scholarly journals Supratentorial cavernous malformations adjacent to the corticospinal tract: surgical outcomes and predictive value of diffusion tensor imaging findings

2018 ◽  
Vol 128 (2) ◽  
pp. 541-552 ◽  
Author(s):  
Yuanxiang Lin ◽  
Fuxin Lin ◽  
Dezhi Kang ◽  
Yuming Jiao ◽  
Yong Cao ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Predictive Value ◽  
Diffusion Tensor ◽  
Motor Deficits ◽  
Short Term ◽  
Cavernous Malformations ◽  
Scale Scores ◽  
The Mean ◽  
Deep Location

OBJECTIVEDiffusion tensor imaging (DTI) findings may facilitate clinical decision making in patients with supratentorial cavernous malformations adjacent to the corticospinal tract (CST-CMs). The objective of this study was to determine the predictive value of preoperative DTI findings for surgical outcomes in patients with CST-CMs.METHODSA prospectively maintained database of patients with CM referred to the authors' hospital between September 2012 and October 2015 was reviewed to identify all consecutive surgically treated patients with CST-CM. All patients had undergone sagittal T1-weighted anatomical imaging and DTI before surgery. Both DTI findings and clinical characteristics of the patients and lesions were analyzed with respect to surgery-related motor deficits. DTI findings included lesion-to-CST distance (LCD) and the alteration (i.e., deviation, interruption, or degeneration due to the CM) of CST on preoperative DTI images. Surgery-related motor deficits at 1 week and the last clinic visit (≥ 3 months) after surgery were defined as short-term and long-term deficits, respectively. Preoperative and final modified Rankin Scale scores were also analyzed to identify the surgical outcomes in these patients.RESULTSA total of 56 patients with 56 CST-CMs were included in this study. The mean LCD was 3.9 ± 3.2 mm, and alterations of the CST were detected in 20 (36.7%) patients. One week after surgery, 21 (37.5%) patients had short-term surgery-related motor deficits, but only 14 (25.0%) patients had long term deficits at the last clinical visit. The mean patient follow-up was 14.7 ± 10.1 months. The difference between preoperative and final modified Rankin Scale scores was not statistically significant (p = 0.490). Multivariate analysis showed that both short-term (p < 0.001) and long-term (p = 0.002) surgery-related motor deficits were significantly associated with LCD. Receiver operating characteristic (ROC) curve results were as follows: for short-term surgery-related motor deficits, the area under the ROC curve (AUC) was 0.860, and the cutoff point was LCD = 2.55 mm; for long-term deficits, the AUC was 0.894, and the cutoff point was LCD = 2.30 mm. Both univariate (p = 0.012) and multivariate (p = 0.049) analyses revealed that CST alteration on preoperative DTI was significantly correlated with short-term surgery-related motor deficits. On univariate analysis, deep location of the CST-CMs was significantly correlated with long-term motor deficits (p = 0.016). Deep location of the CST-CMs had a trend toward significance with long-term motor deficits on the multivariate analysis (p = 0.060).CONCLUSIONSTo facilitate clinical practice, the authors propose that 3.00 mm (2.55 to ∼3.00 mm) may be the safe LCD for surgery in patients with CST-CMs. A CST alteration on preoperative DTI and a deep location of the CST-CM may be risk factors for short- and long-term surgery-related motor deficits, respectively. A randomized controlled trial is needed to demonstrate the predictive value of preoperative DTI findings on surgical outcomes in patients with CST-CMs in future studies.

The utility of preoperative diffusion tensor imaging in the surgical management of brainstem cavernous malformations

2015 ◽  
Vol 122 (3) ◽  
pp. 653-662 ◽  
Author(s):  
Bruno C. Flores ◽  
Anthony R. Whittemore ◽  
Duke S. Samson ◽  
Samuel L. Barnett
Keyword(s):  
Diffusion Tensor ◽  
Medial Longitudinal Fasciculus ◽  
Medial Lemniscus ◽  
Cavernous Malformations ◽  
Fiber Tracts ◽  
The Mean ◽  
Cerebellar Peduncle ◽  
Selection Of

OBJECT Resection of brainstem cavernous malformations (BSCMs) may reduce the risk of stepwise neurological deterioration secondary to hemorrhage, but the morbidity of surgery remains high. Diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) are neuroimaging techniques that may assist in the complex surgical planning necessary for these lesions. The authors evaluate the utility of preoperative DTI and DTT in the surgical management of BSCMs and their correlation with functional outcome. METHODS A retrospective review was conducted to identify patients who underwent resection of a BSCM between 2007 and 2012. All patients had preoperative DTI/DTT studies and a minimum of 6 months of clinical and radiographic follow-up. Five major fiber tracts were evaluated preoperatively using the DTI/DTT protocol: 1) corticospinal tract, 2) medial lemniscus and medial longitudinal fasciculus, 3) inferior cerebellar peduncle, 4) middle cerebellar peduncle, and 5) superior cerebellar peduncle. Scores were applied according to the degree of distortion seen, and the sum of scores was used for analysis. Functional outcomes were measured at hospital admission, discharge, and last clinic visit using modified Rankin Scale (mRS) scores. RESULTS Eleven patients who underwent resection of a BSCM and preoperative DTI were identified. The mean age at presentation was 49 years, with a male-to-female ratio of 1.75:1. Cranial nerve deficit was the most common presenting symptom (81.8%), followed by cerebellar signs or gait/balance difficulties (54.5%) and hemibody anesthesia (27.2%). The majority of the lesions were located within the pons (54.5%). The mean diameter and estimated volume of lesions were 1.21 cm and 1.93 cm3, respectively. Using DTI and DTT, 9 patients (82%) were found to have involvement of 2 or more major fiber tracts; the corticospinal tract and medial lemniscus/medial longitudinal fasciculus were the most commonly affected. In 2 patients with BSCMs without pial presentation, DTI/DTT findings were important in the selection of the surgical approach. In 2 other patients, the results from preoperative DTI/DTT were important for selection of brainstem entry zones. All 11 patients underwent gross-total resection of their BSCMs. After a mean postoperative follow-up duration of 32.04 months, all 11 patients had excellent or good outcome (mRS Score 0–3) at the time of last outpatient clinic evaluation. DTI score did not correlate with long-term outcome. CONCLUSIONS Preoperative DTI and DTT should be considered in the resection of symptomatic BSCMs. These imaging studies may influence the selection of surgical approach or brainstem entry zones, especially in deep-seated lesions without pial or ependymal presentation. DTI/DTT findings may allow for more aggressive management of lesions previously considered surgically inaccessible. Preoperative DTI/DTT changes do not appear to correlate with functional postoperative outcome in long-term follow-up.

Elevations in Thyroid-Stimulating Hormone in Normal Subjects after Receiving Short-Term Lithium Carbonate

1988 ◽  
Vol 22 (3) ◽  
pp. 202-204 ◽  
Author(s):  
Merlin V. Nelson ◽  
Vickie Tutag-Lehr ◽  
R. Lee Evans
Keyword(s):  
Lithium Carbonate ◽  
Normal Subjects ◽  
Thyroid Stimulating Hormone ◽  
Short Term ◽  
The Mean ◽  
Early Rise ◽  
State Concentration ◽  
Male Subjects ◽  
Stimulating Hormone

Nine normal, healthy male subjects had significantly elevated thyroid-stimulating hormone (TSH) concentrations while receiving oral lithium carbonate for two weeks. The mean minimum lithium serum concentration was 0.765 mEq/L. The TSH concentrations after 15 days on lithium were significantly correlated to the TSH concentration at baseline. No correlation was found between mean minimum lithium steady-state concentration and TSH concentration after 15 days on lithium. Further research is necessary to determine if a high baseline TSH concentration or an early rise in TSH will predict those patients who will eventually develop hypothyroidism after long-term lithium therapy.

Predictive value of short-term migration in determining long-term stable fixation in cemented and cementless total knee arthroplasties

2019 ◽  
Vol 101-B (7_Supple_C) ◽  
pp. 55-60 ◽  
Author(s):  
E. K. Laende ◽  
C. G. Richardson ◽  
M. J. Dunbar
Keyword(s):  
Predictive Value ◽  
Predictive Ability ◽  
Porous Metal ◽  
Short Term ◽  
Long Term Follow Up ◽  
Total Knee ◽  
Total Point ◽  
Cementless Components

Aims Early implant migration measured with radiostereometric analysis (RSA) has been proposed as a useful predictor of long-term fixation of tibial components in total knee arthroplasty. Evaluation of actual long-term fixation is of interest for cemented components, as well as for cementless fixation, which may offer long-term advantages once osseointegration has occurred. The objective of this study was to compare the long-term migration with one- and two-year migration to evaluate the predictive ability of short-term migration data and to compare migration and inducible displacement between cemented and cementless (porous metal monoblock) components at least ten years postoperatively. Patients and Methods Patients who had participated in RSA migration studies with two-year follow-up were recruited to return for a long-term follow-up, at least ten years from surgery. Two cemented tibial designs from two manufacturers and one porous metal monoblock cementless tibial design were studied. At the long-term follow-up, patients had supine RSA examinations to determine migration and loaded examinations (single leg stance) to determine inducible displacement. In total, 79 patients (54 female) returned, with mean time since surgery of 12 years (10 to 14). There were 58 cemented and 21 cementless tibial components. Results Migration at one year and two years was significantly correlated with long-term migration (p < 0.001). Median migration at the long-term follow-up was 0.6 mm (maximum total point motion; interquartile range (IQR) 0.4 to 0.9) for the cemented group and 0.6 mm (IQR 0.3 to 1.1) for the cementless group with no difference between groups (p = 0.99). Inducible displacement was significantly lower for the cementless components (p < 0.001). Conclusion Long-term migration was strongly correlated with two-year migration. Although long-term migration was not different for cemented or cementless tibial components, inducible displacement at the long-term visit was significantly lower for these cementless components, suggesting superior fixation. These findings support the predictive value of short-term migration in determining long-term fixation. Cite this article: Bone Joint J 2019;101-B(7 Supple C):55–60

scholarly journals On the Theory of Electron Diffusion in Electrostatic Fields in Gases

1974 ◽  
Vol 27 (2) ◽  
pp. 195 ◽  
Author(s):  
HR Skullerud
Keyword(s):  
Diffusion Coefficient ◽  
Boltzmann Equation ◽  
Diffusion Equation ◽  
Diffusion Tensor ◽  
Lateral Diffusion ◽  
Mean Square ◽  
Electrostatic Fields ◽  
The Mean ◽  
Lateral Diffusion Coefficient

The motion of electrons in a gas in the presence of large electron density gradients has been studied theoretically, starting from the two-term expansion of the Boltzmann equation. The effects of material boundaries have not been considered. An electron swarm released as a b-function in space and with an equilibrium energy distribution is found initially to develop as a spheroid with dimensions determined by the lateral diffusion coefficient. It subsequently passes through a stage involving a slowly decaying pear-shaped deformation, before ultimately becoming an ellipsoid with dimensions determined by the longitudinal and lateral components of the diffusion tensor. Numerical values cited in the literature for the long-term deviations from the mean square widths predicted by the diffusion equation have been found to be in error by factors of 10 or more.

scholarly journals A SLR Pre-Processing Algorithm Based on Satellite Signature Effect

2021 ◽  
Vol 11 (19) ◽  
pp. 8880
Author(s):  
Bowen Guan ◽  
Cunbo Fan ◽  
Ning An ◽  
Ricardo Cesar Podesta ◽  
Dra Ana Pacheco ◽  
...  
Keyword(s):  
Mean Value ◽  
Observation Data ◽  
Short Term ◽  
Error Sources ◽  
Effect Model ◽  
The Mean ◽  
The Stability ◽  
First Time ◽  
Satellite Signature Effect

As one of the major error sources, satellite signature effect should be reduced or even erased from the distribution of the post-fit residuals to improve the ranging precision. A simulation of satellite signature effect removal process for normal point algorithm is conducted based on a revised model of satellite response, which fully considers the structural and distribution characteristics of retroreflectors. In order to eliminate both long-term and short-term satellite signature effect, a clipping method for SLR data processing is proposed by defining the clipping location as 5.6 mm away from the mean value of the long-term fit residuals to select effective returns for normal points. The results indicate that, compared to normal points algorithm, the RMS per NP of LAGEOS-1 observation data processed by the clipping method is reduced from 62.90 ± 9.9 mm to 56.07 ± 4.69 mm, and the stability of RMS is improved 53%. This study improves the satellite signature effect model and simulates the fluctuation of normal points caused by satellite signature effect for the first time. The new method based on the simulation of satellite signature effect has stronger robustness and applicability, which can further minimize the influence of satellite signature effect on the SLR production and significantly improve the data property.

scholarly journals Early and long-term complications following transanal pull through Soave technique in infants with Hirschsprung's diseaseric infants with Hirschsprung's disease

2019 ◽  
Author(s):  
Manoochehr Ghorbanpour ◽  
Mohammad Ali Seyfrabie ◽  
Babak Yousefi
Keyword(s):  
Intestinal Obstruction ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Statistical Tests ◽  
Case Series ◽  
P Value ◽  
Short Term ◽  
Case Series Study ◽  
The Mean

Objective. Patients undergoing Soave surgery for Hirschsprung's disease are at risk for some complications. The aim of this study was to investigate such short-term and long-term complications and evaluate the outcome of the operation in these patients. Methods. A case series study was carried out during the last 12 years, during 2007 to 2018 in Besat hospital of Hamadan. Data collection conducted using a checklist includes questions about demographic information, clinical features, and short-term and long-term complications, and consequences of post-operative surgery. The findings of the study were analyzed using SPSS software version 20 and appropriate statistical tests. P-value less than 0.05 was considered statistically significant. Results. A total of 55 children underwent Soave surgery during the last 12 years in Besat Hospital Hamadan, Iran. The mean age of the patients was 38±10 days during surgery, of which 56.4% were female. The mean hospital stay was 7.3 days. Also, the mean weight of children at birth was 2970±447 gr. Most of the patients were born as NVD (52.7%) and term (74.5%). The most common comorbidity was congenital heart disease. The most common short-term complication was intestinal obstruction in 14 patients (25.5%) and the most frequent long-term complication was intestinal obstruction and constipation (27.3% each cases). The mortality rate of patients in this study was 14.5% in total. Conclusions. One stage surgical procedure in Hirschsprung's disease is a safe and effective method, but care should be taken in choosing patients and patients should be monitored for possible complications, so that they can be considered and implemented for proper treatment.

Long-term and short-term surgical outcomes of single-incision laparoscopic hepatectomy on anterolateral liver segments

2019 ◽  
Vol 34 (7) ◽  
pp. 2969-2979 ◽  
Author(s):  
Kuei-Yen Tsai ◽  
Hsin-An Chen ◽  
Wan-Yu Wang ◽  
Ming-Te Huang
Keyword(s):  
Surgical Outcomes ◽  
Single Incision ◽  
Laparoscopic Hepatectomy ◽  
Short Term

The influence of mixtures of Stylosanthes spp. accessions on the occurrence of anthracnose caused by Colletotrichum gloeosporioides

1994 ◽  
Vol 45 (1) ◽  
pp. 203 ◽  
Author(s):  
RD Davis ◽  
S Chakraborty ◽  
DF Cameron ◽  
JAG Irwin ◽  
RM Boland
Keyword(s):  
Colletotrichum Gloeosporioides ◽  
Resistant Cultivar ◽  
Pure Stand ◽  
Northern Australia ◽  
Short Term ◽  
Mixed Stands ◽  
The Mean ◽  
Moderately Resistant ◽  
Long Term Studies

The effectiveness of using accession mixtures of Stylosanthes spp. to manage anthracnose (Colletotrichum gloeosporioides) in pastures in northern Australia was examined during three consecutive years. Two mixtures containing six accessions were compared with the components grown as pure stands. No significant differences in anthracnose incidence (proportion of infected plants/plot) were indicated between the two mixtures and the mean incidence of their respective components grown in pure swards. Areas under the disease progress curves for the accessions were not significantly different between pure and mixed stands of the cultivars other than Seca and Verano. Resistant cultivar Seca developed more disease in a mixture than in a pure stand, and moderately resistant Verano had less disease in a mixture than in a pure stand. In the short term, no apparent anthracnose control advantage is achieved in highly susceptible accessions of Stylosanthes spp. when they are included in mixtures with less susceptible accessions. Long term studies involving grazing animals are necessary to adequately evaluate control of this disease through the use of mixtures.

scholarly journals Mid-infrared evolution of η Carinae from 1968 to 2018

2019 ◽  
Vol 630 ◽  
pp. L6 ◽  
Author(s):  
A. Mehner ◽  
W.-J. de Wit ◽  
D. Asmus ◽  
P. W. Morris ◽  
C. Agliozzo ◽  
...  
Keyword(s):  
Spectral Energy Distribution ◽  
Circumstellar Dust ◽  
Spectral Energy ◽  
Short Term ◽  
Dust Extinction ◽  
Bolometric Luminosity ◽  
Very Large Telescope ◽  
Optical Wavelengths ◽  
The Mean

η Car is one of the most luminous and massive stars in our Galaxy and is the brightest mid-IR source in the sky outside our solar system. Since the late 1990s, the central source has dramatically brightened at UV and optical wavelengths. This might be explained by a decrease in circumstellar dust extinction. We aim to establish the mid-IR flux evolution and further our understanding of the star’s UV and optical brightening. Mid-IR images from 8−20 μm were obtained in 2018 with VISIR at the Very Large Telescope. Archival data from 2003 and 2005 were retrieved from the ESO Science Archive Facility, and historical records were collected from publications. We present mid-IR images of η Car with the highest angular resolution to date at the corresponding wavelengths (≥0.22″). We reconstruct the mid-IR evolution of the spectral energy distribution of the spatially integrated Homunculus nebula from 1968 to 2018 and find no long-term changes. The bolometric luminosity of η Car has been stable over the past five decades. We do not observe a long-term decrease in the mid-IR flux densities that could be associated with the brightening at UV and optical wavelengths, but circumstellar dust must be declining in our line of sight alone. Short-term flux variations within about 25% of the mean levels could be present.

Neutrophil-to-lymphocyte ratio (NLR) to predict the short-term and long-term outcomes of gastric cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15560-e15560
Author(s):  
Ryoichi Miyamoto ◽  
Satoshi Inagawa ◽  
Naoki Sano ◽  
Sosuke Tadano ◽  
Masayoshi Yamamoto
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Predictive Value ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
Survival Times ◽  
Long Term Outcomes ◽  
Short Term ◽  
Gastric Cancer Patients

e15560 Background: Preoperative NLR was well known as highly repeatable, cost-effective and widely available long-term postoperative prognostic marker of gastric cancer patients. However, the utility of preoperative NLR to predict short-term outcomes in gastric cancer patients remains unclear. In this study, we addressed whether the preoperative NLR is a predictive value of short-term outcome in gastric cancer patients. Methods: We retrospectively evaluated 154 consecutive gastric cancer patients. Mean NLR was calculated, and 3.5 was set as cut-off value. The patient characteristics and perioperative outcomes were respectively compared. In addition, median survival times (MSTs) were also compared. In terms of stage II/III (UICC 7th) gastric cancer patients, median disease-free survival times (MDFSTs) were compared between the two groups. Results: The patients were then divided into two groups: low-NLR group (n = 110) and high-NLR group (n = 44). Among low-NLR group and high-NLR group, significant differences were respectively observed in preoperative symptoms [56 (51%) vs. 31 (70%); p = 0.027] and perioperative outcomes including postoperative complications [3 (2.7%) vs. 5 (11.3%); p = 0.015], intraoperative blood loss (158 ± 168 g vs. 232 ± 433 g; p = 0.022), and intraoperative blood transfusion [0 vs. 3 (6.8%); p = 0.042]. MSTs and MDFSTs were significantly differed (812 vs. 594 days; p = 0.04, 848 vs. 475 days; p = 0.03, respectively). Conclusions: The present study indicated that preoperative NLR influenced not only long-term outcomes but also perioperative outcomes in gastric cancer patients. Preoperative NLR is also a useful predictive value of short-term outcomes in gastric cancer patients.

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