• Title/Summary/Keyword: diversion

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Safety and Efficacy of Flow Diverter Therapy for Unruptured Intracranial Aneurysm Compared to Traditional Endovascular Strategy : A Multi-Center, Randomized, Open-Label Trial

  • Kim, Junhyung;Hwang, Gyojun;Kim, Bum-Tae;Park, Sukh Que;Oh, Jae Sang;Ban, Seung Pil;Kwon, O-Ki;Chung, Joonho;Committee of Multicenter Research, Korean Neuroendovascular Society,
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.772-778
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    • 2022
  • Objective : Endovascular treatment of large, wide-necked intracranial aneurysms by coil embolization is often complicated by low rates of complete occlusion and high rates of recurrence. A flow diverter device has been shown to be safe and effective for the treatment of not only large and giant unruptured aneurysms, but small and medium aneurysms. However, in Korea, its use has only recently been approved for aneurysms <10 mm. This study aims to compare the safety and efficacy of flow diversion and coil embolization for the treatment of unruptured aneurysms ≥7 mm. Methods : The participants will include patients aged between 19 and 75 years to be treated for unruptured cerebral aneurysms ≥7 mm for the first time or for recurrent aneurysms after initial endovascular coil embolization. Participants assigned to a flow diversion cohort will be treated using any of the following devices : Pipeline Flex Embolization Device with Shield Technology (Medtronic, Minneapolis, MN, USA), Surpass Evolve (Stryker Neurovascular, Fremont, CA, USA), and FRED or FRED Jr. (MicroVention, Tustin, CA, USA). Participants assigned to a coil embolization cohort will undergo traditional endovascular coiling. The primary endpoint will be complete occlusion confirmed by cerebral angiography at 12 months after treatment. Secondary safety outcomes will evaluate periprocedural and post-procedural complications for up to 12 months. Results : The trial will begin enrollment in 2022, and clinical data will be available after enrollment and follow-up. Conclusion : This article describes the aim and design of a multi-center, randomized, open-label trial to compare the safety and efficacy of flow diversion versus traditional endovascular treatment for unruptured cerebral aneurysms ≥7 mm.

Structural Analysis of Time and Money Attitudes, Leisure Consumption Behavior and Leisure Satisfaction (시간과 화폐에 대한 태도가 여가소비행동과 여가만족도에 미치는 영향에 대한 구조분석)

  • Huh, Kyungok;Cha, Kyung-Wook;Yoo, Soo-Hyun
    • Journal of Family Resource Management and Policy Review
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    • v.19 no.2
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    • pp.127-148
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    • 2015
  • This study compared types of time and money attitudes by respondents' characteristics, and compared leisure consumption behavior and leisure satisfaction among different groups, which are classified by attitudes toward time and money. It also verified a structural model for the relationship of leisure satisfaction and the attitudes toward time and money, and investigated the moderating effects of leisure consumption behavior. Data were obtained from a questionnaire completed by 512 adult consumers. Using factor analyses and cluster analyses, this study classified the types of time and money attitudes. The time attitude was categorized according to four clusters: time-insensibility, future- oriented, present-oriented, and past-oriented. The money attitude was divided into four clusters: future safety, stinginess/anxiety, diversion, and power/prestige. The major findings of this study were as follows: First, the propensity of leisure consumption behavior to seek fashion and conspicuousness was higher for time-insensibility group than for the others. However, the propensity of rational consumption behavior for leisure was higher for the future-oriented group. The level of leisure satisfaction was the highest for the time-insensibility group. Second, the propensity of leisure consumption behavior to seek fashion and conspicuousness was higher for those who considered money as tools for diversion and power/prestige. The propensity of rational consumption behavior for leisure was higher for the future safety and stinginess/anxiety groups. The level of leisure satisfaction was significantly higher for the diversion group. Third, from the results of structural analyses, the time-insensibility attitude showed a positive effect on the leisure consumption behavior to seek fashion and conspicuousness. The future-oriented attitude had a positive effect on the propensity of rational consumption behavior for leisure. The money attitudes of diversion and power/prestige had positive impacts on the leisure consumption behavior to seek fashion and conspicuousness, although they had negative effects on the propensity of rational consumption behavior for leisure. The leisure consumption behavior to seek fashion and conspicuousness had a positive effect on leisure satisfaction, although the rational consumption behavior for leisure had a negative effect.

Tunnelling in Bangkok - Two Case Studies (방콕의 터널공사 - 두 개의 사례연구)

  • Teparaksa, Wanchai;Cho, Gye-Chun
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.7 no.2
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    • pp.153-163
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    • 2005
  • This paper presents two case studies for tunnelling in Bangkok: a subway tunnel site and a flood diversion tunnel site. The first case study is related to ground displacement response for dual tunnel Bangkok MRT subway. The MRT subway project of Bangkok city consists of dual tunnels about 20 km long with 18 subway stations. The tunnels are seated in the firm first stiff silty clay layer between 15-22 m in depth below ground surface. The behavior of ground deformation response based on instrumentation is presented. The back analysis based on plain strain FEM analysis is also presented and agrees with field performance. The shear strain of FEM analysis is in the range of 0.1-1% and in accordance with the results of self boring pressuremeter tests. Meanwhile, the second case study is related to the EPB tunnelling bored underneath through underground obstruction. The Premprachakorn flood diversion tunnel is the shortcut tunnel to divert the flood water in rainy season into the Choapraya river. The tunnel was bored by means of EPB shield tunnelling in very stiff silty clay layer at about 20-24 m in depth. During flood diversion tunnel bored underneath the existing Bangkok main water supply tunnel and pile foundation of the bridge, instrumentation was monitored and compared with predicted FEM analysis. The prevention risk potential by means of predicting damage assessment is also presented and discussed.

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Design of Sedimentary Rock Slopes in River Diversion Works (가배수로 터널공사의 퇴적암 사면 안정화 설계)

  • Jee, Wang-Ruel
    • Geotechnical Engineering
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    • v.14 no.6
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    • pp.17-32
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    • 1998
  • The Bakun hydroelectric project includes the construction of a hydroelectric power plant with an installed capacity of 2,520MW and a power transmission system connecting to the existing transmission networks in Sarawak and Western Malaysia, The power station will consist of a 210m height concrete faced rockfill dam. During the construction of the dam and the power facilities the Balui river has to be diverted by three diversion tunnels with a length of some 1,400m each. The inner diameter of the tunnels is 12m and the tunnel width is 16m at the portal area. This paper describes the stability analysis and design methods for the open cut rock slopes in the inlet and outlet area of the diversion tunnels. The geotechnical parameters employed in stability calculations were given as a function of four. defined Rock Mass Types (RMT) which were based on RMR system from Bieniawski. The stability calculations procedure of the rock slopes are divided into two stages. In the first stage, it is calculated for the stability of each 'global' slope without any rock support and shotcrete system. In the second stage, it is calculated for each 'local'slope stability with berms and supported with rock bolts and shotcrete. The monitoring instrumentation was performed continuously and some of the design modification was carried out in order to increase the safety of failed area based on the unforeseen geological risks during the open cut excavation.

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Relationships Between Using Rate of Information Media on Diversion by Traffic Condition (소통상황에 따른 정보매체별 우회이용률 분석)

  • Choe, Yun-Hyeok;Choe, Gi-Ju;Go, Han-Geom
    • Journal of Korean Society of Transportation
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    • v.28 no.1
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    • pp.39-49
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    • 2010
  • Although many studies have been carried out on the pattern of behavior of drivers which result from the provision of traffic information, there have been few detailed studies on the composition of message, method for message expression, timing of provision, point of provision, media for provision, changes by traffic condition, etc. This study was intended to provide an insight into the changes in the characteristics related to the provision of information by analyzing how the patterns of information utilization change depending on the traffic condition and reclassifying such patterns according to the characteristics of media. Unlike the existing studies, this study adopted the traffic condition, using rate of information media, and the correlation coefficient label as the basis for information media classification, and categorized them into passive utilization media, active utilization media, and past experience in order to ensure the statistical reasonability. The categorized using rate of information media and traffic condition was found to have a positive(+) correlation with the travel speed in the case of passive utilization media during both consecutive holidays(Korea's traditional Thanksgiving day) and weekends, but had a negative(-) correlation with the positive utilization media and past experience. The rate of decision to take a detour based on the past experience was high at the condition of congestion or slow during both consecutive holidays and weekends, but the rate of decision to take a detour through passive utilization media was high in a smooth traffic. In other words, if the traffic condition worsens, using rate of passive utilization media would be low while the diversion rate would be high which uses the active utilization media and past experience. Therefore, it should be established to suit the traffic condition and media characteristics for strategies of traffic distribution through drivers' diversion behavior on weekends and consecutive holidays.

Diversion Rate Estimation Model for Unexperienced Transportation Mode by Considering Maximum Willingness-to-pay: A Case Study of Personal Rapid Transit (최대 지불의사액을 고려한 미경험 교통수단의 전환율 추정모형: Personal Rapid Transit 사례를 중심으로)

  • Yu, Jeong Whon;Choi, Jung Yoon
    • Journal of Korean Society of Transportation
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    • v.31 no.3
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    • pp.33-44
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    • 2013
  • Personal Rapid Transit(PRT) has emerged as a promising transportation mode for transit-oriented sustainable communities. In this study, an alternative design of questionnaire survey is proposed in order to capture traveler's perception of an unexperienced transportation mode. This study aims at predicting the mode choice diversion behavior of potential PRT users who do not have experience of using it previously, considering their willingness-to-pay. The proposed model was applied to predict an aggregate forecast of PRT patronage for the city of Songdo where PRT is considered to be constructed. For validation of the proposed model, the price elasticity of PRT demand was analyzed, compared with existing models. The analysis results suggest that the proposed design of questionnaire survey is able to capture respondents' attitude and perception to unexperienced transportation mode in an effective manner. Also, they show that the proposed diversion rate model is more realistic than existing models in explaining the effects of users' willingness-to-pay for predicting PRT patronage.

Increase of Downstream Minimum Flow Followed by Increase of Water Storage Size in Yudeungcheon Upstream (유등천 수원확보 규모와 하류 하천유지유량의 상관성)

  • Noh, Jae-Kyoung;Kim, Yong-Kuk;Lee, Jae-Nam
    • Korean Journal of Agricultural Science
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    • v.37 no.2
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    • pp.285-293
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    • 2010
  • To secure instream flow at the Yudeung urban stream reach of Daejeon city in South Korea, Yudeung upstream diversion was designed with total water storage of $59{\times}10^4m^3$, and the upstream Seongol reservoir was planned to raise the bank with various sizes. Downstream streamflows were simulated by considering outflows from upstream diversion and reservoir, and after then flow durations were analyzed and compared with flows of no reservoir condition. In case of no diversion or reservoir upstream, flow durations were $1^{st}$ flow of $84.72m^3/s$, $95^{th}$ flow of $2.10m^3/s$, $185^{th}$ flow of $0.92m^3/s$, $275^{th}$ flow of $0.42m^3/s$, and $355^{th}$ flow of $0.31m^3/s$. In case of upstream diversion, flow durations were $1^{st}$ flow of $94.38m^3/s$, $95^{th}$ flow of $2.96m^3/s$, $185^{th}$ flow of $1.22m^3/s$, $275^{th}$ flow of $0.50m^3/s$, and $355^{th}$ flow of $0.35m^3/s$. The increase flow rates were $0.04m^3/s$ in $355^{th}$ flow, $0.08m^3/s$ in $275^{th}$, and $0.30m^3/s$ in 185th. In case of Seongol reservoir with effective storage capacities of $365{\times}10^4m^3$, $544{\times}10^4m^3$, $750{\times}10^4m^3$, and $992{\times}10^4m^3$, flow durations were $85.5{\sim}83.9m^3/s$ on $1^{st}$ flow, $2.85{\sim}2.57m^3/s$ on $95^{th}$ flow, $1.16{\sim}1.27m^3/s$ on $185^{th}$ flow, $0.64{\sim}0.99m^3/s$ on $275^{th}$ flow, and $0.56{\sim}0.94m^3/s$ on $355^{th}$ flow. The increase flow rates were $0.25{\sim}0.63m^3/s$ in $355^{th}$ flow, $0.22{\sim}0.57m^3/s$ in $275^{th}$, and $0.24{\sim}0.35m^3/s$ in $185^{th}$. The more the sizes of upstream reservoirs increased, the $1^{st}$ and $95^{th}$ flows decreased in which coefficients of determination were 0.92, 0.99, respectively and the $185^{th}$, $275^{th}$, and $355^{th}$ flows increased in which coefficients of determination were 0.93 to 0.99.