• Journal of Korean Neurosurgical Society
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• 제65권4호
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• pp.531-538
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• 2022

Objective : Anterior communicating artery (Acom) aneurysm is one of the most common intracranial aneurysms, constituting approximately 30-35% of all aneurysm formation in the brain. Anatomically, the H-complex (the anatomic morphology of both A1 to A2 segments) is thought to affects the nature of the Acom aneurysm due to its close relationship with the hemodynamics of the vessel. Therefore, we investigated the relative risk factors of aneurysmal rupture, especially focusing on H-complex morphology of the Acom. Methods : From January 2016 to December 2020, a total of 209 patients who underwent surgery, including clipping and coiling for Acom aneurysm in our institution were reviewed. There were 102 cases of ruptured aneurysm and 107 cases of unruptured aneurysm. The baseline morphology of aneurysms was investigated and the relationship between the H-complex and the clinical characteristics of patients with Acom aneurysms was assessed. Results : Of the 209 patients, 109 patients (52.1%) had symmetrical A1, 79 patients (37.8%) had unilateral hypoplastic A1, and 21 patients (10.0%) had aplastic A1. The hypoplastic A1 group and the aplastic A1 group were grouped together as unilateral dominancy of A1, and were compared with the symmetrical A1 group. There was no significant difference in demographic characteristics and radiological findings of Acom aneurysms between two groups. However, when dichotomizing the patients into ruptured cases and unruptured cases, unilateral dominance of the A1 segment was associated with aneurysmal rupture with statistical significance (p=0.011). Conclusion : These results suggest that the unilateral dominance of the A1 segment does not have a significant effect on the morphology of Acom aneurysms, but contributes to aneurysmal rupture. Thus, we can better understand the effects of hemodynamics on Acom aneurysm.

• 수산해양기술연구
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• 제26권2호
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• pp.118-124
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• 1990

PP 로프의 유연도와 모릿줄이 사려지는 현상등을 기초적으로 조사한 다음, 반원형 안내판의 회전중심이 편심되도록 고달이채기 레버를 회전시켜 고달이를 자동으로 채어서 이송벨트에 정리하면서, 모릿줄이 고르게 사려지도록 줄받이의 왕복 회전장치 등을 제작하여 실험실과 통발어선에서 시험한 결과는 다음과 같다. 1. 직경 10mm의 PP 연심 모릿줄이 양승풀리에서부터 사려질 때 한 코일의 최소직경은 14cm 정도, 줄더미의 직경은 60cm 정도였다. 2. 소형 고달이채기에서 이송벨트의 상, 하 10cm이내에 분포하는 고달이의 비율은, 납이 1개 있는 모릿줄에서는 93%정도이나 납이 없는 모릿줄에서는 98%이상이었다. 3. 감속비가 3:1인 소형 고달이채기에서 레버의 회전수 N 하(1) (rpm)과 양승풀리의 회전수 N 하(p) (rpm)와의 관계는 N 하(p) =2.86N 하(1) +23.74 이며, 양승속도에 대한 고달이의 수평최대 이동속도의 비는 70%정도였다. 4. 보조양승기와 고달이채기를 연계시켜 줄받이를 상, 하로 왕복시킬 경우 모릿줄은 길이 방향으로 고루 사릴 수 있었으며, 고달이채기 레버의 회전과 줄받이의 왕복운동 주기는 고달이의 간격에 따라 조절할 수 있다.

• Journal of Korean Neurosurgical Society
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• 제61권4호
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• pp.450-457
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• 2018

Objective : Very large (20-25 mm) and giant (${\geq}25mm$) intracranial aneurysms have an extremely poor natural course, and treatment of these aneurysms remains a challenge for endovascular and surgical strategies. This study was undertaken to describe our experiences of endosaccular treatment of very large and giant intracranial aneurysms with parent artery preservation. Methods : From January 2005 to October 2016, twenty-four very large or giant aneurysms in 24 patients were treated by endosaccular coil embolization with parent artery preservation. Nine (37.5%) aneurysms were ruptured and 15 were unruptured, and of these 15, 11 were symptomatic cases and 4 were incidentally discovered. The cohort comprised 17 women and 7 men of mean age 58.5 years (range, 26-82). Mean aneurysm size was 26.0 mm (range, 20-39) and 13 of the 24 aneurysms were giant. Results : Immediate angiographic results were complete occlusion in nine (37.5%) cases, remnant neck in six (25.0%), and remnant sac in nine (37.5%). Overall procedural related morbidity and mortality rates were 12.5% and 4.2%, respectively. Angiographic follow-up was available in 16 patients (66.7%). Mean and median follow-up periods were 27.2 (range, 2-77) and 10.5 months, respectively. In 12 cases (12/16, 75%) stable occlusion was achieved, four cases (4/16, 25%) had recanalized, and two of these were retreated with additional coiling. At clinical follow-up of the nine ruptured cases, three patients (33.3%) achieved a good clinical outcome (Glasgow outcome scale [GOS] score of 4 or 5), two (22.2%) a poor outcome (GOS score of 2 or 3), and four patients (44.4%) expired (GOS 1). On the other hand, of the 15 unruptured cases, 13 patients (86.7%) achieved a good clinical outcome (GOS 4 or 5), one patient a poor outcome (GOS score of 2 or 3), and one patient expired (GOS 1). Conclusion : The present study shows endosaccular treatment of very large or giant intracranial aneurysms with parent artery preservation is both feasible and effective with acceptable morbidity and mortality.

• Parasites, Hosts and Diseases
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• 제56권4호
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• pp.379-383
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• 2018

The present study was performed with morphological and molecular analysis (cox1 and nad1 mitochondrial genes) to identify the proglottids of spirometrid tapeworm found in the stool of an African lion, Panthera leo, in the Serengeti plain of Tanzania. A strand of tapeworm strobila, about 75 cm in length, was obtained in the stool of a male African lion in the Serengeti National Park ($34^{\circ}$ 50' E, $02^{\circ}$ 30' S), Tanzania, in February 2012. The morphological features of the adult worm examined exhibited 3 uterine coils with a bow tie appearance and adopted a diagonal direction in the second turn. The posterior uterine coils are larger than terminal uterine ball and the feature of uteri are swirling rather than spirally coiling. The sequence difference between the Spirometra species (Tanzania origin) and S. erinaceieuropaei (GenBank no. KJ599680) was 9.4% while those of S. decipiens (GenBank no. KJ599679) differed by 2.1% in the cox1 and nad1 genes. Phylogenetic tree topologies generated using the 2 analytic methods were identical and presented high level of confidence values for the 3 major branches of the 3 Spirometra species in the cox1 gene. The morphological and molecular findings obtained in this study were nearly coincided with those of S. ranarum. Therefore, we can know for the first time that the African lion, Panthera leo, is to the definitive host of this tapeworm.

• Parasites, Hosts and Diseases
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• 제35권4호
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• pp.283-290
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• 1997

경기도 부천시에 거주하는 5명의 주민이 1996년 2월경에 노량진 수산시장에서 가숭어 (Liza haematocheila)글 구입하여 함께 회로 먹고 편절배출을 주소로 1997년 2월에 인하대학교 의괴대학 기생충학효실을 찾아왔다. 이들은 모두 조충의 편절이 자연배출된 경험이 있었다고 하였으려 복통 소화녈량 두통 어지러움증 및 복부 불쾌감 등의 증상을 호소하였으나 혈액검사 소견을 모두 정상범위 내에 있었다. 공복 상태인 환자들에게 praziquantel 15 mg/kg를 단회 투여하고 악 30분 후에 하제 (magnesium sulfate. 30 g)를 투여한 후 충체 수집을 시도하였던 바. 3명으로부터 각각 투절이 포함긴 310 cm와 340 cm 길이의 충체와 두절이 없는 약 100 cm 길이 의 충체를 검출하였다 검출된 충란 및 충체들의 형태학적 소견들을 종합해 보았을 때 광절열두조 충 (Diphyllobothrium Inturn)으로 동정되었고. 환자들의 과거력과 증례발생의 시점 등의 종합적 인 성황을 미루어 보아 가숭어가 감염원이었을 것으로 추정되었다.

• Parasites, Hosts and Diseases
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• 제56권3호
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• pp.275-280
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• 2018

In the present study, we identified a Spirometra species of Myanmar origin (plerocercoid) by molecular analysis using mitochondrial cox1 and nad1 genes, as well as by morphological observations of an adult tapeworm. Spargana specimens were collected from a paddy-field in Taik Kyi Township Tarkwa Village, Yangon, Myanmar in December 2017. A total of 5 spargana were obtained from 20 frogs Hoplobatrachus rugulosus; syn: Rana rugulosa (Wiegmann, 1834) or R. tigrina (Steindachner, 1867). The plerocercoids were used for experimental infection of a dog. After 4 weeks of infection, an adult tapeworm was recovered from the intestine of the dog. Morphologically, the distinct features of Spirometra sp. (Myanmar origin) relative to S. erinaceieuropaei and S. decipiens include a uterine morphology comprising posterior uterine coils that larger than the terminal uterine ball and coiling of the uteri diagonally (swirling) rather than spirally. The cox1 sequences (1,566 bp) of the Myanmar-origin Spirometra species showed 97.9% similarity to a reference sequence of S. decipiens (GenBank no. KJ599679) and 90.5% similarity to a reference sequence of S. erinaceieuropaei (GenBank no. KJ599680). Phylogenetic tree topologies were identical and presented high confidence level of values for the 3 major branches of the 3 Spirometra species in cox1 and nad1 genes. These results indicated that Myanmar-origin Spirometra species coincided with those of S. ranarum and may be considered as a valid species.

• 대한의용생체공학회:의공학회지
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• 제19권4호
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• pp.333-339
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• 1998

본 연구에서는 혈관폐색을 위한 색전코일의 열처리 제조공정 조건을 연구하였다. 2.92mm의 알루미나 심재에 1차코일을 감은 후 475$^{\circ}C$와 600$^{\circ}C$에서 열처리하여 2차코일을 제조하였으며, 열처리 시간에 따른 2차코일의 피치간격, 내경 및 형상복원성을 평가하였다. 2차코일의 피치간격은 475$^{\circ}C$와 600$^{\circ}C$에서 각각 잠복기를 가진 후 열처리 시간이 증가함에 따라 증가하였다. 2차코일의 내경은 열처리 시간이 증가함에 딸 연속적으로 감소하였다. 이 원인은 열처리 초기에 회복에 의하여 재료의 내부에너지가 감소되면서 2차코일의 피치간격과 내경이 감소되나, 열처리 시간이 증가됨에 따라 텅스텐 표면의 산화물이 형성되면서 탄성이 증가되기 때문에 피치간격이 증가하는 것으로 분석되었다. 2차코일의 형상복원성은 텅스텐코일의 표면에 형성된 텅스텐 산화물이 탄성을 증가시킴으로 인해 열처리 시간이 증가함에 따라 연속적으로 증가하였다. 열처리 온도 영향을 비교하면 산화물형성 속도가 빠른 600$^{\circ}C$가 475$^{\circ}C$보다 더 우수한 형상복원성을 나타내었다. 텅스텐 색전코일의 제조공정 연구결과 2차코일의 피치간격, 내경 및 형상 복원성을 최적화하기 위해서는 600$^{\circ}C$에서 20분간 열처리하는 것이 적절한 조건인 것으로 조사되었다.

• 한국재료학회지
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• 제9권12호
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• pp.1252-1262
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• 1999

자동차 휠, 멤버 등의 소재로 사용되는 인장강도 580MPa급 열연강판의 버링성형성을 향상시키기 위하여 강판의 신장 플랜지성(stretch-flangeability)에 대한 미세조직 및 열간압연후 냉각인자의 영향에 대하여 검토하였다. 열간압연후 3단 냉각제어 및 권취온도의 극저온화에 의하여 신장플랜지성이 우수한 페라이트-베이나이트 복합조직강의 제조가 가능하며, 3단 제어냉각에서 강판의 온도를 $Ar_3$ 직하의 페라이트변태역에서 일정 시간 유지하면 페라이트 변태 및 NbC의 석출이 조장됨을 확인하였다. 페라이트-베이나이트 복합조직 열연강판의 우수한 신장플랜지성은 3단 냉각 및 극저온 권취에 의한 등축 페라이트 분율의 증가, 입계 세멘타이트의 미세화 및 구성 상간의 경도차 저하에 의하여 타발공정에서의 미소균열 생성 및 전파가 억제되기 때문인 것으로 판단되었다. 아울러 0.08wt%C-1.5wt%Mn-0.04wt%Nb 성분계를 이용하여 제조된 인장강도 580MPa급 페라이트-베이나이트 복합조직 열연강판은 연신율 22% 이상, 구멍확장율 (신장플랜지성) 90% 이상의 재질특성을 가지며, 버링비 60% 이상의 자동차 휠 디스크에 적용 가능한 것으로 판명되었다.

• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.502-518
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• 2019

Objective : Since less invasive endovascular treatment was introduced to South Korea in 1994, a considerable proportion of endovascular treatments have been performed by neuroradiology doctors, and endovascular treatments by vascular neurosurgeons have recently increased. However, few specific statistics are known regarding how many endovascular treatments are performed by neurosurgeons. Thus, authors compared endovascular treatments collaboratively performed by vascular neurosurgeons with all cases throughout South Korea from 2013 to 2017 to elucidate the role of neurosurgeons in the field of endovascular treatment in South Korea. Methods : The Society of Korean Endovascular Neurosurgeons (SKEN) has issued annual reports every year since 2014. These reports cover statistics on endovascular treatments collaboratively or individually performed by SKEN members from 2013 to 2017. The data was requested and collected from vascular neurosurgeons in various hospitals. The study involved 77 hospitals in its first year, and 100 in its last. National statistics on endovascular treatment from all over South Korea were obtained from the Healthcare Bigdata Hub website of the Health Insurance Review & Assessment Service based on the Electronic Data Interchange (EDI) codes (in the case of intra-arterial (IA) thrombolysis, however, statistics were based on a combination of the EDI and I63 codes, a cerebral infarction disease code) from 2013 to 2017. These two data sets were directly compared and the ratios were obtained. Results : Regionally, during the entire study period, endovascular treatments by SKEN members were most common in Gyeonggido, followed by Seoul and Busan. Among the endovascular treatments, conventional cerebral angiography was the most common, followed by cerebral aneurysmal coiling, endovascular treatments for ischemic stroke, and finally endovascular treatments for vascular malformation and tumor embolization. The number of endovascular treatments performed by SKEN members increased every year. Conclusion : The SKEN members have been responsible for the major role of endovascular treatments in South Korea for the recent 5 years. This was achieved through the perseverance of senior members who started out in the midst of hardship, the establishment of standards for the training/certification of endovascular neurosurgery, and the enthusiasm of current SKEN members who followed. To provide better treatment to patients, we will have to make further progress in SKEN.

• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.536-544
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• 2019

Objective : The objective of this study was to evaluatelong-term radiologic prognosis and characteristics of in-stent stenosis (ISS) after stent assisted coiling (SAC) for cerebral aneurysm and analyze its risk factors. Methods : Radiological records of 362 cases of SAC during 10 years were retrospectively reviewed. Patients were included in this study if they had follow-up angiogram using catheter selected angiography at least twice. All subjected were followed up from 12 months to over 30 months. Of 120 patients, 123 aneurysms were enrolled. Patient data including age, sex, aneurysm size, neck size, procedural complication, kinds of stent, ISS associated symptom, ruptured state, location of ISS, degree of ISS, radiologic prognosis of ISS, follow-up period of time, and medical comorbidities such as hypertension, diabetes mellitus (DM), dyslipidemia, and smoking were collected.Statistical comparisons of group clinical characteristics were conducted for the total population. Results : Among 123 casesof aneurysm, 22 cases (17.9%) of ISS were revealed on follow-up angiography. Multiple stenting was performed in three cases and intra-procedural rupture occurred in two cases. Most cases were asymptomatic and symptomatic stenosis was identified in only one case. Sixteen cases were ruptured aneurysm. Mild stenosis was observed in 11 cases. Moderate stenosis was found in eight cases and severe stenosis was identified in three cases. Mean timing of identification of ISS was 8.90 months. The most common type was proximal type. Most cases were improved or not changed on follow-up angiography. Only one case was aggravated from mild stenosis to occlusion of parent artery. Mean follow-up period was 44.3 months. We compared risk factors and characteristic between ISS group and non-ISS group using univariate analysis. Multiple stenting was performed for three cases (13.6%) of the ISS group and four cases (4.0%) of the non-ISS group, showing no statistical difference between the two groups (p=0.108). Additionally, the proportion of patients who had more than two risk factors among four medical risk factors (hypertension, DM, dyslipidemia, and smoking) was higher in the ISS group than that in the non-ISS group, the difference between the two was not statistically significant either (31.8% vs. 12.9%, p=0.05). Conclusion : Clinical course and long-term prognosis of ISS might be benign. Most cases of ISS could be improved or not aggravated. Control of medical co-morbidity might be important. To the best of our knowledge, our study had more cases with longer follow-up period of time than other reports.