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Silent Embolic Infarction after Neuroform Atlas Stent-Assisted Coiling of Unruptured Intracranial Aneurysms

  • Seungho Shin;Lee Hwangbo;Tae-Hong Lee;Jun Kyeung Ko
    • Journal of Korean Neurosurgical Society
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    • 제67권1호
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    • pp.42-49
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    • 2024
  • Objective : There is still controversy regarding whether neck remodeling stent affects the occurrence of silent embolic infarction (SEI) after aneurysm coiling. Thus, the aim of the present study is to investigate the incidence of SEI after stent-assisted coiling (SAC) using Neuroform Atlas Stent (NAS) and possible risk factors. This study also includes a comparison with simple coiling group during the same period to estimate the impact of NAS on the occurrence of SEI. Methods : This study included a total of 96 unruptured intracranial aneurysms in 96 patients treated with SAC using NAS. Correlations of demographic data, aneurysm characteristics, and angiographic parameters with properties of SEI were analyzed. The incidence and characteristics of SEI were investigated in 28 patients who underwent simple coiling during the same period, and the results were compared with the SAC group. Results : In the diffusion-weighted imaging obtained on the 1st day after SAC, a total of 106 SEI lesions were observed in 48 (50%) of 96 patients. Of these 48 patients, 38 (79.2%) had 1-3 lesions. Of 106 lesions, 74 (69.8%) had a diameter less than 3 mm. SEI occurred more frequently in older patients (≥60 years, p=0.013). The volume of SEI was found to be significantly increased in older age (≥60 years, p=0.032), hypertension (p=0.036), and aneurysm size ≥5 mm (p=0.047). The incidence and mean volume of SEI in the SAC group (n=96) were similar to those of the simple coiling group (n=28) during the same period. Conclusion : SEIs are common after NAS-assisted coiling. Their incidence in SAC was comparable to that in simple coiling. They occurred more frequently at an older age. Therefore, the use of NAS in the treatment of unruptured intracranial aneurysm does not seem to be associated with an increased risk of thromboembolic events if antiplatelet premedication has been performed well.

만성 견관절 동통을 가진 50세 이상 환자의 단순 방사선 사진 분석 (Simple Radiographic Analysis of Chronic Shoulder Pain in Patients 50 Years and Older)

  • 류총일;김휘택;은일수
    • Clinics in Shoulder and Elbow
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    • 제7권1호
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    • pp.14-22
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    • 2004
  • Purpose: To evaluate a usefulness of the simple radiograph in the patients with chronic shoulder pain 50 years and older. Material and method: 1152 patients with chronic shoulder pain and 100 asymptomatic individuals were involved in this study. All patients were 50 years and older. We excluded patients who had a history of fracture or dislocation. Radiographic interpretation was performed on a shoulder AP view, an axillary view and a supraspinatus outlet view. For statistical analysis, a chi-square test was performed. A p value of <0.05 was considered statistically significant. Results: Abnormal radiologic findings were identified in 369(32%) out of 1152 patients with a shoulder pain: greater tuberosity sclerosis, acromial sclerosis, subacromial osteophytes are common abnormal radiologic findings. A rotator cuff tear or impingement syndrome was identified on a final diagnosis in 61(85.2%) out of the 76 patients with radiologic abnormalities in both greater tuberosity and acromion (p<0.05). Abnormal radiologic findings were identified in 18% of the asymptomatic individuals. Conclusion: Simple radiographic analysis is an important primary diagnostic tool in patients (50 years and old) with chronic shoulder pain.

여자 중·고등학생들의 굴절이상 눈에 대한 연구 (The Study of the Abnormal Refraction Eye on the Women Middle and High school Students)

  • 김덕훈;신장철
    • 한국안광학회지
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    • 제4권2호
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    • pp.135-140
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    • 1999
  • 여자 중고등학생들의 시력을 조사하기 위해서 시력검사를 객관적과 주관적인 방법으로 실시하였다. 결과는 다음과 같았다. 1. 눈의 형태는 근시가 96.7%, 정시가 2.5%, 원시가 0.8%였다. 2. 굴절이상안은 단순근시가 61%, 근시성 복합 난시가 35.2%, 단순 근시성 난시가 3%, 단순원시가 0.8%였다. 3. 난시의 축은 도난시가 95%, 직난시가 3%, 사난시가 2%였다. 4. 전체 근시 구면굴절력은 -0.50diopter에서 -2.00diopter 이하가 35.5%, -2.00diopter에서 -6.00 diopter 이하가 56.6%, -6.00diopter이상이 7.9%였다. 5. 난시굴절력에서 0.5diopter에서 1.00diopter가 66.7%, 1.00diopter에서 2.00diopter가 27.8%, 2.00 diopter 이상이 5.5%였다. 6. 동공간 거리는 54mm에서 68mm로 나타났으며, 가장 높은 빈도는 60mm와 62nm로 약 34.7%였다.

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유역의 지상적 요인과 저수지 비퇴사량과의 관계분석 (Regression Analysis Between Specific Sediments of Reservoirs and Physiographic Factors of Watersheds)

  • 서승덕;박흥익;천만복;윤경덕
    • 한국농공학회지
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    • 제30권4호
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    • pp.45-61
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    • 1988
  • The purpose of this study is to develop regression equations between annual specific sedi- ment of reservoirs and physiographic factors of watersheds. 122 irrigation reservoirs, which have irrigation areas equal to or larger than 200 ha, located in Korea except Cheju province are used in the analysis. Simple regression analyses between the specific annual sediment and each of the physical characteristic factors of the reservoirs are carried out at first. Then, multiple regression analyses between the annual specific sediment and the physical characteristic factors with high correlation coefficients in the simple regression analyses are made. The results obtained from this study are as follows : 1. The results of the sirnple regression analyses show that in each province the watershed area, the length of mainstream, the circumferential length of watershed have high cor- relation coefficients (R=0.814-0.986), and that drainage density, reservoir capacity per watershed area, drainage frequency, basin relief have low correlation coefficients (R=0. 387-0.955). 2. The purposed multiple regression equations between the annual specific sediment of reservoirs and three major characteritic factors of watersheds, namely, the watershed area, the circumferential length of watershed, and the length of mainstream, are proposed as given in Table 2. 3. The result of the simple regression analyses with respect to the reservoir elevation except Jeonnam province, which has very different characteristics comparing to other provinces, shows that watershed area, main stream length and circumferential length have high correlation coefficients (R=0.806-0.884) in low-elevation reservoirs and intermediate- elevation reservoirs, but low correlation coefficients (R=0.639-0.739) in high-elevation reservoirs. 4. With respect to the reservoir elevation, the proposed multiple regression equations bet- ween the annual specific sediment of reservoirs and the three major characteristic factors of watershed which have high correlation coefficients are proposed as given in Table 5.

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Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome

  • Cho, Yong-Jun;Cho, Sung-Min;Sheen, Seung-Hoon;Choi, Jong-Hun;Huh, Dong-Hwa;Song, Joon-Ho
    • Journal of Korean Neurosurgical Society
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    • 제42권5호
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    • pp.382-387
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    • 2007
  • Objective : Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper extremity. Although many different operative techniques have been introduced, none of them have been proven superior to others. Simple cubital tunnel decompression has numerous advantages, including simplicity and safety. We present our experience of treating cubital tunnel syndrome with simple decompression in 15 patients. Methods : According to Dellon's criteria, one patient was classified as grade 1, eight as grade 2, and six as grade 3. Preoperative electrodiagnostic studies were performed in all patients and 7 of them were rechecked postoperatively. Five patients of 15 underwent simple decompression using a small skin incision (2 cm or less). Results : Preoperative mean value of motor conduction velocity (MCV) within the segment (above the elbow-below the elbow) was $41.8{\pm}15.2\;m/s$ and this result showed a decrease compared to the result of MCV in the below the elbow-wrist segment ($57.8{\pm}6.9\;m/s$) with statistical significance (p<0.05). Postoperative mean values of MCV were improved in 6 of 7 patients from $39.8{\pm}12.1\;m/s$ to $47.8{\pm}12.1\;m/s$ (p<0.05). After an average follow-up of $4.8{\pm}5.3$ months, 14 patients of 15 (93%) reported good or excellent clinical outcomes according to a modified Bishop scoring system. Five patients who had been treated using a small skin incision achieved good or excellent outcomes. There were no complications, recurrences, or subluxation of the ulnar nerve. Conclusion : Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome.

Comparison of Effectiveness in Differentiating Benign from Malignant Ovarian Masses between IOTA Simple Rules and Subjective Sonographic Assessment

  • Tongsong, Theera;Tinnangwattana, Dangcheewan;Vichak-ururote, Linlada;Tontivuthikul, Paponrad;Charoenratana, Cholaros;Lerthiranwong, Thitikarn
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권9호
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    • pp.4377-4380
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    • 2016
  • Background: To compare diagnostic performance in differentiating benign from malignant ovarian masses between IOTA (the International Ovarian Tumor Analysis) simple rules and subjective sonographic assessment. Materials and Methods: Women scheduled for elective surgery because of ovarian masses were recruited into the study and underwent ultrasound examination within 24 hours of surgery to apply the IOTA simple rules by general gynecologists and to record video clips for subjective assessment by an experienced sonographer. The diagnostic performance of the IOTA rules and subjective assessment for differentiation between benign and malignant masses was compared. The gold standard diagnosis was pathological or operative findings. Results: A total of 150 ovarian masses were covered, comprising 105 (70%) benign and 45 (30%) malignant. Of them, the IOTA simple rules could be applied in 119 (79.3%) and were inconclusive in 31 (20.7%) whereas subjective assessment could be applied in all cases (100%). The sensitivity and the specificity of the IOTA simple rules and subjective assessment were not significantly different, 82.9% vs 86.7% and 94.0% vs 94.3% respectively. The agreement of the two methods in prediction was high with a Kappa index of 0.835. Conclusions: Both techniques had a high diagnostic performance in differentiation between benign and malignant ovarian masses but the IOTA rules had a relatively high rate of inconclusive results. The IOTA rules can be used as an effective screening technique by general gynecologists but when the results are inconclusive they should consult experienced sonographers.

Conditional Integral Transforms on a Function Space

  • Cho, Dong Hyun
    • Kyungpook Mathematical Journal
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    • 제52권4호
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    • pp.413-431
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    • 2012
  • Let $C^r[0,t]$ be the function space of the vector-valued continuous paths $x:[0,t]{\rightarrow}\mathbb{R}^r$ and define $X_t:C^r[0,t]{\rightarrow}\mathbb{R}^{(n+1)r}$ and $Y_t:C^r[0,t]{\rightarrow}\mathbb{R}^{nr}$ by $X_t(x)=(x(t_0),\;x(t_1),\;{\cdots},\;x(t_{n-1}),\;x(t_n))$ and $Y_t(x)=(x(t_0),\;x(t_1),\;{\cdots},\;x(t_{n-1}))$, respectively, where $0=t_0$ < $t_1$ < ${\cdots}$ < $t_n=t$. In the present paper, using two simple formulas for the conditional expectations over $C^r[0,t]$ with the conditioning functions $X_t$ and $Y_t$, we establish evaluation formulas for the analogue of the conditional analytic Fourier-Feynman transform for the function of the form $${\exp}\{{\int_o}^t{\theta}(s,\;x(s))\;d{\eta}(s)\}{\psi}(x(t)),\;x{\in}C^r[0,t]$$ where ${\eta}$ is a complex Borel measure on [0, t] and both ${\theta}(s,{\cdot})$ and ${\psi}$ are the Fourier-Stieltjes transforms of the complex Borel measures on $\mathbb{R}^r$.

전북 지역 고등학생 비정시에 관한 연구 (A Study on the Ametropia of High School Students in Jeonbuk Province)

  • 두하영;심상현;최오목;강명진
    • 한국안광학회지
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    • 제7권2호
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    • pp.67-71
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    • 2002
  • 본 연구는 전북지역 고등학생 비정시 182명 364안을 대상으로 타각적, 자각적 시력 검사를 시행하여 비정시의 정도 및 굴절 이상상태를 연구하였다. 1. 눈의 형태는 근시는 85.7%, 원시는 7.6%, 그리고 정시는 6.6%로 나타났다. 2. 굴절이상안은 단순근시 29.6%, 근시성 복난시 56.3%, 근시성단난시 7.2%, 원시성단난시 1.8%, 원시성 복난시 1.2%, 혼합난시 1.8%, 단순원시 1.8% 이었다. 3. 난시의 축은 직난시 78.7%, 도난시 13.9%, 사난시 7.4%이었다. 4. 난시의 굴절력은 0.50dptr에서 1.0dptr가 64.6%. 1.0dptr 에서 2.0dptr가 29.1%, 2.0dptr 이상이 6%이었다. 5. 근시성 굴절이상안의 등가구면굴절력은 -0.50dptr 에서 -2.0dptr 이하 40.1%, -2.0dptr에서 -6.00dptr 이하 56.6%, -6.00 이상이 36.8% 이였다. 6. 원시성 굴절이상안의 등가구면굴절력은 2.00dptr 이하 50%, 2.00dptr 이상이 50%이었다.

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응급환자의 방사선영상검사 분포 및 Patient Care (The Distribution and Patient Care in Radiography for Emergency Outpatients)

  • 이환형;강원한
    • 대한방사선기술학회지:방사선기술과학
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    • 제19권1호
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    • pp.55-74
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    • 1996
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distribution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 761 emergency outpatients who visit during JAN, 1994 at ER of the general hospital in Pusan city. The results is as follows: Emergency radiography rate of simple radiography was 61.1 %, special radiography 2.5 %, CT 12.6 %, and ultrasonography 6.7 %. In simple radiography rate, a high rate was distributed on male(63.6 %), thoracicsurgery part(90.0%), admission patient(74.9 %), and long stayed patient at ER. In special raiography rate, a high rate was observed in urologic part(28.6%), and in CT rate, observed neurosurgery part(49.2 %) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8 %) and internal medicine part(15.9 %). There are distributed regional radiography rate in radiographic type that chest(55.3 %) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0 %) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neurosurgery, chest(90.0%) in thoracic-surgery, abdomen(58.0%) in general-surgery, spine (40.0% ) in neuro-surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic-surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiographic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transfered patient(2.7) in patient type, and on neurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional part was highly distributed on chest(499 case number). Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, radiographer should know well about dealing with contrastmedia administration and related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography, Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always silted with CT room and monitoring-patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiography should be established in ER area, and the radiographer of this room should be stationed radiologic technician who is career and can implement emergency patient care.

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7075-T6Al 합금에 있어서 변동하중진폭 하에서의 피로균열성장거동 (Fatigue Crack Growth Behavior of 7075-T6Al Alloy under Simple Stepped Variable Amplitude Loading Conditions)

  • 신용승
    • 한국생산제조학회지
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    • 제6권4호
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    • pp.80-88
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    • 1997
  • An experimental investigation of the fatigue through crack growth behavior under simple stepped variable loading condition has been performed using Al7075-T651. Experiments were carried out by using cantilever bending type specimens, with chevron notches on a small electro-magnetic test machine. Tensile overloads have a retarding effect on the fatigue crack growth rates, therefore tensile overloads were used for the beneficial effect on the fatigue life. While in most cases compressive overloads have only a vanishing effect on crack growth rates, some experiments with single edge crack tension specimens reveal a marked growth retardation. The stress ratios used in this investigations varies from R=0.32 to 0.81, from R=0.04 to 0.76, from R=-0.15 to 0.73, and from R=-0.33 to 0.68 and the peak load for each case was not varied. The crack growth and crack closure were measured by Kikukawa's compliance method with a strain gauge mounted on the backside of each specimens. The results obtained are as follows. When the stepped variable load was applied, the smaller the stress ration was, the larger the delayed retardation of the crack growth rate was. The fatigue crack growh rate data obtained for through cracks were plotted well against the effective stress intensity factor range from 4.0 to 20.0MP{a^{SQRT}m}. It was found that the effective stress intensity factor range ratio was related well to the opening stress intensity factor, the maximum stress intensity factor, and crack length.