scholarly journals Long-term results of electrical stimulation of the left vagus nerve in treatment of drug-resistant epilepsy in patients of different ages

2020 ◽  
Vol 22 (3) ◽  
pp. 23-30
Author(s):  
S. A. Katyshev ◽  
T. A. Skoromets ◽  
A. G. Naryshkin ◽  
A. V. Vtorov ◽  
M. N. Klochkov ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Vagus Nerve ◽  
Class Ii ◽  
Response To Therapy ◽  
Class I ◽  
Drug Resistant ◽  
Class Iii ◽  
Drug Resistant Epilepsy ◽  
Class Iv ◽  
Left Vagus

Currently, the effectiveness of medical and surgical treatment of focal forms does not exceed 75 %. In cases when control over attacks by means of conservative therapy is not possible, and resection indications for surgical intervention are not present, the use of vagus nerve electrical stimulation is recommended.The study objective is to evaluate the effectiveness of vagus nerve electrical stimulation in treatment of drug-resistant epilepsy depending on the type of the disease and patient age.Materials and methods. Retrospective analysis of treatment results of 45 patients (22 children between 2 and 17 years of age (mean age 12.3 years) and 23 adults between 18 and 62 years of age (mean age 29.4 years)) with drug-resistant epilepsy was performed. All patients were implanted with electric stimulator of the left vagus nerve. Control examination was carried out 1 year after surgery, the evaluation method – McHugh scale.Results. In the child group, the results corresponded to class I per the McHugh sale in 30 % of cases, class II – in 26 %; class III – in 26 %, class IV – in 18 %. In the adult group, the results corresponded to class I in 18 % of cases, class II – in 19 %, class III – in 37 %, class IV – in 26 %. In patients with duration of the disease >10 years, results of electrical stimulation were good or excellent in 44 % of cases, for patients with duration between 5 and 10 years – in 40 % of cases, with duration <5 years – in 60 %, but due to small sample size the results are not statistically significant. In patients with simple partial seizures, the treatment was effective in 4 (54 %) of 7 cases, in patients with generalized seizures – in 16 (42.8 %) of 38 cases. The best results were also obtained for interventions in patients between 10 and 15 years of age.Conclusion. Children respond better to vagus nerve electrical stimulation; in the adult age group, it is noted that patients with aura have a better response to therapy with vagus nerve electrical stimulation; smaller epianamnesis is associated with better efficiency; patients with symptomatic epilepsy have a worse response to therapy, than patients with cryptogenic epilepsy; there were no gender differences in the effectiveness of vagus nerve electrical stimulation.

scholarly journals ANALYSIS ON THE PATTERN OF USING THE SERVICE OF REMOVABLE PARTIAL DENTURE MAKING IN A DENTAL LABORATORY IN SURABAYA

2017 ◽  
Vol 52 (4) ◽  
pp. 270
Author(s):  
Okti Setyowati ◽  
Endang Kusdarjanti
Keyword(s):  
Dental Health ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Removable Partial Denture ◽  
Partial Denture ◽  
Metal Framework ◽  
Removable Denture ◽  
Class Iv

The making of removable denture is performed by a dental laboratory. To facilitate the identification, according to Kennedy classification, classes are divided onto groups, the Kennedy class I, II, III and IV. To suit with the needs of the dental laboratory tasks commonly done, priority are necessary for common cases and should to be taught to students of Dental Health Technology Diploma. In Surabaya, research of various cases of removable partial denture with the various Kennedy classifications has never been done before. This study was to analyze the pattern of service for the removable partial denture manufacture in dental laboratory at Surabaya (2011 – 2013). The research is an observatory analytic. The population is all dental laboratories located around the campus of the Faculty of Dentistry Airlangga University Surabaya. The sample was the whole population is willing to become respondents. Sampling by total sampling. The method of collecting data using secondary data from a dental laboratory in Surabaya from 2011 until 2013. The note is cases removable denture according to the classification of Kennedy that Kennedy Class I, II, III and IV. Also of note kinds of materials used to make the denture base that is heat cured acrylic resins, thermoplastic resins and metals coherent. The data is a compilation table charting the frequency until needed, then analyzed using cross tabulation. Mostly denture type is flexible type and the least is metal framework. Most cases by classification Kennedy is followed by class II class III and class II and more recently is the fourth. In conclusion, in 2011 and 2013 the manufacture of removable partial dentures according to the classification of Kennedy Class III is the most common in both the upper arch and lower jaw, followed by Class II, Class I and Class IV. In 2012 which is the highest grade III followed by class II, class IV and class I. The denture type most used is a flexible denture, followed acrylic denture and the last is the metal framework.

scholarly journals Experience of post-infarction left ventricular aneurysm reconstruction with on-pump beating heart technique

2019 ◽  
Vol 100 (3) ◽  
pp. 500-504
Author(s):  
D G Tarasov ◽  
I I Chernov ◽  
A V Molochkov ◽  
A V Pavlov
Keyword(s):  
Left Ventricle ◽  
Heart Association ◽  
Class Ii ◽  
Left Ventricular ◽  
Beating Heart ◽  
Class I ◽  
Left Ventricular Aneurysm ◽  
Class Iii ◽  
Left Ventricular Reconstruction ◽  
Class Iv

Aim. To evaluate the results of surgical treatment of post-infarction left ventricular aneurysms with on-pump beating heart technique. Methods. In our center from April, 2009 to January, 2014 169 patients had reconstruction of the left ventricle with on-pump beating heart technique. Among the patients 159 were males (94.1%) and 10 of them were females (5.9%), average age 53.8±8.9 years (39 to 72 years). Angina pectoris class I (according to the classification of Canadian Heart Association) was established in 7 (4.1%) patients, class II - in 49 (29.0%), class III - in 107 (63.3%), class IV - in 4 (2.4%), unstable angina in 2 (1.2%) patients. Chronic heart failure class I (according to New York Heart association functional classification) was diagnosed in 5 (3.0%) patients, class II in 37 (21.9%), class III in 124 (73.4%), class IV in 3 (1.8%) patients. Average ejection fraction of the left ventricle was 38.6±7.9% (25 to 67%). Mitral valve insufficiency stage 2-3 was revealed in 23 (13.6%) patients. Results. Endoventriculoplasty of the left ventricle by Dor's technique was performed in 49 (29.0%) patients, auto-septoplasty of the left ventricle - 59 (34.9%) patients, linear repair in 40 (23.7%) patients. Combined surgical interventions were performed in 21 (12.4%) patients. In-hospital lethality was 2.4% (n=4). Conclusion. Left ventricular reconstruction with on-pump beating heart technique without cardioplegic arest is effective and safe; the method allows performing remodelling of the left ventricle and reaching the target volume parameters.

scholarly journals Outcome of Albumin Infusion in Heart Failure Patients

2019 ◽  
Vol 15 (2) ◽  
pp. 47-53
Author(s):  
Ashaduzzaman Talukder ◽  
Mohamed Mausool Siraj ◽  
Md Noornabi Khondokar ◽  
SM Ahsan Habib ◽  
Md Abu Salim ◽  
...  
Keyword(s):  
Heart Failure ◽  
Serum Albumin ◽  
Nyha Class ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Albumin Infusion ◽  
Group A ◽  
Group B ◽  
Class Iv

Background: Heart Failure (HF) is a major public health burden worldwide. Approximately 5 million Americans, 0.4–2% of the general European population and over 23 million people worldwide are living with heart failure. Like few other chronic disease, low serum albumin is common in patients with heart failure (HF). However, very few studies evaluated the outcome of albumin infusion in different stages of HF. Therefore, the objective of this study is to assess the outcome of albumin infusion in heart failure patients. Methods: It was a cross-sectional study. A total of 50 cases of chronic heart failure with reduced ejection fraction and NYHA class III or IV with serum albumin level <2.5g/dl who were admitted in CCUwere selected by purposive sampling, from September 2017 to August 2018. 100ml of 20% albumin was infused and serum albumin was measured after 3 days. Then the patients were divided into two groups, Patients who failed to attain serum albumin of 3g/dl(Group A) or Patients who attained serum albumin of ≥3g/dl (Group B). Analysis and comparison for symptomatic improvement of heart failure by NHYA classification and LVEF was done at 10th day after infusion between group A and B. Result: Among the 50 patients, mean age of patients was 53.64 ± 13.44 years (age range: 26-84 years) with a male-female ratio of 3:2 (60%-male vs 40%- female). Majority patients were previously re-admitted at least two times (40%), 28% were re-admitted once, 16% were re-admitted three times and 4% were re-admitted for four times. Of all, 56% patients presented NYHA class IV and AHA stage D heart failure (56%) and 44% patients presented with NYHA class III and AHA stage C. At day 10 follow up following albumin infusion, overall frequency of following ten days of albumin therapy, in group B, 8 patients (72.7%) among Class III improved to Class I and 3 patients (27.3%) improved to class II. Also, 7 patients (50%), 5 patients (35.7%) and 2 patients (14.3%) among class IV improved to respectively class I, class II and class III. In group A, 3 patients (27.3%) among class III improve to class II and 8 patients (72.7%) remain in class III. Also, 2 patients (14.3%), 5 Patients (35.7%) and 7 patients (50%) among class IV improve to respectively class I, class II and class III. Moreover, statistically significant improvement was noted in ejection fraction of patents irrespective of initial class of heart failure (p<0.001) in group B patients compare to group A (p<0.09). Conclusion: In this study, the improvement of heart failure was more in patients who attained albumin level of ≥3g/dl.Therefore, in can be concluded that albumin infusion improves both subjective and objective improvement of patients with heart failure. University Heart Journal Vol. 15, No. 2, Jul 2019; 47-53

scholarly journals Adjustments in the tetrazolium test methodology for assessing the physiological quality of chickpea seeds

2019 ◽  
Vol 41 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Humberto Alencar Paraíso ◽  
Delacyr da Silva Brandão Junior ◽  
Ramon Ivo Soares Avelar ◽  
Candido Alves da Costa ◽  
Luan Souza de Paula Gomes ◽  
...  
Keyword(s):  
Seed Quality ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Test Methodology ◽  
Physiological Quality ◽  
Tetrazolium Test ◽  
Class Iv

Abstract: Quick tests are essential tools to evaluate seed quality. The objective of this study was to adapt the methodology of tetrazolium test, by identifying the most suitable pre-conditioning parameters of imbibition temperature and duration, and tetrazolium solution concentrations, in order to assess the physiological quality of chickpea seeds. Also, this work proposed the separation of lots in classes, according to the viability and vigor of the seeds. Three lots of chickpeas (lot 1 - BRS Aleppo C1, lot 2 - BRS Aleppo basic, and lot 3 - Cicero) were evaluated. They were analyzed according to three combinations of imbibition temperature and duration (41 °C for 4 hours, 41 ºC for 6 hours, and 30 ºC for 18 hours) and two tetrazolium concentrations (0.1% and 0.5%). The imbibition at 41 °C for 4 or 6 hours, and at 30 ºC for 18 hours allowed clear visualization of injuries in the seeds after immersion in 0.1% tetrazolium solution. The intense coloration formed by the 0.5% solution of this salt prevented the differentiation of the types of damage. In addition, it was possible to separate the seeds into four classes: class I (viable and vigorous, without damages), class II (viable and vigorous, with superficial injuries), class III (viable and non-vigorous), and class IV (non-viable).

Morphology classification of circulating tumor cells could be a predictor of recurrent disease in patients with non-small cell lung cancer after surgery.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15530-e15530
Author(s):  
Yun Wu ◽  
Yuxu Niu ◽  
Fanzhen Lv ◽  
Wen Gao ◽  
Xiaoyong Shen
Keyword(s):  
Lung Cancer ◽  
Recurrent Disease ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Class V ◽  
Lung Cancer Patients ◽  
Increased Risk ◽  
Class Iv

e15530 Background: CTCs have been widely used in monitoring the efficacy and prognosis of lung cancer. However, CTCs number count alone cannot accurately predict the recurrent disease in patients. In this study, we investigate whether the morphology classification of CTCs could be as a prognostic marker for increased risk of recurrence after surgery. Methods: In this study, 105 lung cancer patients (median age 68y) who underwent surgery were prospectively enrolled in this study. Samples were obtained before, after, and serially up to 24 months after surgery. CTCs were collected and morphology classified by utilizing a CTC test workflow which uses negative enrichment and immunofluorescence methods to capture and identify CTCs from blood sample. Captured CTCs (epithelial type) were screened with a customized imaging analysis pipeline, a cytological profile of each CTC was created, including cell size, shape, fluorescent intensity and texture etc. Results: The CTC detection rate was 78.1% (78 of 105) prior to surgery, and a total of 726 CTCs were enumerated. Median CTC count number was 3. 5 classes of CTCs with distinct morphological features were observed in lung cancer patients’ CTC tests, briefly, CTC class I and class II possessed large nuclei but relatively lower epithelial expression level, CTC class III, IV, V possessed small nuclei but relatively higher epithelial expression level, CTC class III possessed irregular shaped nuclei, CTC class V possessed relatively lower nuclei/cytoplasm ratio. Class III accounted for the highest proportion of captured CTCs III, about 35.5% with Class I 14.8%, Class II 15.3%,Class IV 17.8% and Class 5 16.6%. Postoperative recurrence and metastasis were observed in 16 patients. CTCs positive were found in 14 patients (87.5%). 145 CTCs were collected, Median CTC count number was 3,Cluster III accounted for 47.3%, with Class I 11.8%,Class II 13.3%,Class IV 14.5% and Class V 11.8%; Patients with Cluster 3 dominant were associated with increased risk of local recurrence ( p < 0.05) and distant metastasis ( p < 0.05). Conclusions: Small and irregular nuclei CTC is significant associated with increased risk of recurrence disease. Morphology Classification of circulating tumor cells is feasible in monitoring the recurrence of disease and may potentially identify the patients who may benefit from further therapy.

295 ASSESSMENT OF CYTOTOXICITY AND INTERFERENCE OF ATELEIA GLAZIOVIANA IN BOVINE HERPESVIRUS TYPE 1 (BoHV-1) INTERACTION WITH IN VITRO-MATURED BOVINE OOCYTES

2010 ◽  
Vol 22 (1) ◽  
pp. 304
Author(s):  
D. L. Pavão ◽  
M. M. Piccolomini ◽  
A. C. Góes ◽  
R. Harakava ◽  
M. Haraguchi ◽  
...  
Keyword(s):  
Cumulus Cells ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Herpesvirus Type ◽  
Action Analysis ◽  
Bovine Herpesvirus Type 1 ◽  
Bovine Oocytes ◽  
Class Iv

In vitro embryo production (IVP), as well as having a biotechnical importance, is a valuable tool for studies of gamete and/or embryo interaction with pathogens and xenobiotics. In consequence, it has become an excellent model not only for investigations about sanitary aspects, but also for aspects related to toxic processes. The aim of this study was to evaluate the effect of cytotoxic aqueous extract of Ateleia glazioviana and its interference on the interaction of bovine herpesvirus type 1 (BoHV-1) with bovine oocytes during the In vitro maturation (IVM) period. The statistical analysis of the experiments was made according to Student’s t-test (P < 0.05). The parameters used for this experiment were based on the morphological, physiological, and clastogenic action analysis of the bovine oocytes. The oocytes were collected from ovaries from slaughterhouse and divided into control group (G1, n = 214), a group infected with BoHV-1 (Los Angeles sample 105.5 TCID50 mL-1(G2, n = 210), a group exposed to the extract of A. glazioviana, 0.24 g mL-1; G3, n = 228), and a group simultaneously exposed to the virus and to the extract (G4, n = 210). For IVM, the oocytes were kept in TCM-199 supplemented with hormones and incubated at 38°C, 5%CO2, and 95% humidity for 24 h. The oocytes in G1 showed high expansion of the cumulus cells and ooplasm uniform in appearance; oocytes in G2 showed uniform but moderate expansion of cumulus cells and retraction of ooplasm; the G3 group showed low and irregular expansion with degeneration of cumulus cells and retraction of ooplasm with a granular aspect; and oocytes in G4 showed degeneration of cumulus cells, retracted and granular ooplasm. We observed maturation rates of 81.3% in G1, 31.0% in G2, 5.7% in G3, and 1.4% in G4. As for the clastogenic action analysis, an additional group of oocytes, named in natura (n = 210), was evaluated and presented 41.9% of comets class 0 (zero), 34.8% class I, 12.4% class II, 7.1% class III, and 3.8% class IV G1 (n = 211) presented 6.1% of comets class 0, 47.8% class I, 31.3% class II, 11.0% class III, and 3.8% class IV Oocytes belonging to G3 (217) presented 0.5% of comets class 0, 19.8% class I, 28.1% class II, 34.1% class III, and 17.5% class IV G2 (n = 229) presented 4.4% of comets class 0, 61.2% class I, 26.6% class II, 4.8% class III, and 3.0% class IV Oocytes in G4 (n = 206) presented 3.9% of comets class 0, 26.2% class I, and similar amounts of comets level II (23.8%), III (22.8%), and IV (23.3%). The statistical analysis presented a significant difference in the final results. Such results show the cytotoxic effect of A. glazioviana in bovine oocytes. The simultaneous exposure to the virus and the extract aggravated the effect of the virus, suggesting an increase of the pathogen within the gametic cell. Vitrocel/Embriolife.

scholarly journals MP32: The Pulmonary Embolism Severity Index (PESI) score and disposition decisions in Calgary emergency departments

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S76
Author(s):  
S. Brunet ◽  
D. Wang ◽  
E. Lang
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Mortality Rate ◽  
Class Ii ◽  
Low Risk ◽  
Class I ◽  
Class Iii ◽  
Class V ◽  
Risk Class ◽  
Class Iv

Introduction: The Pulmonary Embolism Severity Index (PESI) score predicts short-term mortality from pulmonary embolism and low-risk patients suitable for home therapy. However, it is unknown if it is a driver for disposition decisions for emergency department (ED) patients. The primary objective of this study was to define the relationship between disposition decisions and the PESI score in Calgary zone hospitals. Methods: The PESI score was calculated retrospectively for 576 patients presenting to one of four Calgary zone hospitals for pulmonary embolism over the last 2 years. The calculated PESI score allowed the mortality risk of each patient to be estimated for very low risk (Class I, 0-1.6% 30-day mortality rate), low risk (Class II, 1.7-3.5% 30-day mortality rate), intermediate risk (Class III, 3.2-7.1% 30-day mortality rate), high risk (Class IV, 4.0-11.4% 30-day mortality rate), and very high risk (Class V, 10.0- 24.5% 30- day mortality rate). The patients were grouped based on being admitted to the hospital for inpatient care, or discharged for outpatient care. Descriptive statistics were used to describe the data. Results: Of the 576 patients, 317 (55%) were discharged and 259 (45%) were admitted to the hospital for inpatient care. Among admitted patients, 20.5% were considered Class I, 29.3% were Class II, 24.3% were Class III, 17.6% were Class IV, and 8.1% were Class V. Among discharged patients, 53.9 % were Class I, 25.6% were Class II, 15.5% were Class III, 4.4% were Class IV, and 0.6% were Class V. Of the 25 very high-risk (Class V) patients, 2 (8.0%) were discharged from the ED and treated as outpatients. Of the 223 very low risk (Class I) patients, 171 (76.7%) were discharged and 52 (23.3%) were admitted to hospital. Conclusion: A significant percentage of pulmonary embolism patients admitted to Calgary Zone hospital wards are PESI low risk (29.3%) or very low risk (20.5%). Implementation of a PESI score-based disposition pathway could improve the safety, cost-effectiveness and quality of ED disposition decisions for PE.

scholarly journals Comparative Prey Consumption of a Predatory Spider, Pardosa pseudoannulata (Bosenberg and Strand) on Three Different Diets

2013 ◽  
Vol 20 (1-2) ◽  
pp. 57-62 ◽  
Author(s):  
M Mala ◽  
M Jahan ◽  
KS Islam
Keyword(s):  
Brown Planthopper ◽  
Wolf Spider ◽  
Class Ii ◽  
Nilaparvata Lugens ◽  
Prey Consumption ◽  
Class I ◽  
Class Iii ◽  
Pardosa Pseudoannulata ◽  
Nilaparvata Lugens Stål ◽  
Class Iv

Prey consumption efficiency of the wolf spider, Pardosa pseudoannulata (Boesenberg and Strand) preying on brown planthopper (BPH), Nilaparvata lugens (Stål), green leafhopper (GLH), Nephotettix virescens (Distant) and drosophila, Drosophila melanogaster was investigated in the laboratory of the Department of Entomology, Bangladesh Agricultural University, Mymensingh during the period from June 2008 to April 2009. Depending on the instars and maturity, the spiders were grouped into four different age classes, namely Class I (3rd and 4th instars), Class II (5th and 6th instars), Class III (7th and 8th instars) and Class IV (egg bearing female). When the spiders of each class was supplied with sufficient number of BPH, GLH and Drosophila then the order of the prey consumption of Class I spider was BPH > drosophila > GLH and the order of the prey consumption of Class II, Class III and Class IV were BPH > GLH > drosophila. But in two cases BPH was highly preferred over drosophila and GLH in a mixed diet.DOI: http://dx.doi.org/10.3329/pa.v20i1-2.16850 Progress. Agric. 20(1 & 2): 57 – 62, 2009  

Atlatl Weights from Certain Sites on the Northern and Central Great Plains

1967 ◽  
Vol 32 (1) ◽  
pp. 36-53 ◽  
Author(s):  
Robert W. Neuman
Keyword(s):  
South Dakota ◽  
North Dakota ◽  
Great Plains ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Class Iv ◽  
Made In

AbstractThis paper begins with a discussion concerning the development of the term "atlatl weight" in archaeological literature. It then proceeds to analyze in detail data relative to 60 atlatl weights from 39 locations on the Plains area of Alberta, Saskatchewan, Montana, Wyoming, Colorado, North Dakota, South Dakota, Nebraska, Kansas, and Iowa. Although most of the specimens are surface finds, a number are from systematically excavated, radiocarbon-dated occupations.Differentiated primarily on their general shapes, five groups of atlatl weights seem apparent: Class I, loaf-shaped; Class II, end-ridged; Class III, long ellipsoidal; Class IV, zoomorphic; and a miscellaneous category.Available evidence suggests that atlatl weights were being made, in the area under consideration, from about 2500 B.C. until A.D. 800.

scholarly journals Utility of the MISDEF2 Algorithm and Extent of Fusion in Open Adult Spinal Deformity Surgery With Minimum 2-Year Follow-up

Neurospine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 824-832
Author(s):  
Bo Li ◽  
Gregory Hawryluk ◽  
Praveen V. Mummaneni ◽  
Michael Wang ◽  
Ratnesh Mehra ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Class Ii ◽  
Class I ◽  
Complication Rates ◽  
Class Iii ◽  
Full Correction ◽  
Class Iv

Objective: Long-segment fusion in adult spinal deformity (ASD) is often needed, but more focal surgeries may provide significant relief with less morbidity. The minimally invasive spinal deformity surgery (MISDEF2) algorithm guides minimally invasive ASD surgery, but it may be useful in open ASD surgery. We classified ASD patients undergoing focal decompression, limited decompression and fusion, and full correction according to MISDEF2 and correlated outcomes.Methods: A retrospective study of ASD patients treated by 2 surgeons at our hospital was performed. Inclusion criteria were: age > 50, minimum 2-year follow-up, and open ASD surgery. Tumor, trauma, and infections were excluded. Patients had open surgery including focal decompression, short segment fusion, or full scoliosis correction. All patients were categorized by MISDEF2 into 4 classes based upon spinopelvic parameters. Perioperative metrics were assessed. Radiographic correction, complications and reoperation were recorded.Results: A total of 136 patients met inclusion criteria. Mean follow-up was 46 ± 15.8 months (range, 24–118 months). Forty-seven underwent full deformity correction, 71 underwent short segment fusion, and 18 underwent decompression alone. There were 24 cases of class I, 66 cases of class II, 23 cases of class III, and 23 cases of class IV patients. Patients in class I and II had perioperative complication rates of 0% and 16.7% and revision rates of 8% and 21.2% when undergoing focal decompression or limited fusion. However, class II patients undergoing full correction had higher perioperative complications rate (p = 0.03) and revision surgery rates (p = 0.047). This difference was not seen in class III patients (p > 0.05). All class IV patients underwent full correction, but they had higher perioperative complication rates (p < 0.019), comparable revision surgery rates (p = 0.27), and better radiographic realignment (p < 0.001). In addition, full deformity correction was associated with longer length of stay, increased blood loss, and longer operative time (p < 0.001).Conclusion: The MISDEF2 algorithm may help guide ASD surgical decision making even in open surgery, with focal treatment used in class I and II patients as a viable alternative and full correction implemented in class IV patients because of severe malalignment. However, class II patients with ASD undergoing full deformity correction do have higher complication rates.

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