• Journal of Korean Neurosurgical Society
• /
• v.59 no.6
• /
• pp.564-569
• /
• 2016

Objective : This study used the intradural procedural time to assess the overall technical difficulty involved in surgically clipping an unruptured middle cerebral artery (MCA) aneurysm via a pterional or superciliary approach. The clinical and radiological variables affecting the intradural procedural time were investigated, and the intradural procedural time compared between a superciliary keyhole approach and a pterional approach. Methods : During a 5.5-year period, patients with a single MCA aneurysm were enrolled in this retrospective study. The selection criteria for a superciliary keyhole approach included : 1) maximum diameter of the unruptured MCA aneurysm <15 mm, 2) neck diameter of the MCA aneurysm <10 mm, and 3) aneurysm location involving the sphenoidal or horizontal segment of MCA (M1) segment and MCA bifurcation, excluding aneurysms distal to the MCA genu. Meanwhile, the control comparison group included patients with the same selection criteria as for a superciliary approach, yet who preferred a pterional approach to avoid a postoperative facial wound or due to preoperative skin trouble in the supraorbital area. To determine the variables affecting the intradural procedural time, a multiple regression analysis was performed using such data as the patient age and gender, maximum aneurysm diameter, aneurysm neck diameter, and length of the pre-aneurysm M1 segment. In addition, the intradural procedural times were compared between the superciliary and pterional patient groups, along with the other variables. Results : A total of 160 patients underwent a superciliary (n=124) or pterional (n=36) approach for an unruptured MCA aneurysm. In the multiple regression analysis, an increase in the diameter of the aneurysm neck (p<0.001) was identified as a statistically significant factor increasing the intradural procedural time. A Pearson correlation analysis also showed a positive correlation (r=0.340) between the neck diameter and the intradural procedural time. When comparing the superciliary and pterional groups, no statistically significant between-group difference was found in terms of the intradural procedural time reflecting the technical difficulty (mean${\pm}$standard deviation : $29.8{\pm}13.0min$ versus $27.7{\pm}9.6min$). Conclusion : A superciliary keyhole approach can be a useful alternative to a pterional approach for an unruptured MCA aneurysm with a maximum diameter <15 mm and neck diameter <10 mm, representing no more of a technical challenge. For both surgical approaches, the technical difficulty increases along with the neck diameter of the MCA aneurysm.

• Journal of the Korean Society of Safety
• /
• v.39 no.1
• /
• pp.104-113
• /
• 2024

Unlike in general manufacturing process, safety management in laboratory-based research area is complicated because the latter generally involves trying untested methods or handling unusual substances in small amounts. Laboratory accidents in South Korea have recently shown an increasing trend. Unfortunately, statistics on such accidents are not officially published by any domestic public agencies. In this study, multivariate analysis was performed on the relationships between variables to develop effective strategies for preventing laboratory accidents. A Cross-Tabulation Analysis of accident-related factors in 179 accident cases revealed that the laboratory type, accident type, and unsafe-act type are all statistically significant, whereas the unsafe condition and management factors differ with the statistical criteria. Furthermore, the results of a Multiple-Correspondence Analysis showed that accidents can be divided largely into three groups having different accident causes and injury types; this confirms the necessity of different strategies to prevent accidents of each type. The findings also reveal differences between the distribution of accident types mentioned in the accident case collection books and actual reported cases. This suggests that an official statistical system administered by a public institution would be necessary for effective prevention of laboratory accidents.

• Journal of Environmental Impact Assessment
• /
• v.15 no.1
• /
• pp.13-22
• /
• 2006

The Korean government adopted the integrated stream water management policy recently with growing perception that natural disasters and pollution in Korea have been due not only to such human factors as urbanization and industrialization, but also to the policy of functionally separated management of irrigation, flood control and ecological management. Contrary to its good intention, research result shows that it is not realistic to expect that this new integrated policy in Korea will work well. In order to be an effective policy and program evaluation, this paper suggests that evaluation indicator on related programs and projects should be made through bottom-up process. For example, environmental benefit should be taken into account rather than just economic benefit, and cultural and social characteristics in the project region should be also considered seriously.