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Surgical Clues of Distal Anterior Cerebral Artery(DACA) Aneurysms (원위부 전대뇌 동맥류 수술의 실마리)

  • Kim, Sung Bum;Yi, Hyeong Joong;Kim, Jae Min;Bak, Koang Hum;Kim, Choong Hyun;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1555-1562
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    • 2000
  • Objects : Surgical management of the distal anterior cerebral artery(DACA) aneurysms presents several unique problems to surgeons, such as difficulty in early identification of parent arteries, high incidence of rebleeding and premature rupture, and requirement of unfamiliar approach other than conventional frontotemporal craniotomy. Therefore, preoperative anatomical knowledge of anterior interhemispheric fissure and entry point of dissection is prerequisite. Authors utilized a frontobasal approach for DACA aneurysms by using consistent external landmark for guidance to the deep structure. Materials and Methods : From Nov. 1995 to Jun. 1999, a surgical clipping of DACA aneurysms was carried out in 9 patients among a total 131 patients with intracranial aneurysms. In each case, the clinical and aneurysmal features were carefully reviewed through the angiograms, medical records, and intraoperative findings. Results : The incidence of DACA aneurysms was 6.9% from our series. All cases were arisen from juxtacallosal por-tion ; 6 cases from pericallosal-callosomarginal(PC-CM) junction and 3 from pericallosal-frontopolar(PC-FP) junction. Associated vascular anomalies were noted in 3 cases and multiple aneurysms in 3 cases, respectively. The preoperative clinical grades were generally poor. An early surgery was performed in 7 cases and frontobasal interhemispheric approaches in 7 cases. Postoperatively, two patients died of complications ; one delayed ischemic vasospasm and one aspiration pneumonia but remaining patients recovered well. Conclusion : The frontobasal interhemispheric approach was useful for DACA aneurysms in early surgery. Division of superior sagittal sinus(SSS) enabled a minimal retraction of brain on both sides, and prevention of intraoperative rupture was possible. Authors suggest the frontopolar(first frontal bridging) vein as a constant external landmark for approaching the genu of the corpus callosum and juxtacallosal DACA aneurysms.

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The E-mail Survey on the Neck Pain for Acupuncture and Moxibustion Clinical Guideline (경항통에 관한 침구임상 진료지침 개발을 위한 전자우편 설문조사)

  • Kim, Hyun-Wook;Kim, Sung-Soo;Nam, Dong-Woo;Kim, Eun-Jung;Hong, Kwon-Eui;Kim, Sung-Chul;Kim, Sun-Woong;Lee, Jae-Dong;Kim, Kap-Sung;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.26 no.3
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    • pp.67-80
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    • 2009
  • Objectives : The purpose of this survey is the development on the neck pain for acupuncture and moxibustion clinical guideline. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results and Conclusions : 1. The first selected pattern identification on the neck pain This study shows that the meridian pattern identification was selected 35 times(61.4%), the pattern identification based on cause of disease was selected 8 times(14.0%), the visceral pattern identification was selected 7 times(12.3%), the other pattern identification was selected 4 times(7.0%), Qi blood yin yang pattern identification was selected 2 times(3.5%), according to symptoms was selected 1 time(2.4%). 2. Meridian pattern identification Small intestine meridian of hand Taeyang was used 39 times(18.1%), Large intestine meridian of hand Yangmyeong and Bladder meridian of foot Taeyang was used 34 times(15.7%), Gall-bladder meridian of foot Soyang was 32 times(14.8%), Tripple energizer meridian of hand Soyang was used 31 times(14.4%), Governor meridian was used 30 times(13.9%), Lung meridian of hand Taeeum was used 8 times(3.7%), Heart meridian of hand Soeum and Pericarduim meridian of hand Gworeum was used 4 times(1.9%). 3. Pattern identification based on cause of disease Wind-Cold-Dampness was used 31 times(17.5%), Accumulation of the collateral by Phelgm-Dampness was used 16 times(14.0%), affection by exopathogen Wind-Cold(stiff neck, sprain of cervical) was used 13 times (11.4%), Defecient-Cold was used 10 times(8.8%), affection by exopathogen Wind-Dampness was used 9 times(7.9%), Deep Invasion by Wind-Cold was used 8 times(7.0%), Wind-Cold was used 7 times (6.1%), Wind-Cold was used 6 times(5.3%), Accumulation in the Center by Phelgm-Dampness, Imparement of bou fluid by Pathogenic Heat, Wind-Heat with Dampness was used 5 times(4.4%), affection by exopathogen Wind-Dampness and Accumulation of the collateral by Wind-Cold was used 4 times(3.5%), Invasion of Dampness-Heat was used 2 times(1.8%). 4. Visceral pattern identification Rising of the Liver yang was used 16 times(41%), Yin deficiency of Liver and Kidney+pathogens was used 15 times(38.5%), Yin deficiency of Liver and Kidney was used 8 times(20.5%) on this survey.

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The effect of labial inclination on intrusion of the upper and lower incisors by three-dimensional finite element analysis (분절호선법으로 상하악 절치부 압하 시 순측경사도가 미치는 영향에 관한 3차원 유한요소법적 연구)

  • Kim, Dong Woo;Yang, Hoon Chul;Kim, Gi Tae;Kim, Sung Sik;Son, Woo Sung
    • The korean journal of orthodontics
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    • v.33 no.4 s.99
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    • pp.259-277
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    • 2003
  • This study was designed to investigate the position of anteroposterior center of resistance for genuine intrusion and the mode of change of the minimum distal force for simultanous intrusion and retraction of the upper and lower incisors according to the increase of labial inclination. For this purpose, we used the three-piece intrusion arch appliance and three-dimensional finite element models of upper and lower incisors. 1. Positions of the center of resistance in upper incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 6m behind the distal surface of the lateral incisor bracket. 2) In $10^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 9mm behind the distal surface of the lateral incisor bracket. 3) In $20^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 12m behind the distal surface of the lateral incisor bracket. 4) In $30^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 16m behind the distal surface of the lateral incisor bracket. 2. Positions of the center of resistance in lower incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 10mm behind the distal surface of the lateral incisor bracket. 2) In $10^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 13m behind the distal surface of the lateral incisor bracket. 3) In $20^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 15m behind the distal surface of the lateral incisor bracket. 4) In $30^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 18m behind the distal surface of the lateral incisor bracket. 3. The patterns of stress distribution were as follows; 1) There were even compressive stresses In and periodontal ligament when intrusion force was applied through determined center of resistance. 2) There were gradual increase of complexity in compressive stress distribution pattern with Increase of the labial inclination when intrusion and retraction force were applied simultaneously. 4. With increase of the labial inclination of the upper and lower incisors, the position of the center of resistance moved posteriorly. And the distal force for pure intrusion was increased until $20^{\circ}$increase of the labial inclination.

The Effects of rhBMP-2/ACS on the Periodontal Healing of 1-Wall Intrabony Defects in Dogs (성견 1면 골결손부에서 rhBMP-2/ACS가 치주조직 치유에 미치는 영향)

  • Jun, Hye-Young;Cho, Kyoo-Sung;Kim, Chong-Kwan;Chai, Jung-Kiu
    • Journal of Periodontal and Implant Science
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    • v.29 no.4
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    • pp.873-893
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    • 1999
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue and repair of function. For more than a decade there have been many efforts to develop materials and bioactive molecule(such as growth factor and differentiation factors) to promote periodontal wound healing. Among the bioactive molecules, bone morphogenetic protein(BMP) was studied for periodontal wound healing. Since Urist demonstrated that demineralized bone matrix could induce the formation of cartilage and bone in ectopic site, many studies on BMP have been reported. Among those BMPs, it was reported that rhBMP-2 enhanced the healing of bone defects in animal studies and clinical studies. However, its efficacy in periodontal regeneration, especially 1-wall intrabony defects is still unknown. The purpose of this study was to examine the effect of rhBMP-2/ACS on the epithelial migration, gingival connective tissue adhesion, cementum formation, alveolar bone regeneration in intrabony defects of dogs. Four millimeter deep and four millimeter wide 1-wall defects were surgically created in the mesial aspects of the 3rd incisors. The test group received rhBMP-2/ACS with a flap procedure and the control underwent buffer/ACS with a flap procedure. Histologic analysis after 8 weeks of healing revealed the following results: 1. The length of epithelial growth(the distance from alveolar crest to the apical end of JE) was $0.9{\pm}1.5mm$ in the control group and $1.2{\pm}1.4mm$ in the test group. There was no statistically significant difference between the two groups. 2. The length of connective tissue adhesion was $2.4{\pm}1.3mm$ in the control group and $1.2{\pm}1.1mm$ in the test group. The control group showed significantly enhanced adhesion(P<0.05). 3. The length of new cementum was $0.9{\pm}1.0mm$ in the control group and $1.7{\pm}0.8mm$ in the test group. The test group showed significantly enhanced cementum regeneration(P<0.05). 4. The length of new bone height was $1.9{\pm}0.6mm$ in the control group and $2.4{\pm}0.9mm$ in the test group. There was no statistically significant difference between the two groups. 5. The new bone area was $4.7{\pm}1.7mm^2$ in the control group and $8.0{\pm}2.0mm^2$ in the test group. The test group showed significantly enhanced bone formed area(P<0.05). 6. The new bone density was $73.0{\pm}8.6%$ in the control group and $66.6{\pm}15.3%$ in the test group. There was no statistically significant difference between the two groups. These results suggest that the use of rhBMP-2 in 1-wall intrabony defects has significant effect on new cementum and new bone formation area, but doesn't have any significant effect on the prevention of junctional epithelium migration and new bone formation height.

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Diffusion-weighted MR Imaging of Hypoxic-Ischemic Encephalopathy (저산소성-허혈성 뇌증의 확산강조영상 소견)

  • Choi, Hye-Young;Choi, Dae-Seob;Ryoo, Jae-Wook;Cho, Jae-Min;Ko, Eun-Sook;Shin, Tae-Beom;Na, Jae-Beom;Choi, Nak-Cheon
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.1
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    • pp.49-54
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    • 2008
  • Purpose : The purpose of this study was to determine the characteristics of hypoxic-ischemic encephalopathy (HIE) on diffusion-weighted imaging (DWI) and the role of DWI for the diagnosis of HIE. Materials and Methods : Six patients with HIE underwent MRI including DWI. MR examinations were performed within 4 - 32 days (mean, 11.8 days) after hypoxic brain insult. We assessed the distribution of the lesions and compared the DWI and T2, FLAIR images for the subjective conspicuity of the lesions. Results : In all patients, symmetrical hyperintense lesions were demonstrated in the bilateral basal ganglia on T2, FLAIR, and DWI. On ADC map image, the lesions were hypointense in four of six patients and isointense in other two patients. Lesion conspicuity on DWI was higher than on T2 and FLAIR images in four of six patients and similar in other two patients. For the involvement of the cortex and subcortical white matter, in five of six patients, bilateral symmetric hyperintense lesions were seen on T2, FLAIR, and DWI. Lesion conspicuity on DWI was higher than on T2 and FLAIR images in three of them and similar in other two patients. On ADC map image, the lesions showed hypointensity in three of five patients and isointensity in other two patients. For the involvement of the deep cerebral white matter, T2, FLAIR, and DWI showed bilateral symmetric hyperintense lesions in four of six patients. Among them, Lesion conspicuity on DWI was higher than on T2 and FLAIR images in only one patient. Conclusion : HIE is characterized by symmetrical hyperintense lesions in the bilateral basal ganglia, cerebral cortex, and white matter on DWI and the lesions are more conspicuously demonstrated on DWI than on T2 and FLAIR images.

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Distribution of Bacterial Decomposers in Lake Khuvsgul, Mongolia (몽골 훕스굴 호수 수층에서 유기물질 분해세균의 분포)

  • Jung, You-Jung;Jung, Da-Woon;Kim, Ju-Young;Zo, Young-Gun;Yim, Joung-Han;Lee, Hong-Kum;Ahn, Tae-Seok
    • Korean Journal of Microbiology
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    • v.45 no.2
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    • pp.119-125
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    • 2009
  • To understand the ecological function of heterotrophic bacterial community in water column of large freshwater lakes in the permafrost zone, we investigated the structure and function of bacterial community in Lake Khuvsgul, Mongolia. Species composition of overall bacterial community was analyzed by denaturing gradient gel electrophoresis (DGGE) of 16S rRNA gene fragments, and bacteria that can be cultured at 10oC were isolated and characterized. Based on the depth profile of environmental parameters, thermocline and chemocline were recognized at the 5~10 m zone of the water column. The stratified DGGE profile indicated that the discontinuity of water properties might influence the structure of bacterial community: band profiles in the 0~5 m zone were diverse with large change by depth, but the profile was relatively stable at the $\geq$10 m zone, with predominance of the band identified as Acidovorax facilis. Bacterial cultures were screened for protease, cellulase, amylase and lipase activity, and 23 isolates were selected for high activity of the hydrolytic enzymes. The isolates were identified based on their 16S rRNA gene sequences. In the surface water (zero meter depth), Acidovorax defluvii and Sphingobacterium faecium with high cellulase activity were present. Flavobacterium succinicans, Mycoplana bullata and A. facilis were stably predominant isolates at 2 m, 5 m, and $\geq$10 m depths, respectively. F. succinicans isolates showed high protease activity while M. bullata isolates showed moderate levels of protease and celluase activity. A. facilis isolates showed either cellulase or lipase activity, exclusively to each other. According to the profile of growth rates of the isolates in the temperature range of $0\sim42^{\circ}C$, the surface-zone (0~5 m) isolates were facultative psychrophiles while isolates from $\geq$10 m depth were typical mesophiles. This stratification is believed to be due to stratified availability of organic materials to the bacterial decomposers. In the water column below the chemoline, the environment is extremely oligotrophic so that the trait of rapid growth in low temperature might not be demanded by deep-lake decomposers. The stratified distribution of community composition and decomposer activity in Lake Khuvsgul implies that ecological functions of bacterial community in lakes of cold region are sharply divided by water column stratification.

An Initiative Study on Relationship between Algal Blooms and Asian Dust for Regulation of Algal Blooms (조류 성장 억제를 위한 녹조 및 적조 발생과 황사의 상관관계 초기적 연구)

  • Kim, Tai-Jin;Jeong, Jaechil;Seo, Rabeol;Kim, Hyung Moh;Kim, Dae Geun;Chun, Youngsin;Park, Soon-Ung;Yi, Sehyoon;Park, Jun Jo;Lee, Jin Ha;Lee, Jay J.;Lee, Eun Ju
    • KSBB Journal
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    • v.29 no.4
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    • pp.285-296
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    • 2014
  • Although the problems of the algal blooms have been world-widely observed in freshwater, estuary, and marine throughout the year, it is not yet certain what are the basic causes of such blooms. Consequently, it is very difficult to predict when and where algal blooms occur. The constituents of the Asian dust are in a good agreement with the elements required for the algal growth, which suggests some possible relationship between the algal blooms and the Asian dust. There have been frequently algal blooms in drinking water from rivers or lakes. However, there is no any algal blooms in upwelling waters where the Asian dust cannot penetrate into the soil due to its relatively weak settling velocity (size of particles, $4.5{\pm}1.5{\mu}m$), which implies the possible close relationship of the Asian dust with algal blooms. The present initiative study is thus intended firstly in Korea to illustrate such a relationship by reviewing typical previous studies along with 12 years of weekly iron profiles (2001~2012) and two slant culture experiments with the dissolved Asian dust. The result showed bacterial suspected colonies in the slant culture experiment that are qualitatively in a good agreement with the recent Japanese studies. Since the diatoms require cheap energy (8%) compared to other phytoplankton (100%) to synthesize their cell walls by silicate, the present results can be used to predict algal blooms by diatoms if the concentrations of iron and silicate are available during spring and fall. It can be postulated that the algal blooms occur only if the environmental factors such as light, nutrients, calm water surface layer, temperature, and pH are simultaneously satisfied with the requirements of the micronutrients of mineral ions supplied by the Asian dust as enzymatic cofactors for the rapid bio-synthesis of the macromolecules during algal blooms. Simple eco-friendly methods to regulate the algal blooms are suggested for the initial stage of blooming with limited area: 1) to cover up the water surface with black curtain and inhibit photosynthesis during the day time, 2) to blow air (20.9%) or pure oxygen into the bottom of the water and inhibit rubisco for carbon uptake and nitrate reductase for nitrogen uptake activities in algal growth during the night, 3) to eliminate the resting spores or cysts by suction of bottom sediments as deep as 5 cm to prevent the next year germinations.

The effects GeongshinhaeGihwan 1(GGT1) has on the hGHTg (human growth hormone transgenic) obese male rats' blood-antiobestic index (형질전환 비만모델 수컷 hGHTg rats에서 경신해지환(輕身解脂丸)이 혈중 항비만지표에 미치는 영향)

  • Jung, Yang-Sam;Tsung, Pei-Chin;Choi, Seung-Bae;Kim, Gyeong -Cheol;Shin, Soon-Shik
    • Herbal Formula Science
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    • v.13 no.2
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    • pp.1-16
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    • 2005
  • Objectives: To find out the effects GGTl, an antiobestic drug widely used in clinics, has on the blood-antiobestic index and the toxicity index using the data from the hGHTg obese male rats. We looked closely into both of the two indices because GGTl antiobestic effect can happen not only by pharmacological action, but also by its toxicity. Also, we verified the difference in effect between GGTl and reductil (sibutramine), which has been approved by the FDA of the United States. Methods: After performing the experiments for 8 weeks on the hGHTg obese male rats divided into three groups: the control group, the GGTl group, and the reductil (RD) group, we anesthetized the rats with Diethyl ether and took a 3ml blood sample from the heart. Then, after coagulating the blood in room temperature by using the plasma separator, we centrifuged it for 25 minutes in 3,000rpm using the high-speed refrigerated centrifuge. We kept the separated plasma in a deep freezer at $-80^{\circ}C$, and repeatedly measured the antiobestic index and the toxicity index twice using the hematology biochemistry analyzer. Also, in order to judge the indirect toxicity index, we separated liver from kidney and observed them. Results: When we looked at the results of the analysis of covariance on the measuring elements related to the antiobestic index (TC, HDL, LDL, TG, and GLU), there was no significant difference among the groups in all measuring elements. Also, the results of the analysis of covariance on the two roups (RD group and GGTl group) showed that the p-values had no significant difference under the level of significance 0.05. When we looked at the result of the analysis of covariance on the measuring elements related to the toxicity index (GOT, GPT, GGT, CREA, UA, ALB, and TP), we could see that the p-values in GPT, ALB, and TP have a significant difference among the groups. Also, the results of the analysis of covariance about the measuring elements related to the toxicity index on both groups, RD group and GGTl group, showed no significant difference in the p-values of all of the measuring elements in the two groups, RD and GGTl group. Conclusions: In conclusion, through this experiment, the safety of GGTl has been approved, and although the verification on its medical effect has not been clearly approved, when we consider the fact that it belongs to the same group as reductil, an antiobestic drug approved by the FDA of the United States, we could indirectly verify that GGTl has an antiobestic effect. We believe that when doing a sample design for a future experiment, it needs to be performed on a greater sample size based on the power analysis that needs to be performed primarily in experiments, and a more accurate verification is needed through more systematic experiment plans.

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Clinical Features of Isolated Noncompaction of the Ventricular Myocardium (심근의 단독 비경화증(Isolated Noncompaction of Ventricular Myocardium)의 임상 양상)

  • Moon, Eun-Kyoung;Lee, Hoon-Young;Chang, Mea-Young;Kil, Hong-Ryang;Chung, Yong-Hun
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1528-1533
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    • 2002
  • Purpose : Isolated noncompaction of the ventricular myocardium(INVM) is one of the unclassified cardiomyopathies that is characterized by numerous, excessively prominent trabeculations, and deep intertrabecular recesses. We performed this study to evaluate the clinical features of INVM in children. Methods : The medical records of 10 patients with INVM were reviewed. We analyzed the clinical manifestations, hemodynamics, pattern of inheritance, and long-term prognosis of INVM in children. Results : Age at diagnosis was $45{\pm}53months$(1 day-14 years) with follow-up lasting as long as 78 months. Most INVM was asymptomatic on diagnosis. Associated cardiac anomalies were noted in six patients(ventricualr or atrial septal defect, patent ductus arteriosus with mitral valve prolapse, or mitral valve cleft). Depressed or flat changes of T wave in lead II, III and aVF were observed on electrocardiography. Various arrhythmia including WPW syndrome with paroxysmal supraventricular tachycardia, third-degree atrioventricular block, and familial sick sinus node dysfuction were observed. The degree of trabeculation in INVM was significantly prominent from level of mitral valve to apex compared to age-matched control. Familial recurrences were noted in two patients. The systolic function of the left ventricle was decreased in 20% of patients during the follow-up period, but systemic embolism or ventricular tachycardia was not observed. Conclusion : INVM is not a rare disorder. The cardiac function may be deteriorated in children as well as adults during long-term follow up. Thus early diagnosis and long-term follow-up must be done. So, the nation-wide multicenter clinical study would be mandatory to evaluate the incidence, long-term prognosis, and establishment of objective diagnostic criteria of INVM.

Distributional Characteristics of Chlorophyll-a and Oceanographic Conditions in the Northern Part of East China Sea (동중국해 북부해역 클로로필-a의 분포특성과 해양환경 특성)

  • OH Hyun Ju;KANG Young Shil;PARK Jung Hoon
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.32 no.1
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    • pp.88-97
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    • 1999
  • The distributional characteristics of chlorophyll-a and their relationship to the oceanographic condition were investigated in the northern part of East China Sea in February, May, August and November during 1995$\~$1997. The temperature and salinity were high in the eastern area and low in the western area. Thermocline and halocline were strongly formed at the 50 m depth in August. Dissolved oxygen was low in August with value of 3.77 ml/$\ell$, particularly in the near coast of East China, where dissolved oxygen was less than 2.0 ml/$\ell$. Transparency was high in May while low in February. Total nitrogen and phosphate concentrations were high in November while silicate concentrations was high in August. They showed the seasonal variations. Total nitrogen and phosphate revealed high concentrations in the near coast of East China, where the salinity was the lowest. Especially, total nitrogen and silicate were higher in August than the other survey months in the near coast of East China. Phosphate showed the even distributional pattern. Chlorophyll-a appeared high in August with 0.512$\mu$g/$\ell$ and low in February with 0.372$\mu$g/$\ell$. Annual means in each survey depth was high at the 10m depth with 0.632 $\mu$g/$\ell$ and gradually decreased toward the more deep depth. But the cencentrations at 150m depth near the bottom again increased as 0.243 $\mu$g/$\ell$. In the seasonal patterns of vortical distribution of chlorophyll-a, the maximum depth value was surface in February, 30 m in May, 10 m in August and 20 m in November. Transparency showed the highest value in May. It means that there are the close relationship between the vertical distribution of chlorophyll-a and transparency.

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