Paraplegia remains unresolved as the most dreaded operative complication with surgical treatment of descending thoracic and thoracoabdominal aortic diseases. In this study, the neuroprotective effect of trimetazidine that has been used clinically for ischemic heart disease was investigated in a rabbit spinal cord ischemia model. Material and Method: Thirty-three New Zealand white rabbits were randomized as follows: control group undergoing abdominal aortic occlusion but receiving no pharmacologic intervention(Group 1, n= 17); TMZ group(Group 2, n= 16) receiving 3 mg/kg trimetazidine intravenously before the occlusion of the aorta. Ischemia was induced by clamping the abdominal aorta just distal to the left renal artery for 30 minutes. Neurologic status was assessed at 2, 24, and 48 hours after the operation according to the modified Tarlov scale, then the lumbosacral spinal cord was processed for histopathologic examinations 48 hours after the final assessment. Result: The average motor function score was significantly higher in the TMZ group(3.20 $\pm$ 0.77 vs 1.13 $\pm$ 1.25 at 2 hours, 3.50 $\pm$ 0.76 vs 1.45 $\pm$ 1.57 at 24 hours, and 3.91 $\pm$ 0.30 vs 1.86 $\pm$ 1.86 at 48 hours after operation; p value$\leq$0.05). Histologic observations were correlated with the motor scores. Conclusion: The results suggested that trimetazidine reduced spinal cord injury during aortic clamping and that it may have clinical utility for the thoracoabdominal aortic surgery:
Background: In 1992, we first developed the technique for video-assisted thoracoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Clinically, patients suffereing from distressing hyperhidrosis in their heads and faces were observed. Materials and methods: From March 1997 to March 1998, the vidio-assisted thoracoscopic sympathectomy and sympathicotomy were performed in 60 patients suffering from craniofacial hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Thirty-nine patients underwent a conventional sympathectomy(T1 sympathectomy group), and twenty-one patients underwent division of the sympathetic nerve trunk above the T2 sympathetic ganglion(T2 sympathicotomy). The median follow up was 9 months. Results: All of the treated patients obtained satisfactory alleviation of craniofacial hyperhidrosis. No recurrence was observed in group T1 sympathectomy whereas one occurred in sympathicotomy. The global rate of compensatory sweating was about the same in both groups ; 76.9% in T1 sympathectomy and 76.2% in T2 sympathicotomy. The rate of embarrassing and disabling compensatory sweating was 38.5% in T1 sympathectomy and 38.1% in T2 sympathicotomy with no significant in the statistic analysis(p> 0.05). No transient Horner's syndrome was observed in group T2 sympathicotomy whereas seven occurred in T1 sympathectomy with improvement in follow-up. Only an overnight hospital stay was required in both group. Conclusions: The video-assist thoracoscopic sympathicotomy is minimally invasive and effective. Video-assisted thoracoscopic T2 sympathicotomy has proven to be effective method and less complicated in treating patients with distressing craniofacial hyperhidrosis and consistent in obtaining the same results as T1 sympathectomy.
Cheon, Hyo Cheol;Kim, Jae Hyoo;Lee, Jung Kil;Kim, Tae Sun;Jung, Shin;Kim, Soo Han;Kang, Sam Suk;Lee, Je Hyuk
Journal of Korean Neurosurgical Society
/
v.30
no.8
/
pp.992-997
/
2001
Objectives : Essential hyperhidrosis is a common condition characterized by excessive body sweating. Excessive sweating beyond what is necessary to maintain normal body temperature need not be considered pathological unless it interferes with one's occupation and/or life-style. The existing non-operative therapeutic options seldom give sufficient relief or show a transient effect. In this regard, the thoracic sympathectomy may provide a definitive cure. In the past, surgical procedures were highly invasive and caused significant morbidity, but the minimally invasive thoracoscopic procedure provided detailed visualization of sympathetic ganglia and is associated with minimally postoperative morbidity. Nowadays, thoracoscopic transthoracic sympathectomy is accepted as the treatment of choice for essential hyperhidrosis. In palmar hyperhidrosis, however, the level of sympathetic chain to be blocked has been somewhat obscure. It is assumed that the incidence of compensatory hyperhidrosis may closely related to the extent of thoracic sympathectomy. Material & Methods : To compare the results of posterior midline approach with endoscopic sympathectomy, and the results of T2 with T2, 3 sympathectomy or sympathicotomy, we retrospectively studied 62 patients treated for palmar hyperhidrosis between September 1993 and May 2000. We reviewed medical records and recently interviewed the patients by telephone calls. Results : The treatment effect of T2 sympathectomy is no different from T2, 3 sympathectomy. But, the incidence of compensatory hyperhidrosis is less in the T2 sympathectomy group than the T2, 3 sympathectomy group. Conclusion : Thoracoscopic sympathectomy is considered a simple, safe, and effective method for treating palmar hyperhidrosis, with a shorter operation time, fewer hospital days, and a better cosmetic result, as compared with the open approaches. However, sympathicotomy seems to provide the advantages of a limited extent of denervation and the resultant decrease of compensatory hyperhidrosis compared to sympathectomy.
Objectives: Chungpaesagan-tang (CPSGT), which is frequently used for treating patients of cerebrovascular disease, has not been reported by clinical doctors concerning the effect of neuronal aptosis caused by brain ischemia. To study the effect of CPSGT on focal cerebral ischemia in normal and diabetic rats and SHR, focal cerebral ischemia was induced by transient MCAO, and after onset CPSGT was administrated. Methods: Rats (Sprague-Dawley) were divided into four groups: sham-operated group, MCA-occluded group, CPSGTadministrated group after MCA occlusion, and normal group. The MCA was occluded by intraluminal method. CPSGT was administrated orally twice (l and 4 hours) after middle cerebral artery occlusion. All groups were sacrificed at 24 hours after the surgery. The brain tissue Was stained with $2\%$ triphenyl tetrazolium chloride (TTC) or $1\%$ cresyl violet solution, to examine effect of CPSGT on ischemic brain tissue. The blood samples were obtained from the heart.~. Tumor necrosis $factor-\alpha$ level and interleukin-6 level of serum was measured from sera using enzyme-linked immunoabsorbent assay (ELISA). Then changes of immunohistochemical expression of $TNF-\alpha$ in ischemic damaged areas were observed. Results: In NC+MCAO+CP and DM+MCAO+CP, CPSGT significantly (p<0.01) decreased the number of neuron cells compared to the control group. CPSGT markedly reduced (p<0.01) the infarct size of the forebrain in distance from the interaural line on cerebral ischemia in diabetic rats. CPSGT significantly reduced the $TNF-\alpha$ expression in penumbra region of damaged hemisphere in diabetic rats. Conclusions: CPSGT had a protective effect on cerebral ischemia in SD rats, especially in diabetic rats compared with normal SD rats.
Ahn, Se-Jin;Griffin, Michael J.;Yoo, Wan-Suk;Jeong, Weui-Bong
Transactions of the Korean Society of Automotive Engineers
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v.15
no.2
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pp.50-57
/
2007
Shocks are excited by impulsive forces and cause discomfort in vehicles. Current standards define means of evaluating shocks and predicting their discomfort, but the methods are based on research with a restricted range of shocks. This experimental study was designed to investigate the discomfort of seated subjects exposed to a wide range of vertical shocks. Shocks were produced from the responses of one degree-of-freedom models, with 16 natural frequencies (from 0.5 to 16 Hz) and four damping ratios (0.05 0.1, 0.2 and 0.4), to a hanning-windowed half-sine force inputs. Each type of shock was presented at five vibration dose values in the range $0.35\;ms^{-1.75}$ to $2.89\;ms^{-1.75}$. Fifteen subjects used magnitude estimation method to judge the discomfort of all shocks. The exponent in Stevens' power law, indicating the rate of growth in discomfort with shock magnitude, decreased with increasing fundamental frequency of the shocks. At all magnitudes, the equivalent comfort contours showed greatest sensitivity to shocks having fundamental frequencies in the range 4 to 12.5 Hz. At low magnitudes the variations in discomfort with the shock fundamental frequency were similar to the frequency weighting $W_b$ in BS 6841, but low frequency high magnitudes shocks produced greater discomfort than predicted by this weighting. At some frequencies, for the same unweighted vibration dose value, there were small but significant differences in discomfort caused by shocks having different damping ratios. The rate of increase in discomfort with increasing shock magnitude depends on the fundamental frequency of the shock. In consequence, the frequency-dependence of discomfort produced by vertical shocks depends on shock magnitude. For shocks of low and moderate discomfort, the current methods seem reasonable, but the response to higher magnitude shocks needs further investigation.
55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients(36 male and 19 female) ranged in age from 3 to 72years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 20 and 90 minutes, with a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases(9.4%), atelectasis in 4(7.5%), transient urine leak in 2(3.8%), delayed bleeding in 2(3.8%) and urinary retention in 2(3.8%), Postoperative residual stones were identified in 15(27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases(87.3%) became stone free, The recurrence of stone was noted in 2 out of 48 patients during the short followup period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.
Journal of the Korean Society of Marine Environment & Safety
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v.23
no.4
/
pp.393-399
/
2017
In a reciprocating compressor, the piston and connecting rod are important parts. Excess mechanical stress on these parts may cause damage, and broken parts are expensive and difficult to replace. Therefore, it is necessary to analyze the mechanical stress affecting durability and longevity. The main purpose of this study was to identify locations of maximum stress on pistons and connecting rods. Based on dynamic calculation of the working process of a specific air compressor, an analysis of piston and connecting rod performance has been completed. A three-dimensional model for the air compressor's pistons and connecting rods was built separately, and FEM analysis of these components was carried out using a numerical method. The pistons were loaded by pressure which was changed according to crankshaft angle without thermal boundary conditions. The simulation results were used to predict and estimate stress concentration as well as the value of this stress on pistons and connecting rods. The maximum equivalent stress calculated are over 190 MPa on pistons and 123 MPa on connecting rods at crank angle $135^{\circ}$ and $225^{\circ}$ but these are under tensile yield strength. Besides, the calculated safety factors of connecting rods and pistons is higher than 1. Moreover, the results obtained can be used to provide manufacturers with references to optimize the design of pistons and connecting rods for reciprocating compressors.
Kim, Il-Man;Lee, Chang Young;Son, Eun Ik;Kim, Dong Won;Yim, Man Bin;Kim, Sang Pyo
Journal of Korean Neurosurgical Society
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v.30
no.3
/
pp.334-341
/
2001
Objective : We have currently changed treatment strategies to methotrexate(MTX)-based preirradiation chemotherapy with subsequent planned radiation for the initial therapy of primary central nervous system lymphoma (PCNSL). The aim of this study was to evaluate the results of treating PCNSL with chemotherapy plus radiotherapy (CRT) or radiotherapy(RT) alone. Method and Material : This study involved 10 females and 3 males patients with a mean age of 54.2 years. All patients underwent surgery, open(8 cases) or stereotactic biopsy(5 cases) for histological diagnosis. Eleven tumors were diffuse large B-cell lymphomas. Tumor volume change in the follow-up images and survival time were evaluated in patients treated with CRT and RT alone. In the beginning, two patients received ProMACE-Cytabom chemotherapeutic regimen, but did not complete the course and died of progressive tumor 8 and 9 months after diagnosis, respectively. One patient died at 6 months before chemotherapy. These three were excluded from the survival analysis. Five patients(RT group) completed full courses of cranial irradiation with or without boost. For the current combined modality treatment, high-dose MTXbased chemotherapy(systemic and intrathecal MTX, IV vincristine, and oral procarbazine) followed by whole brain irrdiation to 45Gy to tumor was introduced in 5 patients of CRT group. Result : A complete response was achieved in three of five who received RT only and in all of five who received CRT. All patients in CRT groups are in disease free status at a mean 23 months following therapy. The RT group patients refused any additional salvage therapy at tumor relapse and survived at mean 20 months from diagnosis. The Karnofsky performance status improved in eight of ten patients with treatment. The treatment toxicity included leukoencephalopathy in RT group and severe leukopenia, transient hepatitis, avascular necrosis of femoral head, hearing loss, and amenorrhea in CRT group, respectively. Conclusion : The combined modality therapy of MTX-based chemotherapy plus radiotherapy for PCNSL may enhance tumor response and improve patient survival. The patients who received CRT should be carefully followed up because of the higher risk of treatment-induced late neurotoxicity.
Rha, Hyung Kyun;Lee, Kyung Jin;Cho, Kyung Keun;Park, Sung Chan;Park, Hae Kwan;Chok, Jeung Ki;Chi, Chul;Kim, Dal Su;Kang, Jun Ki;Choi, Chang Rak
Journal of Korean Neurosurgical Society
/
v.29
no.1
/
pp.118-125
/
2000
Objective : Trigeminal neurinomas are rare tumors that may locate in the middle fossa or posterior fossa and straddled both the middle and posterior fossa, according to their origin in the nerve complex. The aim of this study was to analyze the clinical presentation, operative approaches employed and outcome in 15 patients who were treated surgically, with special emphasis on surgical approach. Method : Between 1994 and 1998, a total of fifteen patients were histopathologically identified as neurinomas originating from the trigeminal nerve complex at the tumor clinic in the neuroscience center of the our university. Results : The surgical approach to these tumors depends on their anatomical location and tumor size. Six patients had tumors confined to the middle fossa, five patients had tumors limited to the posterior fossa, and four patients both in middle and posterior fossa components of their tumors. Nine neurinomas were removed via the conventional approach(pterional, subtemporal, suboccipital) and six were excised using skull base approach(transzygomatic subtemporal, orbitozygomatic, transpetrosal). Total resection of the tumor was possible in 10 cases. Total resection of tumor was accomplished in 83% of patients following skull base approach compared with 56% of patients following conventional approach. The surgical outcome was excellent or good in 13 cases, fair in one and, poor in one. There was no operative death. In the immediate postoperative period, aggravation of preoperative facial hypesthesia and 6th cranial nerve palsy were common. Although, these deficits were generally transient, eight patients remained with some degree of trigeminal hypesthesia, two had facial weakness, one neurotrophic keratitis, one diplopia, and one mastication difficulty. Conclusion : Surgical approach to the trigeminal neurinoma depends on the tumor location and tumor size. Skull base approach provides more complete tumor excision without increased morbidity compared to conventional approach. Surgeons have to be meticulous in order to reduce postoperative complication.
Kim, Sitae;Jung, Kihyun;Lee, Junho;Park, Kihyun;Yang, Kwangjin
Tribology and Lubricants
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v.36
no.2
/
pp.105-115
/
2020
This paper presents a numerical study on the rotordynamic analysis of a dual-spool turbofan engine in the context of blade defect events. The blades of an axial-type aeroengine are typically well aligned during the compressor and turbine stages. However, they are sometimes exposed to damage, partially or entirely, for several operational reasons, such as cracks due to foreign objects, burns from the combustion gas, and corrosion due to oxygen in the air. Herein, we designed a dual-spool rotor using the commercial 3D modeling software CATIA to simulate blade defects in the turbofan engine. We utilized the rotordynamic parameters to create two finite element Euler-Bernoulli beam models connected by means of an inter-rotor bearing. We then applied the unbalanced forces induced by the mass eccentricities of the blades to the following selected scenarios: 1) fully balanced, 2) crack in the low-pressure compressor (LPC) and high pressure compressor (HPC), 3) burn on the high-pressure turbine (HPT) and low pressure compressor, 4) corrosion of the LPC, and 5) corrosion of the HPC. Additionally, we obtained the transient and steady-state responses of the overall rotor nodes using the Runge-Kutta numerical integration method, and employed model reduction techniques such as component mode synthesis to enhance the computational efficiency of the process. The simulation results indicate that the high-vibration status of the rotor commences beyond 10,000 rpm, which is identified as the first critical speed of the lower speed rotor. Moreover, we monitored the unbalanced stages near the inter-rotor bearing, which prominently influences the overall rotordynamic status, and the corrosion of the HPC to prevent further instability. The high-speed range operation (>13,000 rpm) coupled with HPC/HPT blade defects possibly presents a rotor-case contact problem that can lead to catastrophic failure.
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