Objective: : Collateral circulation is associated with the differential treatment effect of endovascular thrombectomy (EVT) in acute ischemic stroke. We aimed to verify the ability of the collateral map to predict futile EVT in patients with acute anterior circulation ischemic stroke. Methods: : This secondary analysis of a prospective observational study included data from participants underwent EVT for acute ischemic stroke due to occlusion of the internal carotid artery and/or the middle cerebral artery within 8 hours of symptom onset. Multiple logistic regression analyses were conducted to identify independent predictors of futile recanalization (modified Rankin scale score at 90 days of 4–6 despite of successful reperfusion). Results: : In a total of 214 participants, older age (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.56 to 3.67; p<0.001), higher baseline National Institutes of Health Stroke Scale (NIHSS) scores (OR, 1.12; 95% CI, 1.04 to 1.21; p=0.004), very poor collateral perfusion grade (OR, 35.09; 95% CI, 3.50 to 351.33; p=0.002), longer door-to-puncture time (OR, 1.08; 95% CI, 1.02 to 1.14; p=0.009), and failed reperfusion (OR, 3.73; 95% CI, 1.30 to 10.76; p=0.015) were associated with unfavorable functional outcomes. In 184 participants who achieved successful reperfusion, older age (OR, 2.30; 95% CI, 1.44 to 3.67; p<0.001), higher baseline NIHSS scores (OR, 1.12; 95% CI, 1.03 to 1.22; p=0.006), very poor collateral perfusion grade (OR, 4.96; 95% CI, 1.42 to 17.37; p=0.012), and longer door-to-reperfusion time (OR, 1.09; 95% CI, 1.03 to 1.15; p=0.003) were associated with unfavorable functional outcomes. Conclusion : The assessment of collateral perfusion status using the collateral map can predict futile EVT, which may help select ineligible patients for EVT, thereby potentially reducing the rate of futile EVT.

Purpose: Evaluate the clinical results of humerus neck nonunion treated with Polarus intramedullary nail. Materials and Methods: 8 patients who underwent surgery for nonunion of humerus surgical neck fracture were included. All patients were female, the average age was 65 years. 5 out the total 8 cases initially received surgery, open reduction and internal fixation with metal plate in 1 case, Ender nail insertion in 2 cases, external fixator in 1 case and closed reduction and percutaneous pinning in 1 case. The other 3 non union cases initial received conservative managemnent. The average period of nonunion was 9 months in the operated group and 6.2 months in the conservative group. All 8 cases received closed reduction with intrameedullary Polarus nail and auto iliac bone graft. Union was confirmed radiologically, and functional evaluation was done with the UCLA functional criteria. Results: All 8 cases showed union on radiologic evaluation. Average time to union was 3.5 months, average follow up period was 27 months. Average UCLA shoulder evaluation score was 7.6 points preoperatively which improved to 26.3 points after surgery. Active shoulder flexion was 40.7 degrees preoperatiely which increased to 104 degrees after surgery. Shoulder abduction improved from 32.9 degrees preoperatively to 96.3 degrees after surgery. UCLA functional criteria was good in 5 cases and fair in 3 cases, which no poor cases. Conclusion: Polarus IM nailing and AIBG is a useful method for treating nonunion of humerus neck fracture with improvement in union and function.
External Fixators ; Female ; Follow-Up Studies ; Humans ; Humerus* ; Neck* ; Shoulder ; Transplants

BACKGROUND: The mortality of liver abscess has remained relatively constant during this century despite earlier diagnosis, treatment of underlying causes and more aggressive antibiotics therapy. The aims of this study were to evaluate the risk factors that associated with mortality of liver abscess. METHODS: This study was carried out retrospectively including 70 patients with liver abscess from January 1992 to August 2001. The clinical features, laboratory, imaging, and microbiologic findings, management strategy, and final outcome were studied, and prognostic factors were analyzed. RESULTS: There were 37 males and 33 females whose ages ranged from 17 to 89 years. The mean age of the patients was 57 years, and the male to female ratio was 1.1:1. In the major part of patients, the abscess was located in the right lobe (61.4%) and single in number (78.5%). Upper abdominal pain, fever and chills were the most common symptoms, and right upper abdominal tenderness was the most common physical findings. Twenty-six percent of patients were diabetic and 40%, 10% had biliary tract disease, malignancy on presentation, respectively. A hypoalbuminemia ( Abdominal Pain ; Abscess ; Anti-Bacterial Agents ; Biliary Tract Diseases ; Catheters ; Chills ; Diabetes Mellitus ; Diagnosis ; Drainage ; Female ; Fever ; Humans ; Hypoalbuminemia ; Liver Abscess* ; Liver* ; Male ; Mortality ; Needles ; Pneumonia ; Retrospective Studies ; Risk Factors

OBJECTIVE: To compare the outcomes of a method of assigning patients to a vaginal or laparoscopically assisted vaginal approach to hysterectomy. METHOD: Hysterectomy is the most common gynecologic operation. A clinical evaluation was attempted to analyze 100 cases of LAVH which was performed at St. Paul hospital from May 1997 to March 2000, and to compare them with 100 cases of vaginal hysterectomy at the same hospital. we used simple electrosurgical technique without using the disposable staples and other instruments. RESULTS: The mean age of the patients for LAVH was 46.18 years and that of VTH was 50.23 years. The most common indication for LAVH and VTH was Myoma uteri. The mean Hb change in LAVH was 2.15 and the Hb change of VTH was 2.17. The mean operative time of LAVH was 142.96 minutes and that of VTH was 77.06 minutes. The mean weight of uterus for LAVH was 221g and the mean weight of VTH was 182 g. The total percentage of urinary tract injury for LAVH was 3 % and that for VTH was 2 %. CONCLUSION: VTH, if possible, must be considered as a primary choice since it is were efficient than LAVH in cost, cosmetic aspects and complications. Further LAVH may be replaced with a laparotomy for hysterectomy in case of an insufficient operational experience, a previous abdominal operation hystory and the incapability of being indicated for VTH.
Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Laparotomy ; Myoma ; Operative Time ; Urinary Tract ; Uterus

To identify the central innervating the mammary nerve, viral retrograde transneuronal labelling methods were employed. Pseudorabies virus 6 microliter was injected into the mammary nerve of adult female Sprague-Dawley rats. After 4 days of survival, the animals were perfused with 4% paraformaldehyde-lysine periodate and their brains were processed for immunohistochemistry and double immunofluorescent staining of Pseudorabies virus or oxytocin using polyclonal antibodies. Several nuclei in brain were retrogradely labelled with Pesudorabies virus.Only a few magnocellular neurons of the paraventricular nucleus throughout whole brain showed double immunoreactivity to Pseudorabies virus and oxytocin. Approximately 11 percent of the oxytocinergic cells of the paraventricular nucleus,especially in three subnuclei[dorsomedial cap, lateral magnocelluar part and ventral part] showed double positive reaction to both Pseudorabies virus and oxytocin. These data demonstrate that some CNS cells projecting to the mammary nerve contained oxytocin and it may acts as a neurotransmitter in this pathway and a hormone targeting milk production and secretion.
Adult ; Animals ; Antibodies ; Brain ; Female ; Herpesvirus 1, Suid ; Humans ; Immunohistochemistry ; Milk ; Neurons ; Neurotransmitter Agents ; Oxytocin ; Paraventricular Hypothalamic Nucleus ; Pseudorabies ; Rats* ; Rats, Sprague-Dawley

No abstract available.

Magnetic resonance images frequently demonstrate asymmetrical mucosal volume in the nasal area of asymptomatic patients. To further evaluate this phenomenon, sequential MR examinations of the nasal cavity and paranasal sinuses were performed three to four times during a 3 to 8 hours period in ten normal volunteers. The study demonstrated that the mucosal volume changes alternated from side to side during this period in eight volunteers. Changes were also observed within the ethmoid sinuses, nasal septum and nasolacrimal ducts. Awareness of MR findings of nasal cycle may reduce the likehood of inflammatory disease being confused with normal physiologic changes, and also may provide another method in the study of this physiologic phenomenon.
Ethmoid Sinus ; Healthy Volunteers ; Humans ; Methods ; Nasal Cavity ; Nasal Septum ; Nasolacrimal Duct ; Paranasal Sinuses ; Volunteers

No abstract available.
Hypophysectomy*

No abstract available.
Child* ; Humans ; Visual Acuity*

Prolonged neuromuscular blockade following succinylcholine may be seen when anticho- linesterase had been administered prior to reverse nondepolarizing muscle relaxant-induced paralysis, possibly anticholinesterase has been reported to inhibit serum cholinesterase activity. Our study was undertaken in order to understand the effect of a nondepolarizing muscle relaxant (vecuronium) following neostigmine pretreatment. In this study, we assessed the effect of vecuronium induced neuromuscular blockade using a train of four, 2 Hz stimulations on ulnar nerve. Patients admitted to our hospital for elective operations were divided into two groups, each group consisting of 16 patients. In group I, vecuronium 0.1 mg/kg was .administered according to the priming principle following normal saline, in group II, vecuronium 1.0mg/kg was administered according to the priming principle following neostigmine 0.05 mg/kg and glycopyrrolate 0.003 mg/kg pretreatment. Then the time for Tl to reach 5% or less(second), and the time for Tl to reach from 25% to 75%(recovery index) were measured in both groups. The time for Tl to reach 5% or less in group I(92.8+/-14.72 second) and group II(97.5+/-16.43 seconds) were not siginificant. However the recovery indexof group I(10.2 5+/-1.93 minute) and group II(8.5+/-1.80 minute) showed significant shortening in group II(p<0. 05)
Cholinesterases ; Glycopyrrolate ; Humans ; Neostigmine* ; Neuromuscular Blockade* ; Paralysis ; Succinylcholine ; Ulnar Nerve ; Vecuronium Bromide*