Three-Dimensional Evaluation and Classification of the Anatomy Variations of Vertebral Artery at the Craniovertebral Junction in 120 Patients of Basilar Invagination and Atlas Occipitalization

2019 ◽  
Vol 17 (6) ◽  
pp. 594-602 ◽  
Author(s):  
Teng Li ◽  
Yi-heng Yin ◽  
Guang-yu Qiao ◽  
Hua-wei Wang ◽  
Xin-guang Yu
Keyword(s):  
Craniovertebral Junction ◽  
Basilar Invagination ◽  
Posterior Arch ◽  
Type I ◽  
Type Ii ◽  
Lateral Mass ◽  
Type Iii ◽  
Different Types ◽  
Type V ◽  
Abnormal Anatomy

Abstract BACKGROUND Patients with basilar invagination and atlas occipitalization usually present abnormal anatomy of the vertebral arteries (VAs) at the craniovertebral junction (CVJ). OBJECTIVE To describe and further classify different types of VA variations at the CVJ with 3D visualization technology. METHODS One hundred twenty patients with basilar invagination and atlas occipitalization who had undergone 3-dimensional computed tomographic angiography (3D-CTA) were retrospectively studied. Imaging data were processed via the separating, fusing, opacifying, and false-coloring-volume rendering technique. Abnormal anatomy of the VA at the CVJ was categorized and related anatomic parameters were measured. RESULTS Seven different types were classified. Type I, VAs enter the cranium after leaving VA groove on the posterior arch of atlas (26.7% of 240 sides); Type II, VAs enter an extraosseous canal created in the assimilated atlas lateral mass-occipital condyle complex before reaching the cranium (53.3%); Type III, VA courses above the axis facet or curves below the atlas lateral mass then enter the cranium (11.7%); Type IV, VAs enter the spinal canal under the axis lamina (1.3%); Type V, high-riding VA (31.3%); Type VI, fenestrated VA (2.9%); Type VII, absent VA (4.2%). Distance from the canal of Type II VA to the posterior facet surface of atlas lateral mass (5.51 ± 2.17 mm) means a 3.5-mm screw can be safely inserted usually. Shorter distance from the midline (13.50 ± 4.35) illustrates potential Type III VA injury during exposure. Decreased height and width of axis isthmus in Type V indicate increased VA injury risks. CONCLUSION Seven types of VA variations were described, together with valuable information helpful to minimize VA injury risk intraoperatively.

Immunological Determined Plasminogen Groups And Its Possible Biological Relevance

1981 ◽  
Author(s):  
V Sachs ◽  
R Dörner ◽  
E Szirmai
Keyword(s):  
Human Plasma ◽  
Type I ◽  
Type Ii ◽  
Precipitation Line ◽  
Gene Frequencies ◽  
Type Iii ◽  
Different Types ◽  
Human Plasminogen ◽  
Gel Diffusion ◽  
Good Agreement

Anti human plasminogen sera of the rabbit precipitate human plasma in the agar gel diffusion test by means of intra-basin absorption with plasminogenfree human plasma with three different types: type I is represented by one strong precipitation line, type II by two lines, a big one and a small one, and type III by three slight but distinct lines. The following frequencies of the different types have been observed in a sample of 516 human plasmas: type I 65%, type II 33% and type III 2%. Suppose the types are phenotypical groups of a diallelic system where the types I and III represent the homozygous genotypes and the type II the heterozygous the estimated gene frequencies are in good agreement with the expected values. There is also a good agreement of the distribution of plasminogen groups determined by electrofocussing from RAUM et al. and HOBART. The plasminogen groups possibly may have also a biological meaning because the plasmas of type III always have a lesser fibrinolytic activity than the plasmas of the other types.

Syntheses of Post-Iboga Alkaloids

Synthesis ◽  
2019 ◽  
Vol 51 (14) ◽  
pp. 2737-2758 ◽  
Author(s):  
Hyeonggeun Lim ◽  
Sikwang Seong ◽  
Sunkyu Han
Keyword(s):  
Secondary Metabolites ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv ◽  
Synthetic Studies ◽  
Type V

Post-iboga alkaloids are secondary metabolites that are biosynthetically derived from iboga-type alkaloids via rearrangements of the indole and/or isoquinuclidine moieties. Herein, we categorize post-iboga alkaloids into five types based on the biosynthetic mode of transformation of the iboga scaffold. We then describe reported syntheses of post-iboga alkaloids, including our laboratory’s recent contributions, based on our own categorization.1 Introduction1.1 Iboga and Post-Iboga Alkaloids1.2 Classification of Post-Iboga Alkaloids1.2.1 Introduction to Type I Post-Iboga Alkaloids1.2.2 Introduction to Type II Post-Iboga Alkaloids1.2.3 Introduction to Type III Post-Iboga Alkaloids1.2.4 Introduction to Type IV Post-Iboga Alkaloids1.2.5 Introduction to Type V Post-Iboga Alkaloids2 Syntheses of Post-Iboga Alkaloids2.1 Syntheses of Type I Post-Iboga Alkaloids2.1.1 Syntheses of Monomeric Type I Post-Iboga Alkaloids2.1.2 Syntheses of Dimeric Type I Post-Iboga Alkaloids2.2 Syntheses of Type II Post-Iboga Alkaloids2.3 Synthetic Studies Toward Type III Post-Iboga Alkaloids2.4 Syntheses of Type IV Post-Iboga Alkaloids2.5 Synthesis of Type V Post-Iboga Alkaloids3 Conclusion and Outlook

scholarly journals Study On The Application of Preoperative Three-Dimensional CT Angiography of Perigastric Arteries In Laparoscopic Radical Gastrectomy

2022 ◽  
Author(s):  
Peng Liu ◽  
Wenbin Yu ◽  
Meng Wei ◽  
Danping Sun ◽  
Xin Zhong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Three Dimensional ◽  
Classification Model ◽  
Type I ◽  
Radical Gastrectomy ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv ◽  
Type V

Abstract Objection: To investigate the clinical value and significance of preoperative three-dimensional computerized tomography angiography (CTA) in laparoscopic radical gastrectomy for gastric cancer.Methods: The clinical data were analyzed retrospectively from 214 gastric cancer patients. We grouped according to whether to perform CTA. The gastric peripheral artery was classified according to CTA images of patients in the CTA group, and we compared and analyzed the difference of the data between the two groups.Results: The celiac trunk was classified according to Adachi classification: Type I (118/125, 94.4%),Type II (3/125, 2.4%),Type III (0/125, 0%),Type IV (1/125, 0.8%),Type V (2/125, 1.6%),Type VI (1/125, 0.8%).Hepatic artery classification was performed according to Hiatt classification standard:Type I (102/125, 81.6％),Type II (9/125, 7.2%),Type III (6/125, 4.8%),Type IV (2/125, 1.6%),Type V (3/125, 2.4%),Type VI (0, 0%),Others (3/125, 2.4%).And this study combined vascular anatomy and clinical surgical risk to establish a new splenic artery classification model. It was found that the operation time and estimated blood loss in the CTA group were significantly lower than those in the non-CTA group. In addition, the blood loss in the CTA group combined with ICG (Indocyanine Green) labeled fluorescence laparoscopy was significantly less than that in the group without ICG labeled. Conclusion: Preoperative CTA can objectively evaluate the vascular course and variation of patients, and then avoid the risk of operation, especially in combination with ICG labeled fluorescence laparoscopy, can further improve the quality of operation.

A Review and Proposed Classification System for the No-Option Patient With Chronic Limb-Threatening Ischemia

2020 ◽  
pp. 152660282096391
Author(s):  
Tanner I. Kim ◽  
Shant S. Vartanian ◽  
Peter A. Schneider
Keyword(s):  
Treatment Strategies ◽  
Major Amputation ◽  
Occlusive Disease ◽  
Tissue Loss ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv ◽  
Foot Anatomy ◽  
Type V

A growing, but poorly defined subset of patients with chronic limb-threatening ischemia (CLTI) have “no option” for revascularization. One notable subgroup includes patients with severe ischemia and advanced pedal artery occlusive disease, termed “desert foot,” who are at high risk for major amputation due to a lack of conventional revascularization options. Although new therapies are being developed for no-option patients with desert foot anatomy, this subgroup and the broader group of no-option patients are not well defined, limiting the ability to evaluate outcomes. Based on a systematic review, a classification of the no-option CLTI patient was constructed for use in clinical practice and studies. Several no-option conditions were identified, including type I—severe and pedal occlusive disease (desert foot anatomy) for which there is no accepted method of repair; type II—lack of suitable venous conduit for bypass in the setting of an acceptable target for bypass; type III—extensive tissue loss with exposure of vital structures that renders salvage impossible; type IV—advanced medical comorbidities for which available revascularization options would pose a prohibitive risk; and type V—presence of a nonfunctional limb. While type I and type II patients may have no option for revascularization, type III and type V patients have wounds, infection, comorbidities, or functional status that may leave them with few options for revascularization. As treatment strategies continue to evolve and novel methods of revascularization are developed, the ability to identify no-option patients in a standardized fashion will aid in treatment selection and assessment of outcomes.

Accuracy and complications associated with the freehand C-1 lateral mass screw fixation technique: a radiographic and clinical assessment

2013 ◽  
Vol 18 (4) ◽  
pp. 372-377 ◽  
Author(s):  
Yong Hu ◽  
Christopher K. Kepler ◽  
Todd J. Albert ◽  
Zhen-shan Yuan ◽  
Wei-hu Ma ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Ct Scanning ◽  
Ct Scans ◽  
Screw Placement ◽  
Type I ◽  
Type Ii ◽  
Lateral Mass ◽  
Type Iii ◽  
Clinical Records ◽  
The Ideal

Object The aims of this study were to evaluate a large series of posterior C-1 lateral mass screws (LMSs) to determine accuracy based on CT scanning findings and to assess the perioperative complication rate related to errant screw placement. Methods Accuracy of screw placement was evaluated using postoperative CT scans obtained in 196 patients with atlantoaxial instability. Radiographic analysis included measurement of preoperative and postoperative CT scans to evaluate relevant anatomy and classify accuracy of instrumentation placement. Screws were graded using the following definitions: Type I, screw threads completely within the bone (ideal); Type II, less than half the diameter of the screw violates the surrounding cortex (safe); and Type III, clear violation of transverse foramen or spinal canal (unacceptable). Results A total of 390 C-1 LMSs were placed, but 32 screws (8.2%) were excluded from accuracy measurements because of a lack of postoperative CT scans; patients in these cases were still included in the assessment of potential clinical complications based on clinical records. Of the 358 evaluable screws with postoperative CT scanning, 85.5% of screws (Type I) were rated as being in the ideal position, 11.7% of screws (Type II) were rated as occupying a safe position, and 10 screws (2.8%) were unacceptable (Type III). Overall, 97.2% of screws were rated Type I or II. Of the 10 screws that were unacceptable on postoperative CT scans, there were no known associated neurological or vertebral artery (VA) injuries. Seven unacceptable screws erred medially into the spinal canal, and 2 patients underwent revision surgery for medial screws. In 2 patients, unilateral C-1 LMSs penetrated the C-1 anterior cortex by approximately 4 mm. Neither patient with anterior C-1 penetration had evidence of internal carotid artery or hypoglossal nerve injury. Computed tomography scanning showed partial entry of C-1 LMSs into the VA foramen of C-1 in 10 cases; no occlusion, associated aneurysm, or fistula of the VA was found. Two patients complained of postoperative occipital neuralgia. This was transient in one patient and resolved by 2 months after surgery. The second patient developed persistent neuralgia, which remained 2 years after surgery, necessitating referral to the pain service. Conclusions The technique for freehand C-1 LMS fixation appears to be safe and effective without intraoperative fluoroscopy guidance. Preoperative planning and determination of the ideal screw insertion point, the ideal trajectory, and screw length are the most important considerations. In addition, fewer malpositioned screws were inserted as the study progressed, suggesting a learning curve to the technique.

scholarly journals PATHOLOGY OF PNEUMOCOCCUS INFECTION IN MICE FOLLOWING INTRANASAL INSTILLATION

1936 ◽  
Vol 63 (1) ◽  
pp. 17-31 ◽  
Author(s):  
Geoffrey Rake
Keyword(s):  
Type I ◽  
Type Ii ◽  
Serial Sections ◽  
Cervical Lymph Nodes ◽  
Intranasal Inoculation ◽  
Type Iii ◽  
Glomerular Nephritis ◽  
Different Types ◽  
Resistant Strains ◽  
Intranasal Instillation

Pneumonia can be produced in mice, which have not been previously prepared, by intranasal inoculation of broth cultures of certain strains of pneumococci. Lesions which are quantitatively different can be produced in different breeds of mice by inoculation of the same type of pneumococcus. Similar inoculation of different types of pneumococci into one breed of mice results in lesions which are qualitatively different. In general, these lesions are as follows: a diffuse pneumonia and an acute glomerular nephritis in unselected mice receiving Type I strains; a confluent pneumonia and a tubular nephritis in the case of Type II strains; and as result of Type III strains, an interstitial pneumonia with extensive gelatinous pleurisy, together with necrosis and abscess formation in the spleen and cervical lymph nodes. Resistant strains of mice with Type III pneumococci show slight changes in the lungs, but marked lesions in the spleen and cervical nodes, while susceptible mice with the same type of pneumococcus show marked changes in the lung and moderate lesions in the spleen and cervical nodes. The method of development of Type III pneumonia, studied by means of serial sections of nasally infected mice, appears to proceed in the stages of vascular engorgement, interalveolar interstitial exudate, albuminous fluid exudate into the alveoli and the perivascular lymphatics draining the affected site, and finally, a frank pneumonia with a cellular exudate in the alveoli but without much fibrin.

scholarly journals Study of the distribution of different types of cleft lip and palate and associated anomalies

2014 ◽  
Vol 03 (04) ◽  
pp. 203-208
Author(s):  
Alpana Barman ◽  
B C Dutta ◽  
J K Sarkar
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Type I ◽  
Type Ii ◽  
Associated Anomalies ◽  
Type Iii ◽  
Congenital Deformities ◽  
Different Types ◽  
Isolated Cleft Palate

Abstract Background : Cleft lip and palate are some of the most common congenital deformities. They frequently occur as isolated deformities, but can be associated with other medical conditions and anomalies. Aim of the study: To study the distribution of different types of cleft lip and palate and associated anomalies. Materials and methods: Forty patients of cleft lip and palate were studied. Relevant history was taken, clinical examination done and recorded with photography with consent. The cases were classified as per Nagpur Classification. Results: In our study 24 cases (60%) were cleft lip and palate (type III) and 10 cases (25%) of cleft palate alone (type II) and 6 cases (15%) of cleft lip alone (type I). Males were found to predominate in type I and III. Females predominated in type II. Among the cleft lip, left side is found to be involved in most of the cases. In our study, out of 40 cases, 8 cases (20%) had other associated anomalies. Most of these were associated with cleft lip and palate (type III) and isolated cleft palate (type II). Conclusion: The typical universal distribution of cleft types and associated anomalies tallies with our results.

scholarly journals ANALISIS KESALAHAN SISWA DALAM MENYELESAIKAN SOAL CERITA MATERI SISTEM PERSAMAAN LINEAR DUA VARIABEL KELAS VIII SMP NEGERI 7 SALATIGA

2018 ◽  
Vol 1 (1) ◽  
pp. 66 ◽  
Author(s):  
Irham Fuadi ◽  
Sutriyono Sutriyono
Keyword(s):  
Linear Equations ◽  
Type I ◽  
Type Ii ◽  
Reading Error ◽  
Process Skill ◽  
Type Iii ◽  
Type Iv ◽  
Type V ◽  
Descriptive Qualitative

Abstrak: Penelitian ini bertujuan untuk menganalisis kesalahan siswa dalam menyelesaikan soal cerita materi sistem persamaan linear dua variable. Metode yang digunakan dalam penelitian ini adalah deskiptif kualitatif. Sampel yang diambil adalah siswa kelas VIII H SMP Negeri 7 Salatiga dengan jumlah subjek sebanyak 3 siswa. Hasil penelitian ini menunjukan siswa masih melakukan kesalahan pada type I (reading error) sebesar 0%, kesalahan pada type II (comprehension error) sebesar 19%, kesalahan pada type III (transformasion error) sebesar 14%, kesalahan pada type IV (process skill error) sebesar 24%, dan kesalahan pada type V (enconding error) sebesar 44%. Abstract:  This study aims to analyze students' errors in solving the material story of the system of two linear equations. The method used in this study is descriptive qualitative. The samples are taken from VIII H grade students of SMP Negeri 7 Salatiga with the number of subjects as many as three students. The result of this research showed students still made an error on type I ( reading error ) as much as 0 % , an error on type II ( comprehension error) is approximately 19 % , an error on type III ( transformation error) 14 %  , an error on type IV (process skill error) 24 %, and an error on type V ( enconding error ) as much as 44 % .

scholarly journals Efficacy and Safety of Transarterial Chemoembolization in Elderly Patients of Advanced Hepatocellular Carcinoma With Portal Vein Tumor Thrombus: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Qinghe Tang ◽  
Wei Huang ◽  
Jun Liang ◽  
Junli Xue
Keyword(s):  
Hepatocellular Carcinoma ◽  
Type I ◽  
Advanced Hepatocellular Carcinoma ◽  
Type Ii ◽  
Type Iii ◽  
Subgroup Analyses ◽  
Different Types ◽  
Tace Group ◽  
Multivariable Analyses ◽  
Tace Treatment

ObjectiveThe aim of the current study was to evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) in elderly patients diagnosed as advanced hepatocellular carcinoma (HCC) accompanied with different types of portal vein tumor thrombosis (PVTT).MethodsElderly HCC patients aged 70-year-old and above from January 2015 to December 2019 were included in this retrospective study. Efficacy data including OS, PFS, DCR, and ORR and safety data were collected in the indicated groups. Outcomes of HCC patients in the TACE group were compared with those patients in the best supportive care (BSC) group. Subgroup analyses were also conducted in the patients with different types of PVTT.ResultsAmong 245 elderly HCC patients, 124 were enrolled in this study. Out of these, 50.0% (n=62) underwent BSC treatment while 50.0% (n=62) underwent TACE. There were no major differences in the baseline characteristics of the two treatment groups. TACE treatment was associated with better median OS compared with BSC alone (11.30 m vs. 7.80 m; P<0.001). Subgroup analyses showed that patients with type I and type II PVTT could benefit from TACE compared with BSC, based on that OS was 14.30 m vs. 7.80 m (P=0.007) and 13.00 m vs. 8.00 m (P=0.002), respectively. The DCR in the TACE group was 62.90%, and 17.74% in the BSC group (p<0.001). The proportion of ORR in TACE group was 35.48%, while 0.00% in the BSC group (p<0.001). Multivariable analyses showed that patients undergoing TACE treatment had 52% lower odds of mortality compared with patients undergoing BSC treatment (HR: 0.48; 95%CI: 0.32-0.72). Similarly, the media PFS was improved following TACE treatment (7.50 m vs. 4.00 m; P<0.001). TACE could significantly prolong the PFS in both type I and type II PVTT subgroups, without greatly significant improvement in type III PVTT patients (4.50 m vs. 2.70 m; P=0.103). Type III PVTT patients in the TACE group had more AEs than type I and type II PVTT patients. According to multivariable analyses, PVTT types (type III vs. type I-II) (HR: 2.18; 95%CI: 1.29-3.70; P=0.004), tumor diameter (>5 cm vs. ≤5 cm) (HR: 1.94; 95%CI: 1.28-2.93; P=0.002), and treatment (TACE vs. BSC) (HR: 0.48; 95%CI: 0.32-0.72; P<0.001) were independent indicators of overall survival.ConclusionsIn elderly advanced HCC patients with PVTT, palliative TACE treatment can be an accessible effective measure to improve the OS and PFS for both type I and type II PVTT patients.

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