VAS for LBP and LP in the surgical group improved from 6.5 and 4.8 to 2.0 and 2.3, respectively. The mean VAS for LBP and LP in the conservative group improved from 4.4 and 4.4 to 3.9 and 2.3, respectively. There was no difference in treatment outcome between surgical and conservative management of symptomatic PP. Conclusion: Although this study was done in limited environment, symptomatic PP was detected at two months' postoperative period in about 1% of cases. Interlaminar approach seems to be more related with PP compared with transforaminal approach.

Recurrent Symptomatic Rathke's Cleft Cyst : Case Report and Review of the Literature (수술 후 재발한 라스케열 낭 - 증례보고 -)

  • Hong, Seokho;Gwak, Ho-Shin;Jung, Hee-Won
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.286-290
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    • 2000
  • A case of symptomatic Rathke's cleft cyst, which recurred five months after drainage of the cyst using transs-phenoidal approach, is presented. Symptomatic recurrence after surgery of Rathke's cleft cyst is very rare and nine cases have been reported in the literatures. The radiological and pathologic features and clinical course of this unusual case are described. Recent concepts about embryological pathogenesis and clinical behavior mimicking craniopharyngioma are discussed with the review of literature.

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Minimally Invasive Combined Interlaminar and Paraisthmic Approach for Symptomatic Lumbar Foraminal Stenosis : Surgical Technique and Preliminary Results

  • Kwon, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.42 no.1
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    • pp.11-15
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    • 2007
  • Objective : Lumbar foraminal stenosis is an important etiology of lumbar radicular symptomatology and frequent causes of remained symptoms after decompressive surgery. This study was conducted to determine the precise clinical and radiologic diagnosis of lumbar foraminal stenosis, and to demonstrate thorough treatment by decompressive surgery using a minimally invasive technique. Methods : Seven patients with established unilateral lumbar foraminal stenosis according to clinical and radiologic diagnosis were retrospectively studied. All patients underwent combined interlaminar and paraisthmic procedure with partial facetectomy. The outcome of surgery was evaluated and classified into excellent, good, fair and poor. Results : The results were excellent in four patients, good in two, and fair in one during the follow-up. There were no surgery-related complications. Conclusion : Minimally invasive combined interlaminar and paraisthmic approach provides good outcome in carefully selected patients with symptomatic lumbar foraminal stenosis.

Primary repair of symptomatic neonates with tetralogy of Fallot with or without pulmonary atresia

  • Lee, Chang-Ha;Kwak, Jae Gun;Lee, Cheul
    • Clinical and Experimental Pediatrics
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    • v.57 no.1
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    • pp.19-25
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    • 2014
  • Recently, surgical outcomes of repair of tetralogy of Fallot (TOF) have improved. For patients with TOF older than 3 months, primary repair has been advocated regardless of symptoms. However, a surgical approach to symptomatic TOF in neonates or very young infants remains elusive. Traditionally, there have been two surgical options for these patients: primary repair versus an initial aortopulmonary shunt followed by repair. Early primary repair provides several advantages, including avoidance of shunt-related complications, early relief of hypoxia, promotion of normal lung development, avoidance of ventricular hypertrophy and fibrosis, and psychological comfort to the family. Because of advances in cardiopulmonary bypass techniques and accumulated experience in neonatal cardiac surgery, primary repair in neonates with TOF has been performed with excellent early outcomes (early mortality<5%), which may be superior to the outcomes of aortopulmonary shunting. A remaining question regarding surgical options is whether shunts can preserve the pulmonary valve annulus for TOF neonates with pulmonary stenosis. Symptomatic neonates and older infants have different anatomies of right ventricular outflow tract (RVOT) obstructions, which in neonates are nearly always caused by a hypoplastic pulmonary valve annulus instead of infundibular obstruction. Therefore, a shunt is less likely to preserve the pulmonary valve annulus than is primary repair. Primary repair of TOF can be performed safely in most symptomatic neonates. Patients who have had primary repair should be closely followed up to evaluate the RVOT pathology and right ventricular function.

Predictive Factors for Symptomatic Dislodgement of Percutaneous Transhepatic Biliary Drainage Catheter in Patients with Malignant Biliary Obstruction (악성 담관 폐쇄 환자에서 경피경간 담도 배액술의 유증상 이탈 발생의 예측 인자)

  • Hee Jeong Yu;Jung Gu Park;Gyoo Sik Jung;Kwang Il Seo;Hyun Joon Park;Jong Hyouk Yun
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1350-1360
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    • 2023
  • Purpose To evaluate the factors that predict symptomatic dislodgement of a percutaneous transhepatic biliary drainage (PTBD) catheter in patients with malignant biliary obstruction. Materials and Methods This retrospective study included 572 patients with malignant biliary obstruction who underwent 733 PTBD catheter insertions between January 2010 and February 2015. The duration of catheter placement, approach site, location of the catheter tip, insertion angle, presence of a closed-loop pigtail, and tube diameter were evaluated. Results During the follow-up period, 224 PTBD catheter dislodgements (30.56%) were observed in 157 patients. Among them, 146 (19.92%) were symptomatic. The mean duration from catheter insertion until dislodgement was 32 days (range: 1-233 days). Male (odds ratio [OR]: 1.636, 95% confidence interval [CI]: 1.131-2.367, p = 0.009), right-sided approach (OR: 1.567, 95% CI: 1.080-2.274, p = 0.018), increased insertion angle (OR: 1.015, 95% CI: 1.005-1.026, p = 0.005), and incomplete closed-loop pigtail formation (OR: 1.672, 95% CI: 1.098-2.545, p = 0.016) were independent factors predictive of symptomatic dislodgement of a PTBD catheter. Conclusion Factors predictive of symptomatic catheter dislodgement included male sex, a right-sided approach, increased insertion angle, and incomplete closed-loop pigtail formation.

Treatment of Vallecular Cyst Using Laryngopharyngoscope (Laryngopharyngoscope를 이용한 후두개곡낭종의 치료)

  • 임상철;조재식
    • Korean Journal of Bronchoesophagology
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    • v.6 no.2
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    • pp.143-146
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    • 2000
  • Cystic lesion which is located in vallecular area is sometimes symptomatic and need surgey. But surgical route to this area is divided external approach into internal one. Internal approach via transoral route with suspension laryngoscope can avoid disadvantages of external approach but conventional laryngoscope is not suitable for this type of procedure. We used Steiner laryngopha-ryngoscope in surgery for vallecular cyst and we could excise cyst easily. Of 20 cases, complete excision was tried in 18 cases and marsupialization in 2 cases. Recurrence was 1 case. We suggest that surgery using laryngopharyngoscope is effective in treating cyst which is located in vallecular area.

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Open Transthoracic Plication of the Diaphragm for Unilateral Diaphragmatic Eventration in Infants and Children

  • Alshorbagy, Ashraf;Mubarak, Yasser
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.307-310
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    • 2015
  • Background: To evaluate our experience of early surgical plication for diaphragmatic eventration (DE) in infancy and childhood. Methods: This study evaluated infants and children with symptomatic DE who underwent plication through an open transthoracic approach in our childhood development department between January 2005 and December 2012. Surgical plication was performed in several rows using polypropylene U-stitches with Teflon pledgets. Results: The study included 12 infants and children (7 boys and 5 girls) with symptomatic DE (9 congenital and 3 acquired). Reported symptoms included respiratory distress (91.7%), wheezing (75%), cough (66.7%), and recurrent pneumonia (50%). Preoperative mechanical ventilatory support was required in 41.7% of the patients. The mean length of hospital stay was $6.3{\pm}2.5days$. The mean follow-up period was $24.3{\pm}14.5months$. Preoperative symptoms were immediately relieved after surgery in 83.3% of patients and persisted in 16.7% of patients one year after surgery. All patients survived to the end of the two-year follow-up and none had recurrence of DE. Conclusion: Early diagnosis and surgical plication of the diaphragm for symptomatic congenital or acquired diaphragmatic eventration offers a good clinical outcome with no recurrence.

Microsurgical Decompression for Lumbar Stenosis via Unilateral Laminotomy (요추 협착증에 대한 일측성 추궁절개술을 통한 미세 수술적 감압술)

  • Shim, Yong-Jin;Ha, Ho-Gyun;Lee, Jong-Sun;Kim, Yong-Seog;Park, Moon-Sun;Kim, Joo-Seung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1505-1513
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    • 2000
  • Objectives : Many surgical procedures have been introduced to a symptomatic lumbar stenosis. Most of these procedures still have been regarded as an extensive surgical intervention with respect to normal aging process of the lumbar spine. We adopted a microsurgical decompression procedure via unilateral exposure as a minimally invasive intervention for symptomatic lumbar stenosis without instability. Materials and Methods : Fifty-seven patients with symptomatic lumbar stenosis underwent microsurgical decompression via unilateral laminotomy between March 1998 and December 1999. The conceptual modification and technical refinements were added to the previously reported microsurgical decompression procedure. Bilateral decompression through a unilateral laminotomy hole was performed in 11 patients. These patients profile also included 9 cases of degenerative spondylolisthesis(Grade I) without instability. Results : Preoperative neurogenic intermittent claudication(NIC) was more notably improved than low back pain, 60% to 82% during the follow-up period. Overall clinical results were excellent in 20(35%), good in 29(51%), fair in 6(11%) and poor in 2(3%). Conclusions : Microsurgical decompression for lumbar stenosis with stable spine provided a satisfactory symptomatic improvement without extensive destruction of the weight-bearing structures and functional mobile segments, even bilateral symptoms existed.

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Endoscopic Release of Carpal Tunnel Syndrome; Temporal Correlation between Symptomatic and Electrophysiologicallmprovements in Postoperative Carpal Tunnel Syndrome

  • Park, Jin-Soo;Yoo, Chan-Jong;Chun, Young-Il;Kim, Woo-Kyung;Lee, Sang-Gu;Park, Cheol-Wan
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.8-15
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    • 2005
  • Objective: We evaluate temporal correlations between postoperative symptomatic and electrophysiological improvements, and assessed the recovery time required for patients with carpal tunnel syndrome(CTS) before returning to routine activities. Methods: 30 CTS patients were treated via the endoscopic monoportal approach, from March 2001 to September 2003. We assessed the symptoms (hyperesthesia in the finger tips, or abnormal sensations and painful numbness or night pain) and electrophysiological changes in the preoperative state, 1 month and 6 months after surgery. We marked the times at which patients became able to return to activities of daily living and work, after undergoing endoscopic carpal tunnel release. Results: At the end of the follow-up period, high levels of achievement and good outcomes were observed, with respect to both the symptoms and electrophysiological studies. We discovered significant differences between the preoperative and postoperative periods, especially in terms of motor nerve onset latency from $4.50{\pm}1.43$ to $3.97{\pm}0.69$ and sensory nerve conduction velocity, the wrist-to-finger from $19.81{\pm}10.03$ to $28.18{\pm}11.01$ and wrist-to-palm from $23.34{\pm}13.40$ to $31.79{\pm}13.38$(P<0.05 for each comparison). The average time interval required before return to activities of daily living was 26.4 days, and time interval required before return to work was 48.08 days. Conclusion: Electrophysiological improvements are largely consistent with symptomatic relief, but there is some disparity between electrophysiological and symptomatic improvement.

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.