Hwang, Sung-Kyun;Benitez, Ronald;Veznedaroglu, Erol;Rosenwasser, Robert H.
Journal of Korean Neurosurgical Society
/
v.38
no.2
/
pp.89-95
/
2005
Objective : The purpose of this study is to analyze aneurysm morphology and define limitations and feasibility in endovascular Gugliemi detachable coil[GDC] embolization for anterior communicating artery [ACoA] aneurysms. Methods : From January 2000 through October 2003, 123patients were treated with endovascular coil embolization for ACoA aneurysms. There were 75women and 48men, with a mean age of 63years. All ruptured aneurysms were treated within 15days of rupture. Aneurysm morphology was classified according to neck size and projection of aneurysm dome as follows-A : neck of aneurysm <4mm & anterior projection, B : neck of aneurysm [4mm & anterior projection, C : neck of aneurysm<4mm & posterior [superior] projection, D : neck of aneurysm [4mm & posterior [superior] projection, E : neck of aneurysm<4mm & inferior projection, and F : neck of aneurysm [4mm & inferior projection. Endovascular procedures were categorized as either "successful" or "unsuccessful". Clinical follow-up was estimated at discharge and at 6months, post treatment results were classified according to Glasgow Outcome Scale[GOS]. Results : Successful embolization for ACoA was performed in 86patients of 123patients [69.9%]. Complete or near complete aneurysm occlusion was observed in 102patients [82.9%]; a neck remnant was observed in 6patients [4.9%]; partial embolization was done in 3patients [2.4%]; and embolization was attempted in 12patients [9.8%]. Among 55patients with follow-up angiographic results, 18patients [32.7%] were defined as recanalization of the aneurysm sac. Morphological analysis demonstrated that anterior projecting aneurysms and morphological classifications [morphological classifications worsens [A - D] chances of successful coil occlusion significantly decrease] were major factors in successful embolization, and, inferiorly projecting and wide neck [${\ge}4mm$] aneurysms are highly related to recanalization of aneurysms. Conclusion : Endovascular coil embolization of ACoA aneurysms shows good outcome in our study. Nevertheless, there is a limitation in the endovascular approach to ACoA, even though advanced modern techniques evolve rapidly. Compensatory surgical approach with the endovascular approach is required for successful treatment of ACoA aneurysms.
Kim, Hyunseok;Yun, Soo-kyung;Son, Won-gyun;Jang, Min;Hwang, Hyeshin;Jo, Sang-min;Shin, Chi Won;Kim, Wan Hee;Yoon, Junghee;Lee, Inhyung
Journal of Veterinary Clinics
/
v.33
no.4
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pp.237-242
/
2016
A 1.86 kg, 3-year-old, female, Maltese was presented to the Veterinary Medical Teaching Hospital of Seoul National University after being hit by a car. The patient was diagnosed with urinary bladder rupture, diaphragmatic hernia and fracture of ilium, tibia and fibula. Repair surgery was performed after stabilizing treatment. During the surgery, hypoxia was identified and it worsened after positive pressure ventilation (partial pressure of oxygen in arterial blood ($PaO_2$): 52 mmHg, pulse oximetry ($SpO_2$): 87%, arterial hemoglobin oxygen saturation ($SpO_2$): 85.8%). In addition to hypoxia, blood pressure decreased to 30 mmHg. Positive pressure ventilation was discontinued because hypoxia and hypotension were aggravated. After suturing the diaphragm, air was withdrawn to form negative pressure within the thorax. However, negative pressure was not attained despite continuous withdrawal of air. A thoracostomy tube was placed because tension pneumothorax was strongly suspected. The patient recovered through close monitoring with the tube for 3 days. Due to limitation of evaluation of the lung, predicting occurrence of tension pneumothorax is difficult in patient of diaphragmatic hernia. Therefore, it is recommended that indicators of tension pneumothorax should be closely monitored during diagnosis and repair procedures of diaphragmatic hernia.
This study represents an attempt to present an analysis of early surgical results in 15 cases of aortic surgery conducted at Chonnam University Hospital between February 1994 to August 1995. The subject, 9 males and 6 females, ranged in age from 32 to 73 years with a mean age of 55.07$\pm$ 1176 years. The patients were treated for dissecting aortic aneurysm in nine, atherosclerotic aneurysm in 4, and traumatic aortic aneurysm in two. There were 9 cases of median stemotomy, 4 cases of posterolateral thoracotomy, and 2 cases of thoracoabdominal incision. Graft replacement of ascending aorta andfor partial or total aortic arch were performed in 9 patients, descending aorta andfor t oracoabdominal aorta in 3 and total aorta in 1, Two traumatic aortic aneurysms were closed directly. Associate procedures were resuspension of aortic valve in three patients and elephant trunk procedure, coronary reimplantation and aortic valve replacement in one patient. Nine patients underwent operation for ascending aorta andfor aortic arch with retrograde cerebral perfusion during deep hypothermia and circulatory arrest. Perfusion pressure was maintained below 25 mmHg and the mean duration of circulatory arrest was 56.67 $\pm$ 29.25 minutes. Three patients underwent graft replacement of desending thoracic and thoracoabdominal aorta during deep hypothermia and circulatory arrest. Three patients died of traumatic bile peritonitis, multioragn failure, and rupture of residual dissecting aortic aneurysm by malignant hypertension. Postoperative complications included reoperation for bleeding in 4 patients, temporary confusion in 3, pulmonary complication in 3, and pericardial effusion in .
Bensulfuron concentrations of $10^{-7}$, $10^{-6}$, $10^{-5}$ and $10^{-4}M$ were applied to agar medium on susceptible (cv. KH 17854 and cv. IR 1846) and tolerant (cv. Chinsurah Boro II and IR 14252) rice cultivars were grown for microscopic inspection. Susceptible cultivars showed the decrease in shoot and root growth at the concentration of $10^{-5}M$ while ones showed no difference. Such a tendency was also observed from microscopic inspection in the elongation zone of shoot meristematic tissue. Seedlings grown in soil for 10 days were transfered to distilled water containing only bensulfuron solutions. There were significant differences between cultivars in terms of supression of shoot meristematic activity and swelling of cell volume. Observations of those cells made it clear that especially susceptible cultivars showed the irregular cell layering, vacuolation, cell swelling and partial damage in membrane of shoot tissue. The major response of root tips of susceptible cultivars showed the disorganization of cortex, rupture and contraction of membrane, inhibition of cell division, swelling and emergence of lateral root while tolerant ones showed no such responses.
Park, Hyeyoung;Kim, Sung-gil;Kim, Sang-suk;Choi, I-chan;Kim, Byungwoo;Kim, Seung-jin
Korean Chemical Engineering Research
/
v.54
no.2
/
pp.145-151
/
2016
In response to the cavitation caused by the partial vacuum caused by the fluid flow, a paint was developed by dispersing the lamella-shaped glass-flake in resin for anti-cavitation. This composite paint was developed by using the inorganic filler (lamella shaped glass-flake) and the NBR (Acrylonitrile-butadiene rubber) which was modified epoxy resin. Especially, the glass-flake was a thin film with a thickness of about 100~200 nm and length of about $20{\sim}30{\mu}m$, the aspect ratio was about 200 to 300 times that of the plate-shaped. So the paint for anti-cavitation have shown excellent performance in corrosion resistance. The results of evaluating anti-cavitation performance was below, tensile strength $4.8{\sim}6N/mm^2$ or more, rupture elongation 30% or higher, abrasive speed $10mm^2/h$ or less. In particular, it showed more than twice the superior performance compared to existing advanced foreign products in anti-cavitation performance evaluation.
As the industries become more developed, the amounts of hazardous materials have been increased. Because of that, the possibility of accidents in plants is expected to increase. Especially, the dispersions of toxic materials cause serious effect to human life and environment, So it is very important to confirm safety distance of discharge accident. For this paper, we proposed new algorithms for toxic liquid, such as benzene and acrylonitrile. and using this argorithm, we are going to predict safety distance. The scenario of accidental release was assumed to be the release of entire quantity in 10 minutes is defined as worst-case scenario and Instantaneous release. Also the release from a partial rupture of line is used as an alternative case scenarios as NICS(National Institute of Chemical Safety) guidelines. Using ALOHA program and the algorithm for liquid toxic materials and suggested the graph, as well as correlated equations which can utilize emergency responders.
Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.
Lysosomes are organelles surrounded by membranes that contain acid hydrolases; they degrade proteins, macromolecules, and lipids. According to nutrient conditions, lysosomes act as signaling hubs that regulate intracellular signaling pathways and are involved in the homeostasis of cells. Therefore, the lysosomal dysfunction occurs in various diseases, such as lysosomal storage disease, neurodegenerative diseases, and cancers. Multiple forms of stress can increase lysosomal membrane permeabilization (LMP), resulting in the induction of lysosome-mediated cell death through the release of lysosomal enzymes, including cathepsin, into the cytosol. Here we review the molecular mechanisms of LMP-mediated cell death and the enhancement of sensitivity to anticancer drugs. Induction of partial LMP increases apoptosis by releasing some cathepsins, whereas massive LMP and rupture induce non-apoptotic cell death through release of many cathepsins and generation of ROS and iron. Cancer cells have many drug-accumulating lysosomes that are more resistant to lysosome-sequestered drugs, suggesting a model of drug-induced lysosome-mediated chemoresistance. Lysosomal sequestration of hydrophobic weak base anticancer drugs can have a significant impact on their subcellular distribution. Lysosome membrane damage by LMP can overcome resistance to anticancer drugs by freeing captured hydrophobic weak base drugs from lysosomes. Therefore, LMP inducers or lysosomotropic agents can regulate lysosomal integrity and are novel strategies for cancer therapy.
Background: Mediastinal masses are not uncommon, and an overall incidence of one case per 100,000 population per year in individuals of all ages and with no difference in sex incidence may be a reasonable estimation. At least half of all mediastinal masses are asymptomatic and this proportion has increased in recent decades with wider use of screening chest roentgenography. Symptoms in patients with mediastinal mass lesions are usually due to compression or invasion of nearby intrathoracic structures. Most mediastinal mass lesions have characteristic predilectional locations. The basic focus of diagnostic evaluation is an orderly preparation for obtaining a tissue diagnosis but even lesions discovered to be benign must generally be removed. Seldom is this status known for certain preoperatively. In additaion, benign tumors may continue to enlarge, thus compromising vital organs; they may rupture, hemorrhage, become infected or have the possibility of various malignant degeneration. Therefore, all mediastinal masses must be surgically removed whether they are malignant or benign. Methods: We reviewed the medical records of 344 cases previously confirmed as mediastinal tumors or cysts from January, 1960 to August, 1992 and investigated the clinical findings. Results: Neurogenic tumors were the most common(24.7%) and thymomas were distinctively increased recently. Overall ratio between males and females was 1.1:1 and age distribution was relatively even among all age groups. Predilectional sites were posterior for neurogenic tumors, and anterior for teratodermoid tumors, thymomas and lymphomas. Dyspnea was the most common symptom in the patients of the mediastinal tumors and asymptomatic patients were 19.5%, Benign mediastinal mass lesions were 66.0% and malignant, 34.0%, Complete or partial resection was done in 42.4%. Conclusion: We could find the increasing incidence and the tendency of aggressive resection as possible in the mediastinal tumors. We expect the discovery of more mediastinal tumors with wider use of regular check-up and development of diagnostic methods.
Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.
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