• Title/Summary/Keyword: Ruptured

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Role of Multislice Computerized Tomographic Angiography after Clip Placement in Aneurysm Patients Based on Comparison with Three Dimensional Digital Subtraction Angiography

  • Han, Myung-Hwan;Kim, Young-Don
    • Journal of Korean Neurosurgical Society
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    • v.42 no.2
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    • pp.103-111
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    • 2007
  • Objective : We evaluated the accuracy of multislice computerized tomographic angiography (MCTA) in the postoperative evaluation of clipped aneurysms by comparising it with three dimensional digital subtraction angiography (3D-DSA). Methods : Between May 2004 and September 2006, we included patients with ruptured cerebral aneurysm of the anterior circulation that was surgically clipped and evaluated by both postoperative MCTA and postoperative 3D-DSA. We measured the diagnostic performance and calculated the sensitivity and specificity of postoperative MCTA compared to 3D-DSA in the detection of aneurysm remnants. Results : A total of 11 neck remnants among the 92 clipped aneurysms (11.9%) were confirmed by 3D-DSA. According to Sindou's classification of aneurysm remnants, 8.7% of clipped aneurysms (8/92) had only neck remnant on 3D-DSA and 3.2% (3/92 aneurysms) had residuum of the neck and sac on 3D-DSA. There were 12 (13.04%) equivocal cases that were difficult to interpret based on the postoperative MCTA. The reasons for the equivocal cases included multiple clips (6 cases, 50.0%). beam-hardening effect (4 cases, 33.3%), motion artifact (1 case, 8.3%), fenestrated clip (1 case, 8.3%) and other combined causes. The sensitivity and specificity of the postoperative MCTA was 81.8% and 88.9%, respectively by ROC curve (p=0.000). Conclusion : MCTA is an accurate noninvasive imaging method used for the assessment of clipped aneurysms in the anterior circulation. If the image quality of postoperative MCTA is good quality and the patient has been treated with a single titanium clip, except a fenestrated clip, the absence of an aneurysm remnant can be diagnosed by MCTA alone and the need for postoperative DSA can be reduced in a large percentage of cases.

Clinical and Radiogical Outcomes of Endovascular Detachable Coil Embolization in Paraclinoid Aneurysms : A 10-Year Experience

  • Jin, Sung-Chul;Kwon, Do-Hoon;Ahn, Jae-Sung;Kwun, Byung-Duk;Song, Young;Choi, Choong-Gon
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.5-10
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    • 2009
  • Objective : Direct surgical clipping of paraclinoid aneurysms poses technical challenges to even very experienced neurosurgeons, making endovascular treatment an alternative treatment modality in many centers. We have therefore retrospectively evaluated the safety and efficacy of endovascular detachable coil embolization of paraclinoid aneurysms. Methods : From June 1997 to June 2007, 65 patients underwent endovascular detachable coiling for 67 paraclinoid aneurysms (of which 9 were ruptured and 58 were unruptured) in our institute. Their medical records, radiological images and readings, and operation records were reviewed retrospectively. Results : After the initial embolization procedure, complete occlusion was achieved in 29 (43.3%) of the aneurysms treated by endovascular detachable coiling. Six aneurysms required retreatment, with two each requiring one, two, or three additional endovascular procedures. Fifty-five (82.1%) aneurysms were measured by three-dimensional time of flight (TOF) magnetic resonance images (MRI) or transfemoral cerebral angiography (TFCA) at a mean follow-up of 29.7 months (range from 4 to 94 months), with 39 aneurysms (70.9%) showing complete occlusion. Thromboembolic events (3.8%) were the most frequent complication. Rupture did not occur during or after any of the procedures. According to the Glasgow Outcome Scale (GOS), 98.4% of the patients treated by coil embolization had a score of 4 or 5. Conclusion : Our results indicate that endovascular detachable coiling is a safe and effective treatment modality in paraclinoid aneurysms.

Characteristics and Management of Residual or Slowly Recurred Intracranial Aneurysms

  • Ihm, Eun-Hyun;Hong, Chang-Ki;Shim, Yu-Shik;Jung, Jin-Young;Joo, Jin-Yang;Park, Seoung-Woo
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.330-334
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    • 2010
  • Objective : Residual aneurysm from incomplete clipping or slowly recurrent aneurysm is associated with high risk of subarachnoid hemorrhage. We describe complete treatment of the lesions by surgical clipping or endovascular treatment. Methods : We analyzed 11 patients of residual or recurrent aneurysms who had undergone surgical clipping from 1998 to 2009. Among them, 5 cases were initially clipped at our hospital. The others were referred from other hospitals after clipping. The radiologic and medical records were retrospectively analyzed. Results : All patients presented with subarachnoid hemorrhage at first time, and the most frequent location of the ruptured residual or recurrent aneurysm was in the anterior communicating artery to posterior-superior direction. Distal anterior cerebral artery, posterior communicating artery, and middle cerebral artery was followed. Repositioning of clipping in eleven cases, and one endovascular treatment were performed. No residual aneurysm was found in postoperative angiography, and no complication was noted in related to the operations. Conclusion : These results indicate the importance of postoperative or follow up angiography and that reoperation of residual or slowly recurrent aneurysm should be tried if such lesions being found. Precise evaluation and appropriate planning including endovascular treatment should be performed for complete obliteration of the residual or recurrent aneurysm.

A Study on the Effective Stress of RC Beams in Applying the Adhesion Reinforced and the External Post-Tensioning Method (RC보의 부착보강공법과 외부강선보강공법의 유효응력에 관한 연구)

  • Park, Yong-Gul;Choi, Jung-Youl;Choi, Jun-Hyeok
    • Journal of the Korean Society for Railway
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    • v.10 no.2 s.39
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    • pp.186-194
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    • 2007
  • This study was performed to compare the load-carrying capacities of the reinforced concrete structure between the carbon fiber adhesion reinforcement method and the external post-tensioning method and further estimate the effective stress of the reinforced material by analyzing the experimental reinforcing effect of each method and the behavior resulting from each method. As a result, it was found out that the effective stress of the carbon fiber reinforcement according to the carbon fiber adhesion reinforcement method had an unexpected value, and also, bearing of the stress was found to be far from sharing thereof. That is to say, while the carbon fiber was bearing the whole stress to some limits, it got to be momentarily ruptured as soon as it went beyond such limits. On the other hand, the external post-tensioning method has the advantage of inducing an initial effective stress by introducing a strain, and thus, it was found that behavior or bearing of the stress was also found to be a solid behavior of the steel wire. This method was also found to be more efficient and excellent than the carbon fiber adhesion reinforcement method in the reinforcing effect or securing the effective stress. Accordingly, we were to discuss the effective stress as comparatively examined, focusing on deriving of the more enhanced reinforcing effect on the basis of the experiment to which the field characteristic is added.

A Stability Analysis for Vehicle Impact in U-Channel Segmental Concrete Bridges (U-채널 세그멘탈 콘크리트 교량의 차량충돌에 대한 안전성 분석)

  • Choi, Dong-Ho;Na, Ho-Sung
    • Journal of the Korean Society of Hazard Mitigation
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    • v.10 no.6
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    • pp.17-25
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    • 2010
  • This paper studied on stability of the U-channel segmental concrete bridge under vehicle-impact loads. The U-channel bridge has advantages in that it reduces an additional dead load and the edge beams role as a barrier. But it has a dangerous factor which collapses the bridge structure when the edge beams are ruptured. Therefore, it is necessary to verify behaviors of the bridge system under vehicle-impact loads. Static and dynamic vehicle impact simulations were carried out on the basis of AASHTO LRFD design specifications. In case of the static analysis, equivalent static loads specified in the AASHTO codes are loaded on the edge beams and in case of the dynamic analysis, FEM vehicle models are modeled by applying the dynamic test specifications of AASHTO codes. As a result, it is shown that U-channel bridge system has sufficient safety against static and dynamic impact loads specified in the AASHTO LRFD design specifications.

Natural History of Unruptured Intracranial Aneurysms : A Retrospective Single Center Analysis

  • Byoun, Hyoung Soo;Huh, Won;Oh, Chang Wan;Bang, Jae Seung;Hwang, Gyojun;Kwon, O-Ki
    • Journal of Korean Neurosurgical Society
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    • v.59 no.1
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    • pp.11-16
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    • 2016
  • Objective : We conducted a retrospective cohort study to elucidate the natural course of unruptured intracranial aneurysms (UIAs) at a single institution. Methods : Data from patients diagnosed with UIA from March 2000 to May 2008 at our hospital were subjected to a retrospective analysis. The cumulative and annual aneurysm rupture rates were calculated. Additionally, risk factors associated with aneurysmal rupture were identified. Results : A total of 1339 aneurysms in 1006 patients met the inclusion criteria. During the follow-up period, 685 aneurysms were treated before rupture via either an open surgical or endovascular procedure. Six hundred fifty-four UIAs were identified and not repaired during the follow-up period. The mean UIA size was $4.5{\pm}3.2mm$, and 86.5% of the total UIAs had a largest dimension <7 mm. Among these UIAs, 18 ruptured at a median of 1.6 years (range : 27 days to 9.8 years) after day 0. The annual rupture risk during a 9-year follow-up was 1.00%. A multivariate Cox proportional hazards analysis revealed that the aneurysm size and a history of subarachnoid hemorrhage (SAH) were statistically significant risk factors for rupture. For an aneurysms smaller than 7 mm in the absence of a history of SAH, the annual rupture risk was 0.79%. Conclusion : In our study, the annual rupture risk for UIAs smaller than 7 mm in the absence of a history of SAH was higher than that of Western populations but similar to that of the Japanese population.

Effect of critical flow model in MARS-KS code on uncertainty quantification of large break Loss of coolant accident (LBLOCA)

  • Lee, Ilsuk;Oh, Deogyeon;Bang, Youngseog;Kim, Yongchan
    • Nuclear Engineering and Technology
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    • v.52 no.4
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    • pp.755-763
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    • 2020
  • The critical flow phenomenon has been studied because of its significant effect for design basis accidents in nuclear power plants. Transition points from thermal non-equilibrium to equilibrium are different according to the geometric effect on the critical flow. This study evaluates the uncertainty parameters of the critical flow model for analysis of DBA (Design Basis Accident) with the MARS-KS (Multi-dimensional Analysis for Reactor Safety-KINS Standard) code used as an independent regulatory assessment. The uncertainty of the critical flow model is represented by three parameters including the thermal non-equilibrium factor, discharge coefficient, and length to diameter (L/D) ratio, and their ranges are determined using large-scale Marviken test data. The uncertainty range of the thermal non-equilibrium factor is updated by the MCDA (Model Calibration through Data Assimilation) method. The updated uncertainty range is confirmed using an LBLOCA (Large Break Loss of Coolant Accident) experiment in the LOFT (Loss of Fluid Test) facility. The uncertainty ranges are also used to calculate an LBLOCA of the APR (Advanced Power Reactor) 1400 NPP (Nuclear Power Plants), focusing on the effect of the PCT (Peak Cladding Temperature). The results reveal that break flow is strongly dependent on the degree of the thermal non-equilibrium state in a ruptured pipe with a small L/D ratio. Moreover, this study provides the method to handle the thermal non-equilibrium factor, discharge coefficient, and length to diameter (L/D) ratio in the system code.

Effect of the SBA-15 template and KOH activation method on CO2 adsorption by N-doped polypyrrole-based porous carbons

  • Yuan, Hui;Jin, Biao;Meng, Long-Yue
    • Carbon letters
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    • v.28
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    • pp.116-120
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    • 2018
  • Nitrogen-doped carbons have attracted much attention due to their novel application in relation to gas storage. In this study, nitrogen-doped porous carbons were synthesized using SBA-15 as a template, polypyrrole as the carbon and nitrogen precursor, and KOH as an activating agent. The effect of the activation temperature ($600-850^{\circ}C$) on the $CO_2$ adsorption capacity of the obtained porous carbons was studied. Characterization of the resulting carbons showed that they were micro-/meso-porous carbon materials with a well-developed pore structure that varied with the activation temperature. The highest surface area of $1488m^2g^{-1}$ was achieved at an activation temperature of $800^{\circ}C$ (AC-800). The nitrogen content of the activated carbon decreased from 4.74 to 1.39 wt% with an increase in the activation temperature from 600 to $850^{\circ}C$. This shows that nitrogen is oxidized and more easily removed than carbon during the activation process, which indicates that C-N bonds are more easily ruptured at higher temperatures. Furthermore, $CO_2$ adsorption isotherms showed that AC-800 exhibited the best $CO_2$ adsorption capacity of $110mg\;g^{-1}$ at 298 K and 1 bar.

Effects of Diluents and Cryoprotectants on Cryopreservation of Black Seabream (Acanthopagrus schligeli) Sperm (감성돔(Acanthopagrus schlegeli) 정자의 냉동보존에 미치는 희석액과 동해방지제의 영향)

  • 임한규;장영진
    • Journal of Aquaculture
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    • v.11 no.1
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    • pp.67-75
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    • 1998
  • Experiments were performed to obtain cryopreservation techniques of black seabream (Acanthopagrus schlegeli) sperm. For sperm collection, brood stock reared in recirculating seawater system and fed with the commercial feed during experimental period. The results indicated that following cryopreservation method in block seabream sperm could be employed. Post-thaw survival rate of sperm revealed the highest value ($80{\pm}1.4$%) in 3% sodium citrate as a diluent for the cryopreservation. Cryopreserved sperm diluted with 5.4% glucose showed the highest fertilization rate to the ovulated eggs. Glycerol was a better cryoprotectant than dimethyl sulfoxide in sperm cryopreservation : survival rate and fertilizing capacity of cryopreserved sperm were decreased according to increase of glycerol concentration and varied in renges of 0.8~59.3% and 32.5~69.4% with 5~30% glycerol, respectively. A few of cryopreserved spermatozoa showed the enlarged head with granulated chromatin and ruptured plasma membrane by freezing and thawing injuries compared with unfrozen normal spermatozoa.

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Effects of Diluents and Cryoprotectants on Sperm Cryopreservation in Starry Flounder (Platichthys stellatus) (강도다리(Platichthys stellatus) 정자의 냉동보존에 미치는 희석액과 동해방지제의 영향)

  • Lim, Han-Kyu;An, Cheul-Min;Noh, Gyong-Ane;Min, Byung-Hwa
    • Journal of Aquaculture
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    • v.20 no.3
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    • pp.173-177
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    • 2007
  • An experiment was performed to obtain cryopreservation techniques of starry flounder (Platichthys stellatus) sperm. Milt obtained from 24 males were cryopreserved using two diluents, artificial seminal plasma (ASP) and Stein's solution (SS) with three cryoprotectants, dimethyl sulfoxide (DMSO), methanol, and glycerol concentrated from 5% to 20%. Post-thaw sperm activity (motility and/or speed) revealed the highest in 10% DMSO and 15% methanol in ASP and SS as diluent. Motility and speed of cryopreserved sperm were decreased according to increase of glycerol concentration. To conclude, DMSO was a better cryoprotectant than methanol or glycerol for cryopreservation of starry flounder sperm. Glycerol was incongruent cryoprotectant because of toxic to starry flounder sperm. Most cryopreserved spermatozoa without cryoprotectant showed the enlarged head with granulated chromatin and ruptured plasma membrane by freezing and thawing injuries compared with unfrozen normal spermatozoa.