• Title/Summary/Keyword: Fenestration

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Microsurgical Fenestration of Middle Cranial Fossa Arachnoid Cyst

  • Kim, In-Soo;Kim, Dong-Won
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.69-73
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    • 2006
  • Objective : The optimal surgical treatment for symptomatic middle cranial fossa arachnoid cysts is controversial. Therapeutic options include endoscopic fenestration, excision, cyst shunting, and craniotomy for fenestration of basal cistern. We reviewed the results of surgically treated middle cranial fossa arachnoid cysts. Methods : We performed a retrospective study in 18 cases of middle cranial fossa arachnoid cysts who had been treated with microsurgical fenestration between 1995 to 2003. The analysis was based on the results of the patients' age, sex distribution, developed area, clinical symptoms, treatment method, and complications. Results : Eighteen surgical treated middle cranial fossa arachnoid cysts patients were evaluated. The age range of cyst development was between 2 years and 44 years with the average of 16.4 years. The follow-up periods averaged 31.48 months. There were 15 male and 3 female patients, with significantly more cyst development in males than females. The most common clinical symptom was headache, followed by seizure. In the entire series, 77.8% of patients demonstrated a decrease in cyst size In serial imaging studies. Of them, 67.3% demonstrated a complete cyst effacement. Overall, 100% of patients with Grade I cysts, 81.8% of patients with Grade II cysts, 60% of patients with Grade III cysts exhibited evidence of decrease in cyst size during long-term monitoring. Complications included headache, meningitis, and hydrocephalus. Conclusion : Patients who were treated with microsurgical fenestration showed good outcome with acceptable complications. We concluded that microsurgical fenestration is a safe and effective surgical method for middle cranial fossa arachnoid cysts.

Fenestration and Duplication of the Vertebrobasilar Artery Detected by Conventional Angiography and Magnetic Resonance Angiography

  • Ahn, Jae-Heung;Kim, Myoung-Soo;Lee, Hyun-Koo;Lee, Seung-Jun;Park, Hyo-Il;Lee, Chae-Heuck
    • Journal of Korean Neurosurgical Society
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    • v.39 no.5
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    • pp.355-359
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    • 2006
  • Objective : The purpose of our study is to examine the clinical significance of vertebrobasilar artery[VBA] fenestration and duplication. In addition, we review its incidence and pathogenesis. Methods : Cerebral angiography was performed in 803 patients and magnetic resonance angiography[MRA] in 880; the patients had or were suspected to have cerebrovascular disease. We retrospectively reviewed angiography and MRA. Results : Fifteen patients [eight men, seven women, 3 to 77 years of age, median age = 58 years] had a VBA fenestration and duplication. Seven [7/803 = 0.87%] of the patients undergoing cerebral angiography revealed fenestrations and one duplication of VBA. Ten patients [10/880 = 114%] among 880 patients that underwent MRA demonstrated fenestration of basilar artery[BA]. Two of 66 patients that underwent both conventional cerebral angiography and cranial MRA showed a fenestration of BA. Twelve fenestrations were located in the proximal portion of the BA and one was in the mid portion of the BA. One vertebral artery[VA] fenestration was located in the intracranial portion of the right VA, and one VA duplication was at the level of $C_{1-2}$ in the left VA. Conclusion : In addition to medial defects, flow phenomena at the proximal end of fenestrations, where hemodynamic stress and increased turbulence are present, may contribute to aneurysm formation. And arterial fenestration is a predisposing factor in vascular injury and cerebral ischemia.

Ruptured Aneurysm Arising from the Distal End of a Proximal A1 Fenestration : Case Report and Review of the Literature

  • Koh, Jun-Seok;Kim, Eui-Jong;Lee, Seung-Hwan;Bang, Jae-Seung
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.43-45
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    • 2009
  • A 75-year-old female presented with subarachnoid hemorrhage. Angiography revealed a partial duplication (fenestration) in the proximal $A_1$ segment and a ruptured aneurysm at the distal end of $A_1$ fenestration. This congenital anomaly accompanying an aneurysm was associated with duplicated ipsilateral middle cerebral artery (MCA). Congenital defect of the arterial wall and hemodynamic factors at the fenestrated $A_1$ are considered to play a significant role in the development of this aneurysm. The present case is peculiar because not only the ruptured $A_1$ aneurysm was related with the anterior and middle cerebral artery duplication but also the location of $A_1$ fenestration and the origin of $A_1$ aneurysm in a fenestration are quite unusual.

A Study on the Application State of the Fenestration Energy Consumption Efficiency Rating System in Construction Field (소규모 민간건축 시공현장에 있어서 창호에너지 소비효율등급제의 적용 현황에 관한 연구)

  • Kang, Suk-Pyo;Jin, Eun-Mi;Yun, Yeo-Myun;Park, Sang-Eun
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2014.05a
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    • pp.24-25
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    • 2014
  • Up to now, most the fenestration industry is consisted of glazing and window frame in Korea. According to the Fenestration Energy Consumption Efficiency Rating System and Energy Saving Design Standards of Buildings, u-value of fenestration is defined as the value of calculation with glazing and frame. For this reason, when applying for a building permit, in most cases, the official approval test report of the set of windows and doors is used. Nevertheless, in windows construction progresses, most construction manager take delivery of the glazing and frame separately. For those reason, windows and doors are constructed regardless of the report of the Fenestration Energy Consumption Efficiency Rating System in most construction fields. From now on, the research of the connection method between reality of policy and reality of construction fields should be carried out.

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Development and Evaluation of an Apparatus to Measure the Solar Heat Gain Coefficient of a Fenestration System According to KS L 9107 (KS L 9107에 의한 태양열 취득률(SHGC) 측정장치 개발 및 평가)

  • Kim, Tae-Jung;Choi, Hyun-Jung;Kang, Jae-Sick;Park, Jun-Seok
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.26 no.11
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    • pp.512-521
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    • 2014
  • Recently, multiple glazing units, frames, complex fenestration systems, and windows with shading devices have been developed to save cooling energy in buildings. However, very little work has been conducted on developing a direct experimental test method of the solar heat gain coefficient(SHGC) for new fenestration techniques. This study aims to develop and evaluate a test apparatus to measure the SHGC, according to the KS L 9107 test method. The performance of the solar simulator was class A, B, and A, for spectral match, non-uniformity, and instability irradiance, respectively. The differences between the measured and calculated SHGC values were found to range between 0.001 and 0.011, and for all test specimens they agreed within 4%. These results establish the validity of the test apparatus. This system is thus expected to be useful in assessing the energy performance for various types of fenestration.

Concomitant Dual Origin and Fenestration of the Left Vertebral Artery Resembling Dissection

  • Kim, Dae-Won
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.498-500
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    • 2009
  • Dual origin and fenestration of the vertebral artery (VA) are very rare anomalies. Understanding of these variations, however, is important because they can be misdiagnosed as a VA dissection. A 42-year-old woman presented with motor weakness and sensory disturbance of the right upper extremity. Radiologic evaluations showed ectatic change in the right VA and an arteriovenous fistula between the right VA and the vertebral vein. We decided on endovascular occlusion of the proximal right VA and its fistulous portion. During the endovascular procedure, we had misunderstood the dual origin and fenestration of the VA as a dissection. Thus, failure to recognize these anomalies might result in unnecessary anticoagulation or therapeutic intervention. Clinicians should be alert to such VA variations when making a diagnosis and when planning any intervention or surgery involving the proximal VA.

Cerebral Aneurysm in the Long Fenestration at the Middle Portion of M1 Segment

  • Sim, Ki-Bum;Lee, Chang-Sub;Park, Jung-Cheol;Huh, Ji-Soon
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.434-437
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    • 2010
  • We report a unique case of bilateral mirror image M1 aneurysms, one of which was an unruptured aneurysm arising from the proximal end of right middle cerebral artery fenestration with long loop and the other ruptured aneurysm from the contralateral side. We clipped ruptured aneurysm first and unruptured one in three months after the first operation. The difficulties of identifying this unusual vascular anomaly and possible problems during the surgery of an aneurysm at the site of fenestration are discussed with a review of the literature.

A Prospective Study Comparing Steroid Injection and Needle Fenestration for the Treatment of Chronic Plantar Fasciitis (만성 족저 근막염 환자에게 전향적으로 시행한 스테로이드 주사와 주사침 천공술)

  • Lee, Jiwon;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.171-176
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    • 2021
  • Purpose: This study sought to compare needle fenestration with a corticosteroid injection for the treatment of chronic plantar fasciitis. We hypothesized that needle fenestration would be as effective as a corticosteroid injection while avoiding the potential adverse effects of the corticosteroid. Materials and Methods: Forty female patients with unilateral chronic plantar fasciitis who did not respond to a minimum of 6 months of various conservative treatments were prospectively randomized to receive either a corticosteroid injection or needle fenestration. Visual analogue scale and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used for all patients before treatment and at 3-, 6-, and 12-month following treatment. Results: The corticosteroid injection group had a before-treatment average AOFAS Ankle-Hindfoot score of 56.4, which increased to 87.3 at 3 months and 78.2 at 6 months after treatment but decreased to 62.4 at 12 months. The needle fenestration group had a before treatment average AOFAS ankle-hindfoot score of 49.5, which increased to 77.8 at 3 months and 92.1 at 6 months after treatment and remained at a high score of 89.4 at 12 months. There were no complications in either group. Conclusion: In the treatment of chronic plantar fasciitis, needle fenestration is as effective at 3- and 6-month post-treatment as a corticosteroid injection. Also, unlike a corticosteroid, its effect remains until 12 months post-treatment.

Multiloculated Hydrocephalus : Open Craniotomy or Endoscopy?

  • Lee, Yun Ho;Kwon, Young Sub;Yang, Kook Hee
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.301-305
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    • 2017
  • Multiloculated hydrocephalus (MLH) is a condition in which patients have multiple, separate abnormal cerebrospinal fluid collections with no communication between them. Despite technical advancements in pediatric neurosurgery, neurological outcomes are poor in these patients and the approach to this pathology remains problematic especially given individual anatomic complexity and cerebrospinal fluid (CSF) hydrodynamics. A uniform surgical strategy has not yet been developed. Current treatment options for MLH are microsurgical fenestration of separate compartments by open craniotomy or endoscopy, shunt surgery in which multiple catheters are placed in the compartments, and combinations of these modalities. Craniotomy for fenestration allows better visualization of the compartments and membranes, and it can offer easy fenestration or excision of membranes and wide communication of cystic compartments. Hemostasis is more easily achieved. However, because of profound loss of CSF during surgery, open craniotomy is associated with an increased chance of subdural hygroma and/or hematoma collection and shunt malfunction. Endoscopy has advantages such as minimal invasiveness, avoidance of brain retraction, less blood loss, faster operation time, and shorter hospital stay. Disadvantages are also similar to those of open craniotomy. Intraoperative bleeding can usually be easily managed by irrigation or coagulation. However, handling of significant intraoperative bleeding is not as easy. Currently, endoscopic fenestration tends to be performed more often as initial treatment and open craniotomy may be useful in patients requiring repeated endoscopic procedures.

Correlation Analysis Between Fenestration Energy Consumption Efficiency Rating System and Building Energy Consumption (창호 에너지 소비 효율 등급제와 건물 에너지 소비의 상관관계 분석)

  • Kwak, Hee-Jeong;Jang, Hyang-In;Lee, Hyun-Soo;Eom, Jae-Yong;Suh, Seung-Jik
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.25 no.6
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    • pp.338-345
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    • 2013
  • The purpose of this study is to analyze the correlation between the 'Fenestration Energy Consumption Efficiency Rating System' (hereafter referred to as FECERS) and building energy consumption. 'EnergyPlus' was used for the calculation of energy consumption in apartments and office buildings, according to FECERS's rating and SHGC. The result indicates that the FECERS has high correlation with apartments, but has low correlation with office buildings. Also, it indicates that office buildings have a large impact from SHGC, which is not reflected in the FECERS. Consequently, the FECERS needs to be improved, by adding optical properties to assessment items. Additional study is required to establish the fenestration rating system, which, on the basis of this work, has high relevance to building energy consumption.