• Title/Summary/Keyword: clipping

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Clipping of T2 Sympathetic Chain Block for Essential Hyperhidrosis (다한증 환자에서의 Clipping에 의한 T2 Sympathetic Chain Block의 효과)

  • 이두연;윤용한;백효채;신화균;이성수;강정신
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.745-748
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    • 1999
  • Background: A definitive cure for an essential hyperhidrosis can be obtained by an upper thoracic sympathectomy. However, this is offset by the occurrence of a compensatory hyper hidrosis as a side effect and it is irreversible. We performed a thoracoscopic sympathetic chain block using an endoscopic clip in order to avoid the compensatory hyperhidrosis. Material and Method: From Aug. 1998 to Nov. 1998, 42 cases of thoracoscopic clipping of the T2 sympathetic chain were performed. The sympathetic chain was clipped using an endoscopic clip instead of cutting. Result: Bilateral procedure took less than 40 minutes and occasionally necessitated one night in the hospital. There were no mortality nor life- threatening complications. Horners syndrome occurred in two cases. At the end of postoperative follow-up(median 3 months), 95.0% of the patients were satisfied with the results. Compensatory sweating occurred in 31 cases(77.5%) where nine of those cases were classified as either embarrassing(6 cases-15.0%) or disabling(3 cases-7.5%). Conclusion: Endoscopic thoracic T2 sympathetic chain block using endoscopic clipping is an efficient, safe and minimally invasive surgical method for the treatment of palmar and craniofacial hyperhidrosis and the results were similar to those underwent T2 sympathicotomy. We recommend that patients receive endoscopic sympathetic chain block in summer.

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Total Degradation Performance Evaluation of the Time- and Frequency-Domain Clipping in OFDM Systems (OFDM 시스템에서 시간 및 주파수 영역 클리핑의 Total Degradation 성능평가)

  • Han, Chang-Sik;Seo, Man-Jung;Im, Sung-Bin
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.44 no.7 s.361
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    • pp.17-22
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    • 2007
  • OFDM (Orthogonal Frequency Division Multiplexing) is a special case of multicarrier transmission, where a single data stream is transmitted over a number of lower-rate subcarrier. One of the main reasons to use OFDM is to increase robustness against frequency-selective fading or narrowband interference. Unfortunately, an OFDM signal consists of a number of independently modulated subcarriers, which can give a large PAPR (Peak-to-Average Power Ratio) when added up coherently. In this paper, we investigate the performance of a simple PAPR reduction scheme, which requires no change of a receiver structure or no additional information transmission. The approach we employed is clipping in the time and frequency domains. The time-domain clipping is carried out with a predetermined clipping level while the frequency-domain clipping is done within EVM (Error Vector Magnitude). This approach is suboptimal with lower computational complexity compared to the optimal method. This evaluation is carried out on the OFDM system with an nonlinear amplifier. The simulation results demonstrated that the PAPR reduction algorithm is one of ways to reduce the effects of the nonlinear distortion of an HPA (High Power Amplifier).

Middle Cerebral Artery Aneurysm in a Premature Neonate

  • Choi, Chan-Young;Lee, Chae-Heuck
    • Journal of Korean Neurosurgical Society
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    • v.53 no.6
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    • pp.371-373
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    • 2013
  • Intracranial aneurysms in the neonate are very rare and their clinicopathological findings remain unclear. We report a 26-day-old premature neonate who underwent microsurgical clipping on the ruptured middle cerebral artery bifurcation aneurysm successfully with a review of relevant literature.

Incidence and Risk Factors of Chronic Subdural Hematoma after Surgical Clipping for Unruptured Anterior Circulation Aneurysms

  • Lee, Won Jae;Jo, Kyung-Il;Yeon, Je Young;Hong, Seung-Chyul;Kim, Jong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.57 no.4
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    • pp.271-275
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    • 2015
  • Objective : Chronic subdural hematoma (CSDH) is a rare complication of unruptured aneurysm clipping surgery. The purpose of this study was to identify the incidence and risk factors of postoperative CSDH after surgical clipping for unruptured anterior circulation aneurysms. Methods : This retrospective study included 518 patients from a single tertiary institute from January 2008 to December 2013. CSDH was defined as subdural hemorrhage which needed surgical treatment. The degree of brain atrophy was estimated using the bicaudate ratio (BCR) index. We used uni- and multivariate analyses to identify risk factors correlated with CSDH. Results : Sixteen (3.1%) patients experienced postoperative CSDH that required burr hole drainage surgery. In univariate analyses, male gender (p<0.001), size of aneurysm (p=0.030), higher BCR index (p=0.004), and the use of antithrombotic medication (p=0.006) were associated with postoperative CSDH. In multivariate analyses using logistic regression test, male gender [odds ratio (OR) 4.037, range 1.287-12.688], high BCR index (OR 5.376, range 1.170-25.000), and the use of antithrombotic medication (OR 4.854, range 1.658-14.085) were associated with postoperative CSDH (p<0.05). Postoperative subdural fluid collection and arachnoid plasty were not showed statistically significant difference in this study. Conclusion : The incidence of CSDH was 3.1% in unruptured anterior circulation aneurysm surgery. This study shows that male gender, degree of brain atrophy, and the use of antithrombotic medication were associated with postoperative CSDH.

Histogram Matching-based Power Reduction Technique for OLED Display (OLED 디스플레이를 위한 히스토그램 정합 기반 파워 소모 저감 기법)

  • Choi, Songwoo;Kim, Young Hwan;Kang, Suk-Ju
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.1
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    • pp.137-144
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    • 2014
  • In this paper, we propose the histogram matching-based power reduction technique considering the perceptual image quality. The conventional methods cannot analyze the clipping error of an image, and hence, they significantly degrade the image quality when pixels with the clipping error are concentrated on small area. The proposed method generates histograms for various images with different characteristics, and it calculates and stores the optimal clipping rate in a database. Then, it compares the histograms with that of an input image, and selects the histogram and clipping rate with the minimum difference to prevent the image quality degradation. In the experimental results, the proposed method improved the average PSNR and SSIM by up to 15.795 dB and 0.036, compared with the conventional methods.

Analysis of Clip-induced Ischemic Complication of Anterior Choroidal Artery Aneurysms

  • Cho, Min-Soo;Kim, Min-Su;Chang, Chul-Hoon;Kim, Sang-Woo;Kim, Seong-Ho;Choi, Byung-Yon
    • Journal of Korean Neurosurgical Society
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    • v.43 no.3
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    • pp.131-134
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    • 2008
  • Objective: The surgical approach for anterior choroidal artery (AChA) aneurysm is typically similar to those used for other supraclinoid internal carotid artery (ICA) lesions. However, the surgical clipping of this aneurysm is complicated and as a result. can result in postoperative ischemic complications. The purpose of this study was to clarify the risk of clip-induced ischemic complication in AChA aneurysm and to get the benefits for helping decision making. Methods: We retrospectively investigated 53 cases (4.0%) of AchA aneurysm treated surgically. We divided the AChA aneurysm to 3 subtype according to the origin of aneurysmal neck; A type originating from the AChA itself. J type from junction of AChA and ICA and I type from the ICA itself. We evaluated brain CT about 1 week post-operative day to confirm the low density in AChA territory. Results: Ruptured aneurysm was 26 cases and unruptured aneurysm 27 cases. The aneurysmal subtype of A, J, and I was 13, 17, and 23 cases. Of the 53 cases who performed surgical neck clipping, twelve (22.6%) had postoperative AChA distribution infarcts. Increased infarct after neck clipping had statistic significance in non-I subtype (r=0.005) Conclusion: AChA aneurysm surgery carries a significant risk of postoperative stroke. Don't always stick to clipping only, especially in non-I type of incidental small aneurysm, which has high risk of post-clip ischemic complications.

Mortality and Morbidity of Aneurysmal Neck Clipping during the Learning Curve

  • Lee, Sang-Ho;Hwang, Hyung-Sik;Moon, Seung-Myung;Kim, Sung-Min;Choi, Sun-Kil
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.16-21
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    • 2006
  • Objective : Young neurosurgeons need to focus on the mortality and morbidity of aneurysmal neck clipping to develop a personal experience with an initial series. Methods : Total 88 aneurysms from 75 patients who underwent neck clipping by the same operator from 2001 to 2004 were reviewed. Patients were divided into three groups : first year [Group I], second year [Group II], and third year [Group III] in each group. Location of aneurysm, age, Fisher grade, Hunter-Hess grade [H-H grade], postoperative Glasgow outcome scale [GOS], and complications related to surgical procedures were evaluated with Chi-square and logistic regression analyses. Results : Fourteen patients had complications related to surgery [18.7%]. The major causes of mortality and morbidity related to surgery were cerebral infarction, hemorrhage and brain swelling due to intraoperative rupture, brain retraction and vasospasm. Among the 4 cases of mortality were 2 patients in Group I, 1 patient in Group II and 1 patient in Group III, and location of aneurysms were 2 internal carotid artery[ICA] and 2 posterior communicating artery[PCoA] aneurysms. There were 4 morbidity and new neurological deficits in Group I, 4 in Group II and 2 in Group III. Although mortality and morbidity during the learning curve had a statistical significance in H-H grade, age [>60 years old], and aneurysm location [especially ICA aneurysm] as variables, mortality mainly occurred in ICA and PCoA aneurysms. Conclusion : Experienced supervision or endovascular approach should be considered for the treatment of ICA and PCoA aneurysms during the learning curve.

Aneurysmal Neck Clipping as the Primary Treatment Option for Both Ruptured and Unruptured Middle Cerebral Artery Aneurysms

  • Choi, Jai Ho;Park, Jung Eon;Kim, Myeong Jin;Kim, Bum Su;Shin, Yong Sam
    • Journal of Korean Neurosurgical Society
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    • v.59 no.3
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    • pp.269-275
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    • 2016
  • Objective : Although middle cerebral artery (MCA) aneurysms are less amenable to coil embolization, an increasing number of studies support favorable endovascular treatment for them. The purpose of this study is to compare the outcomes of two different treatments (surgery versus coiling) and evaluate the benefits of surgical clipping for MCA aneurysms. Methods : Here we retrospectively analyzed the outcomes of 178 ruptured and unruptured MCA aneurysms treated in patients between September 2008 and April 2012. Parameters assessing treatment outcomes include degree of aneurysm occlusion, presence of regrowth, clinical status, and complications. Results : Among 178 MCA aneurysms, 153 were treated surgically. After a mean follow-up of 12 months, the surgery group showed a clinically significant complete occlusion rate (98%) compared with the coiling group (56%) (p<0.001). Follow-up radiologic evaluation showed a higher regrowth rate (four of 16 cases) in the coiling group than in the surgery group (one of 49 cases) (p=0.003). There was no statistically significant difference in favorable clinical outcome rate between the two groups. The procedure-related permanent morbidity and mortality rates were 2% (three of 153 cases) in the surgery group and 0% (0 of 25 cases) in the coiling group. Conclusion : Compared to endovascular treatment, surgical neck clipping for both ruptured and unruptured MCA aneurysms results in a significantly higher complete obliteration rate and less regrowth. Therefore, even in this endovascular era, we still recommend surgical clipping as the primary treatment option for MCA aneurysms rather than coil embolization.

Comparative Cost Analysis for Surgical and Endovascular Treatment of Unruptured Intracranial Aneurysms in South Korea

  • Kim, Myungsoo;Park, Jaechan;Lee, Joomi
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.455-459
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    • 2015
  • Objective : A cost comparison of the surgical clipping and endovascular coiling of unruptured intracranial aneurysms (UIAs), and the identification of the principal cost determinants of these treatments. Methods : This study conducted a retrospective review of data from a series of patients who underwent surgical clipping or endovascular coiling of UIAs between January 2011 and May 2014. The medical records, radiological data, and hospital cost data were all examined. Results : When comparing the total hospital costs for surgical clipping of a single UIA (n=188) and endovascular coiling of a single UIA (n=188), surgical treatment [$mean{\pm}$standard deviation (SD) : \$8,280,000{\pm}1,490,000$] resulted in significantly lower total hospital costs than endovascular treatment ($mean{\pm}SD$ : \$11,700,000{\pm}3,050,000$, p<0.001). In a multi regression analysis, the factors significantly associated with the total hospital costs for endovascular treatment were the aneurysm diameter (p<0.001) and patient age (p=0.014). For the endovascular group, a Pearson correlation analysis revealed a strong positive correlation (r=0.77) between the aneurysm diameter and the total hospital costs, while a simple linear regression provided the equation, y (\)=6,658,630+855,250x (mm), where y represents the total hospital costs and x is the aneurysm diameter. Conclusion : In South Korea, the total hospital costs for the surgical clipping of UIAs were found to be lower than those for endovascular coiling when the surgical results were favorable without significant complications. Plus, a strong positive correlation was noted between an increase in the aneurysm diameter and a dramatic increase in the costs of endovascular coiling.

Influence of Re-growth Interval on Chemical Composition, Herbage Yield, Digestibility and Digestion Kinetics of Setaria sphacelata and Cenchrus ciliaris in Buffaloes

  • Mahr-un-Nisa, Mahr-un-Nisa;Khan, M. Ajmal;Sarwar, Muhammad;Mushtaque, M.;Murtaza, G.;Lee, W.S.;Kim, H.S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.19 no.3
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    • pp.381-385
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    • 2006
  • This study examined the influence of re-growth periods on chemical composition, biomass production, nutritive value and digestion kinetics of Setaria sphacelata (SS) and Cenchrus ciliaris (CC) in ruminally cannulated buffalo bulls. Two re-growth intervals i.e. clipping every month ($CI_1$) and clipping after every two months ($CI_2$) were compared with the control (clipped after 4 months). Mean values of leaf to stem ratio in SS and CC grasses were decreased (p<0.05) with increasing re-growth interval. The lowest leaf to stem ratio was recorded in control plots of both grasses. In both grasses, increasing growth period increased the concentrations of dry matter (DM), neutral detergent fiber (NDF) and organic matter (OM) and decreased crude protein (CP). Mean dry herbage, OM and CP yields of SS and CC were increased (p<0.05) with increasing re-growth interval. Ruminal DM and NDF digestibilities of SS and CC were decreased (p<0.05) with increasing interval. Ruminal rate of DM and NDF disappearance was higher while the ruminal lag time of these nutrients was lower with monthly than with bi-monthly clipping interval. The results from present study imply that SS and CC clipped after every two months is more beneficial than when clipped every month or every four months in terms of optimal biomass with adequate nutritional value for buffaloes.