A New Classification of Cochleovestibular Malformations and Implications for Predicting Speech Perception Ability after Cochlear Implantation

2015 ◽  
Vol 20 (2) ◽  
pp. 90-101 ◽  
Author(s):  
Sung-Wook Jeong ◽  
Lee-Suk Kim
Keyword(s):  
Speech Perception ◽  
Cochlear Implantation ◽  
Test Scores ◽  
Type A ◽  
Cochlear Nerve ◽  
Type B ◽  
New Classification ◽  
Type D ◽  
Type C

Objectives: The aims of this study were to introduce a new classification of cochleovestibular malformation (CVM) and to investigate how well this classification can predict speech perception ability after cochlear implantation in children with CVM. Methods: Fifty-nine children with CVM who had used a cochlear implant for more than 3 years were included. CVM was classified into 4 subtypes based on the morphology of the cochlea and the modiolus on temporal bone computed tomography (TBCT): normal cochlea and normal modiolus (type A, n = 16), malformed cochlea and partial modiolus (type B, n = 31), malformed cochlea and no modiolus (type C, n = 6), and no cochlea and no modiolus (type D, n = 6). Speech perception test scores were compared between the subtypes of CVM using analysis of covariance with post hoc Bonferroni test. Univariate and multivariate regression analyses were used to identify the significant predictors of the speech perception test scores. Results: The speech perception test scores after implantation were significantly better in children with CVM type A or type B than in children with CVM type C or type D. The test scores did not differ significantly between the implanted children with CVM type A or type B and those without CVM. In univariate regression analysis, the type of CVM was a significant predictor of the speech perception test scores in implanted children with CVM. Multivariate regression analysis revealed that the age at cochlear implantation, cochlear nerve size and preimplantation speech perception test scores were significant predictors of the postimplantation speech perception test scores. The chance of cochlear nerve deficiency increased progressively from CVM type A to type D. Conclusion: The new classification of CVM based on the morphology of the cochlea and the modiolus is simple and easy to use, and correlated well with postimplantation speech perception ability and cochlear nerve status. This simple classification of CVM using TBCT with cochlear nerve assessment by magnetic resonance imaging is helpful in the preoperative evaluation of children with CVM.

MRI analysis and surgical treatment of Wassel Type IV duplicated thumbs

2021 ◽  
pp. 175319342098321
Author(s):  
Anyuan Wang ◽  
Jian Ding ◽  
Long Wang ◽  
Tinggang Chu ◽  
Zhipeng Wu ◽  
...  
Keyword(s):  
Type A ◽  
Surgical Reconstruction ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Type D ◽  
Type Iv ◽  
Secondary Operations ◽  
Type C

We present the MRI findings for 39 Wassel Type IV duplicated thumbs in 38 patients. We found that MRI revealed the morphology of the cartilaginous connection between the thumb anlages and the location of the deviation corresponding to the classification of Horii, which allowed precise preoperative planning of corrective osteotomies. All 39 thumbs were available for follow-up after surgical reconstruction at a mean of 29 months (range 25 to 39). Four out of nine Horii Type A cases and all 12 Type B, as well as the six Type C and the six Type D cases, achieved good results according to the Tada scoring system. Five Type A cases achieved fair results with residual stiffness of the interphalangeal joint. No secondary operations were needed. We conclude that MRI proved useful in subclassifying Wassel Type IV duplicated thumbs and may aid in planning the osteotomies needed for their reconstruction. Level of evidence: IV

scholarly journals The effectiveness of TiO2 additions to mortar to maintain initial conditions in terms of its reflectance to solar radiation

2017 ◽  
Vol 17 (3) ◽  
pp. 39-56 ◽  
Author(s):  
Sérgio Roberto Andrade Dantas ◽  
Fulvio Vittorino ◽  
Kai Loh
Keyword(s):  
Solar Radiation ◽  
Ultraviolet Radiation ◽  
Initial Conditions ◽  
Type A ◽  
Just Noticeable Difference ◽  
Type B ◽  
Climate Conditions ◽  
Type D ◽  
Type C ◽  
Over Time

Abstract Contact of facades with degradation agents and direct incidence of ultraviolet radiation on external coatings make them more opaque over time, affecting their colour and reflectance characteristics. This study evaluated the effect of adding different TiO2 contents to mortars applied in concrete substrates in order to verify the reflectance maintenance on surfaces after exposure over time. Mortar with different concentrations of TiO2 (1%, 5%, 10%) were produced in relation to the total dry premix, added as a powder and compared to unpainted mortar without TiO2 (type "A") and painted mortar without TiO2 (type "B"), both used as a reference for colour and reflectance. Exposed over 16 months to climate conditions in São Paulo, regarding the maintenance of reflectance and solar radiation, the results showed that type "B" (0%TiO2) painted mortar presented the best performance. Type "C" (1%TiO2) and type "D" (5%TiO2) unpainted mortar remained more stable. Type "A" (0%TiO2) and type "E" (10%TiO2) unpainted mortar showed greater differences according to the Just Noticeable Difference (JND) range caused by dirt pick up.

Feasibility, safety, and changes in systolic blood pressure associated with endovascular revascularization of symptomatic and chronically occluded cervical internal carotid artery using a newly suggested radiographic classification of chronically occluded cervical internal carotid artery: pilot study

2019 ◽  
Vol 130 (5) ◽  
pp. 1468-1477 ◽  
Author(s):  
David Hasan ◽  
Mario Zanaty ◽  
Robert M. Starke ◽  
Elias Atallah ◽  
Nohra Chalouhi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Type B ◽  
Type D ◽  
Type C ◽  
Radiographic Classification

OBJECTIVEThe overall risk of ischemic stroke from a chronically occluded internal carotid artery (COICA) is around 5%–7% per year despite receiving the best available medical therapy. Here, authors propose a radiographic classification of COICA that can be used as a guide to determine the technical success and safety of endovascular recanalization for symptomatic COICA and to assess the changes in systemic blood pressure following successful revascularization.METHODSThe radiographic images of 100 consecutive subjects with COICA were analyzed. A new classification of COICA was proposed based on the morphology, location of occlusion, and presence or absence of reconstitution of the distal ICA. The classification was used to predict successful revascularization in 32 symptomatic COICAs in 31 patients, five of whom were female (5/31 [16.13%]). Patients were included in the study if they had a COICA with ischemic symptoms refractory to medical therapy. Carotid artery occlusion was defined as 100% cross-sectional occlusion of the vessel lumen as documented on CTA or MRA and confirmed by digital subtraction angiography.RESULTSFour types (A–D) of radiographic COICA were identified. Types A and B were more amenable to safe revascularization than types C and D. Recanalization was successful at a rate of 68.75% (22/32 COICAs; type A: 8/8; type B: 8/8; type C: 4/8; type D: 2/8). The perioperative complication rate was 18.75% (6/32; type A: 0/8 [0%]; type B: 1/8 [12.50%]; type C: 3/8 [37.50%], type D: 2/8 [25.00%]). None of these complications led to permanent morbidity or death. Twenty (64.52%) of 31 subjects had improvement in their symptoms at the 2–6 months’ follow-up. A statistically significant decrease in systolic blood pressure (SBP) was noted in 17/21 (80.95%) patients who had successful revascularization, which persisted on follow-up (p = 0.0001). The remaining 10 subjects in whom revascularization failed had no significant changes in SBP (p = 0.73).CONCLUSIONSThe pilot study suggested that our proposed classification of COICA may be useful as an adjunctive guide to determine the technical feasibility and safety of revascularization for symptomatic COICA using endovascular techniques. Additionally, successful revascularization may lead to a significant decrease in SBP postprocedure. A Phase 2b trial in larger cohorts to assess the efficacy of endovascular revascularization using our COICA classification is warranted.

scholarly journals Postsurgical residual lung complications following left upper trisegmentectomy

2019 ◽  
Author(s):  
Yutaro Koike ◽  
Aritoshi Hattori ◽  
Takeshi Matsunaga ◽  
Kazuya Takamochi ◽  
Shiaki Oh ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Type A ◽  
X Rays ◽  
Limited Information ◽  
Type B ◽  
Type D ◽  
Thoracic Computed Tomography ◽  
Isolated Segment ◽  
Type C ◽  
Lung Torsion

AbstractOBJECTIVESSegmentectomy has become an increasingly popular surgical procedure for small-sized lung lesions. Left upper trisegmentectomy (LUTS) is one of the most common segmentectomies performed because of its relative ease and simplicity; however, limited information is currently available on the specific postoperative complications associated with this procedure.METHODSAmong 2060 surgically resected cases in our institute between 2009 and 2016, 129 (6.2%) underwent LUTS. Postoperative chest X-rays and/or thoracic computed tomography (CT) scans were retrospectively assessed for all cases to assess postsurgical residual lung complications following LUTS. We categorized cases into 4 groups: type A (atelectasis of the lingular segment), type B (lung torsion of the lingular segment), type C (necrosis of the ‘isolated segment’) and type D (haematoma along stapling lines).RESULTSPostsurgical lung complications following LUTS were observed in 17 (13.1%) patients (type A: n = 7, type B: n = 1, type C: n = 4 and type D: n = 5). Three patients (2.3%) required surgical intervention because of type B (n = 1) and type C (n = 2), namely, decreased permeability and remaining ground glass opacities in the residual lung, showing an exacerbated systemic inflammatory response. In contrast, type A and D cases were successfully observed by chest CT without any surgical intervention, and patients recovered within a few months of surgery.CONCLUSIONSWe identified several postoperative residual lung complications following LUTS. Lung torsion or necrosis of the residual segment may require intensive care, including reoperation. Potentially serious complications always need to be ruled out after LUTS when radiological consolidation is detected postoperatively.

scholarly journals Microsurgical Management of Hypoglossal Schwannomas Over 3 Decades: A Modified Grading Scale to Guide Surgical Approach

2011 ◽  
Vol 69 (suppl_2) ◽  
pp. ons121-ons140 ◽  
Author(s):  
Yoichi Nonaka ◽  
Peter M. Grossi ◽  
Ketan R. Bulsara ◽  
Raymond M. Taniguchi ◽  
Allan H. Friedman ◽  
...  
Keyword(s):  
Sural Nerve ◽  
Hypoglossal Nerve ◽  
Type A ◽  
Nerve Graft ◽  
Type B ◽  
Nerve Reconstruction ◽  
Type D ◽  
Grading Scale ◽  
Type C ◽  
Sural Nerve Graft

Abstract BACKGROUND Schwannomas originating from the hypoglossal nerve are extremely rare. Microsurgical resection with the goal for cure has traditionally been associated with a high risk of postoperative deficits. OBJECTIVE To summarize our clinical experience using tailored cranial base approaches for these formidable lesions. METHODS The clinical records of 13 patients were retrospectively reviewed. In addition, all reported patients in the literature were reviewed. The extreme lateral infrajugular transcondylar-transtubercular exposure approach was used in all of our patients. Based on our experience and literature analysis, we propose the following modified grading scale to facilitate surgical planning: type A, intradural tumors; type B, dumbbell-shaped tumors; type C, extracranial tumors; and type D, peripheral tumors. RESULTS All 13 patients underwent total, near-total, or subtotal tumor resection. Eight patients were men, 5 were women (mean age, 41.7 years). Sural nerve graft reconstruction for the hypoglossal nerve was performed in 4 patients. Three of the 4 patients in whom nerve reconstruction was performed regained satisfactory movement of their tongue. In the review of the literature, the mean patient age was 45.8 years. Patients presented with tongue atrophy (91.6%), headache (60.9%), and dysphagia (31.8%). The tumors were categorized as type A in 31.7% of these patients, type B in 38.6%, type C in 6.2%, and type D in 23.4%. CONCLUSION The extreme lateral infrajugular transcondylar-transtubercular exposure approach, which is a modification of the extreme lateral suboccipital approach, provides sufficient exposure for most intracranial dumbbell-shaped hypoglossal schwannomas. Hypoglossal nerve reconstruction using a sural nerve graft improves tongue atrophy and movement for patients with resected nerves.

scholarly journals Pigmentary demarcation lines: a clinical profile of 50 subjects and report of new pattern of pigmentation observed

2018 ◽  
Vol 4 (3) ◽  
pp. 323
Author(s):  
Anju Antony ◽  
Pramod Kumar
Keyword(s):  
Family History ◽  
Type A ◽  
Common Type ◽  
Type B ◽  
Demarcation Line ◽  
Abrupt Transition ◽  
Type D ◽  
History Of ◽  
Type C ◽  
The Common

<p class="abstract"><strong>Background:</strong> Pigmentary demarcation lines (PDL) correspond to a border of abrupt transition between the more deeply pigmented skin of the outer surfaces and the lighter inner surfaces. On the basis of their location they have been classified into eight types, type A to type H. The present study is an attempt to obtain a better understanding of the clinical types of pigmentary demarcation lines in Indians, and to report any previously undescribed patterns of pigmentation.</p><p class="abstract"><strong>Methods:</strong> Patients attending the Outpatient Department for various complaints were examined for the presence of pigmentary demarcation lines, and those with pigmentary demarcation lines were analysed further.<strong></strong></p><p class="abstract"><strong>Results:</strong> 50 subjects of Fitzpatrick skin types 4 and 5, with pigmentary demarcation lines were examined in detail. The various types of pigmentary demarcation lines seen were Type A (38%), Type B (14%), Type C (24%), Type F (22%), Type G (4%), Type H (4%). All types were more common in females with the exception of Type C, which was observed only in males. Type D and Type E PDL were not observed in any of the subjects screened.</p><p class="abstract"><strong>Conclusions:</strong> The most common type of PDL observed in our study was Type A PDL, followed by Type C PDL. The youngest subject was 2 years old, the oldest was aged 75.The majority were seen in adults; Type A and Type C PDL were the common types seen in children. A family history of PDL was present in 5 (10%) and all were females. A hitherto undescribed pigmentary demarcation line is also described along with this study.</p>

Decomposition of VOC in Air Using a Streamer Corona Discharge Reactor Combined with Catalyst

2003 ◽  
Vol 6 (1) ◽  
Author(s):  
Toshikazu Ohkubo ◽  
Duan Li ◽  
Daisuke Yakushiji ◽  
Seiji Kanazawa ◽  
Yukiharu Nomoto
Keyword(s):  
Corona Discharge ◽  
Catalyst Layer ◽  
Type A ◽  
Electrode System ◽  
Plasma Reactors ◽  
Type B ◽  
Type D ◽  
Streamer Corona ◽  
Type C ◽  
Basic Configuration

AbstractIn this study, the improvement in the decomposition of volatile organic compounds (VOCs) was investigated by combining discharge plasma with catalyst. DC streamer corona plasma reactors combined with a catalyst were developed. The basic configuration of the reactors is a multineedle-to-plane mesh electrode system. By changing the position of catalyst against the plasma region, several reactors were developed and compared with each other. As a catalyst, a honeycomb catalyst (Mn type) was tested. A catalyst layer was located between the needles and plane mesh electrodes (type A reactor), or the catalyst layer was placed just behind the mesh electrode (type B reactor). In other reactors, the catalyst layer was followed by the needles-to- plane mesh electrode system (type C reactor) or the catalyst layer was removed (type D reactor). The needles- to-plane mesh electrode system produced the stable streamer corona discharge. The streamers covered the surface of the catalyst layer in the type A and type B reactors. However, the characteristics of the streamer were different for the type A and type B reactors. Toluene (C

scholarly journals 3. Shang and Zhou Bronze Nao Bells Excavated in South China

Early China ◽  
1986 ◽  
Vol 9 (S1) ◽  
pp. 5-7
Author(s):  
Gao Zhixi
Keyword(s):  
South China ◽  
Type A ◽  
Entire Body ◽  
Type B ◽  
Type D ◽  
Type C ◽  
Western Zhou ◽  
Set Up ◽  
Cloud Pattern

ABSTRACTTwenty-two bronze nao-bells dating to the late Shang and early Western Zhou periods have been unearthed from the five southern provinces of Hunan, Jiangsi, Zhejiang, Jiangsu, and Fujian. Of these, sixteen were from Hunan, three from Zhejiang, and one each from the remaining three provinces. These bells can be classified into four categories: type A has an animal mask decoration (eleven examples); type B has a cloud pattern (three examples); type C has nipples (only one example); type D has stalks (mei, seven examples).The nao is a bell that can produce two tones. It can be used in sacrificial offerings as well as war. Because most of these bells have been discovered at the top, mid-section, or foot of mountains or on the banks of a river, we surmise that they may have been used in contemporary sacrifices to the mountains and streams, wind and rain, and stars, etc. Based on the periodization of the style of their shape and decoration we conclude that type A may be as early as late Shang, type B can be assigned to the end of the Shang, type C is from the beginning of the Zhou and type D belongs to the early Western Zhou. They developed from type A to B to C to D and then to the yong-bell. The characteristics of southern nao bells are: they are large, thick and heavy; most have whorls on the circular handle; many animal masks and cloud and lightning patterns are formed from thick lines among the decoration; the entire body is usually covered with decoration; most appear singly, and they were set up on their stands with the mouth facing up. In contrast, northern nao-bells are very small, they have no whorls on the handle, their decoration is simple, and they are unearthed in groups of several together.

scholarly journals A BIOLOGICAL CLASSIFICATION OF ENCAPSULATUS PNEUMONIÆ (FRIEDLÄNDER'S BACILLUS)

1926 ◽  
Vol 44 (1) ◽  
pp. 113-128 ◽  
Author(s):  
Louis A. Julianelle
Keyword(s):  
Serological Test ◽  
Type A ◽  
Heterogeneous Group ◽  
Type B ◽  
Biological Classification ◽  
Type C ◽  
Working Out

A biological classification has been made of thirty strains of Friedländer's bacillus. This study reveals that there exist among these strains three sharply defined and specific types and one heterogeneous group. The three types are Type A, fifteen strains; Type B, six strains; Type C, three strains; and Group X, six strains. The agglutination, agglutinin adsorption, protection, thread, and precipitin reactions have been employed in the working out of this classification, and the types have been proved highly specific by means of each serological test.

Depositional models for moraine formation in East Antarctic coastal oases

1997 ◽  
Vol 43 (144) ◽  
pp. 256-264 ◽  
Author(s):  
Sean J. Fitzsimons
Keyword(s):  
Type A ◽  
Structural Features ◽  
Type B ◽  
Debris Accumulation ◽  
Type D ◽  
Unconsolidated Sediment ◽  
History Of ◽  
Quaternary History ◽  
Type C ◽  
Depositional Models

AbstractThis paper examines the origin of moraine ridges in East Antarctic coastal oases and derives depositional models appropriate for the reconstruction of Quaternary history. On the basis of morphology, structure and sedimentology, four principal types of ridge may be identified: (1) type A moraines from when the basal debris zone crops out near an ice margin; (2) type B moraines form when large recumbent folds develop in the basal debris zone; (3) type C moraines are ice-contact screes and fans which form when debris accumulates at steep or cliffed ice margins; and (4) type D moraines are thrust-block moraines that form when unconsolidated sediment is entrained by freezing, shearing and thrusting of sediment blocks at the base of the glacier. Simple calculations of the rate of debris accumulation at ice margins suggest that type A, B and C moraines take thousands of years to form and record stable ice margins. Type D moraines are structural features that may form relatively quickly when ice margins override unconsolidated sediment. Constructing models to explain the origin of the moraines is an important part of reconstructing the Quaternary history of Antarctic coastal oases, because the models provide a basis for reconstructing the position and behaviour of the ice sheet during advance and retreat

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