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Safety and Efficacy of Hypothermia (34℃) after Hemicraniectomy for Malignant MCA Infarction

  • Park, Hyun-Seok;Choi, Jae-Hyung
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.267-276
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    • 2018
  • Objective : The beneficial effect of hypothermia after hemicraniectomy in malignant middle cerebral artery (MCA) infarction has been controversial. We aim to investigate the safety and clinical efficacy of hypothermia after hemicraniectomy in malignant MCA infarction. Methods : From October 2012 to February 2016, 20 patients underwent hypothermia (Blanketrol III, Cincinnati Sub-Zero, Cincinnati, OH, USA) at $34^{\circ}C$ after hemicraniectomy in malignant MCA infarction (hypothermia group). The indication of hypothermia included acute cerebral infarction >2/3 of MCA territory and a Glasgow coma scale (GCS) score <11 with a midline shift >10 mm or transtentorial herniation sign (a fixed and dilated pupil). We retrospectively collected 27 patients, as the control group, who had undergone hemicraniectomy alone and simultaneously met the inclusion criteria of hypothermia between January 2010 and September 2012, before hypothermia was implemented as a treatment strategy in Dong-A University Hospital. We compared the mortality rate between the two groups and investigated hypothermia-related complications, such as postoperative bleeding, pneumonia, sepsis and arrhythmia. Results : The age, preoperative infarct volume, GCS score, National institutes of Health Stroke Scale score, and degree of midline shift were not significantly different between the two groups. Of the 20 patients in the hypothermia group, 11 patients were induced with hypothermia immediately after hemicraniectomy and hypothermia was initiated in 9 patients after the decision of hypothermia during postoperative care. The duration of hypothermia was $4{\pm}2days$ (range, 1 to 7 days). The side effects of hypothermia included two patients with arrhythmia, one with sepsis, one with pneumonia, and one with hypotension. Three cases of hypothermia were discontinued due to these side effects (one sepsis, one hypotension, and one bradycardia). The mortality rate of the hypothermia group was 15.0% and that of the control group was 40.7% (p=0.056). On the basis of the logistic regression analysis, hypothermia was considered to contribute to the decrease in mortality rate (odds ratio, 6.21; 95% confidence interval, 1.04 to 37.05; p=0.045). Conclusion : This study suggests that hypothermia after hemicraniectomy is a viable option when the progression of patients with malignant MCA infarction indicate poor prognosis.

Detection of Abnormal Area of Ground in Urban Area by Rectification of Ground Penetrating Radar Signal (지하투과레이더 신호의 보정을 통한 도심지 내 지반 이상구간의 검측)

  • Kang, Seonghun;Lee, Jong-Sub;Lee, Sung Jin;Lee, Jin Wook;Hong, Won-Taek
    • The Journal of Engineering Geology
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    • v.27 no.3
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    • pp.217-231
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    • 2017
  • The subsidence of ground in urban area can be caused by the occurrence of the cavity and the change in ground volumetric water content. The objective of this study is the detection of abnormal area of ground in urban area where the cavity or the change in ground volumetric water content is occurred by the ground penetrating radar signal. GPR survey is carried out on the test bed with a circular buried object. From the GPR survey, the signals filtered by the bandpass filtering are measured, and the methods consisting of gain function, time zero, background removal, deconvolution and display gain are applied to the filtered signals. As a result of application of the signal processing methods, the polarity of signal corresponds with the relation of electrical impedance of the cavity and the ground in test bed. In addition, the relative permittivity calculated by GPR signal is compared with that of predicted by volumetric water content of the test bed. The relative permittivities obtained from two different methods show similar values. Therefore, the abnormal area where the change in ground volumetric water content is occurred can be detected from the results of the GPR survey in case the depth of underground utilities is known. Signal processing methods and estimation of relative permittivity performed in this study may be effectively used to detect the abnormal area of ground in urban area.

Implication of the Ratio of Exchangeable Cations in Mountain Wetlands (산지습지 치환성 양이온 함량비의 특성과 함의)

  • Shin, Young Ho;Kim, Sung Hwan;Rhew, Hosahang
    • Journal of the Korean Geographical Society
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    • v.49 no.2
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    • pp.221-244
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    • 2014
  • We suggested several implications by examining geochemical properties of sediments in Simjeok, Jangdo, and Hwaeomneup mountain wetlands which are natural preservation areas. Geochemical properties of wetland sediments show that all wetlands were included in the type of fens, but their distribution patterns were different from one another. We classified three sub-groups of sediments using the two step cluster analysis on the ratio of exchangeable cations. Wetland sediments can be grouped into Ca-dominated, Mg-dominated, and K-dominated types. Simjeok wetland have Ca-dominated sediments, while the sediments of Jangdo wetland indicate the Mg-dominated and Ca-dominated characteristics. Hwaeomneup wetland is composed of K-dominated sediment mainly. Different properties in the ratio are affected by various environmental factors such as geological, pedological, and vegetational settings. Because these geochemical properties will be affected by climate change and human impacts, these will be environmental indicator in mountain wetlands and be used in wetland management. This scheme can be used for classification of mountain wetlands. Therefore, we should work on geochemical properties of wetland sediments and classification schemes based on geochemical properties not only to widen understanding in geomorphic system or ecosystem of mountain wetlands but to conserve mountain wetlands properly.

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First Report for Appearance and Distribution Patterns of the Epiphytic Dinoflagellates in the Korean Peninsula (우리나라 전국연안해역에서 저서 와편모조류의 출현 및 분포현황에 대한 첫 보고)

  • Baek, Seung Ho
    • Korean Journal of Environmental Biology
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    • v.30 no.4
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    • pp.355-361
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    • 2012
  • Genus of Gambierdiscus, Ostrepsis, Prorocentrum, Coolia and Amphidinium are epiphytic ciguatoxin-producing armored dinoflagellate, often attached on macroalgae. These organisms are the primary causative agent of ciguatera fish poisoning which occurs in tropical and subtropical regions. However, regardless of the fact that population of epiphytic dinoflagellates have expanded to such temperate areas from sub-trophic and trophic areas, monitoring of the epiphytic dinoflagellates was greatly lacked in coastal water of Korean Peninsula. This study was performed in the Korean Peninsula in November, 2011. Cell densities of Gambierdiscus spp. on macroalgae ranged from zero to 10 cells $g^{-1}$ and the maximum density was recorded at St.18 (Pohang guryongpo). The abundance of Ostreopsis spp. was highest on macro-algaes Chondrus ocellatus, Lomentaria catenata and Plocamium telfairiae (140 cells $g^{-1}$). The maximum abundance of Prorocentrum, Coolia and Amphidinium were 52, 3 and 1 cells $g^{-1}$, respectively. Of these, Prorocentrum lima was observed at most stations of East Sea. Therefore, our results suggest that the epiphytic armored dinoflagellates may have adapted to Korean coastal water of temperate areas (i.e., East Sea) and those abundances may be related to the macroalgal species.

Fundamental Properties of Magnesia-Prosphate Composite Considering Mix Conditions and Curing Temperature (배합조건 및 양생온도에 따른 마그네시아 인산염 복합체의 기초물성 평가)

  • Cho, Hyun Woo;Kang, Su Tae;Shin, Hyun Seop;Lee, Jang Hwa
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.16 no.6
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    • pp.163-170
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    • 2012
  • With the advantage of a rapid exothermic reaction property, jet set concrete may be used as a cold weather concrete because it can reach the required strength before being damaged by cold weathers. And it can be hardened more quickly if the field temperature is properly compensated by heating. Because ordinary concrete cannot be hardened well under sub-zero temperatures, anti-freeze agents are typically added to prevent the frost damage and to ensure the proper hardening of concrete. While the addition of a large amount of anti-freeze agent is effective to prevent concrete from freezing and accelerates cement hydration resulting in shortening the setting time and enhancing the initial strength, it induces problems in long-term strength growth. Also, it is not economically feasible because most anti-freeze agents are mainly composed of chlorides. Recent studies reported that magnesia-phosphate composites can be hardened very quickly and hydrated even in low temperatures, which can be used as an alternative of cold weather concrete for cold weathers and very cold places. As a preliminary study, to obtain the material properties, mortar specimens with different mixture proportions of magnesia-phosphate composites were manufactured and series of experiments were conducted varying the curing temperature. From the experimental results, an appropriate mixture design for cold weathers and very cold places is suggested.

Real Time Environmental Classification Algorithm Using Neural Network for Hearing Aids (인공 신경망을 이용한 보청기용 실시간 환경분류 알고리즘)

  • Seo, Sangwan;Yook, Sunhyun;Nam, Kyoung Won;Han, Jonghee;Kwon, See Youn;Hong, Sung Hwa;Kim, Dongwook;Lee, Sangmin;Jang, Dong Pyo;Kim, In Young
    • Journal of Biomedical Engineering Research
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    • v.34 no.1
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    • pp.8-13
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    • 2013
  • Persons with sensorineural hearing impairment have troubles in hearing at noisy environments because of their deteriorated hearing levels and low-spectral resolution of the auditory system and therefore, they use hearing aids to compensate weakened hearing abilities. Various algorithms for hearing loss compensation and environmental noise reduction have been implemented in the hearing aid; however, the performance of these algorithms vary in accordance with external sound situations and therefore, it is important to tune the operation of the hearing aid appropriately in accordance with a wide variety of sound situations. In this study, a sound classification algorithm that can be applied to the hearing aid was suggested. The proposed algorithm can classify the different types of speech situations into four categories: 1) speech-only, 2) noise-only, 3) speech-in-noise, and 4) music-only. The proposed classification algorithm consists of two sub-parts: a feature extractor and a speech situation classifier. The former extracts seven characteristic features - short time energy and zero crossing rate in the time domain; spectral centroid, spectral flux and spectral roll-off in the frequency domain; mel frequency cepstral coefficients and power values of mel bands - from the recent input signals of two microphones, and the latter classifies the current speech situation. The experimental results showed that the proposed algorithm could classify the kinds of speech situations with an accuracy of over 94.4%. Based on these results, we believe that the proposed algorithm can be applied to the hearing aid to improve speech intelligibility in noisy environments.

Application of Deconvolution Methods to Improve Seismic Resolution and Recognition of Sedimentary Facies Containing Gas Hydrates (동해 가스하이드레이트 퇴적상 해석 및 분해능 향상을 위한 디컨볼루션 연구)

  • Yi, Bo-Yeon;Lee, Gwang-Hoon;Kim, Han-Joon;Jeong, Gap-Sik;Yoo, Dong-Geun;Ryu, Byoung-Jae;Kang, Nyeon-Keon
    • Geophysics and Geophysical Exploration
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    • v.13 no.4
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    • pp.323-329
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    • 2010
  • Three deconvolution methods were applied to stacked seismic data obtained to investigate gas-hydrates in the Ulleung Basin, East Sea: (1) minimum-phase spiking deconvolution, (2) minimum-phase spiking deconvolution using an averaged wavelet from all traces, and (3) deterministic deconvolution using a wavelet with phases computed from well-logs. We analyzed the resolving property of these methods for lithological boundaries. The first deconvolution method increases temporal resolution but decreases lateral continuity. The second method shows, in an overall sense, similar results to the spiking deconvolution using a minimum phase wavelet for each trace; however, it results in a more consistent and continuous bottom-simulating reflector (BSR) and better resolved sub-BSR reflectors. The results from the third method reveal more detailed internal structures of debris-flow deposits and increased continuity of reflectors; in addition, the seafloor reflection and the BSR appear to have changed to a zero-phase waveform. These properties help more precisely estimate the distribution and reserves of gas hydrates in the exploration area by improving analysis of facies and amplitude of the BSR.

Estimation of Allowable Drop Height for Oriental Pears by Impact Tests (충격시험에 따른 배의 허용낙하높이 추정)

  • Kim, M. S.;Jung, H. M.;Seo, R.;Park, I. K.;Hwang, Y. S.
    • Journal of Biosystems Engineering
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    • v.26 no.5
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    • pp.461-468
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    • 2001
  • Impact between fruits and other materials is a major cause of product damage in harvesting and handling systems. The oriental pears are more susceptible to bruising than other fruits such as European pears and apples, and are required more careful handling. The interest in the handling of the pears for the processing systems has raised the question of the allowable drop height to which pears can be dropped without causing objectionable damage. Drop tests on pears were conducted using an impact device developed by authors to estimate the allowable drop height without bruising. The impact device was constructed to hold in a selected orientation and to release a fruit by vacuum for dropping on to a force transducer. The drop height was adjustable for zero to 60 cm to achieve the desired distance between the bottom of the fruits and the top of the impact force transducer. The transducer was secured to 150 kg$\sub$f/ concrete block. The transducer signal was sampled every 0.17 ms with a strain gage measurement board in the micro computer where it was digitaly stored for later analysis. The selected sample fruit was Niitaka cultivar of pears which is one of the most promising fruit for export in Korea. The pears were harvested during the 1998 harvest season from an orchard in Daejeon. The sample fruit was selected from two groups which were stored for 3 months and 5 months respectively by the method of current commercial practice. The pears were allowed to stabilize at environmental condition(18$^{\circ}C$, 65% rh) of the experimental room. One hundred fifty six pears were tested from the heights of 5, 7.5. 10 and 12.5 cm while measurement were made of impact peak force, contact time, time to peak force, dwell time, pear diameter and mass. The bioyield strength and modulus of elasticity were measured using UTM immediately after each drop test. The allowable drop height was estimated on the base of bioyield strength of the pears in two ways. One was assumed the peak force during impact test increasing linearly with time, and the other was based on the actual drop test results. The computer program was developed for measuring the impact characteristics of the pears and analyzing the data obtained in the study. The peak force increased while contact times decreased with increasing drop height and contact times of the sample from the hard tissue group. The allowable drop height increased with increasing bioyield strength and contact times, and also varied with Poisson\`s ratio, mass and equilibrium radius of the pears. The allowable drop height calculated by a theoretical method was in the range from 1 to 4 cm, meanwhile, the estimated drop height considering the result of the impact test was in the range from 1 to 6 cm. Since the physical properties of fruits affected significantly the allowable drop height, the physical properties of the fruits should be considered when estimating the allowable drop height.

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The Second Demographic Transition in Industrialized Countries (산업국가에서의 제2차 인구변천)

  • Chung, Sung-Ho
    • Korea journal of population studies
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    • v.32 no.1
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    • pp.139-164
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    • 2009
  • The first demographic transition refers to the historical decline in mortality and fertility, as shown from the 18th Century in several European populations, and continuing present in most developing countries. The end point of the first demographic transition(FDT) was supposed to be a stationary and stable population corresponding with replacement fertility and zero population growth. In addition, households in all parts of the world would converge toward the nuclear and conjugal types, composed of married couples and their offspring. The second demographic transition(SDT), on the other hand, sees no such equilibrium as the end-point. Rather, new developments bring sub-replacement fertility, a multitude of living arrangements other than marriage, and the disconnection between marriage and procreation. Populations would face declining sizes if not complemented by new migrants. Over the last decades birth rates have been on the decline in all countries of the world, and it is estimated that already more than half of he world's population has below replacement level fertility. Measured in terms of the Total Fertility Rate (TFR), currently 34 countries have fertility levels of 1.5 or less. Similarly, Korea has been below lowest-low fertility for eight consecutive years since 2001 and below the replacement level for more than twenty years. In explaining the low fertility in Korea, some researchers explain the low fertility as revenge against a male-dominated society and institution, while others focus the impact of the employment instability. These studies share the basic ideas (spread of individualism, delayed marriage and childbearing, high divorce rate etc.) of a second demographic transition in order to explain the low fertility in Korea.

Rock-Surface Temperatures of Baeknokdam Northwest Face in the Summit Area of Mt. Halla (한라산 백록담 서북벽 암온의 향별 특성)

  • KIM, Taeho
    • Journal of The Geomorphological Association of Korea
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    • v.19 no.3
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    • pp.109-121
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    • 2012
  • Rock-surface temperatures were observed at a trachytic lava dome, called as Baeknokdam Northwest Face, in the summit area of Mt. Halla, Jeju Island, to examine the frequency and occurrence season of freeze-thaw cycles and the rate of temperature changes during a freezing period. Long-term measurements were recorded over 18 months from November 2006 to April 2008, at a 1-hour logging interval and rock depth of 1.5 cm. Both diurnal freeze-thaw cycles and effective freeze-thaw cycles appear in larger numbers on a south-facing rock face than a north-facing rock face. The diurnal cycles were dominantly observed on February and March for the south face and on November and April for the north face, respectively. The annual freeze-thaw cycles were confirmed in terms of the presence of seasonal freezing periods lasting from mid-November to mid-April for the south face and from early-November to late-April for the north face, respectively. The rate of decreasing temperatures during the seasonal freezing periods is larger on the north face than the south face. Notwithstanding the lower numbers of freeze-thaw events, the north face experiences a higher frost intensity since the number of hours below $-3^{\circ}C$ is larger on the north face than the south face. The number of freeze-thaw events and the duration of days with continuous sub-zero rock temperatures largely depend on the solar radiation controlled by the aspect of the monitored rock surfaces, and thus the high-frequency short-term frost cycle dominantly appears on the south face and the annual frost cycle on the north face, respectively.