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A comparison study of vessel twisting by different microsurgical suture techniques in a chicken wing artery side to side bypass training model

  • Junho Jung;Donghwan Jeong
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.3
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    • pp.260-266
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    • 2023
  • Objective: Microvascular anastomosis, particularly side-to-side (STS) bypass, is a complex surgical procedure. While several suture techniques exist, none of them is superior to the others. We assessed the association between various STS bypass techniques and vessel twisting using chicken wing training models. Methods: Three suture techniques were compared over an anterior wall suture procedure. The unidirectional continuous suture (UCS) group used a downward "right-to-left" continuous suture. The reverse continuous suture (RCS) group used a downward "left-to-right" continuous suture. The interrupted suture (IS) group used the standard interrupted suture. The number of samples in each of the three groups was 30 (n=90). We compared the incidence of vessel twisting and rotation angles across groups. Results: Vessel twisting occurred in 96.7%, 56.7%, and 0% of the cases in the UCS, IS, and RCS groups, respectively. The incidence of vessel twisting differed significantly in all 3 groups (p<0.001), with an apparent trend (p=0.002). The mean rotation angles were 201°±90.6°, 102°±107.6°, and 0° in the UCS, IS, and RCS groups, respectively, which were significantly different (p<0.001). On excluding cases without twisting, the rotation angles of twisted vessels in the UCS and IS groups were 207.9°±83.7° and 180°±77.9°, respectively, which yielded a significant difference between these groups (p<0.001). Conclusions: We found that the incidence and trend of vessel twisting differed significantly across suture techniques. The RCS technique may aid in preventing vessel twisting in the STS bypass procedure.

The Usefulness of 4D Echocardiographic Modality for Assessing RV Affection in Uncontrolled Hypertensive Patients

  • Rehab M. Hamdy;Shaimaa A Habib;Layla A Mohamed;Ola H. Abd Elaziz
    • Journal of Cardiovascular Imaging
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    • v.30 no.4
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    • pp.279-289
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    • 2022
  • BACKGROUND: In many cardiovascular disorders, the contractile performance of the right ventricle (RV) is the primary determinant of prognosis. For evaluating RV volumes and function, 4 dimensional (4D)-echocardiography has become common. This research used 2D and 4D modalities to assess RV contractile performance in hypertensive patients. METHODS: A total of 150 patients with essential hypertension were enrolled in this study, along with 75 age and sex-matched volunteers. Clinical evaluation and echocardiographic examination (including M-mode, tissue Doppler imaging, and 2D speckle tracking) were conducted on all participants. RV volumes, 4D-ejection fraction (EF), 4D-fractional area change (FAC), 4D-tricuspid annular plane systolic excursion (TAPSE), 4D-septal and free wall (FW) strain were all measured using 4D-echocardiography. RESULTS: Hypertensive patients showed 2D-RV systolic and diastolic dysfunction (including TAPSE, 2D-right ventricular global longitudinal strain, RV-myocardial performance index and average E/EaRV) and 4D-RV impairment (including right ventricular EF, FAC, RV strain and TAPSE, right ventricular end-diastolic volume and right ventricular end-systolic volume) compared to the control group. We verified the prevalence of RV systolic dysfunction in hypertension patients using the following parameters: 1) 15% of them had 2D-TAPSE < 17 mm vs. 40% by 4D-TAPSE; 2) 25% of them had 2D-GLS < 19% vs. 42% by 4D-septal strain and 35% by 4D FW strain; 3) 35% of hypertensive patients had 4D-EF < 45%; and finally; 4) 25% of hypertensive patients had 2D-FAC < 35% compared to 45% by 4D-FAC. CONCLUSIONS: The incidence of RV involvement was greater in 4D than in 2D-modality trans-thoracic echocardiography. We speculated that 4D-echocardiography with 4D-strain imaging would be more beneficial for examining RV morphology and function in hypertensive patients than 2D-echocardiography, since 4D-echocardiography could estimate RV volumes and function without making geometric assumptions.

Intra-aneurysmatic thrombectomy in a distal anterior cerebral artery aneurysm

  • Juan Luis Gomez-Amador;Leoncio Alberto Tovar-Romero;Andrea Castillo-Matus;Ricardo Marian-Magana;Jorge Fernando Aragon-Arreola;Marcos Vinicius Sangrador-Deitos;Alan Hernandez-Hernandez;German Lopez-Valencia;Gerardo Yoshiaki Guinto-Nishimura;Jorge Rios-Zermeno
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.462-467
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    • 2023
  • Thrombectomy procedures following intra-aneurysmatic lesions are extremely rare, and few cases have been reported. This article describes a microsurgical intra-aneurysmatic thrombectomy (MIaT) for a distal anterior cerebral artery (DACA) aneurysm. We present the case of a 48-year-old female that was admitted to the emergency room, showing neurologic deterioration with focal deficits. A computed tomography angiography (CTA) scan revealed an aneurysm located in the distal segment of the left anterior cerebral artery. During the surgical procedure, after clipping, a well-formed clot was visualized through the aneurysm's wall obstructing the left DACA flow. We proceeded to open the aneurysm's dome to remove the thrombus and clip the aneurysm neck, re-establishing the flow of the left DACA. Intra-aneurysmatic thrombosis can occur as a complication during clipping, obstructing the distal flow of vital arteries and causing fatal results in the patient's postoperative status. MIaT is a good technique for restoring the flow of the affected vessel and allows a secure aneurysm clipping after thrombus removal.

Derivation of Green Infrastructure Planning Factors for Reducing Particulate Matter - Using Text Mining - (미세먼지 저감을 위한 그린인프라 계획요소 도출 - 텍스트 마이닝을 활용하여 -)

  • Seok, Youngsun;Song, Kihwan;Han, Hyojoo;Lee, Junga
    • Journal of the Korean Institute of Landscape Architecture
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    • v.49 no.5
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    • pp.79-96
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    • 2021
  • Green infrastructure planning represents landscape planning measures to reduce particulate matter. This study aimed to derive factors that may be used in planning green infrastructure for particulate matter reduction using text mining techniques. A range of analyses were carried out by focusing on keywords such as 'particulate matter reduction plan' and 'green infrastructure planning elements'. The analyses included Term Frequency-Inverse Document Frequency (TF-IDF) analysis, centrality analysis, related word analysis, and topic modeling analysis. These analyses were carried out via text mining by collecting information on previous related research, policy reports, and laws. Initially, TF-IDF analysis results were used to classify major keywords relating to particulate matter and green infrastructure into three groups: (1) environmental issues (e.g., particulate matter, environment, carbon, and atmosphere), target spaces (e.g., urban, park, and local green space), and application methods (e.g., analysis, planning, evaluation, development, ecological aspect, policy management, technology, and resilience). Second, the centrality analysis results were found to be similar to those of TF-IDF; it was confirmed that the central connectors to the major keywords were 'Green New Deal' and 'Vacant land'. The results from the analysis of related words verified that planning green infrastructure for particulate matter reduction required planning forests and ventilation corridors. Additionally, moisture must be considered for microclimate control. It was also confirmed that utilizing vacant space, establishing mixed forests, introducing particulate matter reduction technology, and understanding the system may be important for the effective planning of green infrastructure. Topic analysis was used to classify the planning elements of green infrastructure based on ecological, technological, and social functions. The planning elements of ecological function were classified into morphological (e.g., urban forest, green space, wall greening) and functional aspects (e.g., climate control, carbon storage and absorption, provision of habitats, and biodiversity for wildlife). The planning elements of technical function were classified into various themes, including the disaster prevention functions of green infrastructure, buffer effects, stormwater management, water purification, and energy reduction. The planning elements of the social function were classified into themes such as community function, improving the health of users, and scenery improvement. These results suggest that green infrastructure planning for particulate matter reduction requires approaches related to key concepts, such as resilience and sustainability. In particular, there is a need to apply green infrastructure planning elements in order to reduce exposure to particulate matter.

Leaf epidermal microstructure of the genus Scopolia Jacq. s.l. (Solanaceae-Hyoscymeae) and its systematic significance (광의의 미치광이풀속(Scopolia Jacq. s.l., 가지과-Hyoscymeae족)의 잎표피 미세구조와 이의 계통분류학적 중요성)

  • Hong, Suk-Pyo;Paik, Jin-Hyub
    • Korean Journal of Plant Taxonomy
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    • v.31 no.3
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    • pp.267-282
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    • 2001
  • To examine the leaf epidermal microstructure of three genera (Scopolia s.s., Anisodus, AtroPanthe, including Przewalskia as an outgroup) in the genera Scopolia Jacq. s.l., leaves of 10 species (37 specimens) were investigated by the light microscopy (LM) and scanning electron microscopy (SEM). The stomata of studied taxa were 'amphistomatic type' and the size (guard cell) range was $18-64{\times}11-48{\mu}m$. The size of stomata is slightly differed from between the taxa; the smallest size of stomata were found in the monotypic genus, Przewalskia ($24-27{\times}16-17{\mu}m$), on the other hand the largest one was found in Anisodus carniolicoides ($62-64{\times}43-48{\mu}m$). The stomatal complex was mostly anomocytic (in Scopolia s.s., Anisodus taxa : A. luridus, A. carniolicoides, A. acutangulus) and sometimes anisocytic (in Anisodus tanguticus, Przewalskia, Atropanthe). The stomata is mostly crescent in shape, but rarely circular, especially in Przewalskia tangutica. The shapes of epidermal cells are similar in both adaxial and abaxial sides, and mostly undulate/sinuate polygonal anticlinal wall, but rarely arched in Przewalskia tangutica. The epicuticular wax was not well developed in most studied taxa, except Anisodus tanguticus which is well developed cuticular striae around the stomatal complex. The elongate-headed glandular trichomes were found in Scopolia s.s. and Przewalskia. While the taxa of Anisodus and Atropanthe have not any trichomes (i. e., glabrous), except Anisodus luridus, which has simple or sometimes branched (dendritic- type) non-glandular trichome. Finally, the systematic and ecological significance of the leaf micromorphological features (stomata complex, trichome, etc.) in identification and elucidation of Scopolia s.l. including Przewalskia, especially between or within the genera including among the species is also discussed.

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The taxonomic consideration of leaf epidermal microstructure in Korean Thymelaeaceae Adans (한국산 팥꽃나무과 잎표피 미세구조의 분류학적 검토)

  • Jung, Eun-Hee;Hong, Suk-Pyo
    • Korean Journal of Plant Taxonomy
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    • v.33 no.4
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    • pp.421-433
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    • 2003
  • To examine the leaf epidermal microstructure, nine species in five genera (Daphne L. - 4 spp., Diarthron Turcz. - 1 sp., Edgewarthia Meisn. - 1 sp., Stellera L. - 1 sp., Wikstroemia Endl. - 2 spp.) of the Korean Thymelaeaceae were investigated by light microscopy (LM) and scanning electron microscopy (SEM). The stomata of stuo야ed taxa were 'hypostomatic type' and the size range of guard cell was $13.8-34.4{\times}8.7-22.9{\mu}m$: the smallest size of stomata was found in Diathran linifolium ($15.9{\pm}2.6{\times}10.0{\pm}1.3{\mu}m$), while the largest one was measured to Daphne adara ($32.8{\pm}1.6{\times}20.7{\pm}1.3{\mu}m$). The stomatal complex was anomocytic in the most studied taxa, except Daphne kiusiana by having combined with anisocytic together. The shapes of epidermal cells are undulate anticlinal wall. The size range of epidermal cell was $20.7-61.0{\mu}m$; the smallest size of epidermal cell was found in Stellera charnaejasme ($26.0{\pm}1.9{\mu}m$), on the other hand the largest one was found in Edgeworthia chrysantha ($53.6{\pm}3.1{\mu}m$). The well-developed flaky epicuticular waxes can be divided three kinds of pattern - (1) smooth in comparison, not entire platelets and scattered, (2) isolated flake-like platelets, mostly paralleled, sparsely, (3) flake-like platelets, flat, membraneous, protruding from the surfaces at varying angles and densely. Two types of trichome are recognized; (1) Type I: uniseriate trichome of striate surface (D. genkwa, Diarthron linifalium, E. chrysantha, W. ganpi and W. trichotama), (2) Type II: multicellular trichome of papillose surface, uncinated 3-4 nodes (Diathron linifolium). Finally, the systematics significance of the leaf micromorphological features in identification and elucidation of Korean Thymelaeaceae, especially between or within the genera including among the species is also briefly discussed.

Measurement of Verticality and Joint Gaps of a Near-surface Disposal Facility Vault Through a Mock-up Test for Fill-up Stages (표층처분시설 처분고의 목업테스트를 통한 채움단계별 수직도 및 이음부 벌어짐 측정)

  • Choi, Dong-Ho;Ann, Ki-Yong;Choi, In-Yong;Lee, Hyuk-Jin
    • Journal of the Korean Recycled Construction Resources Institute
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    • v.9 no.4
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    • pp.537-544
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    • 2021
  • In order to describe the fill-up stages of a near-surface disposal facility vault, a mock-up test is performed, and its behavior during the fil l -up stages is investigated. On an in-site concrete foundation with a l ength of 6600mm, a width of 6600mm and a thickness of 400mm, a reinforced concrete disposal vaul t is manufactured with 4 precast (PC) corner wal l s and 8 PC side wal l s. 36 wasted drums are pl aced on the 1st fl oor in 6 by 6, and then the empty space is fil l ed with grout fil l er. These processes are repeated up to the 5th floor, and the verticality and the joint gaps are measured for each fill-up stage. The verticality is measured using a level at 6 positions on each side wall (3 positions on the left and right sides, respectivel y), i.e. a total of 24 positions on the 4 side wal l s. The joint gaps are measured at 9 positions on each side wal l (3 positions on the left, center and right sides, respectively), I.e. a total 36 positions on the 4 side walls. To measure the joint gaps, crack tips are installed on the left and right sides of every joint gap, and vernier calipers are used. The measured verticality obtained through the mock-up test was found to be ±0.1° based on the initial stage (ST0), and the result of the joint gap was up to 0.38mm. This appears to have a negligible effect on the structure.

Distribution and Management of Spatial Dose Rate in Neuro Angio Room (두개부 혈관조영실에서 공간산란선량의 분포와 관리)

  • Lee, Mi-Hwa;Jung, Hong-Ryang;Lim, Cheong-Hwan;Hong, Dong-Hee;Kim, Ki-Jeong;Kim, Sang-Hyun
    • Journal of Digital Convergence
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    • v.12 no.4
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    • pp.427-435
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    • 2014
  • This study is performed in the intervention unit, during interventional procedures and in accordance with the direction and distance during the exposure indoor space is to measure the dose. I was classified at an angle of $45^{\circ}$ counterclockwise from the phantom. Seven(A, B, C, D, E, F, G) were classified as direction. Length was measured from the center of the phantom. Each direction 50cm, 100cm, 150cm, 200cm were classified. I was analyzed by measuring of frontal, lateral, Bi-plan fluoroscopic Spatial dose rate in all 28 points. Measured dose was the highest at 50cm and over 200cm, dose was rapidly decreasing as increased distance. Dose was different more than nine times depending on the distance and direction, Installation of shielding wall can reduce exposure about 84.52% to 93.54%.

Studies on the Geology and Geochemistry in the Beonam Mine, Korea (전북 번암광산의 지질과 지화학적 연구)

  • Chung, Jae-Il;Na, Choon-Ki;Lee, Young-Up;Jeon, Seo-Ryeong;Kim, Seon-Young
    • Economic and Environmental Geology
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    • v.28 no.6
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    • pp.623-633
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    • 1995
  • The Beonam deposits which is located in south-western part of Sobaeksan massif are emplaced along $N20{\sim}30^{\circ}E$ trending fissures in Precambrian Sobaeksan gneiss complex. Surrounding granites are inferred to be differentiated and formed from calc-alkaline magma which was generated from remelting or partial melting of the crustral material having igneous composition. The Sr isotope data of ore minerals showing significantly low initial Sr value relative to those of surrounding granite batholiths suggest that the ore-bearing fluid formed the Beonam Au-Ag mine are isotopically distinct from those of the wall rocks, and it indicates that there is no evidence of genetic relationship between ore-bearing fluids and surrounding granites, although further study should be needed. The results of paragenetic studies suggest three stages of hydrothermal mineralization; stage I: base-metal sulfides stage, stage II: late base-metal sulfides, electrum and silver-bearing sulfosalts stage, stage III: minor silverbearing minerals, barren quartz and carbonates stage. The temperature, salinity and pressure of the Beonam deposits estimated from mineral assemblage, chemical composition, fluid inclusion and sulfur isotope geothermometry are as follows; stage I: $200{\sim}315^{\circ}C$, 3.5~6.5 NaCl eq. wt%, 0.28~0.61 Kbar, stage II: $150{\sim}235^{\circ}C$, 4.5~7.4 NaCl eq. wt%, 0.11~0.15 Kbar. The estimated oxygen and sulfur fugacity during first stage mineralization, based on phase relation of associated minerals, range from $10^{35.1}{\sim}10^{-39.7}$ atm. and $10^{-11.0}{\sim}10^{-13.4}$ atm., respectively. All these evidences suggest that the Beonam deposits are polymetallic meso-epithermal ore deposits.

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Microbiological Hazard Analysis of Foodservice Facilities and Equipment at Kindergarten Foodservice Establishments (유치원 급식시설.설비에 대한 미생물학적 위해분석)

  • Lee, Hye-Yeon;Bae, Hyun-Joo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.10
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    • pp.1457-1465
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    • 2009
  • This study was conducted to analyze the food safety management practices and to provide data that could be used to improve food safety management at kindergarten foodservice establishments in Daegu and Gyeongbuk province. Microbiological hazard analysis was conducted from May to July, 2008 at the four foodservice establishments. A total (20 items) of foodservice facilities, cooking utensils, and equipment were tested about total plate counts, coliforms, E. coli, Staphylococcus aureus, Salmonella spp., and Listeria monocytogenes. The microbiological detected levels were higher than the critical limits for prepreparing and cooking knives, chopping boards, working tables (both prepreparing and cooking), refrigerator (inside wall), bart, basket, and tray. E. coli, Salmonella spp., and Listeria monocytogens were not detected in any samples. However, Staphylococcus aureus were detected in rubber gloves for cooking and trench in the bottom at one foodservice establishment. In conclusion, these results suggest that a prerequisite programs guideline should be provided to improve the food safety levels at kindergarten foodservice establishments and the foodservice manager must maintain proper food safety technique for foodservice facilities, cooking utensils, and equipment at kindergarten foodservice establishments to prevent cross-contamination and spread of foodborne pathogens.