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Journal of Clinical Neurophysiology :... Dec 2016Stereoelectroencephalography denotes the strategic placement of multiple depth electrodes for invasive localization of focal epilepsy in surgical patients. It differs... (Review)
Review
Stereoelectroencephalography denotes the strategic placement of multiple depth electrodes for invasive localization of focal epilepsy in surgical patients. It differs significantly from the alternative subdural grid approach, in both conceptualization of partial epilepsy-as a 3-D distributed network, rather than as focal pathology with contiguous spread-and by the method of sampling used-which is sparse and directed rather than continuous over adjacent brain areas. The electrode implantation strategy in stereoelectroencephalography involves appreciation of these features, which are illustrated by four cases drawn from distinct electroclinical epilepsy syndromes.
Topics: Brain Mapping; Electrodes, Implanted; Electroencephalography; Epilepsies, Partial; Humans; Stereotaxic Techniques
PubMed: 27918343
DOI: 10.1097/WNP.0000000000000254 -
Chirurgia (Bucharest, Romania : 1990) 2017Laparoscopic adrenalectomy became the gold standard for adrenal disease, from incidentaloma to cancer. Partial adrenalectomy is difficult to accept due to its technical...
Laparoscopic adrenalectomy became the gold standard for adrenal disease, from incidentaloma to cancer. Partial adrenalectomy is difficult to accept due to its technical difficulties as well as hemorrhagic risk and a consensus has not been reached. On the other hand, in selected cases of benign adrenal tumors, adrenalectomy may be futile, partial resections being perfectly justified and with lower hemorrhagic risks. For functioning tumors smaller than 3 cm with an anterior or lateral location, partial adrenalectomy may be indicated. The key points reside in adenoma identification, preservation of the remaining glandular parenchyma and its blood supply with dissection in the space between the adenoma and the normal parenchyma. Laparoscopic partial adrenalectomy is feasible and effective for the treatment of benign tumors. Although partial resections have clear-cut advantages over conventional adrenalectomy especially for bilateral tumors, it remains a difficult intervention.
Topics: Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenalectomy; Feasibility Studies; Humans; Laparoscopy; Treatment Outcome
PubMed: 28266298
DOI: 10.21614/chirurgia.112.1.77 -
Andrology Jul 2022To describe the association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome. (Review)
Review
AIM
To describe the association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome.
METHODS
A scoping review was performed according to the recommendations of the Joanna Briggs Institute. Moreover, we performed a search strategy using the MEDLINE, EMBASE, and CENTRAL databases. We included the available information, evaluating the conditions of partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome, and their molecular and physiological mechanisms and clinical presentation.
RESULTS
We identified 207 articles and chose eight studies published between 2001 and 2021. The total number of patients was 34, and their mean age was 28.2 years. Moreover, in 84% of the studies, the pathophysiology of the events was related to microtrauma or prolonged perineal compression. Additionally, 94.2% of the patients had some degree of erectile dysfunction. In addition, out of all patients, 94% underwent magnetic resonance imaging (MRI). However, patients with hard flaccid syndrome did not show relevant findings in these studies. Conversely, MRI showed asymmetry in the proximal corpora cavernosa, thrombosed corpus cavernosum segments, and mainly cavernous fibrous septum in patients with partial cavernous thrombosis and partial priapism.
CONCLUSION
Partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome occurred more frequently in young patients, possibly related to microtraumas that generate cavernous fibrosis and trigger alterations in the erection of the distal portion of the penis. Additionally, they cause proximal hardening of the pelvis, perineal pain, painful ejaculations, and cavernous asymmetry. Moreover, the imaging characteristics are similar in patients with partial priapism and partial cavernous thrombosis.
Topics: Adult; Humans; Magnetic Resonance Imaging; Male; Pelvic Pain; Penis; Priapism; Thrombosis
PubMed: 35460544
DOI: 10.1111/andr.13190 -
Hormones (Athens, Greece) Sep 2020Adrenal insufficiency represents a debilitating condition which mandates lifelong steroid replacement and which is associated with significant long-term morbidity, due... (Review)
Review
Adrenal insufficiency represents a debilitating condition which mandates lifelong steroid replacement and which is associated with significant long-term morbidity, due to either inadequate or excessive replacement. The concept of preserving healthy cortical tissue by means of partial adrenalectomy has evolved as a means of avoiding the detrimental consequences of adrenal insufficiency. The advent of advanced technology in adrenal surgery has greatly facilitated the performance of partial adrenalectomy, enabling utilization of this method in an increasing number of endocrine diseases. Hereditary pheochromocytoma, Conn's syndrome, Cushing's syndrome, and non-functional adrenal masses represent the current indications for partial adrenalectomy, although the specific circumstances under which adrenal-sparing surgery should be proposed are still debatable. Partial adrenalectomy can be achieved by all types of minimally invasive surgery. In the absence of randomized, prospective, controlled studies designed to compare laparoscopic, retroperitoneoscopic, and robot-assisted partial adrenalectomy, none of these techniques has as yet been proven to be the gold standard for adrenal-sparing surgery. Apart from indications for surgery, results of surgery, and different types of partial adrenalectomy, controversial topics addressed in this review article include technical aspects such as the volume of residual adrenal tissue needed, ligation of adrenal vein, and means of tumor identification. Discussion of these controversial topics represents an attempt to define the role of partial adrenalectomy in modern adrenal surgery.
Topics: Adrenal Gland Neoplasms; Adrenal Insufficiency; Adrenalectomy; Humans
PubMed: 32388629
DOI: 10.1007/s42000-020-00202-0 -
Ecology and Evolution Sep 2022The actual state of ecological systems is rarely known with certainty, but management actions must often be taken regardless of imperfect measurement (partial... (Review)
Review
The actual state of ecological systems is rarely known with certainty, but management actions must often be taken regardless of imperfect measurement (partial observability). Because of the difficulties in accounting for partial observability, it is usually treated in an ad hoc fashion, or simply ignored altogether. Yet incorporating partial observability into decision processes lends a realism that has the potential to improve ecological outcomes significantly. We review frameworks for dealing with partial observability, focusing specifically on dynamic ecological systems with Markovian transitions, i.e., transitions among system states that are influenced by the current system state and management action over time. Fully observable states are represented in an observable Markov decision process (MDP), whereas obscure or hidden states are represented in a partially observable process (POMDP). POMDPs can be seen as a natural extension of observable MDPs. Management under partial observability generalizes the situation for complete observability, by recognizing uncertainty about the system's state and incorporating sequential observations associated with, but not the same as, the states themselves. Decisions that otherwise would depend on the actual state must be based instead on state probability distributions ("belief states"). Partial observability requires adaptation of the entire decision process, including the use of belief states and Bayesian updates, valuation that includes expectations over observations, and optimal strategy that identifies actions for belief states over a continuous belief space. We compare MDPs and POMDPs and highlight POMDP applications to some common ecological problems. We clarify the structure and operations, approaches for finding solutions, and analytic challenges of POMDPs for practicing ecologists. Both observable and partially observable MDPs can use an inductive approach to identify optimal strategies and values, with a considerable increase in mathematical complexity with POMDPs. Better understanding of POMDPs can help decision makers manage imperfectly measured ecological systems more effectively.
PubMed: 36172296
DOI: 10.1002/ece3.9197 -
IEEE Transactions on Neural Networks... Jun 2021To deal with ambiguities in partial label learning (PLL), the existing PLL methods implement disambiguations, by either identifying the ground-truth label or averaging...
To deal with ambiguities in partial label learning (PLL), the existing PLL methods implement disambiguations, by either identifying the ground-truth label or averaging the candidate labels. However, these methods can be easily misled by the false-positive labels in the candidate label set. We find that these ambiguities often originate from the noise caused by highly correlated or overlapping candidate labels, which leads to the difficulty in identifying the ground-truth label on the first attempt. To give the trained models more tolerance, we first propose the top-k partial loss and convex top-k partial hinge loss. Based on the losses, we present a novel top-k partial label machine (TPLM) for partial label classification. An efficient optimization algorithm is proposed based on accelerated proximal stochastic dual coordinate ascent (Prox-SDCA) and linear programming (LP). Moreover, we present a theoretical analysis of the generalization error for TPLM. Comprehensive experiments on both controlled UCI datasets and real-world partial label datasets demonstrate that the proposed method is superior to the state-of-the-art approaches.
PubMed: 34086582
DOI: 10.1109/TNNLS.2021.3083397 -
Journal of Clinical and Diagnostic... Jun 2015Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The... (Review)
Review
Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The pattern of partial edentulism has been evaluated in many selected populations in different countries by different methods. Most of the studies have evaluated partial edentulism by surveying of Removable Partial Dentures (RPDs), patients visiting clinics, clinical records and population in particular locality. The objective of the study is to review the prevalence of partial edentulousness and its correlation to age,gender, arch predominance, socio economic factors and incidence of various Kennedy's Classes. Key observations drawn from the review are as below. There is no gender correlation for partial edentulism.Prevalence of partial edentulism is more common in mandibular arch than maxillary arch.Younger adults have more Class III and IV RPDs. Elders have more distal extension RPDs Class I and II.
PubMed: 26266237
DOI: 10.7860/JCDR/2015/13776.6124 -
Otolaryngology--head and Neck Surgery :... Mar 2017Objective To assess the effectiveness of partial versus total tonsillectomy in children. Data Sources MEDLINE, EMBASE, and Cochrane Library from January 1980 to June... (Comparative Study)
Comparative Study Review
Objective To assess the effectiveness of partial versus total tonsillectomy in children. Data Sources MEDLINE, EMBASE, and Cochrane Library from January 1980 to June 2016. Review Methods Two investigators independently screened studies and extracted data. Investigators independently assessed risk of bias and strength of evidence of the literature. Heterogeneity precluded quantitative analysis. Results In 16 eligible randomized controlled trials (RCTs), definitions of "partial" tonsillectomy varied. In addition to comparing partial with total tonsil removal, 11 studies compared surgical techniques (eg, coblation). In studies comparing the same technique, return to normal diet or activity was faster with partial removal (more favorable outcomes in 4 of 4 RCTs). In studies with differing surgical techniques, return to normal diet and activity was faster with partial versus total tonsillectomy (more favorable outcomes in 5 of 6 studies). In 3 of 4 RCTs, partial tonsillectomy was associated with more throat infections than total tonsillectomy. Differences between groups were generally not statistically significant for obstructive symptom persistence, quality of life, or behavioral outcomes. Across all studies, 10 (6%) of roughly 166 children had tonsillar regrowth after partial tonsillectomy. Conclusions Data do not allow firm conclusions regarding the comparative benefit of partial versus total removal; however, neither surgical technique nor extent of surgery appears to affect outcomes markedly. Partial tonsillectomy conferred moderate advantages in return to normal diet/activity but was also associated with tonsillar regrowth and symptom recurrence. Effects may be due to confounding given differences in populations and surgical approaches/techniques. Heterogeneity and differences in the operationalization of "partial" tonsillectomy limited comparative analyses.
Topics: Child; Humans; Tonsillectomy; Treatment Outcome
PubMed: 28093947
DOI: 10.1177/0194599816683916 -
The Canadian Journal of Urology Apr 2017To review oncological and functional outcomes for partial nephrectomy in the setting of T2 tumors. (Review)
Review
INTRODUCTION
To review oncological and functional outcomes for partial nephrectomy in the setting of T2 tumors.
MATERIALS AND METHODS
We performed a comprehensive literature review on partial nephrectomy for T2 tumors, focusing on major primary series reporting oncological and functional outcomes, as well as complication rates in the last 10 years.
RESULTS
Recent series have reported comparable oncological outcomes between partial nephrectomy and radical nephrectomy for ≥ T2 tumors. However, most of these studies are retrospective in design with small sample sizes. With regard to functional outcomes, partial nephrectomy outperforms radical nephrectomy. However, outcomes are dependent on the amount of residual renal parenchyma left after partial nephrectomy for larger tumors. Partial nephrectomy is associated with an increased rate of complications when compared to radical nephrectomy, but in experienced hands this increase tends to remain at an acceptable level. There are few studies that have investigated the role of minimally invasive surgery (MIS) in the setting of T2 tumors. Although MIS techniques may be underutilized for management of T2 tumors, it is a feasible approach in highly selected patients.
CONCLUSIONS
Partial nephrectomy has emerged as an acceptable alternative for surgical management of T2 renal tumors over the last decade. Nephron-sparing surgery demonstrates similar oncological outcomes compared to radical nephrectomy and can be considered even for larger tumors in carefully selected patients whenever feasible.
Topics: Humans; Kidney Neoplasms; Neoplasm Staging; Nephrectomy; Postoperative Complications; Recovery of Function; Treatment Outcome
PubMed: 28436354
DOI: No ID Found -
Journal of Clinical Neurophysiology :... Jul 2017In this review, authors discuss the semiology and noninvasive investigations of insular epilepsy, an underrecognized type of epilepsy, which may mimic other focal... (Review)
Review
In this review, authors discuss the semiology and noninvasive investigations of insular epilepsy, an underrecognized type of epilepsy, which may mimic other focal epilepsies. In line with the various functions of the insula and its widespread network of connections, insular epilepsy may feature a variety of early ictal manifestations from somatosensory, visceral, olfactory, gustatory, or vestibular manifestations. Depending on propagation pathways, insular seizures may also include altered consciousness, dystonic posturing, complex motor behaviors, and even autonomic features. Considering the variability in seizure semiology, recognition of insular epilepsy may be challenging and confirmation by noninvasive tests is warranted although few studies have assessed their value. Detection of an insular lesion on MRI greatly facilitates the diagnosis. Scalp EEG findings in frontocentral and/or temporal derivations will generally allow lateralization of the seizure focus. Ictal single-photon computed tomography has moderate sensitivity, whereas positron emission tomography has lower sensitivity. Among newer techniques, magnetoencephalography is highly beneficial, whereas proton magnetic resonance spectroscopy currently has limited value.
Topics: Cerebral Cortex; Epilepsies, Partial; Humans
PubMed: 28644201
DOI: 10.1097/WNP.0000000000000396