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Feasibility, Safety, and Follow-up Angiographic Results of Endovascular Treatment for Non-Selected Ruptured Intracranial Aneurysms Under Local Anesthesia with Conscious Sedation

  • Kang, Jongsoo;Kang, Chul-Hoo;Roh, Jieun;Yeom, Jeong A;Shim, Dong-Hyun;Kim, Young Soo;Lee, Sang Won;Kim, Young-Soo;Park, Kee Hong;Kim, Chang-Hun;Kim, Soo-Kyoung;Choi, Nack-Cheon;Kwon, Oh-Young;Kang, Heeyoung;Baik, Seung Kug
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.93-101
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    • 2018
  • Background: At most centers, general anesthesia (GA) has been preferred for endovascular treatment (EVT) of ruptured intracranial aneurysms (RIAs). In this study, we analyzed procedural results, clinical outcomes, and follow-up angiographic findings for patients undergoing EVT for RIA under local anesthesia (LA) with conscious sedation (CS). Methods: We retrospectively evaluated 308 consecutive patients who underwent EVT for RIAs at a single institution between June 2009 and February 2017. EVT under LA with CS was considered for all patients with aneurysmal subarachnoid hemorrhage, regardless of Hunt and Hess (HH) scale score. Results: EVT was performed for 320 aneurysms in 308 patients with subarachnoid hemorrhages. The mean patient age was $55.5{\pm}12.6$ years. Moderate (III) and poor (IV, V) HH grades were observed in 75 (24.4%) and 77 patients (25%), respectively. Complete occlusion immediately after EVT was achieved for 270 (84.4%) of 320 aneurysms. Thromboembolic complications and intraprocedural ruptures occurred in 25 (7.8%) and 14 cases (4.3%), respectively. The morbidity rate at discharge (as defined by a modified Rankin scale score of 3 or greater) was 27.3% (84/308), while the mortality rate was 11.7% (36/308). Follow-up angiographic results were available for 210 (68.1%) of 308 patients. Recanalization was observed in 64 (29.3%) of 218 aneurysms in 210 patients. Conclusion: Based on our experience, EVT for RIAs under LA with CS was feasible, regardless of the clinical grade of the subarachnoid hemorrhage. Complication rates and follow-up angiographic results were also comparable to those observed when GA was used to perform the procedure.

Understanding the Effects of Deep Fertilization on Upland Crop Cultivation and Ammonia Emissions using a Newly Developed Deep Fertilization Device (신개발 심층시비장치를 이용한 심층시비의 밭작물 재배 효과)

  • Sung-Chang Hong;Min-Wook Kim;Jin-Ho Kim;Seong-Jik Park
    • Korean Journal of Environmental Agriculture
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    • v.42 no.1
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    • pp.28-34
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    • 2023
  • Nitrogen fertilizers applied to agricultural lands for crop cultivation can be volatilized as ammonia. The released ammonia can catalyze the formation of ultrafine dust (particulate matter, PM2.5), classified as a short-lived climate change pollutant, in the atmosphere. Currently, one of the prominent methods for fertilizer application in agricultural lands is soil surface application, which comprises spraying the fertilizers onto the soil surface, followed by mixing the fertilizers with the soil. Owing to the low nitrogen absorption rate of crops, when nitrogen fertilizers are applied in this manner, they can be lost from land surfaces through volatilization. Therefore, investigating a new fertilization method to reduce ammonia emissions and increase the fertilizer utilization efficiency of crops is necessary. In this study, to develop a method for reducing ammonia emissions from nitrogen fertilizers applied to soil surfaces, deep fertilization was conducted using a newly developed deep fertilization device, and ammonia emissions from barley, garlic, and onion fields were examined. Conventional fertilization (surface application) and deep fertilization (soil depth of 25 cm) were conducted for analysis. The fertilization rate was 100% of the standard fertilization rate used for barley, and deep fertilization of N, P, and K fertilizers was implemented. Ammonia emissions were collected using a wind tunnel chamber, and quantified subsequently susing the indole-phenol blue method. Ammonia emissions released from the basal fertilizer application persisted for approximately 58 d, beginning from approximately 3 d after fertilization in conventional treatments; however, ammonia was not released from deep fertilization. Moreover, barley, garlic, and onion yields were higher in the deep fertilization treatment than in the conventional fertilization treatment. In conclusion, a new fertilization method was identified as an alternative to the current approach of spraying fertilizers on the soil surface. This new method, which involves injecting nitrogen fertilizers at a soil depth of 25 cm, has the potential to reduce ammonia emissions and increase the yields of barley, garlic, and onion.

A Study on Estimating Ship's Emission in the Port Area of Mokpo Port (목포항 항만구역 내 선박 배기가스 배출량 산정에 대한 연구)

  • Bui, Hai-Dang;Kim, Hwayoung
    • Journal of Korea Port Economic Association
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    • v.39 no.3
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    • pp.47-60
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    • 2023
  • A thorough inventory of ship emissions, particularly ship's emission of in-port area is necessary to identify significant sources of exhaust gases such as NOx, SOx, PM, and CO2 and trends in emission levels over time, and reduce their serious effects on the environment and human health. Therefore, the goal of this study is to assess the volume of emissions from ships in Mokpo port, which serves as a gateway to the southwest coast of Korea, using a bottom-up methodology and data from the automatic identification system (AIS) and the Korean Port Management Information System (Port-MIS). In this work, an analysis of ship movement utilizing AIS data and an actual set of data on ship specification were gathered. By examining ship movement using AIS data, We also proposed a new approach for identifying cruising/maneuvering mode. Finally, the results were classified by ship operating mode, by exhaust gas, by ship type, and by berth, which provides a thorough and in-depth analysis of the air pollution caused by ships in Mokpo port.

Factors Related to Bone Mineral Content Among Adolescents in Seoul (서울시 일부 청소년의 골질량 관련요인)

  • Shin, Sang-Ah;Hong, Kyung-Eui;Choi, Hyun-Jeong;Roh, Ji-Hyun;Joung, Hyo-Jee
    • Journal of Nutrition and Health
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    • v.41 no.2
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    • pp.156-164
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    • 2008
  • The purpose of this study was to investigate factors related to bone mineral contents (BMC) at os calcis of adolescents. The subjects were 604 students (327 boys and 277 girls) between 7th and 9th grade in Seoul, Korea. The mean age was 14.2 ${\pm}$ 0.9 years. General characteristics were collected by a questionnaire, bone mineral contents (BMC) were measured in os calcis by Duel Energy X-ray Absorptiometry (PIXI, General Electronics, USA) and height and weight were measured by bioelectrical impedance analysis method (Inbody 4.0, Biospace Co. Ltd, Seoul, Korea). Mean BMC of os calsis were 2.241 g. Height (p <.0001), weight (p <.0001I), BMC (p <.0001I) ofboys were higher than those of girls. Percent body fat of girls, however, was higher than that of boys (p <.0001). Anthropometric measurement, pocket money, sibling, experience of fracture, pubertal stage, intake of supplements, physical or outdoors activity, and eating habit had significant influence on BMC of boys. Anthropometric measurement, physical or outdoors activity, and eating habit had significant influence on BMC of girls. Multivariate regression with adjustment for sex and age showed that BMC was associated positively with height, BMI, frequency of regular activity, and intake of spinach or radish leaves (all p <0.05), and negatively with percent body fat (p <.0000 and Korean traditional diet pattern (p = 0.01). On the basis of these results, it is recommended to develop nutrition education and physical activity program for adolescents to improve BMC and prevent osteoporosis.

Accuracy of soft tissue Profile change prediction in mandibular set-back surgery patients: a comparison of Quick Ceph Image $Pro^{TM}$ (ver 3.0) and $V-Ceph^{TM}$(ver 3.5) (하악골 후퇴 수술 환자의 연조직 측모 예측의 정확성: Quick Ceph Image $Pro^{TM}$(ver 3.0)와 $V-Ceph^{TM}$(Ver 3.5)의 비교)

  • Kim, Myoung-Kyun;Choi, Yong-Sung;Chung, Song-Woo;Jeon, Young-Mi;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.35 no.3 s.110
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    • pp.216-226
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    • 2005
  • The purpose of this study was to test and compare the accuracy and reliability of soft tissue profile predictions generated from two computer software programs (Quick Ceph Image $Pro^{TM}$ (ver 3.0) and $V-Ceph^{TM}$(ver 3.5)) for mandibular set-back surgery. The presurgical and postsurgical lateral cephalograms of 40 patients (20 males and 20 females) were traced on the same acetate paper with the reference taken as the cranial base outline. The presurgical skeletal outlines were digitized onto each computer program and the mandible was moved to mimic the expected surgical procedure with reverence to the mandibular anterior border and lower incisor position of the actual postsurgical skeletal outline. The soft tissue profile was generated and the amount and direction of skeletal movement was calculated with each software. The predicted soft tissue profile was compared to the actual postsurgical soft tissue profile. There were differences between the actual and the predicted surgical soft tissue profile charges in the magnitude and direction, especially the upper lip. lower lip and the soft tissue chin (P<0.05). Quick Ceph had more horizontal measurement errors and thickness errors for the upper lip and lower lip, but V-Ceph had more vertical measurement errors of the lower lip (P<0.05). There was a positive correlation between the prediction errors and the amount of mandibular movements in the vertical position of Sn, the horizontal position of Ls and the upper lip thickness for V-Ceph, and there was a negative correlation in the horizontal position and the thickness of the lower lip for Quick Ceph (P<0.05). However all of the Prediction errors of both imaging softwares were ranged within 3mm, and this was considered to be allowable clinically.

A Study on the Prevalence Rate of Hypertension and the Actual Conditions of Control (일 지역 성인의 고혈압 유병률 및 관리 실태)

  • Kim, Hyeon-Ok
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.154-172
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    • 1999
  • In order to analyse the prevalence rate of hypertension and the actual conditions of control, we selected five districts out of eleven eups and myuns in Chinan Country. We administered structured questionaries to 309 adults above the age of 40, computerized the data using SPSS - PC+. More than 40.1% of adults over 40 in Chinan County have health disorders ranging from high blood pressure to hypertension including alert high blood pressure at 36.2%, relatively high. Among general characteristics, differences in the rate of hypertension were influenced by age, occupation and places of residence. Over 71 who are engaged in agriculture, who don't have jobs, who reside in Sungsu, Jungchun, Chinan-eup all have higher hypertension rates than other groups. Accordingly, the control of hypertension should be focused on these people. As a result of the control of blood pressure, the survey showed 93.0% of the subjects were checked mainly at hospitals clinics, health centers subhealth centers and community health posts more than once a year, relatively high level of blood pressure management. However, the difference between their blood pressure measurements at ordinary times and the level of blood pressure at the time of research was quite considerable. Only 47.3% of the subjects diagnosed with high blood pressure and 70.3% of the subjects with normal blood pressure recognized their blood pressure accurately 52.7% of the subjects diagnosed with high blood pressure showed errors in understanding their blood pressure at normal times. Because these errors can cause problems in the control of blood pressure, proper management should be executed through a systematic examination. As a result of the high blood pressure control condition, the average period of hypertension was 74.5( ${\pm}92.8$) months, 92.3% of the subjects were diagnosed with high blood pressure at hospitals clinics, health centers subhealth centers community health posts, but only 29.5% were examined after a general check up on high blood pressure was completed. 70.5% were diagnosed with high blood pressure only after measuring their blood pressure. 14.1% of the subjects were hospitalized because of falls influenced by high blood pressure. 33.3% attended hospitals and health centers regularily for medical treatment and this shows how low the rate of the control of blood pressure. Most people did not undergo medical treatment, because they had no painful symptoms (46.7%), they didn't need to take the medicine(28.9%), or they forget to take the medicine(20.0%). These problems in the control of hypertension were discovered in the process of diagnosing high blood pressure at health medical institutions. Many people did not recognize the need for consistent control of blood pressure. That is, although the diagnosis for high blood pressures performed at hospitals clinics, health centers subhealth centers and community health posts, was 92.3%, more than 70.5% of the subjects were not examined completely with regard to blood pressure. Accordingly, heath medical institutions must diagnose high blood pressure not only by only measuring blood pressure but also by using systematic process of examination. As for the people diagnosed with high blood pressure, one should perform consistent medical approaches and help them to recognize the importance of the continuous control of blood pressure through subject-oriented education. Problems the subjects experienced were the following numbness in the limbs easily paralyzed stitches in their shoulders which felt painful, stiff necks, occiputs felt heavy, headaches when they got up in the morning, felt dizzy when standing and moving their heads and poor eyesight. The rate of knowledge related to high blood pressure was 78.7 points, comparatively low. Whether they had normal blood pressure or hypertension made no difference. These results are not desirable. Adult-oriented education forgot the prevention and management of high blood pressure should be implemented. Hypertensive-oriented education should be especially reinforced. Because there was a difference in the level of knowledge according to age, academic career, occupation or place of residence, education related to hypertension should be intensified and focused on those over the age of 71 those who did not attend school, those who do not have jobs and are engaged in agriculture and residents living in Bugui, Jungchun regions. The degree of healthy life practice in hypertensives is poor, particularly weight control, as opposed to people who have normal blood pressure. It makes no difference in smoking, the amount of daily smoking, drinking, the control of salt because each result means that they are not practicing healthy life or modifying their life-style. The development and programs to improve a healthy life should be executed.

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Effects of Green Tea on Hepatic Antioxidative Defense System and Muscle Fatigue Recovery in Rat after Aerobic Exercise (녹차가 유산소 운동 후 흰쥐 간조직의 항산화 작용 및 근피로 회복에 미치는 영향)

  • 김미지;이순재
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.6
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    • pp.1058-1064
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    • 2002
  • The purpose of this study was to investigate the effects of green tea on hepatic antioxidative defense system and recovery of muscle fatigue in rat after aerobic exercise. Male Sprague-Dawley rats weighing 150$\pm$ 10 g were randomly assigned to one normal (N) group and aerobic exercise training groups. Exercise training groups were classified into two groups: training (T) group and green tea (TG) group which were supplemented the distilled water and green tea extracts by dringking water during experimental periods, respectively. The experimental rats in exercise training groups (T and TG) ran on a treadmill 30 min/day at a speed of 28 m/min (7% incline) 5 days/week or were cage confined (Normal group) for 4 weeks. And rats were sacrificed with an overdose of pentobarbital injection just after running. Hepatic xanthine oxidase (XOD) activities were not significantly different among three groups. The activity of superoxide dismutase (SOD) in T group was no significant difference from N group, but those of TG groups were significantly increased, compared with that of T group. Hepatic glutathione peroxidase (GSHpx) activites of TG groups showed a similar tendency to that of normal group, but it was increased to 20% in TG group, compared with normal group. The reduced glutathione (GSH) contents in liver was not significantly different from that of any three group. The oxidized glutathione (GSSG) contents in T group was increased to 69%, compared with the normal group, but TG group significantly decreased, compared with the T group. The ratio of GSH/GSSG in liver of T group was lower than that of normal group, but those of TG group was a similar tendency to that of normal group. Contents of thiobarbituric acid reactive substance(TBARS) in T group was increased to 52%, compared with that of normal group but those of TG group were recovered the normal level. Contents of hepatic glycogen in T group were decreased to 23% compared with those of normal group, while that of TG group was the same as normal levels. The contents of serum lactic acid in T group were increased to 261%, compared with normal group, but those of TG group maintained the normal level by green tea supplementations. In conclusion, the effects of green tea in exercise training rats would appear to reduce peroxidation of tissue as an antioxidative defense mechanism and promote recovery of muscle fatigue.

Allogeneic Hematopoietic Stem Cell Transplantation in Juvenile Myelomonocytic Leukemia (연소형 골수단구성 백혈병에서의 동종 조혈 모세포 이식)

  • Yoo, Keon Hee;You, Dong Kil;Lee, Soo Hyun;Sung, Ki Woong;Cho, Eun Joo;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.178-185
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    • 2005
  • Purpose : The purpose of this study was to evaluate the outcome of children with juvenile myelomonocytic leukemia(JMML) treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods : Eleven JMML patients aged 8-39 months underwent allo-HSCT. The sources of grafts were unrelated donors(n=7), HLA-matched siblings(n=3) and an HLA 1-antigen mismatched familial donor. All patients had received chemotherapy ${\pm}13$-cis-retinoic acid(CRA) before transplant, and CRA was used, posttransplant, in six patients. Results : Only three patients were in complete remission(CR) at the time of transplantation. Initial chimeric status revealed complete donor chimerism(CC) in five patients, mixed chimerism(MC) in five and autologous recovery(AR) in one. One patient with MC having persistent splenomegaly eventually turned to CC and CR after rapid tapering of cyclosporine, combined with daily use of CRA. An AR case relapsed shortly after transplant but was rescued with second, unrelated cord blood transplantation. Ultimately, six patients are alive, event-free, with a median follow-up of 15.5 months posttransplant. All three deaths occurred in patients who failed to achieve CC, leading to disease progression. Conclusion : We suggest that graft-versus-leukemia effect play an important role and CRA a possible role in posttransplant leukemic involution in JMML. In patients whose leukemic burden is still high with MC after transplant, early tapering of immunosuppressants and introduction of CRA might provide a chance of a cure for some patients.

The Development of Differentiating Method between Fresh and Frozen Beef by Using the Mitochondrial Malate Dehydrogenase Activity (Mitochondrial Malate Dehydrogenase 활성을 이용한 냉장우육과 냉동우육의 판별법 개발)

  • Han, Kyu-Ho;Kim, Nam-Kyu;Lee, Si-Kyung;Cho, Jin-Kook;Choi, Kang-Duk;Jeons, You-Jin;Lee, Chi-Ho
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.10
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    • pp.1599-1605
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    • 2005
  • The object of this study is to develop the method for differentiating fresh meat from frozen meat by using the measurement of the mitochondrial malate dehydrogenase in the Korean native cattle. The principle of this experiment is based on the fact that the enzyme proteins associated with mitochondrial membrane could be released by freezing. The methods of differentiating fresh meat from thawed, frozen meat were studied by measurements of mitochondrial malate dehydrogenase activity of meat press juice. Fresh and frozen beef were stored at 4, -4, -18 and -77$^{\circ}C$ for 15-day storage period. A meat press machine using air pressure was manufactured especially for these experiments, and sufficient amount of drip (about 0.15 mL/g) from 1.5 g of beef sample was efficiently obtained under a pressure of 8 kg/$cm^{2}$ generated by the meat pressing machine. The mitochondrial malate dehydrogenase activities of frozen meat drip i년ices stored at -18 and -77$^{\circ}C$ were significantly higher than those of fresh and frozen meat samples at -4$^{\circ}C$ (p < 0.05) during 10-min reaction period. However, the enzyme activities of the frozen meat drip juices (-18 and -77$^{\circ}C$) disappeared after 5 minutes of the reaction, which was not observed from the fresh and -4$^{\circ}C$ frozen meats. The enzyme activity maintained until 12 minutes for the fresh and -4$^{\circ}C$ frozen meats. From these results, the mitochondrial malate dehydrogenase could be considered as an indicator to differentiate fresh beef from frozen one.

Role of Redistribution and 24 Hour Reinjection Images to assess Myocardial Viability in Patients with Acute Myocardial Infarction (급성심근경색환자의 심근생존능 평가에 있어서 T1-201 재분포영상과 24시간 재주사영상의 역할)

  • Yoon, Seok-Nam;Pai, Moon-Sun;Park, Chan-H.;Yoo Myung-Ho;Choi, Byung-Il William
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.325-331
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    • 1998
  • Purpose: We evaluated the importance of redistribution and 24 hour reinjection images in T1-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection T1-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or 1 (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assessment in stress-redistribution and stress-reinjection images. Results: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. Conclusion: The 24 hour reinjection imaging is useful in the assessment of myocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.

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