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Diagnosis of Unruptured Intracranial Aneurysms Using Proton-Density Magnetic Resonance Angiography: A Comparison With High-Resolution Time-of-Flight Magnetic Resonance Angiography

  • Pae Sun Suh;Seung Chai Jung;Hye Hyeon Moon;Yun Hwa Roh;Yunsun Song;Minjae Kim;Jungbok Lee;Keum Mi Choi
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.575-588
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    • 2024
  • Objective: Differentiating intracranial aneurysms from normal variants using CT angiography (CTA) or MR angiography (MRA) poses significant challenges. This study aimed to evaluate the efficacy of proton-density MRA (PD-MRA) compared to high-resolution time-of-flight MRA (HR-MRA) in diagnosing aneurysms among patients with indeterminate findings on conventional CTA or MRA. Materials and Methods: In this retrospective analysis, we included patients who underwent both PD-MRA and HR-MRA from August 2020 to July 2022 to assess lesions deemed indeterminate on prior conventional CTA or MRA examinations. Three experienced neuroradiologists independently reviewed the lesions using HR-MRA and PD-MRA with reconstructed voxel sizes of 0.253 mm3 or 0.23 mm3, respectively. A neurointerventionist established the gold standard with digital subtraction angiography. We compared the performance of HR-MRA, PD-MRA (0.253-mm3 voxel), and PD-MRA (0.23-mm3 voxel) in diagnosing aneurysms, both per lesion and per patient. The Fleiss kappa statistic was used to calculate inter-reader agreement. Results: The study involved 109 patients (average age 57.4 ± 11.0 years; male:female ratio, 11:98) with 141 indeterminate lesions. Of these, 78 lesions (55.3%) in 69 patients were confirmed as aneurysms by the reference standard. PD-MRA (0.253-mm3 voxel) exhibited significantly higher per-lesion diagnostic performance compared to HR-MRA across all three readers: sensitivity ranged from 87.2%-91.0% versus 66.7%-70.5%; specificity from 93.7%-96.8% versus 58.7%-68.3%; and accuracy from 90.8%-92.9% versus 63.8%-69.5% (P ≤ 0.003). Furthermore, PD-MRA (0.253-mm3 voxel) demonstrated significantly superior per-patient specificity and accuracy compared to HR-MRA across all evaluators (P ≤ 0.013). The diagnostic accuracy of PD-MRA (0.23-mm3 voxel) surpassed that of HR-MRA and was comparable to PD-MRA (0.253-mm3 voxel). The kappa values for inter-reader agreements were significantly higher in PD-MRA (0.820-0.938) than in HR-MRA (0.447-0.510). Conclusion: PD-MRA outperformed HR-MRA in diagnostic accuracy and demonstrated almost perfect inter-reader consistency in identifying intracranial aneurysms among patients with lesions initially indeterminate on CTA or MRA.

3-Dimensional Analysis of the Running Motion in the Max-Velocity Phase and the Fatigue Phase During 400m Sprint by Performed Elementary School Athletes (달리기시 최고 속도 및 피로 구간의 3차원 동작 분석)

  • Bae, Sung-Jee
    • Korean Journal of Applied Biomechanics
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    • v.16 no.4
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    • pp.115-124
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    • 2006
  • This study was conducted to investigate the running motion in the max-velocity phase(150-160m) and the fatigue phase(350-360m) during 400m sprint by performed elementary school athletes. Eighteen elementary school male athletes who achieved at least the 3rd place in the sprint at the Korea Gangwon-Do elementary school track and field meetings during 2004 and 2005 were selected as subjects. The running motions performed by the subjects were recorded using two 8mm high speed cameras at the nominal speed of 100 frames per second. The Direct Linear Transformation technique was adopted from the beginning of filming to the final stage of data extraction. KWON 3D motion analysis package program was used to compute the 3 Dimensional coordinates, smoothing factor in which lowpass filtering method was used and cutoff frequency was 6.0 Hz. The movement patterns during foot touchdown and takeoff for the running stride were related with the biomechanical consideration. Within the limitations of this study it is concluded: In order to increase running velocity, several conditions must be fullfilled at the instant of leg touchdown and takeoff during the fatigue phase(350-360m). First, the body C.O.G(Center of Gravity) height should be raised at the instant of leg touchdown and takeoff during the fatigue phase. Second, the foot contact time should be shortened and the takeoff distance should be increased at the foot takeoff during the fatigue phase. Third, the shank angular velocity with respect to a transverse axis through the center of gravity should be increased during the leg touchdown and takeoff in the fatigue phase. Forth, the active landing style described as clawing the ground with the sole of the foot should be performed during the leg touchdown and takeoff in the fatigue phase) phase. Fifth, In order to increase running velocity in the fatigue phase while taking a slightly greater leg knee angle and body lean angle within the range of the subject's running motion during the fatigue phase would result in greater flight distance.

Occurrence of and Damage by the Oriental Fruit Moth, Grapholita molesta (Busck) (Lepidoptera: Tortricidae) in Pear Orchards (배나무에서 복숭아순나방의 발생과 피해)

  • 양창열;한경식;부경생
    • Korean journal of applied entomology
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    • v.40 no.2
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    • pp.117-123
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    • 2001
  • The occurrence and damage by the oriental fruit moth, Grapholita molesta (Busck) were investigated on pear trees from 1996 to 2000 in the Naju, Korea. The number of overwintering larvae in pear trees considerably varied depending on the maturation time of varieties. The density of overwintering larvae on late cultivars such as Gamcheonbae and Okusankichi was high, but relatively low on early cultivars. Trunk and main branch of pear trees were main overwintering sites. In 1997, overwintering larvae began to pupate from middle February, and to emerge from late March. Male moths were caught in the sex pheromone traps from late March until early October with four peaks of flight in 1996~2000. In every generation larvae damaged both the shoots and fruits of pear tree, but the first and second generation larvae tended to damage mainly shoots, while most of the injured fruits were due to the third and fourth generation larvae. In pear fruits damaged by fruit moths, most of these were caused by oriental fruit moth larvae and none of pear fruits were damaged by peach fruit moth or pear fruit moth larvae in 1998~2000.

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Kinematical Analysis of Somersault with Twist in Men's Vault: Focusing on the Lou Yun and Akopian Motions

  • Lim, Kyu-Chan;Park, Hyung Suh
    • Korean Journal of Applied Biomechanics
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    • v.26 no.3
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    • pp.243-248
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    • 2016
  • Objective: The aim of this study was to determine the kinematical characteristics of somersault with twist in the Lou Yun and Akopian motions and to provide useful information to gymnastic athletes in men's vault. Method: The study subjects were 12 male adult top athletes. After 12 trials (7 Lou Yun and 5 Akopian trials) filmed by using two digital high-speed camcorders set at 90 frames/sec, kinematical data were collected through the direct linear transformation (DLT) method. The mean differences in biomechanical variables were compared during the second flight upward phase. The kinematic characteristics of somersault with twist in the Lou Yun and Akopian motions were identified. Results: In Lou Yun motion, the vertical release velocity through horse breaking was not difficult to obtain, so the athletes had enough time to prepare for the twist. Therefore, the Lou Yun motion has an advantage to make a cat twist in the pike posture. In the Akopian motion, obtaining the horizontal velocity through horse pushing was so easy that the Akopian athletes attained a large angular impulse and angular momentum. Therefore, the Akopian motion has an advantage to making a tilt twist in the body tilting posture. Conclusion: This study suggests that gymnastic athletes should control their body segment movements in order to increase the twisting angular velocity of the whole body, which requires regulation of the longitudinal moment of inertia of the body. Moreover, athletes should prepare for the shoulder and hip twists early in order to make the landing position in advance.

Rare Imaging of Fat Embolism Seen on Computed Tomography in the Common Iliac Vein after Polytrauma

  • Lee, Hojun;Moon, Jonghwan;Kwon, Junsik;Lee, John Cook-Jong
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.103-106
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    • 2018
  • Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of -86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.

Effect Verification of Wearable Assisting Wear for Increasing Golf Carry Distance (골프 비거리 증가를 위한 기능성 보조 웨어의 효과 검증)

  • Park, Yang-Sun;Woo, Byung-Hoon;Lim, Young-Tae
    • Korean Journal of Applied Biomechanics
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    • v.22 no.4
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    • pp.421-428
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    • 2012
  • The purpose of this study was to verify the effects of developed assisting wear which maximize trunk(back) muscle's stretch-shortening effect during backswing and downswing for increasing golf ball carrying distance. Design and fabrication of assistive wear were performed based on the results of analyzed data of trunk EMG activity from the golf drive swings of elite professional male golfers during back swing and downswing phases. After the prototype of wear was produced, surface EMG and Flight scope tests were conducted to verify the effectiveness of the wear for increasing distance to the professional golfers. Results indicated that wearing trial showed significant longer carry distance than the non-wearing trial(p<.001). The carry distance of wearing trial showed an average 229 m compared to the non-wearing trial, the average 225 m. The swing with wearing also produced significantly faster ball speed than the trial without wearing(p<.05). Average 245 Km/h and 244 Km/h were produced for the swing with and without wearing trails, respectively. EMG results also indicated that the muscle activity of left psoas was significantly increased for wearing trial during downswing and near the impact. Thus, this may affect positively to increase club head speed. The activity of the left latissimus dorsi was dramatically increased during the final stage of swing. This generates elongation effect for longer follow-through and increased impulse between club and ball so eventually valid assistance to increase carry distance. Therefore, the developed assisting wear was proved to be effective tool for increasing golf ball carry distance with maximizing trunk(back) muscle's stretch-shortening effect during backswing and downswing.

Comparison on the Kinematic Variables of Racket Movement According to Velocity in Tennis Serve (테니스 서브 속도에 따른 라켓 움직임의 운동학적 변인 비교)

  • Lee, Dong-Jin;Oh, Cheong-Hwan;Jeong, Ik-Su;Park, Chan-Ho;Lee, Gun-Hee
    • Korean Journal of Applied Biomechanics
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    • v.19 no.2
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    • pp.337-345
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    • 2009
  • The purpose of this study were to find out the differences in kinematic variables of racket movement by performing the tennis serve. Three top male tennis players participated in this study. Three synchronized high-speed cameras were used to record the service action of top players for Three dimensional video analysis. The results of this study showed that (1) the velocity of the tennis racket at impact is important to the generation of racket velocity to Y-axis. This result indicates that forward motion and upward movement of the racket; (2) with respect to racket angular velocity at impact, the fast angular momentum of X-axis is important to generate the velocity of the tennis ball. This result indicate upward movement of the racket with a strong flexor of wrist joint; (3) the velocity of the tennis ball was influenced by the change of angular linking the Z-axis to -X-axis. This result indicates that the high velocity of the tennis ball is obtained from having the racket unitedly moving to the direction of the bill's flight at the acceleration interval and acquiring the distance of acceleration with the racket head vertically to the ground at the back scratching.

Chemical Synthesis and Orientation Disruption Bioassay of Sex Pheromone of the Oriental Fruit Moth, Grapholita molests (Busck) (복숭아순나방(Grapholita molests) 성페로몬 합성과 유인력 교란생물검정)

  • Kim, Yong-Gyun;Bae, Sung-Woo;Bae, Soo-Il;Yoon, Hyang-Mi;Hong, Yong-Pyo
    • Korean journal of applied entomology
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    • v.45 no.3 s.144
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    • pp.309-316
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    • 2006
  • Three sex pheromone components (cis-8-dodecenyl acetate (Z12Ac), trans-8-dodecenyl acetate (E12Ac), cis-8-dodecenol (Z12OH)) of the Oriental fruit moth, Grapholita molesta, were chemically synthesized. Especially to increase the composition of cis-stereoisomer, a triple bond intermediate was hydrogenated at $-20^{\circ}C$ with catalytic $Pd/BaSO_{4}$. The resulting product consisted of the acetates with a stereoisomer ratio in 92:8 (Z:E). The biological activity of the synthesized pheromone compounds was analyzed both in male responses and orientation disruption. The indoor pheromone effect was determined by male flight behavior showing wing movement in response to lure. Different mixtures of the synthetic pheromone components were prepared by mixing acetate and alcohol components in 100:0, 99:1, and 90:10 (g/g) and tested with a comparison of a standard commercial pheromone lure. The highest pheromone effect was observed in only acetate mixture (100:0) and the effect was reduced with the addition of the alcohol component. This indoor pheromone effect could be observed in field monitoring trial, in which 100:0 mixture showed the highest trap catches. Orientation disruption assay was conducted indoor by using a cage, in which the center had a commercial lure on sticky plate and the four candidates were placed at 6 cm away from the central lure on each of four directions. Test males were released to the arena during overnight (12 h) and then the caught males on the sticky plate were counted. The synthesized pheromone as well as the commercial pheromone showed 100% orientation disruption. However, the orientation disruption effect was reduced with decrease in the number of the surrounding disrupting pheromone baits. These results clearly suggest that the synthesized sex pheromone of G. molesta is biologically active and can be used for field mating disruption.

Study on the Patterns of Helicopter Emergency Medical Services in Ullung Island (울릉도 지역의 헬리콥터를 이용한 응급환자 후송 실태)

  • Kim, Tae-Hun;Lim, Hyun-Sul;Lee, Kwan
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.115-123
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    • 2002
  • Objective: The aim of this study was to evaluate the patterns of helicopter emergency medical services (HEMS) in Ullung Island. Methods : The authors reviewed the records from emergency room diaries and the lists of helicopter transfers in the Ullung Public Health Medical Center over the 5-year period from Jan 1, 1997 to Dec 31, 2001. Results : One hundred thirteen cases were transferred by helicopters in 88 flights. According to year, the number of flights was 13(14.8%) and the number of cases was 15(13.3%) in 1997; 17(19.3%) and 21(18.6%) in 1998; 18(20.5%) and 20(17.7%) in 1999; 17(19.3%) and 20(17.7%) in 2000; and 23(26.1%) and 37(32.7%) in 2001. According to the kind of helicopter, the number of flights was 46(52.3%) and the number of cases was 60(53.1%) by Maritime police; and 19(21.6%) and 28(25.1%) by 119 rescue. According to time zone, there were no night flights. According to sex and age, there were 75 male cases(66.4%) and 28 cases(28.3%) of patients aged sixty years and over. The number of flights was 11(12.5%) and the number of cases was 15(13.3%) in November; 10 flights(11.4%) and 14 cases(12.4%) in March; and 7 cases(8.0%) in each of September, October and April. The most common season of helicopter transfer cases was autumn. According to transfer area, there were 48 cases (42.5%) in Pohang city, Gyeonsangbukdo; 35(31.0%) in Gangnung city, Gangwondo; and 17(15.0%) in Daegu metropolitan city. According to condition, there were 27 cases(23.9%) of cerebro-vascular accident, 13(11.5%) of fracture and 11(9.7%) of head injury. According to admission department, there were 42 cases(37.2%) in Neurosurgery, 21(18.6%) in Internal Medicine and 13(11.5%) in Orthopedic Surgery. According tothe Korea Standard Classification of Disease(3-KSCD), circulatory systemic disease(IX) and injury, intoxication and others (XIX) were the two most frequent categories with 34 cases(30.1%) each, followed by digestive system disease (XI) with 23 cases(20.4%). Conclusions : HEMS in Ullung Island leave much to be desired. Helicopters cannot make a night flight and are not equipped with medical facilities. HEMS in islands such as Ullung Island are essential. We hope that night flights, equipment-monitoring systems for emergency patients in the helicopters, and a law related to HEMS in the island will all be established.

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