• Title/Summary/Keyword: Burr-hole

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Delayed Burr Hole Surgery in Patients with Acute Subdural Hematoma : Clinical Analysis

  • Choi, Yoon Heuck;Han, Seong Rok;Lee, Chang Hyun;Choi, Chan Young;Sohn, Moon Jun;Lee, Chae Heuck
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.717-722
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    • 2017
  • Objective : To evaluate the effectiveness and efficacy of delayed burr hole surgery in relation to the reduction of postoperative subdural hematoma (SDH) volume in patients with acute SDH. Methods : We retrospectively analyzed patients with acute SDH who received delayed burr hole surgery at our institute. Age, sex, Glasgow coma scale, maximal SDH thickness, volume of SDH, midline shifts, hounsfield unit (HU), and medical history of anticoagulant agent usage were recorded. Outcome measures were delayed operation day, reduction of SDH volume after operation, and the Glasgow outcome scale (GOS) score at discharge. The patients were divided two groups according to the postoperative reduction of volume of SDH (${\geq}50%$, group A; <50%, group B). We also analyzed variables and differences between two groups. Results : Eighteen patients were available for this analysis. The mean delayed of surgery was $13.9{\pm}7.5$ days. Maximal thickness of SDH was changed from $10.0{\pm}3.5mm$ to $12.2{\pm}3.7mm$. Volume of SDH was changed from $38.7{\pm}28.0mL$ to $42.6{\pm}29.6mL$. Midline shifts were changed from $5.8{\pm}3.3mm$ to $6.6{\pm}3.3mm$. HU were changed from $66.4{\pm}11.2$ to $53.2{\pm}20.6$. Post-operative reduction of SDH volume was $52.1{\pm}21.1%$. Eleven patients (61%) had a discharge GOS score of 1 (good recovery). Ten patients (56%) were enrolled in group A. Midline shifting was greater in group A than in group B ($7.4{\pm}3.3$ vs. $3.0{\pm}2.4mm$; p<0.02). The delay of surgery was shorter for group A than group B ($9.2{\pm}2.3$ vs. $19.8{\pm}7.7$ days; p<0.0008). Conclusion : Among well selected patients, delayed burr hole surgery in patients with acute SDH may be effective for reduction of SDH volume. Further studies will be necessary to establish the effectiveness and safety of delayed burr hole surgery in patients with acute SDH.

Measurement and Effective Deburring for the Micro Burrs in Piercing Operation

  • Ko, Sung-Lim
    • International Journal of Precision Engineering and Manufacturing
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    • v.1 no.1
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    • pp.152-159
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    • 2000
  • In piercing operation for small hole in very thin plate, micro burrs are formed. The micro burr is very difficult to remove because the thin plate is to be deformed during deburring and deteriorate accuracy. As a first step to remove the micro burrs effectively, the burr must be measured accurately as much as possible. For most micro burrs are so small as less than 10$\mu\textrm{m}$, it is very difficult to measure. Several methods are reviewed to measure the micro burr formed in piercing operation from very thin plate with thickness less than 0.1mm. Also the effective deburring methods are reviewed. Barreling ultrasonic and chemical deburring methods are performed and the results are compared.

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FE Analysis for hydro-mechanical Hole Punching Process (Hydro-mechanical hole punching 공정의 유한요소 해석)

  • Yoon J. H.;Kim S. S.;Park H. J.;Choi T. H.;Lee H. J.;Huh H.
    • Proceedings of the Korean Society for Technology of Plasticity Conference
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    • 2005.05a
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    • pp.159-162
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    • 2005
  • The milli-components for electronic and medical device etc. have been manufactured by conventional process. Forming and machining process for those milli-components need tremendous cost and time because products require higher dimensional accuracy than the conventional ones. For instance, conventional mechanical punching process has many drawbacks for applying to high accuracy products. The final radius of hole can be varied and burr which interrupting another procedure is generated. Hydro-mechanical punching process makes possible to reduce amount of burr and obtain the fine shearing surface using the operating fluid. Hydrostatic pressure retards occurrence of initial crack and induces to locate the fracture surface in the middle of sheet to thickness direction. In this paper, Hydro-mechanical punching process is analyzed using finite element method and the effect of hydrostatic pressure is evaluated during punching process. The prediction of fracture is performed adopting the various ductile fracture criteria such as Cockcroft, Brozzo and Oyane's criterion using a user subroutine in ABAQUS explicit.

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A Study on the Drilling Performance of the Assembly Machine for the an Aircraft's Main Wings (항공기 주익 조립 장비의 드릴링 성능에 관한 연구)

  • Hong, Seong-Min;Park, Dae-Hun;Han, Sung-Gil;Song, Chul-Ki
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.17 no.1
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    • pp.8-15
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    • 2018
  • Recently, the manufacturing market for low-cost airlines has led to an increase in aircraft demand. Most processes in the production of these aircrafts are manual such as drilling, sealing, and swaging. A drilling and riveting machine is a numerical-control based equipment that automatically performs drilling, sealing, and swaging operations. The accuracy of the drilled holes and the exit burr length has a significant impact on the quality of the aircraft wing during assembly. This study was conducted to identify the conditions necessary to maintain a uniform quality by controlling the rotation speed of the spindle, which directly affects the hole diameter and the quality of the exit burr.

Machine Vision Inspection System of Micro-Drilling Processes On the Machine Tool (공작기계 상에서 마이크로드릴 공정의 머신비전 검사시스템)

  • Yoon, Hyuk-Sang;Chung, Sung-Chong
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.28 no.6
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    • pp.867-875
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    • 2004
  • In order to inspect burr geometry and hole quality in micro-drilling processes, a cost-effective method using an image processing and shape from focus (SFF) methods on the machine tool is proposed. A CCD camera with a zoom lens and a novel illumination unit is used in this paper. Since the on-machine vision unit is incorporated with the CNC function of the machine tool, direct measurement and condition monitoring of micro-drilling processes are conducted between drilling processes on the machine tool. Stainless steel and hardened tool steel are used as specimens, as well as twist drills made of carbide are used in experiments. Validity of the developed system is confirmed through experiments.

Cerebral Venous Thrombosis Complicated by Hemorrhagic Infarction Secondary to Ventriculoperitoneal Shunting

  • Son, Won-Soo;Park, Jae-chan
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.357-359
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    • 2010
  • While a delayed intracerebral hemorrhage at the site of a ventricular catheter has occasionally been reported in literature, a delayed hemorrhage caused by venous infarction secondary to ventriculoperitoneal shunting has not been previously reported. In the present case, a 68-year-old woman underwent ventriculoperitoneal shunting through a frontal burr hole, and developed a hemorrhagic transformation of venous infarction on the second postoperative day. This massive venous infarction was caused by bipolar coagulation and occlusion of a large paramedian cortical vein in association with atresia of the rostral superior sagittal sinus. Thus, to eliminate the risk of postoperative venous infarction, technical precautions to avoid damaging surface vessels in a burr hole are required under loupe magnification in ventriculoperitoneal shunting.

Burr Hole Drainage : Could Be Another Treatment Option for Cerebrospinal Fluid Leakage after Unidentified Dural Tear during Spinal Surgery?

  • Huh, Jisoon
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.59-61
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    • 2013
  • Authors report a rare case of acute intracranial subdural and intraventricular hemorrhage that were caused by intracranial hypotension resulted from cerebrospinal fluid leakage through an unidentified dural tear site during spinal surgery. The initial brain computed tomography image showed acute hemorrhages combined with preexisting asymptomatic chronic subdural hemorrhage. One burr hole was made over the right parietal skull to drain intracranial hemorrhages and subsequent drainage of cerebrospinal fluid induced by closure of the durotomy site. Among various methods to treat cerebrospinal fluid leakage through unidentified dural injury site, primary repair and spinal subarachnoid drainage are well known treatment options. The brain imaging study to diagnose intracranial hemorrhage should be taken before selecting the treatment method, especially for spinal subarachnoid drainage. Similar mechanism to its spinal counterpart, cranial cerebrospinal fluid drainage has not been mentioned in previous article and could be another treatment option to seal off an unidentified dural tear in particular case of drainage of intracranial hemorrhage is needed.

Bilateral Chronic Subdural Hematoma Contaminated with Klebsiella Pneumoniae : An Unusual Case

  • Bakar, Bulent;Sungur, Cem;Tekkok, Ismail Hakki
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.397-400
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    • 2009
  • This article presents the case of a bilateral chronic subdural hematoma which was contaminated with Klebsiella pneumoniae and resulted in a life-threatening central nervous system infection. After repeated of bilateral burr-hole drainage, the patient became hyperpyrexic and drowsy. Suppuration within the subdural space was suspected and then the patient underwent bilateral fronto-temporo-parietal craniotomies, and pus was evacuated. Its cultures revealed Klebsiella pneumoniae. Intravenous meropenem was given for 6 weeks. He recovered completely. Microorganisms like Klebsiella pneumoniae may directly infect the subdural space with iatrogenic contamination.

Stereotaxic Neurotomy of the Ganglion Impar in the Management of Perineal Pain -A case report- (회음부통증 환자를 위한 Ganglion Impar의 정위적 신경절제술 -증례 보고-)

  • Shin, Keun-Man;Kim, Jin-Soo;Cho, Yong-Roew;Lim, So-Young;Hong, Soon-Yong;Choi, Young-Ryong
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.415-418
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    • 1996
  • The first reported the neural blockade of ganglion impar for pain control of perineal pain in 1990 by Plancarte and his fellows. they used 6ml of 10 percent phenol. but the point of issues, same as other neurolytics, are that it is impossible to check and control its spreading, so it might be possible to destruct the coccygeal plexus and sacral nerve, and also it has only short action time. Because of these problems, it could be very dangerous to attempt this procedure especially not for relieving the pain on cancer terminal patient, but for the sympathectomy of ganglion impar on the other purpose. We used the RF generator which had the control ability to point out the destructive lesion accurately. inserted We made the small burr hole on the sacrum near the sacrococcygeal junction directly, through the hole, and performed thermocoagulation to the ganglion impar.

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Comparison of the Indications and Treatment Results of Burr-Hole Drainage at the Maximal Thickness Area versus Twist-Drill Craniostomy at the Pre-Coronal Point for the Evacuation of Symptomatic Chronic Subdural Hematomas

  • Kim, Gi Hun;Kim, Bum-Tae;Im, Soo-Bin;Hwang, Sun-Chul;Jeong, Je Hoon;Shin, Dong-Seong
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.243-247
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    • 2014
  • Objective : To analyze the clinical data and surgical results from symptomatic chronic subdural hematoma (CSDH) patients who underwent burr-hole drainage (BHD) at the maximal thickness area and twist-drill craniostomy (TDC) at the precoronal point. Methods : We analyzed data from 65 symptomatic CSDH patients who underwent TDC at the pre-coronal point or BHD at the maximal thickness area. For TDC, we defined the pre-coronal point to be 1 cm anterior to the coronal suture at the level of the superior temporal line. TDC was performed in patients with CSDH that extended beyond the coronal suture, as confirmed by preoperative CT scans. Medical records, radiological findings, and clinical performance were reviewed and analyzed. Results : Of the 65 CSDH patients, 13/17 (76.4%) with BHD and 42/48 (87.5%) with TDC showed improved clinical performance and radiological findings after surgery. Catheter failure was seen in 1/48 (2.4%) cases of TDC. Five patients (29.4%) in the BHD group and four patients (8.33%) in the TDC group underwent reoperations due to remaining hematomas, and they improved with a second operation, BHD or TDC. Conclusion : Both BHD at the maximal thickness area and TDC at the pre-coronal point are safe and effective drainage methods for symptomatic CSDHs with reasonable indications.