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Comparison between Lateral Supraorbital Approach and Pterional Approach in the Surgical Treatment of Unruptured Intracranial Aneurysms

  • Cha, Ki-Chul;Hong, Seung-Chyul;Kim, Jong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.51 no.6
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    • pp.334-337
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    • 2012
  • Objective : The lateral supraorbital (LSO) approach is a modified method of the classic pterional approach and it has advantages of short skin incision and small craniotomy compared with the pterional approach. This study was designed to compare the two approaches in the surgical treatment of unruptured intracranial aneurysms. Methods : We retrospectively reviewed 122 patients with 137 unruptured intracranial aneurysms treated by clipping, from July 2009 to April 2011. Between August 2010 and April 2011, 61 patients were treated by clipping via the lateral supraorbital approach and the same number of patients treated by clipping via the pterional approach were retrospectively enrolled. We analyzed the two groups and compared demographic, radiologic and clinical variables. Results : The mean age of patients in the two groups was 54.6 years (LSO group) and 55.7 years (Pterion group). The mean duration of hospitalization was shorter in the LSO group than in the Pterion group (7.9 days vs. 9.0 days, p=0.125) and the mean operation time was also significantly shorter in the LSO group (117.1 minutes vs. 164.3 minutes, p<0.001). Furthermore, the mean craniotomy area was much smaller in the LSO group (1275.4 $mm^2$ vs. 2858.9 $mm^2$, p<0.001). The two groups showed similar distributions of aneurysm location and postoperative complications. Conclusion : The lateral supraorbital approach for the clipping of unruptured intracranial aneurysm could be a good alternative to the classic pterional approach.

Clipping of Basilar Trunk Aneurysm - Case Report - (뇌기저동맥 체간부에 발생한 뇌동맥류 결찰술 - 증례보고 -)

  • Yang, Tai-Ki;Kim, Chul-Jin;Ahn, Byung-Jo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.128-132
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    • 2001
  • Aneurysm of the basilar artery trunk are rare and the surgical approach is very difficult because of the complexity of surgical anatomy around the basilar trunk and the vulnerable adjacent neurovascular structures. The development of brain CT and MRI makes the accurate diagnosis and produces the improvement of surgical approaches at the lesion of the skull base. One of the surgical approaches of basilar trunk aneurysms, the retrolabyrinthine presigmoid transtentorial transpetrosal approach to the aneurysm of the basilar trunk has some advantages of minimal retraction of cerebellum and temporal lobe, intact auditory and facial nerve function by the preservation of the vestibulocochlear and facial nerves, a preservation of sigmoid sinus and vein of Labbe and a relatively good operation field. We had a good result with this approach for the patient of basilar trunk aneurysm and reported the case with the review of literatures.

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Improvement of Infraorbital Rim contour Using Medpor

  • Hwang, So Min;Park, Seong Hyuk;Lee, Jong Seo;Kim, Hyung Do;Hwang, Min Kyu;Kim, Min Wook
    • Archives of Craniofacial Surgery
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    • v.17 no.2
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    • pp.77-81
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    • 2016
  • Background: Asymmetry of the infraorbital rim can be caused by trauma, congenital or acquired disease, or insufficient reduction during a previous operation. Such asymmetry needs to be corrected because the shape of the infraorbital rim or midfacial skeleton defines the overall midfacial contour. Methods: The study included 5 cases of retruded infraorbital rim. All of the patient underwent restoration of the deficient volume using polyethylene implants between June 2005 and June 2011. The infraorbital rim was accessed through a subciliary approach, and the implants were placed in subperiosteal space. Surgical outcomes were evaluated using preoperative and postoperative computed tomography studies. Results: Implant based augmentation was associated with a mean projection of 4.6 mm enhancement. No postoperative complications were noted during the 30-month follow-up period. Conclusion: Because of the safeness, short recovery time, effectiveness, reliability, and potential application to a wide range of facial disproportion problems, this surgical technique can be applied to midfacial retrusion from a variety of etiologies, such as fracture involving infraorbital rim, congenital midfacial hypoplasia, lid malposition after blepharoplasty, and skeletal changes due to aging.

A Historical Approach to the Development of Democracy and the Archival Society in Korea (한국 기록관리와 '거버넌스'에 대한 역사적 접근)

  • OH, Hang-Nyeong
    • The Korean Journal of Archival Studies
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    • no.11
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    • pp.15-40
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    • 2005
  • 'Governance' is a subject that is widely discussed these days in the government and the academic world. I think that the new concept, 'governance', is a strategy to develop the democracy of the society in its institutional and functional aspects. When we are going to discuss about governance, public records and their relationships, without understanding the meaning of 'public' in Korea, we cannot expect to discuss the matter precisely. It is said that Korean public service sectors are awash with authoritarianism and unreasonableness, and that they are at the center of seething corruption and bribe scandals. It is the legacy that the regimes adopted in the aftermath of the Japanese colonial rule for 35 years. The colonial legacy included not simply the practice of the Japanese colony, but also people who had collaborated the Japanese. The American military government and Rhee, Sung-Man regime also appointed the same officials to government posts. As was the same case in other areas including economy, press, education, politics, law, etc. In this point of view, "Righting historical wrongs", a controversial issue now in Korea, aims at establishing the right relationships between an individual and the public, and eventually laying the foundation of democracy for future generation, a procedure of achieving good governance. Apparently, Korea has made progress in developing democracy, as well as in reforming the government policy and organization. Many independent commissions are performing the projects instead of the government institutions that mandated to do the job, but has not played their roles. The e-government projects in Korea was launched in 2001 by the former administration. However, the confusion of records-management after the promulgation of the act is the result of the lack of strategy and the inconsistency of the vision. Good record-keeping supports effective, transparent and accountable government. Accountability is a key element of good governance. It is a recognized fact that without information, there is no guidance for decision-making, and accountability. Thus without records, there is no accountability for the decisions of actions. Transparency means that the decisions taken and their enforcement are carried out based on led-out rules and regulations. When both accountability and transparency are non-existent, good governance is bound to fail. Archival institutions have to give an attention to inner-governance because of the new trend of archival practice, namely 'macro-appraisal'. This 'macro-appraisal' is a kind of a functions-based approach. However, macro-appraisal focuses not just on function, but on the three-way interaction of function, structure and citizen, which combined reflect the functioning of the state within civil society, that is to say, its governance. In conclusion, the public and democracy are major challenges in the Korean society. The so-called good governance requires good record management. In this respect, records managers are in the front line of instituting good governance, and achieving better public and democracy for future generation, a procedure of achieving good governance.

Estimation of C*-Integral for Defective Components with General Creep-Deformation Behaviors (일반 크리프 거동을 고려한 균열 구조물 C*-적분 예측)

  • Kim, Yeong-Jin;Kim, Jin-Su;Kim, Yun-Jae
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.26 no.5
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    • pp.795-802
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    • 2002
  • For assessing significance of a defect in a component operating at high (creeping) temperatures, accurate estimation of fracture mechanics parameter, $C^{*}$-integral, is essential. Although the J estimation equation in the GE/EPRl handbook can be used to estimate the $C^{*}$-integral when the creep -deformation behavior can be characterized by the power law creep, such power law creep behavior is a very poor approximation for typical creep behaviors of most materials. Accordingly there can be a significant error in the $C^{*}$-integral. To overcome problems associated with GE/EPRl approach, the reference stress approach has been proposed, but the results can be sometimes unduly conservative. In this paper, a new method to estimate the $C^{*}$-integral for deflective components is proposed. This method improves the accuracy of the reference stress approach significantly. The proposed calculations are then validated against elastic -creep finite element (FE) analyses for four different cracked geometries following various creep -deformation constitutive laws. Comparison of the FE $C^{*}$-integral values with those calculated from the proposed method shows good agreements.greements.

Treatment of a Carotid-Cavernous Sinus Fistula via the Superior Ophthalmic Vein Approach: A Case Report (상안정맥을 이용한 해면정맥동루의 색전술 치험례)

  • Moon, In-Sun;Shin, Han-Kyung;Kim, Dong-Il
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.116-119
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    • 2010
  • Purpose: Arteriovenous fistulas that involve the cavernous sinus often produce ophthalmologic symptoms and signs. Transvenous endovascular access is the method of choice for a carotid-cavernous sinus fistula. The superior ophthalmic vein is a safe and reasonable alternative route for the transvenous embolization of carotid-cavernous sinus fistula. We report a case of the embolization of a carotid-cavernous sinus fistula using the superior ophthalmic vein approach. Methods: A 58 year old female had conjunctival congestion, periocular pain and diplopia with a 2 month duration. Diagnostic orbital CT, brain MRI and cerebral angiography revealed a carotid-cavernous sinus fistula. The fistula occlusion was treated by coil embolization using the superior ophthalmic vein approach. Results: The initial presenting symptoms, conjunctival congestion, periocular pain and diplopia, decreased after surgery. Coil embolization via the superior ophthalmic vein approach was difficult because of the venous tortuosity and friability. During the follow up period, the patient was in a good condition without complications. Conclusion: Surgical exposure of the superior ophthalmic vein provides direct venous access to the cavernous sinus as well as an effective and safe treatment approach. The cooperation of the plastic surgeon and interventionist is a factor in successful treatment.

The Analysis of Welding Deformation in Large Welded Structure by Using Local & Global Model (Local & Global 모델을 이용한 용접구조물 변형 해석에 관한 연구)

  • Jang Kyoung-Bok;Cho Si-Hoon;Jang Tae-Won
    • Journal of Welding and Joining
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    • v.22 no.6
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    • pp.25-29
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    • 2004
  • Some industrial steel structures are composed by components linked by several welding joints to constitute an assembly. The main interest of assembly simulation is to evaluate the global distortion of welded structure. The general method, thermo-elasto-plastic analysis, leads to excessive model size and computation time. In this study, a simplified method called "Local and Global approach" was developed to break down this limit and to provide a accurate solution for distortion. Local and global approach is composed of 3 steps; 1) Local simulation of each welding joint on a dedicated mesh (usually very fine due to high thermal gradients), taking into account for the non linearity of the material properties and the moving heat source. 2) Transfer to the global model of the effects of the welding joints by projection of the plastic strain tensors. 3) Elastic simulation to determine final distortions in global model. The welding deformation test for mock-up structure was performed to verify this approach. The predicted welding distortion by this approach had a good agreement with experiment results.

Interdisciplinary approach in esthetic dentistry (심미치과에 있어서의 Interdisciplinary approach)

  • Kim, II-Young
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.9 no.1
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    • pp.38-41
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    • 2000
  • There are clinical cases that always give us trouble in our daily practice. But, those kind of difficulties may be from our intradisciplinary approach not from interdisciplinary approach. Many dentists are getting good results from interdisciplinary treatments, involving periodontics, operative dentistry and prosthodontics. But, the orthodontics is the discipline can't be missed to the dentists trying to esthetic treatment. Here, I'd like to share the following cases because I couldn't get esthetic outcomes if there was no orthodontic involvement, with periodontics, operative dentistry and prosthodontics.

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An Adaptive Genetic Algorithm with a Fuzzy Logic Controller for Solving Sequencing Problems with Precedence Constraints (선행제약순서결정문제 해결을 위한 퍼지로직제어를 가진 적응형 유전알고리즘)

  • Yun, Young-Su
    • Journal of Intelligence and Information Systems
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    • v.17 no.2
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    • pp.1-22
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    • 2011
  • In this paper, we propose an adaptive genetic algorithm (aGA) approach for effectively solving the sequencing problem with precedence constraints (SPPC). For effective representation of the SPPC in the aGA approach, a new representation procedure, called the topological sort-based representation procedure, is used. The proposed aGA approach has an adaptive scheme using a fuzzy logic controller and adaptively regulates the rate of the crossover operator during the genetic search process. Experimental results using various types of the SPPC show that the proposed aGA approach outperforms conventional competing approaches. Finally the proposed aGA approach can be a good alternative for locating optimal solutions or sequences for various types of the SPPC.

Topology Aggregation Schemes for Asymmetric Link State Information

  • Yoo, Young-Hwan;Ahn, Sang-Hyun;Kim, Chong-Sang
    • Journal of Communications and Networks
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    • v.6 no.1
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    • pp.46-59
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    • 2004
  • In this paper, we present two algorithms for efficiently aggregating link state information needed for quality-of-service (QoS) routing. In these algorithms, each edge node in a group is mapped onto a node of a shufflenet or a node of a de Bruijn graph. By this mapping, the number of links for which state information is maintained becomes aN (a is an integer, N is the number of edge nodes) which is significantly smaller than N2 in the full-mesh approach. Our algorithms also can support asymmetric link state parameters which are common in practice, while many previous algorithms such as the spanning tree approach can be applied only to networks with symmetric link state parameters. Experimental results show that the performance of our shufflenet algorithm is close to that of the full-mesh approach in terms of the accuracy of bandwidth and delay information, with only a much smaller amount of information. On the other hand, although it is not as good as the shufflenet approach, the de Bruijn algorithm also performs far better than the star approach which is one of the most widely accepted schemes. The de Bruijn algorithm needs smaller computational complexity than most previous algorithms for asymmetric networks, including the shufflenet algorithm.