Brain Abscess Surgery Outcome: A Comparison between Craniotomy with Membrane Excision versus Burr Hole Aspiration

Introduction: Brain abscess represents 8% of intracranial masses in developing countries. Despite the advances in neuro-imaging, still, the diagnosis of brain abscess is difficult and may need a biopsy in most cases to verify the diagnosis because may even lead to death. CT scan with contrast is a good tool for diagnosing and localizing brain abscesses in late stages, however, it is difficult to diagnose them in the early stages. The development of MRI helps to more accurately diagnose brain abscess. Surgical management of brain abscesses is either medical or surgical through craniotomy or burr holes. Indications of each are still a point of debate among most neurosurgeons. Methodology: This is a descriptive longitudinal prospective study to compare the outcomes of two surgical procedures used in The National Centre for Neurological Sciences-Khartoum-Sudan (NCNS) from 2012 to 2015, craniotomy and excision of the abscess membrane versus burr hole and aspiration of brain abscess in terms of duration of hospitalization, length of antibiotic use, recurrence rate, number of images needed for follow-up, and the final postoperative early and late outcomes. The data was collected through a designed questionnaire and was then analyzed using SPSS version 20. No significant ethical approval was required for this study. Results: Fifty-four patients were operated on through craniotomy (29/54) and burr hole (25/54). Their ages ranged from 1 year to 53 years with an average presentation at 13 years of age. Most patients presented with fever (23.1%), convulsions (16%), vomiting (16.7%) and headache (15.4%). The mean of illness for both groups was almost 2 months. The majority of patients in this study were having no risk factors (38.9%) while the major risk factors seen were cardiac diseases (14.8%), neurosurgical procedures (13%) and otitis media (11.1%). As most patients presented late, the diagnosis of most was made using CT brain with contrast (83.3%). In most of the patients (85.2%) there were no organisms separated in the culture. 8/54 patients had positive cultures, 7/8 were bacterial and only one (1/8) was fungal. Most patients received antibiotics for 45 days postoperatively in both craniotomy and burr hole groups. When both groups were compared, those operated with craniotomy were found to have a relatively higher length of hospital stay, however, no significant difference was found between both groups. Also, it was found that those operated on with craniotomy had a high cure rate and less recurrence in comparison with burr hole group. Deterioration and death were significantly higher among craniotomy group. Only CT brain was used as the imaging modality of choice for follow-up in both groups for 4 months’ duration and it was noted that complete evacuation was significantly higher among craniotomy group while remnants were higher among burr hole group. Conclusion: Brain abscess is still a challenging condition for neurosurgeons in Sudan. The limited number of Sudanese neurosurgeons, neurosurgical centers and diagnostic facilities contributed to delay in diagnosing brain abscess in most patients. It is important to design a strict protocol and precautions for any neurosurgical operation or bedside procedure to prevent infection and subsequent brain abscess development. CT brain with contrast is a good imaging tool for assessing the size, site and stage of brain abscesses. No significant difference between craniotomy or burr hole for clearance from brain abscess in terms of antibiotic used or duration of hospital stay. However, burr hole aspiration is associated with higher rates of recurrences. On the other hand, craniotomy and excision have relatively higher neurologic morbidity postoperative with expectantly higher post-operative hospitalization but no differences in the final outcome. Therefore, the selection of surgical technique should be individualized in each case based on the abscess site size source patient fitness for surgery and neurosurgeon’s preference.

A Comparison between Chinese and Western Cultures

Cultural awareness, which plays a big part in our efforts of culture development, comes from active comparison and contrast of different cultures, especially between the domestic and foreign cultures. Though the Chinese culture and the western cultures have much in common, they differ in value and morality concepts, Social customs, etiquette, relations, the spirit of individuality and so on. We should bear in mind this cultural awareness when making cultural policies, or having cross-cultural communications, which enables us to become more active in culture development.

Laparoscopic resection for hepatocellular carcinoma: comparison between Middle Eastern and Western experience

Laparoscopic liver resection （LLR） for hepatocellular carcinoma （HCC） is increasing in this era of minimal invasive liver surgery. LLR for HCC is currently known to be a safer procedure than it was before because of technical advances and improvement in postoperative patient management and remains the first-line treatment for HCC in compensated cirrhosis in many centers. We have the chance of analyzing the paper about the comparison between Middle Eastern and Western experience for LLR as treatment of HCC.

A COMPARISON BETWEEN THE pzc AND iep OF α-FeOOH AQUEOUS SUSPENSION

The salt titration of goethite((?)-FeOOH)aqueous suspension had been carried out with the addition of solid NaCl at several different star- ting pH values and the point of zero charge(pzc)was estimated.Then the electrophoretic mobilities of positively charged (?)FeOOH particles dispersed in NaCl solution were measured as a function of pH to obtain the isoelec- tric point(iep).The two parameters were compared.

Comparison between the Requirements of Flowability and Moldability and the Shape Retention of PIM Compacts during Debinding Process

To successfully employ powder injection molding (PIM) as a manufacturing technique, the function of the component, design of the part, material and process should be optimized for overall processing ability of the PIM process. A comparison between the requirements of flowability and moldability and the compacts shape retention has been made in this work. There is often a contradiction between the requirements of flowability and the compacts shape retention. Many works have been done to attain good molding conditions. However, they fail to take into account the effect of some factors that satisfies good molding conditions on the compacts shape retention during debinding. This paper studies the effect of the powder-binder mixture characteristics and the molding conditions on the flowability and moldability and the shape retention of PIM compacts during debinding process so as to attain the benefits of each.

Comparison between Two Kinds of Methods of Locating Acupoints

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From Nobody to Somebody ——A Comparison between Jay Gatsbyand Duddy Kravitz

After a series of comparison between Jay Gatsby——the protagonist of "The Great Gatsby"and Duddy kravitz——the protagonist of "The Apprenticeship of Duddy kravitz",the authorof this essay gets such a conclusion,that Jay Gatsby was a pure idealist,while Duddykravitz a vulgar materialist.

Contrast and Comparison Between the Old and New Bar Code for Commodity Management Measures

With the development of socialism market economy, the former Bar Code ForCommodity Management Measures (being called Old Measures for short hereafter) issued by the NationalBureau of Quality and Technical Supervision can not adapt to the requirement of managing for barcode for commodity. Therefore, for the purpose of standardize bar code for commodity managementstandard, ensuring its quality, speeding up the application of it in electronic business andcirculating field and accelerating the course of being a well informed country, a new Bar Code ForCommodity Management Measures (New Measures for short) has been issued by the General Administratorof Quality Supervision, Inspection and Quarantine of P.R. China (AQSIQ) on May 30th, 2005, and putinto force in October, 2005. At the same time, the Old Measures issued on July 3rd, 1998 has beenabolished.

The Comparison between "I Hear America Singing " and "春望"

Through the introduction of the American poem "I Hear America Singing" and its writer Walt Whitman, the Chinese poem " 春望 "and its writer:杜甫, and the comparison of these two poems in prosody, language, contents and emotion, writing techniques, political views field, etc, this essay analyses further some poetic phenomenon, and also draws a vivid picture of America in 19 century and China in 8 century.

A Comparison between American Individualism and Chinese Collectivism-From the View of Cherishing Life in War

There is a large discrepancy in the value concept of life.We know that the ways of cherishing life are different in war to the soldiers from different cultures.We may perceive that people's concept has been much influenced by the different cultural background and social environment.And similar cultural background and social environment may make people's value trend introject.

The Rights of Persons Charged with Penal Offences to Access to Lawyers——A comparison between international and domestic laws

I. Getting help from lawyers and its realization according to international standards The right to defense for a person involving in a law suit is a universal human right. Article 11 of the Universal Declaration of Human Rights provides： ＂Everyone charged with a penal offence has the right to be presumed innocent until proved guilty according to law in a public trial at which he has had all the guarantees necessary for his defence.＂ This means （1） the right to defence is a basic human right due to all persons charged with a penal offence; （2） it is a basic requirement for the principle of presumption of innocence and fair trial; and （3） the realization of the fight needs practical and effective guarantees.

Comparison between different reconstruction routes in esophageal squamous cell carcinoma

AIM:To compare postoperative complications and prognosis of esophageal squamous cell carcinoma patients treated with different routes of reconstruction. METHODS:After obtaining approval from the Medical Ethics Committee of the Sun Yat-Sen University Cancer Center, we retrospectively reviewed data from 306 consecutive patients with histologically diagnosed esophageal squamous cell carcinoma who were treated between 2001 and 2011. All patients underwent radical McKeown-type esophagectomy with at least two-field lymphadenectomy. Regular follow-up was performed in our outpatient department. Postoperative complica-tions and long-term survival were analyzed by treatment modality, baseline patient characteristics, and operative procedure. Data from patients treated via the retrosternal and posterior mediastinal routes were compared. RESULTS:The posterior mediastinal and retrosternal reconstruction routes were employed in 120 and 186 patients, respectively. Pulmonary complications were the most common complications experienced during the postoperative period (46.1% of all patients; 141/306). Compared to the retrosternal route, the posterior mediastinal reconstruction route was associated with a lower incidence of anastomotic stricture (15.8% vs 27.4%, P = 0.018) and less surgical bleeding (242.8 ± 114.2 mL vs 308.2 ± 168.4 mL, P < 0.001). The median survival time was 26.8 mo (range:1.6-116.1 mo). Upon uni/multivariate analysis, a lower preoperative albumin level (P = 0.009) and a more advanced pathological stage (pT; P = 0.006; pN; P < 0.001) were identified as independent factors predicting poor prognosis. The reconstruction route did not influence prognosis (P = 0.477). CONCLUSION:The posterior mediastinal route of reconstruction reduces incidence of postoperative complications but does not affect survival. This route is recommended for resectable esophageal squamous cell carcinoma.

Motor competence and health-related fitness in children:A cross-cultural comparison between Portugal and the United States

Background: Motor competence and health-related fitness are important components for the development and maintenance of a healthy lifestyle in children. This study examined cross-cultural performances on motor competence and health-related fitness between Portuguese and U.S.children.Methods: Portuguese(n = 508; 10.14 § 2.13 years, mean § SD) and U.S.(n = 710; 9.48 § 1.62 years) children performed tests of cardiorespiratory fitness(Progressive Aerobic Cardiovascular Endurance Run), upper body strength(handgrip), locomotor skill performance(standing long jump), and object projection skill performance(throwing and kicking). Portuguese and U.S. children were divided into 2 age groups(6à9 and 10à13 years) for data analysis purposes. A twoàfactor oneàway analysis of covariance(ANOVA) was conducted with the Progressive Aerobic Cardiovascular Endurance Run, handgrip, standing long jump scores, kicking, and throwing speed(km/h) as dependent variables.Results: Results indicated that Portuguese children, irrespective of sex, presented better performances in locomotor and cardiorespiratory performance(standing long jump and Progressive Aerobic Cardiovascular Endurance Run) than U.S. children in both age bands. U.S. children outperformed Portuguese children during throwing and handgrip tests. Kicking tests presented gender differences: Portuguese boys and U.S. girls outperformed their internationally matched counterparts.Conclusion: Cultural differences in physical education curricula and sports participation may impact differences in motor competence and fitness development in these countries.

A comparison between different ecological de-farming modes in the loess hilly-gully region in China

The eco-environmental restoration has been a chief task of the western development strategies carried out by the central and local governments of China since the late 1990s, and the ecological de-farming has been regarded as a powerful measure for the ecological restoration in the Loess Plateau and the upper reaches of the Yangtze River. "Relieving and de-farming" (RD) and "rebuilding terrace and de-farming" (RTD) are two more mature ones among various de-farming modes. Taking the loess hilly-gully region as a case, this paper summarized the basic characteristics of RD and RTD modes, calculated the sizes of de-farming slope farmland, rebuilt terraces, enlarged garden plots and restored vegetation, and compared the differences of two modes in terms of de-farming area, ecological reestablishment index, investment demand amount and benefits. The results showed that RTD mode has many advantages, including suitable investment, sufficient grain supply and great benefits, and will be the best ecological reestablishment mode in the loess hilly-gully region, and RD mode which is being carried out in this region should be replaced by RTD mode as soon as possible.

Morphological Comparison between Chinese Ayu and Japanese Ayu and Establishment of Plecoglossus altivelis chinensis Wu&Shan subsp.nov.

The countable characters of Qingdao, Zhejiang, Liaoning and Japanese Ayu arecompared. There are no substantial different characters among the former three Ayu, so thecomprehensive values of them are taken as representative of Chinese Ayu, which is in turn comparedwith Japanese Ayu ( Plecoglossus altivelis altivelis and Plecoglossus altivelis ryukyuensis). By thecoefficient of difference test, 3 and 4 characters are found to be beyond the subspecies levelbetween Chinese Ayu and nominate subspecies (Plecoglossus altivelis altivelis) and between ChineseAyu (Plecoglossus altivelis chinensis) and Ryukyus subspecies (Plecoglossus altivelis ryukyuensis),respectively, which shows that they belong to different subspecies. The China mainland Ayu is a newsubspecies, Plecoglossus altivelis chinensis Wu and Shan, the establishment of which and its formingcauses are discussed.

Comparison between the preparation,structure and mechanical properties of long fiber reinforced thermoplastics and short fiber reinforced thermoplastic

This article summarizes the comparison between the preparation, structure and mechanical properties of long fiber reinforced thermoplastics （LFT） and short fiber reinforced thermoplastics （SFT）. Both of the experiment and theory results showed that the mechanical properties of long glass fiber reinforced thermoplastics pellets （LGFRT） have been enhanced better than that of short glass fiber reinforced thermoplastics pellets （SGFRT） manufactured by molding procession. After regulation of the relative humidity by 50 % , the mechanical properties of 30 % （ weight percent） short glass fiber content in SFT （ SFT-PA6-SGF30 ） are similar to that of 40 % long glass fiber content in LFT. Howev- er, the density of the latter is about 17 % lower than that of the former. Thus, the corresponding weight of products is reduced by 13 % ;output rate is increased by 21% , and the cost is therefore significantly lowered. And it has the fol- lowing advantages： impact strength is increased by 87 % ; the proportion is reduced by 20 % ; molding cycle is short- ened by 10 % ;materials cost is saved by 20 % -30 % and the final total cost is saved by 30 % -40 %. So LFT （LFT-PP-LGF40） can replace SFT （SFT-PA6-SGF30） with the similar basic mechanical properties under normal tem- perature or 160 ℃ lower.

Comparison between Microwave Coherent and Incoherent Scattering Models in Corn Field

[Objective] The aim was to compare and analyze microwave coherent and incoherent scattering models in a corn field. [Method] In the research, based on a coherent scattering model （Stile）, we proposed a coherent scattering model exclusive for corn, in which, physical optics （PO） and infinite-length dielectric cylinder were used to calculate single-scattering matrices of corn leaves and stalks. In addition, coherent components produced from interaction among the scattering mechanisms were also considered and this coherent model was compared with the Michigan Mi- crowave Canopy Scattering （MIMICS） model. The measured data in a corn filed in Gongzhuling in Jilin Province were used as the input parameters of the coherent and incoherent models. We simulated backscattering coefficients of VV and HH po- larization at L and C bands and made a comparison between the simulation results. [Result] The simulation results at L-band were poor, which indicated that we could not find regularity at early growth stage of vegetation. In addition, comparisons be- tween coherent and incoherent scattering models proved that the coherence triggered by the scattering mechanism was small. [Conclusion] In the research, we analyzed differences between coherent and incoherent scattering models with change of incident angle, and further analysis on the differences with change of vegetation and soil needed to be made in future.