CT and angiographic findings in ruptured intracranial aneurysms (original) (raw)
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Carotid Cavernous Fistula: Role of Open Surgery in The Era of Endovascular Treatment
Nepal Journal of Neuroscience, 2017
A 18-year-old right handed girl presented with progressive proptosis, chemosis, diplopia and an orbital bruit of right eye, 3 days after alleged history of fall from a tree, The intraocular pressure was increased. The suspected diagnosis of a direct carotid cavernous fistula (CCF) was confirmed by CT angiography CT Angiography showed direct fistulous communication of cavernous segment of right internal carotid artery with right cavernous sinus (type A right CCF) and linear minimally displaced fracture of right zygomatic arch and linear undisplaced fracture of wall of right orbit. The patient underwent right pterional craniotomy and transcavernous occlusion of fistula of right internal carotid artery (ICA). Surgery was performed with gradual resolution of the symptoms and normalization of the intraocular pressure.The pathogencsis, symptomatology, treatment of carotid cavernous fistulas are discussed.Nepal Journal of Neuroscience, Volume 14, Number 1, 2017, Page: 36-39
Korean Journal of Endocrine Surgery, 2015
Purpose: Fine needle aspiration (FNA) is a useful preoperative diagnostic tool for thyroid nodule because of the high sensitivity and specificity. The aim of this study is to determine the necessity of intraoperative frozen section (IOFS) after fine needle aspiration. Methods: Data of 534 patients with a single thyroid nodule who underwent thyroidectomy from June 2006 to August 2013 were reviewed retrospectively. FNA was performed preoperatively in all patients and IOFS was performed selectively according to the intraoperative findings and FNA results. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNA and IOFS for malignant nodules were analyzed. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA for malignant nodules were 100%, 95.5%, 99.8%, 100%, and 99.8%, respectively. All nodules diagnosed as benign by FNA were reaffirmed as benign nodules by permanent sections. When the result of FNA was suspicious for malignancy, specific features of preoperative ultrasound, including hypoechoic, size＜10 mm showed high positive predictive value and accuracy (98%, 86.9%, and 100%, 78.7% respectively). Conclusion: Performance of IOFS was not necessary when the result of FNA was consistent with malignancy or benign. However when the result of FNA was non-diagnostic or atypia, IOFS should be performed for more accurate detection of malignancy. When the result of FNA is suspicious for malignancy, IOFS is restrictively useful for excluding benign nodules using the features of ultrasound. In addition, IOFS is not useful in finding malignant thyroid nodules when the result of FNA is follicular neoplasm.
Surgical Excision of Symptomatic Non United Fragment of Anterior Process Fractures of the Calcaneus
The Korean Journal of Sports Medicine, 2012
A fracture of the anterior process of the calcaneus has been considered unusual injury. A clinically missed diagnosis is often, that had gone on to non united fragment. Particularly if the patient has calcaneocuboid pain and disability, and that early excision of the fragment is usually advisable. There were 12 cases with performing the simple excision. The fracture characteristics were analyzed by Degan's classification; type 1 was 1case (8.3%), type 2 was 6 cases (50.0%) and type 3 was 5 cases (41.7%); and their morphology; elongation was 3 cases (50.0%) and fragmentation 3 cases (50.0%). And, the pre and post operative American Orthopedic Foot and Ankle Society midfoot score and visual analog scale was evaluated; 66.0 and 5.8 was significantly improved to 90.1 (p=0.007) and 2.2 (p=0.003), respectively. Postoperative Excellent and good satisfaction with possible return to previous sports activity was 10 cases (83.3%). Conclusively, simple excision of non united fragment of anterior process of the calcaneus is a successful clinical option.
Journal of the Korean Glaucoma Society
Purpose: We describe a novel use of intracameral Indocyanine green (ICG) to confirm aqueous outflow to collector channels and aqueous veins after trabecular microbypass Schlemm's canal stent insertion (iStent inject ® W; Glaukos Corporation, Laguna Hills, CA, USA). Case summary: We report three cases of glaucoma patients who underwent trabecular microbypass stent to observe aqueous outflow into episcleral veins using intracameral ICG dye injection. 0.5% ICG dye was injected intraoperatively into the anterior chamber near the stents. Automated irrigation or manual injection of balanced salt solution was used to pressurize the eye after ICG injection. We confirmed the episcleral and intrascleral vein engorgement and aqueous egression with ICG in two of the three cases. Although one case did not demonstrate the ICG egression into episcleral vein, episcleral vein engorgement was observed immediately. Conclusions: To the best of our knowledge, this is first report using ICG dye to identify the aqueous outflow, especially trabeculocanalicular outflow during trabecular microbyapss stenting. Intracameral ICG dye injection might be safe and effective to identify aqueous outflow and Schlemm's canal stent patency during trabecular microbypass stents implantation.
Collapse Mechanism of Truss Tower Structures Including Buckling and Fracture of Tubular Members
Nihon Kenchiku Gakkai kōzō-kei ronbunshū, 2014
Although truss towers used for telecommunication, electric power transportation, supporting structures for smokestacks in power plants have been designed against wind loads, a higher level of safety is recently required because of the increase of anticipated large seismic inputs. The ultimate strength of these structures is governed by tubular member buckling which is easily led to member fracture. This paper proposes the post-fracture analysis methods for truss structures composed with tubular members of large diameter-to-thickness ratios, and study on the collapse mechanism of such truss towers after the buckling and fracture of main columns and diagonals are investigated, using IDA analyses taking these member fractures into account.
Renal Failure with Branchio-Oto-Renal Syndrome
The Korean Journal of Medicine, 2018
Branchio-oto-renal (BOR) syndrome is a rare autosomal dominant disorder that is characterized by preauricular pits, branchial fistula, branchial cyst, hearing impairment, and kidney anomalies. Hearing impairment is the single most common feature of BOR syndrome, affecting 89% of patients. Preauricular pits (77%), kidney anomalies (66%), branchial fistula (63%), external auditory canal anomalies (41%) are also common. For most patients, BOR syndrome does not affect life expectancy. The major life-threatening feature of this condition is kidney dysfunction, which occurs with about 6% of kidney anomalies. Therefore, once BOR syndrome is recognized in a patient, careful evaluation to detect renal anomalies and treatment of any kidney involvement are necessary. No case reports of BOR syndrome involving adult-onset end-stage kidney disease have been published in the Korean medical literature. We report a case of end-stage kidney disease in a 19-year-old male patient with BOR syndrome, together with a review of the pertinent literature.
Journal of the Korean Ophthalmological Society, 2012
Purpose: To evaluate clinical features of patients who have experienced decreased exodeviation after refractive error correction. Methods: Thirty-four patients who experienced decreased exodeviation after refractive error correction between 2003 and 2010 were evaluated. Visual acuity, refractive errors, reported age at onset, duration of wearing glasses, stereopsis, and function of fusion were evaluated. Results: The present study included 34 patients with intermittent exotropia. Before correcting refractive errors, the mean visual acuity was 0.34 ± 0.27 for the right eye and 0.37 ± 0.27 for the left eye according to log MAR. After refractive error correction, mean visual acuity improved to 0.12 ± 0.11 for the right eye and 0.11 ± 0.11 for the left eye according to log MAR. Before correcting refractive errors, the amount of deviation was 18.