• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.619-630
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• 2021

Objective : The skull base reconstruction step, which prevents cerebrospinal fluid (CSF) leakage, is one of the most challenging steps in endoscopic skull base surgery (ESS). The purpose of this study was to assess the outcomes and complications of a reconstruction technique for immediate CSF leakage repair using multiple onlay grafts following ESS. Methods : A total of 230 consecutive patients who underwent skull base reconstruction using multiple onlay grafts with fibrin sealant patch (FSP), hydroxyapatite cement (HAC), and pedicled nasoseptal flap (PNF) for high-flow CSF leakage following ESS at three institutions were enrolled. We retrospectively reviewed the medical and radiological records to analyze the preoperative features and postoperative results. Results : The diagnoses included craniopharyngioma (46.8%), meningioma (34.0%), pituitary adenoma (5.3%), chordoma (1.6%), Rathke's cleft cyst (1.1%) and others (n=21, 11.2%). The trans-planum/tuberculum approach (94.3%) was the most commonly adapted surgical method, followed by the trans-sellar and transclival approaches. The third ventricle was opened in 78 patients (41.5%). Lumbar CSF drainage was not performed postoperatively in any of the patients. Postoperative CSF leakage occurred in four patients (1.7%) due to technical mistakes and were repaired with the same technique. However, postoperative meningitis occurred in 13.5% (n=31) of the patients, but no microorganisms were identified. The median latency to the diagnosis of meningitis was 8 days (range, 2-38). CSF leakage was the unique risk factor for postoperative meningitis (p<0.001). Conclusion : The use of multiple onlay grafts with FSP, HAC, and PNF is a reliable reconstruction technique that provides immediate and complete CSF leakage repair and mucosal grafting on the skull base without the need to harvest autologous tissue or perform postoperative CSF diversion. However, postoperative meningitis should be monitored carefully.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.13-21
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• 2022

Objective : Nontraumatic subdural hematoma (SDH) is a common disease, and spinal cerebrospinal fluid (CSF) leakage is a possible etiology of unknown significance, which is commonly investigated by several invasive studies. This study demonstrates that heavily T2-weighted magnetic resonance myelography (HT2W-MRM) is a safe and clinically effective imaging modality for detecting CSF leakage in patients with nontraumatic SDH. Methods : All patients who underwent HT2W-MRM for nontraumatic SDH workup at our institution were searched and enrolled in this study. Several parameters were measured and analyzed, including patient demographic data, initial modified Rankin Scale (mRS) score upon presentation, SDH bilaterality, hematoma thickness upon presentation, CSF leakage sites, treatment modalities, follow-up hematoma thickness, and follow-up mRS score. Results : Forty patients were identified, of which 22 (55.0%) had CSF leakage at various spinal locations. Five patients (12.5%) showed no change in mRS score, whereas the remaining (87.5%) showed decreases in follow-up mRS scores. In terms of the overall hematoma thickness, four patients (10.0%) showed increased thickness, two (5.0%) showed no change, 32 (80.0%) showed decreased thickness, and two (5.0%) did not undergo follow-up imaging for hematoma thickness measurement. Conclusion : HT2W-MRM is not only safe but also clinically effective as a primary diagnostic imaging modality to investigate CSF leakage in patients with nontraumatic SDH. Moreover, this study suggests that CSF leakage is a common etiology for nontraumatic SDH, which warrants changes in the diagnosis and treatment strategies.

• International Journal of Computer Science & Network Security
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• v.24 no.2
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• pp.43-52
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• 2024

Medical imaginings assume a important part in the analysis of tumors and cerebrospinal fluid (CSF) leak. Magnetic resonance imaging (MRI) is an image segmentation technology, which shows an angular sectional perspective of the body which provides convenience to medical specialists to examine the patients. The images generated by MRI are detailed, which enable medical specialists to identify affected areas to help them diagnose disease. MRI imaging is usually a basic part of diagnostic and treatment. In this research, we propose new techniques using the 4D-MRI image segmentation process to detect the brain tumor in the skull. We identify the issues related to the quality of cerebrum disease images or CSF leakage (discover fluid inside the brain). The aim of this research is to construct a framework that can identify cancer-damaged areas to be isolated from non-tumor. We use 4D image light field segmentation, which is followed by MATLAB modeling techniques, and measure the size of brain-damaged cells deep inside CSF. Data is usually collected from the support vector machine (SVM) tool using MATLAB's included K-Nearest Neighbor (KNN) algorithm. We propose a 4D light field tool (LFT) modulation method that can be used for the light editing field application. Depending on the input of the user, an objective evaluation of each ray is evaluated using the KNN to maintain the 4D frequency (redundancy). These light fields' approaches can help increase the efficiency of device segmentation and light field composite pipeline editing, as they minimize boundary artefacts.

• Journal of the Korean Society of Marine Environment & Safety
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• v.25 no.5
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• pp.617-626
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• 2019

This study analyzes the optimal location of gas detectors through the gas dispersion in a cargo compressor room of a 174K LNG carrier equipped with high-pressure cargo handling equipment; in addition, we propose a reasonable method for determining the safety regulations specified in the new International Code of the Construction and Equipment of Ships Carrying Liquefied Gases in Bulk (IGC). To conduct an LNG gas dispersion simulation in the cargo compressor room-equipped with an ME-GI engine-of a 174 K LNG carrier, the geometry of the room as well as the equipment and piping, are designed using the same 3D size at a 1-to-1 scale. Scenarios for a gas leak were examined under high pressure of 305 bar and low pressure of 1 bar. The pinhole sizes for high pressure are 4.5, 5.0, and 5.6mm, and for low pressure are 100 and 140 mm. The results demonstrate that the cargo compressor room will not pose a serious risk with respect to the flammable gas concentration as verified by a ventilation assessment for a 5.6 mm pinhole for a high-pressure leak under gas rupture conditions, and a low-pressure leak of 100 and 140 mm with different pinhole sizes. However, it was confirmed that the actual location of the gas detection sensors in a cargo compressor room, according to the new IGC code, should be moved to other points, and an analysis of the virtual monitor points through a computational fluid dynamics (CFD) simulation.

• Journal of the Korean Institute of Gas
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• v.26 no.6
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• pp.45-51
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• 2022

Technologies for collecting and treating pollutants from point sources are steadily being developed, but Non-point sources, it is difficult to develop emission treatment technologies and effective emission coefficients. However, since non-point sources make up about 60% of domestic emissions, and first of all, the method of calculating emissions should be reasonable, and the workplace should develop emission reduction technologies based on this. This study suggest the effectiveness and improvement of the emission coefficient currently used for the petrochemical industry with high emissions. The emission characteristics of non-point sources emission were confirmed by analyzing the LDAR (Leak Detection And Repair) data of OO company located in Yeosu, Jeollanam-do over the past five years. As a result, there was no difference in discharge characteristics according to fluid phase, but it was confirmed that there was a difference in the size of the device and the characteristics of each manufacturer. In addition, it was confirmed that the emission coefficient applied in the petrochemical industry was larger than that of the refining industry, and improvement measures were suggested. Through these studies, it is expected that emission coefficients specialized in the petrochemical industry can be applied and that the workplace itself will contribute to the development of technologies that can drastically reduce them.

• Tuberculosis and Respiratory Diseases
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• v.52 no.3
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• pp.219-229
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• 2002

Background : Sepsis-induced acute lung injury (ALI) is caused by many cellular and humoral mediators induced by an endotoxin. Histamine, which is widely distributed in the lungs and has been considered as an important mediator of sepsis. It increases P-selectin expression on the endothelial cell surfaces and induces IL-8 secretion. Therefore, an endotoxin-induced histamine may be related to neutrophil-mediated ALI by inducing the migration and activation of neutrophils in the lung tissue. However, the role of endogenous histamine in endotoxin ALI has not been clarified. The purpose of this study was to investigate how endotoxin-induced ALI is influenced by endogenous histamine and to identify the possible mechanism of action. Materials and Methods : The study consisted of 4 groups using Sprague-Dawley rats : 1) control group, where the rats were infused intratracheally by normal saline, 2) an endotoxin group, where lipopolysaccharide (LPS) was administered intratracheally 3) the $H_2$ receptor antagonist-treated group ($H_2$ group) and 4) the $H_1$ receptor antagonist-treated group ($H_1$ group), where $H_2$-receptor blocker (ranitidine) and $H_1$-receptor blocker(pyrilamine) were co-treated intravenously with the intratracheal administration of an endotoxin. The lung leak index using $I^{125}$-BSA, the total protein and LDH concentration in the lung lavage fluid, myeloperoxidase(MPO) activity in the lung tissue, the pathologic score and the total number of neutrophils, TNF-$\alpha$, IL-$1{\beta}$ and IL-10 in lung lavage (BAL) fluid were measured in each group as the indices of lung injury. Results : Compared to the control group, the endotoxin group exhibited significant increases in all lung injury indices. Significant reductions in the endotoxin-mediated increases in lung leak index (p<0.05) were observed in both the $H_1$ and $H_2$ groups. In addition the total protein (p<0.05) and LDH concentration (p<0.05) in the BAL fluid were also lower in the $H_2$ group compared to the endotoxin group. However, there was no change in the MPO activity in the lung tissue, the pathologic score and the total number of neutrophils in the BAL fluid in both the $H_2$ and $H_1$ groups compared to the endotoxin group. The increases in TNF-$\alpha$ IL-$1{\beta}$ and IL-10 concentrations in the BAL fluid observed in the endotoxin group were not reduced in the $H_2$ and $H_1$ groups. Conclusion : Antihistamine attenuated the enhanced alveolar-capillary permeability induced by the endotoxin via the $H_2$ receptor. However the attenuating mechanism may not be related to the pathogenesis of neutrophil dependent lung injury.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.338-342
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• 1998

Postural headache due to spontaneous intracranial hypotension occurs without any diagnostic lumbar puncture, myelography, cranial or spinal injury, or spinal anesthesia. The clinical characteristics of the syndrome are disappearance of the headache or a notable decrease in its severity with recumbency, the finding of meningeal enhancement and subdural fluid collection on brain MRI, the pleocytosis and the increased CSF protein concentration. We report a case of a 40-year-old woman who exhibited the signs and symptoms of postural headache due to low CSF pressure. Her headache started suddenly at the occiput and radiated to frontal head. Magnetic resonance imaging (MRI) of her brain showed enhancement of the meninges and subdural fluid collection. Intrathecal radionuclide cisternography showed the delayed appearance of the isotope in the cranium and the minimal CSF leak at the left upper thoracic region. Her headache was relieved completely after a lumbar (L2-L3) epidural injection of 12 ml of autologous blood and remained asymptomatic.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.35 no.10
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• pp.1097-1103
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• 2011

Liquid droplet impingement erosion (LDIE) is caused by the impact of high-velocity droplets entrained in steam or air on metal. The degradation caused by the LDIE has been experienced in steam turbine internals and high-velocity airplane components (particularly canopies). Recently, LDIE has also been observed in the pipelines of nuclear plants. LDIE among the pipelines occurs when two-phase steam experiences a high pressure drop (e.g., across an orifice in a line to the condenser). In 2011, a nuclear power plant in Korea experienced a steam leak caused by LDIE in a pipe through which a two-phase fluid was flowing. This paper describes a study on the design change of a pipe affected by LDIE in order to mitigate the damage. The design change has been reviewed in terms of fluid dynamics by using the FLUENT code.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.224-230
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• 2022

Background: An epidural blood patch (EBP) is a procedure to treat intracranial hypotension that does not respond to conservative treatment. EBPs are commonly repeated when the symptoms persist. In this study, we used a large single-center retrospective cohort and evaluated the factors associated with repeated EBPs. Methods: From January 2010 to December 2020, a total of 596 patients were treated with EBPs for intracranial hypotension. We evaluated the factors associated with repeated EBPs in the entire population, in patients with spontaneous intracranial hypotension (SIH), and in those with available myelographies. Results: In a total of 596 patients, 125 (21.1%) patients required repeated EBPs, and 96/278 (34.5%) in SIH and 29/314 (9.2%) in iatrogenic population. In patients with SIH, international normalized ratio (INR) and cerebrospinal fluid (CSF) leakage on myelographies consistently exhibited significant associations (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.02-1.87; P = 0.043 and OR, 2.18; 95% CI, 1.28-3.69; P = 0.004). In patients with iatrogenic injury, INR and CSF leakage on myelogram did not show difference in repeated EBPs. Conclusions: Repeated EBPs may be more frequently required in patients with SIH. Prolonged INR and CSF leakage were associated with repeated EBPs in patient with SIH. Further studies are needed to determine factors associated with repeated EBP requirements.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.667-670
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• 2007

Purpose: Among the materials for cranioplasty, autogenous bone is ideal because it is less susceptible to infection and has lower rates of subsequent exposure. However, the procedure is technically demanding to perform and requires a donor site. Disadvantages further exist when the defect is large and there are attendant limitations in donor site. The authors present their experience with reconstruction of large skull defect using right-angled zigzag osteotomized outer table of autogenous calvarial bone, overcoming the limitation in donor site. Methods: From 2000 to 2006, 9 patients were retrospectively reviewed, who had undergone reconstruction with right angled zigzag osteotomized outer table of autogenous calvarial bone. Results: Aesthetically satisfactory skull shape was achieved. Major complications of infection, hematoma, plate exposure, and donor site complications of dural tear with bleeding, cerebrospinal fluid leak, and meningitis were not seen. One patient had delayed wound healing and was successfully managed conservatively. Conclusion: Autogenous bone is the material of choice for cranioplasty, especially in complicated cases. Right angled zigzag osteotomy is a useful method in reconstruction of large skull defects with less donor site morbidity.