• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.313-318
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• 2010

Objective : The amount of hemorrhage observed on a brain computed tomography scan, or a patient's Fisher grade (FG), is a powerful risk factor for development of shunt dependent hydrocephlaus (SDHC). However, the influence of treatment modality (clipping versus coiling) on the rate of SDHC development has not been thoroughly investigated. Therefore, we compared the risk of SDHC in both treatment groups according to the amount of subarachnoid hemorrhage (SAH). Methods : We retrospectively reviewed 839 patients with aneurysmal SAH for a 5-year-period. Incidence of chronic SDHC was analyzed using each treatment modality according to the FG system. In addition, other well known risk factors for SDHC were also evaluated. Results : According to our data, Hunt-Hess grade, FG, acute hydrocephalus, and intraventricular hemorrhage were significant risk factors for development of chronic SDHC. Coiling group showed lower incidence of SDHC in FG 2 patients, and clipping groups revealed a significantly lower rate in FG 4 patients. Conclusion : Based on our data, treatment modality might have an influence on the incidence of SDHC. In FG 4 patients, the clipping group showed lower incidence of SDHC, and the coiling group showed lower incidence in FG 2 patients. We suggest that these findings could be a considerable factor when deciding on a treatment modality for aneurysmal SAH patients, particularly when the ruptured aneurysm can be occluded by either clipping or coiling.

• 대한치과교정학회지
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• 제49권4호
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• pp.214-221
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• 2019

Objective: To investigate the effects of reversing the coiling direction of nickel-titanium closed-coil springs (NiTi-CCSs) on the force-deflection characteristics. Methods: The samples consisted of two commercially available conventional NiTi-CCS groups and two reverse-wound NiTi-CCS groups (Ormco-Conventional vs. Ormco-Reverse; GAC-Conventional vs. GAC-Reverse; n = 20 per group). The reverse-wound NiTi-CCSs were directly made from the corresponding conventional NiTi-CCSs by reversing the coiling direction. Tensile tests were performed for each group in a temperature-controlled acrylic chamber ($37{\pm}1^{\circ}C$). After measuring the force level, the range of the deactivation force plateau (DFP) and the amount of mechanical hysteresis (MH), statistical analyses were performed. Results: The Ormco-Reverse group exhibited a significant shift of the DFP end point toward the origin point (2.3 to 0.6 mm), an increase in the force level (1.2 to 1.3 N) and amount of MH (1.0 to 1.5 N) compared to the Ormco-Conventional group (all p < 0.001), which indicated that force could be constantly maintained until the end of the deactivation curve. In contrast, the GAC-Reverse group exhibited a significant shift of the DFP-end point away from the origin point (0.2 to 3.3 mm), a decrease in the force level (1.1 to 0.9 N) and amount of MH (0.6 to 0.4 N) compared to the GAC-Conventional group (all p < 0.001), which may hinder the maintenance of force until the end of the deactivation curve. Conclusions: The two commercially available NiTi-CCS groups exhibited different patterns of change in the force-deflection characteristics when the coiling direction was reversed.

• 한국소성가공학회:학술대회논문집
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• 한국소성가공학회 2003년도 춘계학술대회논문집
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• pp.172-175
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• 2003

Run-Out-Table is the region between EDT and CT. Hot killed strip is cooled by air and water in ROT. In this procedure, phase transformation and shape deformation occur due to temperature drop. Because of un-ideal cooling condition, deformation of strip and non-uniform phase distribution come into existence. This phenomenon affects the strip property and lead th the existence of residual stress. And it exerts effects on the Coiling process, Coil Cooling process, and Un-coiling process. Through these process, the residual stresses of strip are more larger and unbalance of these stresses become more severe. Finite element (FE) based models for the analysises of non-steady state heat transfer and elastoplastic deformation are described in this investigation. The analysises of thermodynamics and phase transformation kinetics are suggested also. Using the ROT simulation result coiling process and coil cooling process simulations are carried out.

• Journal of Korean Neurosurgical Society
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• 제41권3호
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• pp.193-195
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• 2007

Middle cerebral artery [MCA] aneurysms are a common source of subarachnoid hemorrhage [SAH]. But, ruptured distal MCA aneurysm is very rare, and their clinical and radiological features are poorly understood. Microsurgical repair remains the most common method used to treat distal MCA aneurysm, even though endovascular coiling has been favored recently. We report our experience of successful coiling for ruptured distal MCA aneurysm, In selected patients, coiling may be a good treatment option for ruptured distal MCA aneurysm.

• Journal of Korean Neurosurgical Society
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• 제54권6호
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• pp.525-527
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• 2013

Upward migration of the peritoneal catheter of a subgaleo-peritoneal (SP) shunt and coiling into the subgaleal space is an extremely rare complication of a SP shunt. A 32-year-old male patient visited our hospital presenting with a large skull defect due to a prior craniectomy performed elsewhere. The patient underwent a cranioplasty with methylmetacrylate, but subsequently developed progressive pseudomeningocele and subgaleal cerebrospinal fluid (CSF) collection. The patient underwent CSF diversion via a SP shunt. After SP shunting, the pseudomeningocele disappeared completely. Six months later, the patient presented with progressive scalp swelling. Skull X-ray showed migration and coiling of the distal catheter of the SP shunt. The patient was treated by removing the entire shunt catheter and the dura was covered with a subgaleal flap. We would like to report our experience with a very rare complication of subgaleo-peritoneal shunting.

• 소성∙가공
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• 제12권4호
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• pp.302-307
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• 2003

Hot rolled strip is cooled by air and water in Run-Out-Table. In this process, phase transformation and shape deformation occurs due to temperature drop. Because of un-ideal cooling condition of ROT, irregular shape deformation and phase transformation arise in the strip. which affect the strip property and lead to the residual stress of strip. And these exert effects on the following processes, coiling process, coil cooling process, and re-coiling process. Through these processes, the residual stress becomes higher and severe. For the prediction of residual stress distribution and shape deformation of final product, Finite element(FE) based model was used. It consists of non-steady state heat transfer analysis, elasto-plastic analysis. thermodynamic analysis and phase transformation kinetics. Successive FEM simulation were applied from ROT process to coil cooling process. In each process simulation, previous process simulation results were used for the next process simulation. The simulation results were matched well with the experimental results.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.269-275
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• 2016

Objective : Although middle cerebral artery (MCA) aneurysms are less amenable to coil embolization, an increasing number of studies support favorable endovascular treatment for them. The purpose of this study is to compare the outcomes of two different treatments (surgery versus coiling) and evaluate the benefits of surgical clipping for MCA aneurysms. Methods : Here we retrospectively analyzed the outcomes of 178 ruptured and unruptured MCA aneurysms treated in patients between September 2008 and April 2012. Parameters assessing treatment outcomes include degree of aneurysm occlusion, presence of regrowth, clinical status, and complications. Results : Among 178 MCA aneurysms, 153 were treated surgically. After a mean follow-up of 12 months, the surgery group showed a clinically significant complete occlusion rate (98%) compared with the coiling group (56%) (p<0.001). Follow-up radiologic evaluation showed a higher regrowth rate (four of 16 cases) in the coiling group than in the surgery group (one of 49 cases) (p=0.003). There was no statistically significant difference in favorable clinical outcome rate between the two groups. The procedure-related permanent morbidity and mortality rates were 2% (three of 153 cases) in the surgery group and 0% (0 of 25 cases) in the coiling group. Conclusion : Compared to endovascular treatment, surgical neck clipping for both ruptured and unruptured MCA aneurysms results in a significantly higher complete obliteration rate and less regrowth. Therefore, even in this endovascular era, we still recommend surgical clipping as the primary treatment option for MCA aneurysms rather than coil embolization.

• 대한기계학회논문집A
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• 제41권5호
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• pp.409-414
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• 2017

두께가 얇은 스트립의 권취공정에서는 맨드렐과 함께 슬리브가 사용된다. 이때 스트립과 슬리브의 응력분포는 코일의 좌굴 및 슬리브의 두께 결정에 중요한 요인으로 작용한다. 하지만 스트립 권취 시 압력이 과도하게 누적됨에 따라 이를 실측하는 데에는 어려움이 있다. 이에 본 논문에서는 권취공정에 대한 유한요소모델을 수립하였다. 제안된 모델을 이용하여 슬리브의 반경, 원주방향 응력 및 스트립 층간 응력에 대해 분석하였다. 스트립 두께 변화에 따른 응력분포를 확인하였으며, 1 mm 스트립의 경우 권취 시작점에서 6.3배 큰 응력이 발생하였다. 맨드렐이 제공하는 반력에 의해 스트립 90 mm 적층 시 슬리브의 반경방향 응력이 선행이론대비 14.8 % 증가하였다.

• 한국재료학회지
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• 제14권12호
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• pp.863-869
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• 2004

The purpose of this research is to investigate the mechanical property and ductile-brittle transition temperature of Ti-Nb-P added extra low carbon interstitial free steel having a tensile strength of 440 MPa. The mechanical property and transition temperature of hot rolled steel sheets were more influenced by the coiling temperature rather than by the small amount of alloying element. Further, at the same composition, the property of the specimen coiled at low temperature was superior to that obtained at higher coiling temperature. The fracture surface of 0.005C-0.2Si-1.43Mn steel coiled at $630^{\circ}C$ showed a ductile fracture mode at $-100^{\circ}C$, but coiling at $670^{\circ}C$ showed a transgranular brittle fracture mode at $-90^{\circ}C$. The galvannealed 0.006C-0.07Si-1.33Mn steel sheet annealed at $810^{\circ}C$ has tensile strength and elongation of 442.8 MPa and $36.6\%$, respectively. The transition temperature of galvannealed 0.006C-0.07Si-1.33Mn steel sheet was increased with a drawing ratio, and the transition temperature of the galvannealed 0.006C-0.07Si-1.33Mn steel was $-60^{\circ}C$ at a drawing ratio of 1.8

• Journal of Korean Neurosurgical Society
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• 제55권4호
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• pp.185-189
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• 2014

Objective : General anesthesia is often preferred for endovascular coiling of intracranial aneurysm at most centers. But in the authors' hospital, it is performed under monitored anesthesia care (MAC) using dexmedetomidine. To determine the feasibility and safety of this approach, the authors reviewed our initial experience. Methods : Retrospective data was analyzed from July 2012 to November 2012. We performed coil embolization in 28 cases using this method. Among them, for statistical significance, we analyzed 12 cases in which the procedure time exceeded an hour. Vital signs were analyzed every 10 minutes. Depth of sedation was measured according to the Ramsay sedation scale and frequency of the repeated roadmap image(s) caused by movement of the patient's head during the procedure. Results : All procedures were completed without occurrence of procedure related complications. Under MAC using dexmedetomidine, vital signs of the patients were stable, no statistical significance regarding hemodynamic and respiratory parameters was observed between time points (p>0.05). Adequate sedation was achieved. Mean Ramsay sedation scale was $3.67{\pm}1.61$ (2 to 6). Repeated roadmap image(s) due to patient's factor occurred in only one case. The mean dosage of drug for adequate sedation for the procedure was $0.65{\pm}0.12mcg/kg/hr$ without loading doses. Conclusion : To the best of my knowledge, this is the first report published in English using the method of monitored anesthesia with dexmedetomidine for intracranial aneurysm coiling. Monitored anesthesia care using dexmedetomidine without loading dose for embolization of intracranial aneurysms appeared to be a safe and effective alternative to general anesthesia.