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Intra-aneurysmatic thrombectomy in a distal anterior cerebral artery aneurysm

  • Juan Luis Gomez-Amador;Leoncio Alberto Tovar-Romero;Andrea Castillo-Matus;Ricardo Marian-Magana;Jorge Fernando Aragon-Arreola;Marcos Vinicius Sangrador-Deitos;Alan Hernandez-Hernandez;German Lopez-Valencia;Gerardo Yoshiaki Guinto-Nishimura;Jorge Rios-Zermeno
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.462-467
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    • 2023
  • Thrombectomy procedures following intra-aneurysmatic lesions are extremely rare, and few cases have been reported. This article describes a microsurgical intra-aneurysmatic thrombectomy (MIaT) for a distal anterior cerebral artery (DACA) aneurysm. We present the case of a 48-year-old female that was admitted to the emergency room, showing neurologic deterioration with focal deficits. A computed tomography angiography (CTA) scan revealed an aneurysm located in the distal segment of the left anterior cerebral artery. During the surgical procedure, after clipping, a well-formed clot was visualized through the aneurysm's wall obstructing the left DACA flow. We proceeded to open the aneurysm's dome to remove the thrombus and clip the aneurysm neck, re-establishing the flow of the left DACA. Intra-aneurysmatic thrombosis can occur as a complication during clipping, obstructing the distal flow of vital arteries and causing fatal results in the patient's postoperative status. MIaT is a good technique for restoring the flow of the affected vessel and allows a secure aneurysm clipping after thrombus removal.

Correlation between contrast leakage period of procedural rupture and clinical outcomes in endovascular coiling for cerebral aneurysms

  • Sung-Tae Kim;Sung-Chul Jin;Hae Woong Jeong;Jin Wook Baek;Young Gyun Jeong
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.420-428
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    • 2023
  • Objective: Intraprocedural rupture (IPR) is a fatal complication of endovascular coiling for cerebral aneurysms. We hypothesized that contrast leakage period may be related to poor clinical outcomes. This study aimed to retrospectively evaluate the relationship between clinical outcomes and contrast leakage period. Methods: Data from patients with cerebral aneurysms treated via endovascular coiling between January 2010 and October 2018 were retrospectively assessed. The enrolled patient's demographic data, the aneurysm related findings, endovascular treatment and IPR related findings, rescue treatment, and clinical outcome were analyzed. Results: In total, 2,859 cerebral aneurysms were treated using endovascular coiling during the study period, with IPR occurring in 18 (0.63 %). IPR occurred during initial frame coiling (n=4), coil packing (n=5), stent deployment (n=7), ballooning (n=1), and microcatheter removal after coiling (n=1). Tear sites included the dome (n=14) and neck (n=4). All IPRs were controlled and treated with coil packing, with or without stenting. Flow arrest of the proximal balloon was not observed. Temporary focal neurological deficits developed in two patients (11.1%). At clinical follow-up, 14 patients were classified as modified Rankin Scale (mRS) 0, three as mRS 2, and one as mRS 4. The mean contrast leakage period of IPR was 11.2 min (range: 1-31 min). Cerebral aneurysms with IPR were divided into late (n=9, mean time: 17.11 min) and early (n=9, mean time: 5.22 min) control groups based on the criteria of 10 min of contrast leakage period. No significant between-group differences regarding clinical outcomes were observed after IPR (p=1). Conclusions: In our series, all patients with IPR were controlled with further coil packing or stenting without proximal balloon occlusion within 31 min of contrast leakage. There was no difference in clinical outcomes when the long contrast leakage period group and short contrast leakage period group were compared.

ELECTRON MICROSCOPIC STUDY OF SLOWLY ADAPTING PERIODONTAL MECHANORECEPTIVE PRIMARY AFFERENT FIBERS WITHIN THE SUBNUCLEUS ORALIS OF THE CAT (서순응형 치근막 일차구심성 신경섬유 종말부의 Subnucleus oralis에서의 시냅스 양상에 관한 전자현미경적 연구)

  • Kim, Moo-Jung;Bae, Yong-Chul;Kim, Chin-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.4
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    • pp.281-301
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    • 1993
  • It was revealed that the morphology and projection pattern of terminal arbors from single primary afferent are different among distinct fiber types, functional types and the different subdivision of trigeminal sensory nucleus complex(TSNC). But it was not identified the ultrastructural morphology and synaptic connections of terminal arbors from each primary afferent within TSNC. So we employed the intra-axonal horseradish peroxidase(HRP) injection technique to define the terminal arbors of primary afferent fiber from slowly adapting mechanoreceptors in the periodontal ligament of the cat, and examined 66 labeled terminal arbors within the rostrodorsomedial part(Vo.r) of the trigeminal nucleus oralis, electromicroscopically with 90nm serial sections. All the boutons labelled with HRP contained clear, spherical and uniform sized synaptic vesicles(diameter : $47.66{\pm}3.58nm$ ). Most of the labelled boutons were boutons en passant type and they were connected by unmyelinated axonal strand. In which neurofilament and microtubule was not developed but occasionally contained synaptic vesicle in contrast to the myelinated axon. The size of the labelled bouton was relatively small(long diameter : $1.46{\pm}0.24{\mu}m$, short diameter $0.85{\pm}0.26{\mu}m$, average diameter $1.15{\pm}0.24{\mu}m$) and the shape of which varied from dome to elongated shape, but scalloped glomerulus shape was not developed. Each primary ending in Vo.r made synapse with one or two neuronal propiles(average : $1.11{\pm}0.31$), of which, 89.4% of labelled boutons made synapse with only one neuronal pro pile, the remainder, 10.6% of labelled boutons, made synapse with two neuronal propile. So characteristically they made very simple synapse. Most of labelled boutons(80.03%) made asymmetrical synapse only with dendritic shaft or spine, and 6.1% of labelled boutons received symmetrical synapse from pleomorphic vesicle containing axonal ending(p-ending). So presynaptic inhibiton was relatively scarce. Synaptic triad, in which a p-ending is presynaptic both pre-and post-synaptic element of the axo-dendritic contact from the labelled primary ending was not observed.

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MORPHOLOGY OF THE TERMINAL ARBORS FROM THE MASSETERIC MUSCLE SPINDLE AFFERENTS IN THE TRIGEMINAL MOTOR NUCLEUS (삼차신경 운동핵에서 교근 근방추 구심성 신경섬유 종말지의 미세구조)

  • Lee, Kyung-Woo;Bae, Yong-Chul;Kim, Chin-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.3
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    • pp.321-347
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    • 1994
  • Muscle spindle afferents from masseter muscle were labelled by the intra-axonal HRP injection and were processed for light microscopic reconstruction. Regions containing terminal arbors scattered in the central portion of the masseteric motor neuron pool (type I a) and those restricted to 2-3 small portion of it (type II) were selected and processed for electronmicroscopic analysis with serial sections. The shape of the labelled boutons was dome or elongated shape. Scalloped or glomerulus shape with peripherial indentation containing pre or postsynaptic neuronal propiles, which is occasionally found in the trigeminal main sensory nucleus and spinal dorsal horn, was not observed. Both type Ia and type II boutons had pale axoplasm and contained clear, spherical vesicles of uniform size(dia : 49-52nm) and occasionally large dense cored vesicles(dia : 87-118nm). The synaptic vesicles were evenly distributed throughout the boutons although there was a slight tendency of vesicles to accumulate at the presynaptic site. The average of short and long diameter(short D. + long D./2) of type I a bouton was smaller than that of type II bouton. All the labelled boutons, which showed prominent postsynaptic density, large synaptic area and multiple synaptic contact, made asymmetrical synaptic contact with postsynaptic neuronal propiles. Most of the type Ia and type II boutons made synaptic contact with only one neuronal propile and boutons which shows synaptic contact or more neuronal propiles was not observed. Most of the type Ia boutons(87.2%) were presynaptic to the soma or proximal dendrite and a few remainder(12.8%) made synaptic contact with dendritic shaft or distal dendrite. In contrast, majority of type II boutons showed synaptic contact with dendritic shaft and remainder with soma or proximal dendrite. In conclusion, terminal boutons which participate in the excitatory monosynaptic jaw jerk reflex made synaptic contact with more proximal region of the neuron, and showed very simple synaptic connection, compared with those from the primary afferenst in the other region of the central nervous system such as spinal dorsal horn and trigeminal main sensory nucleus which assumed to be responsible for the mediating pain, tactile sensation, sensory processing or sensory discrimination.

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Acoustic Characteristics of Gas-related Structures in the Upper Sedimentary Layer of the Ulleung Basin, East Sea (동해 울릉분지 퇴적층 상부에 존재하는 가스관련 퇴적구조의 음향 특성연구)

  • Park, Hyun-Tak;Yoo, Dong-Geun;Han, Hyuk-Soo;Lee, Jeong-Min;Park, Soo-Chul
    • Economic and Environmental Geology
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    • v.45 no.5
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    • pp.513-523
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    • 2012
  • The upper sedimentary layer of the Ulleung Basin in the East Sea shows stacked mass-flow deposits such as slide/slump deposits in the upper slope, debris-flow deposits in the middle and lower slope, and turbidites in the basin plain. Shallow gases or gas hydrates are also reported in many area of the Ulleung Basin, which are very important in terms of marine resources, environmental changes, and geohazard. This paper aims at studying acoustic characteristics and distribution pattern of gas-related structures such as acoustic column, enhanced reflector, dome structure, pockmark, and gas seepage in the upper sedimentary layer, by analysing high-resolution chirp profiles. Acoustic column shows a transparent pillar shape in the sedimentary layer and mainly occurs in the basin plain. Enhanced reflector is characterized by an increased amplitude and laterally extended to several tens up kilometers. Dome structure is characterized by an upward convex feature at the seabed, and mainly occurs in the lower slope. The pockmark shows a small crater-like feature and usually occurs in the middle and lower slope. Gas seepage is commonly found in the middle slope of the southern Ulleung Basin. These gas-related structures seem to be mainly caused by gas migration and escape in the sedimentary layer. The distribution pattern of the gas-related structures indicates that formation of these structures in the Ulleung Basin is controlled not only by sedimentary facies in upper sedimentary layer but also by gas-solubility changes depending on water depth. Especially, it is interpreted that the chaotic and discontinuous sedimentary structures of debris-flow deposits cause the facilitation of gas migration, whereas the continuous sedimentary layers of turbidites restrict the vertical migration of gases.

Migration of the Dokdo Cold Eddy in the East Sea (동해 독도 냉수성 소용돌이의 이동 특성)

  • KIM, JAEMIN;CHOI, BYOUNG-JU;LEE, SANG-HO;BYUN, DO-SEONG;KANG, BOONSOON
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.24 no.2
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    • pp.351-373
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    • 2019
  • The cold eddies around the Ulleung Basin in the East Sea were identified from satellite altimeter sea level data using the Winding-Angle method from 1993 to 2015. Among the cold eddies, the Dokdo Cold Eddies (DCEs), which were formed at the first meandering trough of the East Korea Warm Current (EKWC) and were pinched off to the southwest from the eastward flow, were classified and their migration patterns were analyzed. The vertical structures of water temperature, salinity, and flow velocity near the DCE center were also examined using numerical simulation and observation data provided by the Hybrid Coordinate Ocean Model and the National Institute of Fisheries Science, respectively. A total of 112 DCEs were generated for 23 years. Of these, 39 DCEs migrated westward and arrived off the east coast of Korea. The average travel distance was 250.9 km, the average lifespan was 93 days, and the average travel speed was 3.5 cm/s. The other 73 DCEs had moved to the east or had hovered around the generated location until they disappeared. At 50-100 m depth under the DCE, water temperature and salinity (T < $5^{\circ}C$, S < 34.1) were lower than those of ambient water and isotherms made a dome shape. Current faster than 10 cm/s circulates counterclockwise from the surface to 300 m depth at 38 km away from the center of DCE. After the EKWC separates from the coast, it flows eastward and starts to meander near Ulleungdo. The first trough of the meander in the east of Ulleungdo is pushed deep into the southwest and forms a cold eddy (DCE), which is shed from the meander in the south of Ulleungdo. While a DCE moves westward, it circumvents the Ulleung Warm Eddy (UWE) clockwise and follows U shape path toward the east coast of Korea. When the DCE arrives near the coast, the EKWC separates from the coast at the south of DCE and circumvents the DCE. As the DCE near the coast weakens and extinguishes about 30 days later after the arrival, the EKWC flows northward along the coast recovering its original path. The DCE steadily transports heat and salt from the north to the south, which helps to form a cold water region in the southwest of the Ulleung Basin and brings positive vorticity to change the separation latitude and path of the EKWC. Some of the DCEs moving to the west were merged into a coastal cold eddy to form a wide cold water region in the west of Ulleung Basin and to create a elongated anticlockwise circulation, which separated the UWE in the north from the EKWC in the south.

Geology and Landscape of Mt. Mudeung Province Park, Korea (무등산 도립공원의 지질과 경관)

  • Ahn, Kun-Sang
    • The Journal of the Petrological Society of Korea
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    • v.19 no.2
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    • pp.109-121
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    • 2010
  • Mt. Mudeung is located in Gwangju city, Damyang-Gun, Hwasun-Gun and its round form give us the mood of soft and rich. Its location is $126^{\circ}06'-127^{\circ}01'E$ and $35^{\circ}06'-35^{\circ}10'N$ and its highest peak is Cheonwang-bong with the height of 1,187 m. The Gwangju city is located in the West of Mt. Mudeng and the mountain range with a small basin in its East. The pavilion such as the Soswaewon, Songganjeong, Sigyongjeong are distributed along the stream in the north of Mt. Mudeung. The mountain is formed from the volcanic activity, Gwangju cauldron during the Cretaceous. The top part of Mt. Mudeung is composed of dark gray quartz-andesite and its K-Ar whole rock age is $48.1{\pm}1.7Ma$. The composition of the north area, where the Wonhyosa temple is located, is micrographic granite, whereas the composition of south area is rhyolite mainly. The main ridge of Mt. Mudeung runs from North, starting from the Bukbong, to south, passing Cheonwangbong, Jangbuljae and ending Anyangsan. Geologic feature of the mountain includes volcanic landform, mountaineous landform, and stream landform. The Seosukdae, Ipseokdae, Gyubongam, which are main ridges and formed from volcanic activity, are composed of mainly columnar joint. Saeinbong and Majipbong in the south-west are composed of mainly cliff and dome. The typical erosion landform of the mountain has three different types of the weathering-cave, each of which reflect the property of the original rock. Four different area of wide block stream, they makes the geological feature of spring-water, though its scale is small compared to that of water fall.

Green Port Strategies for Reducing Air Pollution in Port of Incheon (대기오염 저감을 통한 인천항의 Green Port 전략)

  • Han, Chul-Hwan
    • Journal of Korea Port Economic Association
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    • v.27 no.1
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    • pp.281-304
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    • 2011
  • In the energy-climate era, pollution emissions from port activities have a significant issue in international shipping and port community. Thus international organization such as IMO and developed countries are seeking to develop various reduction strategies against air pollution. However Korea has recently conducted several studies concerning air pollution in port industry. The main purpose of the paper is to suggest emission reduction strategies for bulk terminal in Port of Incheon, which handles large amount bulk cargoes as a gateway for the metropolitan area. For this aim, the clean air strategies of the world major ports were considered and air pollution reduction strategies were suggested. The main findings of this paper are as follows. First, the emission reduction strategies for container terminal are should be integrated based on technologies changes, operational changes and market-based measures. Second, the emission reduction strategies for bulk terminal can be effective when use innovative measures during loading, unloading and storage process such as telescopic cascade trimming chute, snake sandwich equipment, dry fog system and dome structure. Finally, investigation on actual conditions of air pollution in Korean ports and development of environmental evaluation scheme for persisting monitoring should be conducted.

STRAW PRESERVATION UNDER WET CONDITION DURING MONSOON IN BANGLADESH: EFFECT OF PRESERVING WET STRAW WITH UREA ON ITS KEEPING QUALITY AND NUTRITIVE VALUE IN CATTLE WHEN FED ALONE OR SUPPLEMENTED WITH CONCENTRATE

  • Chowdhury, S.A.;Huque, K.S.;Haque, M.E.
    • Asian-Australasian Journal of Animal Sciences
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    • v.9 no.3
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    • pp.319-329
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    • 1996
  • During the monsoon in Bangladesh, the possibility of preserving wet ($700g\;H_2O$) straw by urea (50 g/kg straw DM) with or without polythene cover has been studied. The quality of preserved straw (PS) in terms of colour, smell and fungal infestation were recorded. Nutritive value of the PS was compared to that of a dry straw (DS) in two separate feeding trials on growing bulls (about 290 kg) without (Expt. 1) or with (Expt. 2) concentrate supplements. Over 96% of the wet straw was excellently preserved for over 5 months when covered with polythene in horizontal heaps (of appx. 4 tons). Whereas only 33% of the straw was well preserved in the uncovered (dome shaped) heaps (of approximately 9.5 tons). Each ton of wet straw costed Tk. 1413 and its preservation cost incurred Tk. 345. Urea preservation increased the crude protein content (95 vs. 50 g/kg), dry matter (DM) degradability at all (8, 16, 24, 48, 72 and 96) hours of incubation and at 48 hours, DM degradability (%) were 45 and 25 respetively for the PS and the DS. When fed alone, DM intake (75 vs. $106g/kg\;W^{0.75}/d$), total microbial N yield (27 vs. 54 g/d) and growth rate (-379 vs. 283 g/d) were higher (p < 0.01) in the PS than the DS. Supplementation of concentrate reduced the straw DM intake both in the DS ($51g/kg\;W^{0.75}/d$) and the PS ($958g/kg\;W^{0.75}/d$), but the substitution rate (SR%) was higher in the PS (42) than the DS (27). Higher substitution rate was probably responsible for the reduction in the differences between the DS and PS in their nutrient digestibilities, total microbial N yield (62 vs. 64 g/d) and growth rate(669 vs 339 g/d) when supplemented with concentrate. On 28th day of Expt. 2, feeding PS from one of the polythene covered heaps resulted nervous disorder due to unknown reason(s). Further studies on the effect of size and shape of heap on the preservation quality need to be determined.

Study on Structure Visual Inspection Technology using Drones and Image Analysis Techniques (드론과 이미지 분석기법을 활용한 구조물 외관점검 기술 연구)

  • Kim, Jong-Woo;Jung, Young-Woo;Rhim, Hong-Chul
    • Journal of the Korea Institute of Building Construction
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    • v.17 no.6
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    • pp.545-557
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    • 2017
  • The study is about the efficient alternative to concrete surface in the field of visual inspection technology for deteriorated infrastructure. By combining industrial drones and deep learning based image analysis techniques with traditional visual inspection and research, we tried to reduce manpowers, time requirements and costs, and to overcome the height and dome structures. On board device mounted on drones is consisting of a high resolution camera for detecting cracks of more than 0.3 mm, a lidar sensor and a embeded image processor module. It was mounted on an industrial drones, took sample images of damage from the site specimen through automatic flight navigation. In addition, the damege parts of the site specimen was used to measure not only the width and length of cracks but white rust also, and tried up compare them with the final image analysis detected results. Using the image analysis techniques, the damages of 54ea sample images were analyzed by the segmentation - feature extraction - decision making process, and extracted the analysis parameters using supervised mode of the deep learning platform. The image analysis of newly added non-supervised 60ea image samples was performed based on the extracted parameters. The result presented in 90.5 % of the damage detection rate.