• Journal of Korean Neurosurgical Society
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• v.53 no.5
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• pp.293-296
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• 2013

The aneurysm arising from fenestrated proximal anterior cerebral artery (ACA) is considered to be unique. The authors report a case of a 59-year-old woman who presented with a subarachnoid hemorrhage (SAH) secondary to a ruptured aneurysm originating from the fenestrated A1 segment of right ACA. The patient had another unruptured aneurysm which was located at the right middle cerebral artery bifurcation. She was successfully treated with surgical clipping for both aneurysms. From the previously existing literatures, we found 18 more cases (1983-2011) of aneurysms associated with fenestrated A1 segment. All cases represented saccular type of aneurysms, and 79% of the patients had SAH. There were three subtypes of the fenestrated A1 aneurysms depending on the anatomical location, relative to the fenestrated segment. The most common type was the aneurysms located on the proximal end of fenestrated artery (82%). Azygos ACA and hypoplastic A1 were frequently accompanied by the aneurysm (33% and 31%, respectively), and multiple aneurysms were shown in three cases (16%). Considering that fenestrated A1 segment is likely to develop an aneurysm, which has high risk of rupture, early management may benefit patients with aneurysms accompanied by fenestrated proximal ACA.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1150-1154
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• 1995

Pneumomediastinum[Mediastinal emphysema is characterized by the presence of air in the mediastinum, and classified as spontaneous[occurring without obvious cause or secondary[caused by a trauma or artificial ventilation . To study the clinical evaluation of pneumomediastinum, data were obtained from 20 patients. The incidences of spontaneous pneumomedisastinum were 5 and those of secondary pneumomedistinum were 15 cases. The mean age was 21.2$\pm$3.4 years[$\pm$SD in spontaneous pneumomediastinum and 44.1$\pm$20.0 years[$\pm$SD in secondary pneumomediastinum. There were 16 male and 4 female patients. The common presenting compliants were retrosternal pain in 19 patients[95% , dyspnea in 12[60% , and hoarsness in 2[10% . The predisposing factors were asthma,excessive exercise and vomiting in spontaneous pneumomediastinum;trauma, artificial ventilation, tracheostomy, the rupture of trachea or esophagus in secondary pneumomediastinum. The physical findings were subcutaneous emphysema in 17 patients[85% , Hamman`s sign in 11 patients[55% and decreased cardiac dullness in 2 patients[10% . Spontaneous pneumomediastinums were managed conservatively, however, surigical procedures were needed in secondary pneumomediastinums. There was no recurrence, but one patinet died of tension pneumomedistinum. We concluded that spontaneous pneumomediastinum is uncommon, usually benign, and self-limited and secondary pneumomedistinum due to trauma or artificial ventilation is more increasing, and necessitates the early, aggressive intervention.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.605-614
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• 1985

The principal aim of surgery for congenital heart anomalies is the establishment of normal hemodynamic function. Palliative and corrective operations are selected with time to attain this end with minimal risk. In recent years, as operative mortality after primary total correction is lower than the mortality after early palliation and delayed correction, corrective operations in infants have increasingly supplanted palliative ones. Two hundred and eighteen infants below 10 kg with congenital heart anomalies underwent primary surgical intervention at Yonsei Medical Center from March 1979 to June 1985. There were 155 infants with VSD, 35 Infants with TOF, 5 infants with ECD, 4 infants with TGV, 3 infants with DORV, 3 infants with Pulmonary atresia, 3 infants with ASD and PDA, 2 infants with DOLV, and the remainders were Sinus Valsalva rupture, residual mitral regurgitation after total correction of ECD, PAPVR, Cor triatriatum, Truncus arteriosus, and Tricuspid atresia. The overall surgical mortality was 15.1%. In the acyanotic group, 13 infants died among 168 infants, and mortality was 7.7%. But in the cyanotic group, the mortality rate was very high and 20 infants died among 50 infants raising the mortality to 40.0%. These poor surgical results in the cyanotic or complicated group was due to inaccurate diagnosis, improper surgical methods and inadequate post-operative care which should be improved.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.482-487
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• 1990

The leading cause of death in patients with chronic renal failure is cardiovascular diseases. The problems relevant to cardiac surgery in these patients are occurring more frequently with a growing number of patients at risk. Among these, important risk factors related to uremic patients undergone open heart surgery are fluid and electrolytes imbalance, coagulopathy, increased susceptibility to infection. Since 1968 when Lansing and colleagues reported the first successful aortic valve replacement in patients with chronic renal failure and infective endocarditis, there have been increasing reports of the cardiopulmonary bypass surgery in chronic renal failure patients with acceptable perioperative morbidity and mortality From Jan. 1988 to Nov. 1989 we have experienced four uremic patients necessitating open heart surgery ; one needing a coronary artery bypass graft and the other 3 needed cardiac valve replacement. Based on our observations we would like to suggest followings 1]Intraoperative ultrahemofiltration during C-P bypass thought to be an excellent means for the control of hyperkalemia and fluid balance. 2] The immediate postoperative application of peritoneal dialysis instead of hemodialysis is beneficial in controlling fluid and electrolyte imbalance. 3]The cause of one early postoperative death was not associated to renal failure, rather it was the result of an accidental rupture in the right ventricular wall.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.35-42
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• 1998

The complications of a tracheotomy are caused by inappropriate surgical techniques, unsuitable cannula selections, and improper wound care. Among these, the solutions to problems of surgical technique and wound care have been reported in many articles. Detailed methods for preventing complications by the cannula are rare. The authors tried to find a way of preventing complications by the cannula Materials and Methods : The authors analized complications in 70 patients who had a temporary tracheotomy and were wearing a cannula. And the complications were compared between 4 commercial cannulas used in our institute. The examination methods used were a simple neck lateral radiogram and flexible endoscopy. Results： The order of most commonly found complications were as followed; at the suprastoma, end of cannula, level of tracheotomy, and infrastoma. Among 4 cannulas, a particular product had so many complications compared to the other 3 cannulas. The most common cause of complications was unsuitable cannula. All complications were cured with no sequelae. Flexible endoscopy is far superior to radiologic exam for detecting tracheal complications. Conclusion： Flexible endoscopy through the tracheostoma is very helpful for detecting complications early and determining if a proper cannula is used, which can prevent further complications such as stenosis or innominate artery rupture. The authors, therfore, recommend using the flexible endoscopy to all patients wearing tracheotomy tubes. Some complications can simply be prevented by replacing the one to another cannula properly fit for the individual patients. Various cannulas should be prepared at the hospital because the tracheal curvature and distance of skin to trachea are individualized.

• Nuclear Engineering and Technology
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• v.51 no.6
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• pp.1525-1531
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• 2019

The indigenous nuclear power program of India is based mainly on a series of Pressurised Heavy Water Reactors (PHWRs). A burst correlation for Indian PHWR fuel claddings has been developed and empirical burst parameters are determined. The burst correlation is developed from data available in literature for single-rod transient burst tests performed on Indian PHWR claddings in inert environment. The heating rate and internal overpressure were in the range of 7 K/s-73 K/s and 3 bar-80 bar, respectively, during the burst tests. A burst criterion for inert environment, which assumes that deformation is controlled by steady state creep, has been developed using the empirical burst parameters. The burst criterion has been validated with experimental data reported in literature and the prediction of burst parameters is in a fairly good agreement with the experimental data. The burst criterion model reveals that increasing the heating rate increases the burst temperature. However, at higher heating rates, burst strain is decreased considerably and an early rupture of the claddings without undergoing considerable ballooning is observed. It is also found that the degree of anisotropy has significant influence on the burst temperature and burst strain. With increasing degree of anisotropy, the burst temperature for claddings increases but there is a decrease in the burst strain. The effect of anisotropy in the ${\alpha}$-phase is carried over to ${\alpha}+{\beta}$-phase and its effect on the burst strain in the ${\alpha}+{\beta}$-phase too can be observed.

• Journal of English Language & Literature
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• v.64 no.3
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• pp.383-401
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• 2018

Wordsworth is a poet who thought seriously about problems of human's relation to the world as perceiving subjects. What he calls "the life of things" illustrates the enabling power of things and their vitalities at play in excess of human elements. Drawing on this, he provides insights into vital materialities that act upon, and are acted upon by, the collaborative circulation between human and nonhuman agency. This paper aims to reinvigorate the debate about Wordsworth's ethics of things in terms of such critical notions as things, objects, agency, and nonhumans in an attempt to explain what he envisions as new environmental realities built upon nonhierarchical, collaborative relationships between all participants. From the vantage point of things, we see clearly what has been neglected in the New Historicist critical method. It holds fast to the conceit that humans are entitled to have sole agential legitimacy, disregarding the vibrancy of things. They opt for the objectified matter or the (re)presented state of things. But in terms of Wordsworth's life of things, all participants have equal amounts of agency regardless of their forms and for that reason humans are expected to respect other things' sovereignty. Through encounters with things, things in their thingness show up for us, only to reveal the ineradicable rupture between themselves and their objectified forms.

• 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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4651-4655
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• 2015

The subclavian artery pseudoaneurysm in blunt trauma is uncommon and rarely occurs secondary to penetrating injury. Subclavian artery injuries represent an uncommon complication of blunt chest trauma, this structure being protected by subclavius muscle, the clavicle, the first rib, and the deep cervical fascia as well as the costo-coracoid ligament, a clavi-coraco-axillary fascia portion. Subclavian artery injury appears early after trauma, and arterial rupture may cause life-threatening hemorrhages, pseudoaneurysm formation and compression of brachial plexus. Most injuries were related to clavicle fracture, gunshot, other penetrating trauma, and complication of central line insertion. The presence of large hematomas and pulsatile palpable mass in supraclavicular region should raise the suspicion of serious vascular injury and these clinical evidences must be carefully worked out by physical examination of the upper limb. Since the first reports of endovascular treatment for traumatic vascular injuries in the 1993, an increasing number of vascular lesions have been treated this way. We report a case of subclavian artery pseudoaneurysm 10 days after blunt chest trauma due to traffic accident, treated by endovascular stent grafting.

• Applied Microscopy
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• v.17 no.1
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• pp.98-114
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• 1987

Degranulation of the rat peritoneal mast cell induced by intraperitoneal injection of horseradish peroxidase(HRP) was studied using light and electron microscopes. 1. Rat peritoneal mast cells in the Tyrode's buffered salt solution injected control group did not show any particular morphological changes following the specified time course. 2. Under the light microscope, the majority of mast cells observed 10 minutes after HRP injection were nearly the same as those of the control group. However, after 30 minutes, granule densities or staining properties of certain cells began to decrease and these appearances increased gradually until 12 hours after injection, at which time small groups of granules being stained pale-red or pink with toluidine blue were easily identified in the cytoplasm of many cells, and numerous extruded granuleg were scattered around these cells. 3. In the mast cells representing the early stage of degranulation induced by HRP, the electron densities of certain granules decreased as the size enlarged, and perigranular cavities were formed by perigranular membrane expansion. As a result, a thin cytoplasmic septum was formed between the expanded perigranular membrane and the cytoplasmic membrane in the cell periphery, and fusion of the adjacent perigranular membranes was observed in the inner side of the cell. 4. In some mast cells, one or two changes in the peripheral cytoplasmic septum could be seen. One was a focal rupture of the peripheral septum and the other was the formation of a saccule containing one or more vesicles. This saccule was thought to be used for granule-extrusion site and/or material absorptive apparatus judging from the morphological characteristics. 5. As the degranulation proceeded, the granule was extruded from the cell after partial rupture of the peripheral cytoplasmic septum. This phenomenon proceeded to-ward the inner side of the cell through the fused perigranular cavities, and consequently several distinct cavities containing a few unextruded membrane-free granules were formed throughout the cytoplasm after 12 hours. As a rule, the granule-extrusion sites were relatively fewer while the cytoplasmic cavities resulting from degranulation were more numerously observed. Thus, it was thought that the granule-extrusion sites tended to be restricted in the HRP-induced degranulation.