• Title/Summary/Keyword: Limited approach

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Postoperative Clipping Status after a Pterional versus Interhemispheric Approach for High-Positioned Anterior Communicating Artery Aneurysms

  • Kim, Myungsoo;Kim, Byoung-Joon;Son, Wonsoo;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.524-533
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    • 2021
  • Objective : When treating high-positioned anterior communicating artery (ACoA) aneurysms, pterional-transsylvian and interhemispheric approaches are both viable options, yet comparative studies of these two surgical approaches are rare. Accordingly, this retrospective study investigated the surgical results of both approaches. Methods : Twenty-four patients underwent a pterional approach (n=11) or interhemispheric approach (n=13), including a unilateral low anterior interhemispheric approach or bifrontal interhemispheric approach, for high-positioned ACoA aneurysms with an aneurysm dome height >15 mm and aneurysm neck height >10 mm both measured from the level of the anterior clinoid process. The clinical and radiological data were reviewed to investigate the surgical results and risk factors of incomplete clipping. Results : The pterional patient group showed a significantly higher incidence of incomplete clipping than the interhemispheric patient group (p=0.031). Four patients (36.4%) who underwent a pterional approach showed a postclipping aneurysm remnant, whereas all the patients who experienced an interhemispheric approach showed complete clipping. In one case, the aneurysm remnant was obliterated by coiling, while follow-up of the other three cases showed the remnants remained limited to the aneurysm base. A multivariate analysis revealed that a pterional approach for a large aneurysm with a diameter >8 mm presented a statistically significant risk factor for incomplete clipping. Conclusion : For high-positioned ACoA aneurysms with a dome height >15 mm and neck height >10 mm above the level of the anterior clinoid process, a large aneurysm with a diameter >8 mm can be clipped more completely via an interhemispheric approach than via a pterional approach.

3-Dimensional fasciectomy: A highly efficacious common ground approach to Dupuytren's surgery

  • Miranda, Benjamin H;Elliott, Charlotte;Kearsey, Christopher C;Haughton, David N;Webb, Mark R;Harvey, Ian;Fahmy, Fahmy S
    • Archives of Plastic Surgery
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    • v.45 no.6
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    • pp.557-563
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    • 2018
  • Background Numerous Dupuytren's fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren's disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren's disease and unite current limited fasciectomy practice that varies considerably between surgeons. Methods We describe the 3DF principles; raising thin skin flaps (addressing dermal involvement), excising diseased palmar fascia with a 3-5 mm clearance margin (treating highly locally recurrent conditions) and excising the vertical septae of Legueu and Juvara (providing deep clearance, hence addressing all potentially involved pathological tissue). The surgical outcomes between traditional limited fasciectomy (LF) and 3DF are compared. Results From the 786 operations included (n=585), postoperative recurrence rates were significantly lower for the 3DF group (2/145, 1.4%) than the LF group (72/641, 11.2%) (P= 0.001), and the time to recurrence was significantly longer ($5.0{\pm}0years$ vs. $4.0{\pm}0.2years$; P<0.0001). With recurrence excluded, there were no differences between the postoperative complication rates for 3DF (5/145, 3.5%) and LF (41/641, 6.4%) (P=0.4). Conclusions Our results suggest that 3DF leads to lower recurrence rates and a longer disease-free period for patients, without increasing complications. 3DF provides a safe, efficacious, common ground surgical approach in the treatment of Dupuytren's flexion deformity.

A Method to Manage Local Storage Capacity Using Data Locality Mechanism (데이터 지역성 메커니즘을 이용한 지역 스토리지 용량 관리 방법)

  • Kim, Baul;Ku, Mino;Min, Dugki
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2013.10a
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    • pp.324-327
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    • 2013
  • Recently, due to evolving cloud computing technology, we can easily and transparently utilize both local computing resource and remote computing resource in real life. Especially, enhancing smart device technologies and network infrastructures promote an increase of needs to share files between local smart devices and cloud storages. However, since smart devices have a limited storage space, storing files on cloud storage causes a starvation problem of local storage. It means that users can face a storage-lack problem even a cloud storage service provide a huge file storing space. In this research, we propose a method to manage files between smart devices and cloud storages. Our approach calculate file usage pattern based on recently used date, and then this approach determines local files being migrated. As a result, our approach is sufficient for handling data synchronization between big data storage farm and local thin client which contains limited storage space.

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Comparison of dorsal and medial arthroscopic approach to canine coxofemoral joint: a cadaveric study

  • Sangjun Oh;Jinsu Kang;Namsoo Kim;Suyoung Heo
    • Journal of Veterinary Science
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    • v.24 no.1
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    • pp.12.1-12.10
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    • 2023
  • Background: Arthroscopic exploration of ventromedial part of canine coxofemoral joint is limited in conventional dorsal approach. Objectives: We evaluated the efficacy of a medial arthroscopic approach to the coxofemoral joint of dogs by analyzing the joint visible area and performing a safety analysis. Methods: Arthroscopic approaches to the coxofemoral joint were made in five cadavers using a traditional (dorsal) and novel (medial) approach. Three observers scored the visible area of images and videos of the acetabulum and femur. A safety analysis was performed via dissection of the medial hind limb. The distance between neurovascular structures and arthroscopic portals was measured. Results: The acetabulum was more visible in the dorsal than in the medial approach, with mean visualization scores of 16 ± 0.00 and 11.83 ± 1.26, respectively. The medioventral side of the femur was significantly more visible in the medial than in the dorsal approach, with mean visualization scores of 3.9 ± 0.99 and 6.93 ± 0.58, respectively. Safety analysis confirmed the medial portal site was safe, provided that the surgeon has comprehensive knowledge of the joint. The minimum distance from the arthroscopic medial portals to the nearest neurovascular structures was 2.5 mm. Conclusions: A medial arthroscopic approach to the canine coxofemoral joint has potential clinical application. Dorsal and medial approaches differ significantly and have distinct purposes. The medial approach is useful to access the ventromedial joint, making it an eligible diagnostic method for an arthroscopic evaluation of this area.

A Composite Cluster Analysis Approach for Component Classification (컴포넌트 분류를 위한 복합 클러스터 분석 방법)

  • Lee, Sung-Koo
    • The KIPS Transactions:PartD
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    • v.14D no.1 s.111
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    • pp.89-96
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    • 2007
  • Various classification methods have been developed to reuse components. These classification methods enable the user to access the needed components quickly and easily. Conventional classification approaches include the following problems: a labor-intensive domain analysis effort to build a classification structure, the representation of the inter-component relationships, difficult to maintain as the domain evolves, and applied to a limited domain. In order to solve these problems, this paper describes a composite cluster analysis approach for component classification. The cluster analysis approach is a combination of a hierarchical cluster analysis method, which generates a stable clustering structure automatically, and a non-hierarchical cluster analysis concept, which classifies new components automatically. The clustering information generated from the proposed approach can support the domain analysis process.

Mode shape expansion with consideration of analytical modelling errors and modal measurement uncertainty

  • Chen, Hua-Peng;Tee, Kong Fah;Ni, Yi-Qing
    • Smart Structures and Systems
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    • v.10 no.4_5
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    • pp.485-499
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    • 2012
  • Mode shape expansion is useful in structural dynamic studies such as vibration based structural health monitoring; however most existing expansion methods can not consider the modelling errors in the finite element model and the measurement uncertainty in the modal properties identified from vibration data. This paper presents a reliable approach for expanding mode shapes with consideration of both the errors in analytical model and noise in measured modal data. The proposed approach takes the perturbed force as an unknown vector that contains the discrepancies in structural parameters between the analytical model and tested structure. A regularisation algorithm based on the Tikhonov solution incorporating the L-curve criterion is adopted to reduce the influence of measurement uncertainties and to produce smooth and optimised expansion estimates in the least squares sense. The Canton Tower benchmark problem established by the Hong Kong Polytechnic University is then utilised to demonstrate the applicability of the proposed expansion approach to the actual structure. The results from the benchmark problem studies show that the proposed approach can provide reliable predictions of mode shape expansion using only limited information on the operational modal data identified from the recorded ambient vibration measurements.

Ultrasound-Guided Posterolateral Approach for Midline Calcified Thoracic Disc Herniation

  • Tan, Lee A.;Lopes, Demetrius K.;Fontes, Ricardo B.V.
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.383-386
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    • 2014
  • Objective : Symptomatic thoracic disc herniation often requires prompt surgical treatment to prevent neurological deterioration and permanent deficits. Anterior approaches offer direct visualization and access to the herniated disc and anterior dura but require access surgeons and are often associated with considerable postoperative pain and pulmonary complications. A disadvantage with using posterior approaches in the setting of central calcified thoracic disc herniation however, has been the limited visualization of anterior dura and difficulty to accurately assess the extent of decompression. Methods : We report our experience with intraoperative ultrasound (US) guidance during a modified posterior transpedicular approach for removal of a central calcified thoracic disc herniation with a review of pertinent literature. Results : The herniated thoracic disc was successfully removed with posterior approach with the aid of intraoperative US. The patient had significant neurological improvement at three months follow-up. Conclusion : Intraoperative ultrasound is a simple yet valuable tool for real-time imaging during transpedicular thoracic discectomy. Visualization provided by intraoperative US increases the safety profile of posterior approaches and may make thoracotomy unnecessary in a selected group of patients, especially when a patient has existing pulmonary disease or is otherwise not medically fit for the transthoracic approach.

An Energy Efficient Distributed Approach-Based Agent Migration Scheme for Data Aggregation in Wireless Sensor Networks

  • Gupta, Govind P.;Misra, Manoj;Garg, Kumkum
    • Journal of Information Processing Systems
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    • v.11 no.1
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    • pp.148-164
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    • 2015
  • The use of mobile agents for collaborative processing in wireless sensor network has gained considerable attention. This is when mobile agents are used for data aggregation to exploit redundant and correlated data. The efficiency of agent-based data aggregation depends on the agent migration scheme. However, in general, most of the proposed schemes are centralized approach-based schemes where the sink node determines the migration paths for the agents before dispatching them in the sensor network. The main limitations with such schemes are that they need global network topology information for deriving the migration paths of the agents, which incurs additional communication overhead, since each node has a very limited communication range. In addition, a centralized approach does not provide fault tolerant and adaptive migration paths. In order to solve such problems, we have proposed a distributed approach-based scheme for determining the migration path of the agents where at each hop, the local information is used to decide the migration of the agents. In addition, we also propose a local repair mechanism for dealing with the faulty nodes. The simulation results show that the proposed scheme performs better than existing schemes in the presence of faulty nodes within the networks, and manages to report the aggregated data to the sink faster.

Icefex: Protocol Format Extraction from IL-based Concolic Execution

  • Pan, Fan;Wu, Li-Fa;Hong, Zheng;Li, Hua-Bo;Lai, Hai-Guang;Zheng, Chen-Hui
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.7 no.3
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    • pp.576-599
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    • 2013
  • Protocol reverse engineering is useful for many security applications, including intelligent fuzzing, intrusion detection and fingerprint generation. Since manual reverse engineering is a time-consuming and tedious process, a number of automatic techniques have been proposed. However, the accuracy of these techniques is limited due to the complexity of binary instructions, and the derived formats have missed constraints that are critical for security applications. In this paper, we propose a new approach for protocol format extraction. Our approach reasons about only the evaluation behavior of a program on the input message from concolic execution, and enables field identification and constraint inference with high accuracy. Moreover, it performs binary analysis with low complexity by reducing modern instruction sets to BIL, a small, well-specified and architecture-independent language. We have implemented our approach into a system called Icefex and evaluated it over real-world implementations of DNS, eDonkey, FTP, HTTP and McAfee ePO protocols. Experimental results show that our approach is more accurate and effective at extracting protocol formats than other approaches.

Study on the effect of the management system establish through process approach on operation performance - Focused on ISO/IEC 17021 certification body - (프로세스 접근방법을 통한 경영시스템 구축이 운영성과에 미치는 영향에 대한 연구 - ISO/IEC 17021 인증기관을 중심으로 -)

  • Cho, Kyeong-Seok;Lee, Chang-ho
    • Journal of the Korea Safety Management & Science
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    • v.17 no.2
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    • pp.183-190
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    • 2015
  • For the sustainable development, companies are making a lot of efforts such as activities of sales increase and cost reduction. Among these, efforts to use limited resources efficiently and effectively is still being made steadily. And many methods for management innovation are being introduced and used. However there were partial or temporary effects only. So there are not enough to achieve operations performance to cover the entire system. Therefore, in order to maximize performance or to improve sustainability across the companies, it is necessary to rebuild the existing system with process perspective not with existing functional perspective. This study was performed to achieve the objective that is operation performance improvement of certification body. So literature review was researched and analyed about the process innovation and the process approach. And basic model which is compatible with ISO/IEC 17021 requirement for the certification body was established in this study. Based on this model, one of the certification body was selected and operation system for this organization was established, documented and implemented through the process approach method. In the result, operations performance of certification body on the side of efficiency and effectiveness is analyzed and the effect of reconstruction of system on operations performance was figured out