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Flow diversion of a middle cerebral artery pseudoaneurysm secondary to a gunshot wound: A case report

  • Justin C. Gelman;Max Shutran;Michael Young;Philipp Taussky;Rafael A. Vega;Rocco Armonda;Christopher S. Ogilvy
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.434-439
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    • 2023
  • Pseudoaneurysms are rare but devastating complications of penetrating head traumas. They require rapid surgical or endovascular intervention due to their high risk of rupture; however, complex presentations may limit treatment options. Our objective is to report a case of severe vasospasm, flow diversion, and in-stent stenosis complicating the treatment of a middle cerebral artery pseudoaneurysm following a gunshot wound. A 33-year-old woman presented with multiple calvarial and bullet fragments within the right frontotemporal lobes and a large right frontotemporal intraparenchymal hemorrhage with significant cerebral edema. She underwent an emergent right hemicraniectomy for decompression, removal of bullet fragments, and evacuation of hemorrhage. Once stable enough for diagnostic cerebral angiography, she was found to have an M1 pseudoaneurysm with severe vasospasm that precluded endovascular treatment until the vasospasm resolved. The pseudoaneurysm was treated with flow diversion and in-stent stenosis was found at 4-month follow-up angiography that resolved by 8 months post-embolization. We report the successful flow diversion of an middle cerebral artery (MCA) pseudoaneurysm complicated by severe vasospasm and later in-stent stenosis. The presence of asymptomatic stenosis is believed to be reversible intimal hyperplasia and a normal aspect of endothelial healing. We suggest careful observation and dual-antiplatelet therapy as a justified approach.

Delayed diagnosis of proximal ureter injury after a blunt abdominal trauma in Korea: a case report

  • Soon Ki Min;Byungchul Yu;Gil Jae Lee;Min A Lee;Yang Bin Jeon;Youngeun Park;Kang Kook Choi;Hyuk Jun Yang
    • Journal of Trauma and Injury
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    • v.37 no.3
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    • pp.243-246
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    • 2024
  • Traumatic ureteral injuries account for fewer than 1% of traumatic urologic injuries, and those caused by blunt trauma are even rarer than those caused by penetrating trauma. The symptoms associated with ureteral injury may be subtle, with or without hematuria, making it difficult to diagnose. We report the case of a 31-year-old man with a delayed diagnosis of proximal ureter injury after abdominal blunt trauma sustained in a motorcycle traffic accident. The patient underwent emergency laparotomy on admission for liver injury, mesenteric injury, and resultant hemoperitoneum. On postoperative day 6, he underwent angioembolization for suspected remnant intra-abdominal bleeding. Persistent symptoms of flank pain and leukocytosis led to follow-up imaging studies that revealed proximal ureter injury, and the patient underwent unilateral nephrectomy. This case stresses the importance of clinical suspicion for genitourinary injuries in the presence of abdominal trauma.

"Beauty" of Oriental Culture-Take Wang Shizhen's "Yuyang's Notes on Poetry" as An Example

  • Chen Shiqiang
    • International Journal of Advanced Culture Technology
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    • v.12 no.3
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    • pp.194-198
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    • 2024
  • Beauty is inclusive, which appears everywhere. As classic forms, poetry, calligraphy and painting are a good way to express the beauty of literature and art. In history, literature was almost identical to art. Among them, there is no lack of penetrating judgment about beauty, but which is often forgotten. Since the Qing Dynasty, Yuyang's Notes on Poetry can be said to be one of the representatives. There are many versions, whose common ones are three volumes and two volumes. The three volumes were the first carving copies of Kangxi in the Qing Dynasty. The two volumes are the lithographic books in 1909, with the "Preface of Yongzheng and Yu Zhaosheng" as the base. For details, please refer to the text, which needs no further elaboration here. We it includes too many contents, so some parts are chosen as an example to trigger thought about aesthetics. Wang Shizhen was the literati of the Qing Dynasty who had the greatest influence on the Korean Peninsula in terms of poetry. In Yuyang's Notes on Poetry, he also specifically talked about the poetry diplomacy between the Qing Dynasty and the Chosun Dynasty, whose literature value was extremely high. Art contains both beauty and crafts.

대변형 해석에서 평활화를 이용한 사면체 요소망의 재조성

  • Gwon, Gi-Hwan;Chae, Su-Won;Sin, Sang-Yeop
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.24 no.9 s.180
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    • pp.2397-2405
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    • 2000
  • The remeshing is a method to replace a distorted mesh by a new mesh without interrupting the finite element calculation. The remeshing procedure in this paper refers to the rezoning, for which a sm oothing process is developed to alleviate the distortions of mesh. In the paper, an automatic finite element rezoning system with tetrahedral elements for large deformation analysis has been developed. Our smoothing process is composed of two steps, a surface smoothing and a volume smoothing. In the surface smoothing, checking the dihedral angle and projection on surface patch reduced the change of shape and nodes penetrating die. The constrained Laplacian smoothing has been employed for the volume smoothing process. The state variables are mapped from old mesh to new mesh by using volume coordinates within a tetrahedral element. All these procedures have been linked to the NIKE3D program As illustrated in the examples the overall strategy ensures a robust and efficient rezoning scheme for finite element simulation of metal-forming processes.

Electrical Properties of a High Tc Superconductor for Renewed Electric Power Energy

  • Lee Sang-Heon
    • Journal of Electrical Engineering and Technology
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    • v.1 no.3
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    • pp.371-375
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    • 2006
  • Effects of $Ag_2O$ doping on the electromagnetic properties in the BiSrCaCuO superconductor. The electromagnetic properties of doped and undoped $Ag_2O$ in the BiSrCaCuO superconductor were evaluated to investigate the contribution of the pinning centers. It was confirmed experimentally that a larger amount of magnetic flux was trapped in the $Ag_2O$ doped sample than in the undoped one, indicating that the pinning centers of magnetic flux are related closely to the occurrence of the magnetic effect. We have fabricated superconductor ceramics by the chemical process. A high Tc superconductor with a nominal composition of $Bi_2Sr_2Ca_2Cu_3O_y$ was prepared by the organic metal salts method. Experimental results suggest that the intermediate phase formed before the formation of the superconductor phase may be the most important factor. The relation between electromagnetic properties of Bi HTS and the external applied magnetic field was studied. The electrical resistance of the superconductor was increased by the application of the external magnetic field. But the increase in the electrical resistance continues even after the removal of the magnetic field. The reason is as follows; the magnetic flux due to the external magnetic field penetrates through the superconductor and the penetrated magnetic flux is trapped after the removal of the magnetic flux. During the sintering, doped $Ag_2O$ was converted to Ag particles that were finely dispersed in superconductor samples. It is considered that the area where normal conduction takes place increases by adding $Ag_2O$ and the magnetic flux penetrating through the sample increases. The results suggested that $Ag_2O$ acts to amplify pinning centers of magnetic flux, contributing to the occurrence of the electromagnetic properties.

Species Identification of Wooden Members in the Youngsanjeon Hall of Sucknamsa Temple (안성 석남사 영산전 목부재의 수종 분석)

  • Park, Won-Kyu;Jeong, Hyun-Min;Kim, Sang-Kyu
    • Journal of the Korean Wood Science and Technology
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    • v.36 no.1
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    • pp.1-11
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    • 2008
  • The purpose of this study is to examine the species of wooden members used in the Youngsanjeon Hall of the Sucknamsa temple in Anseong, Korea. Ninety-five wood samples from pillars, head-penetrating ties, beams, corner rafter, rafter, floor board and other wood members were identified. Seven species identified were hard pine, exotic pine, Zelkova serrata, Ginkgo biloba, Diospyros, Quercus(Cerrus) and Pyrus spp. In the case of pillars, eight were hard pines and the others Zelkova and Pyrus. Species of angle rafter were Ginkgo biloba and Zelkova. and those of beams were one hard pine and one Zelkova. Two purlin samples were Quercus(Cerrus) and rafters were hard pines except one Ginkgo and one exotic pine. Roof-filling timbers were identified as Zelkova and Diospyros spp. The other samples of roof-filling timbers were all identified as hard pines. The use of Ginkgo and several hardwoods in addition to hard pines may indicate supply of local logs near the Sucknamsa temple.

Stability of a Natural Slope in Sedimentary Rocks (퇴적암 지역의 자연사면 안정성)

  • 권오일;김교원;박덕근
    • The Journal of Engineering Geology
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    • v.10 no.3
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    • pp.205-216
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    • 2000
  • An unstable natural slope located at Icheon-Ri, Dasa-Eup, Dalseong-Kun which has been severely cracked during heavy rain fall in September, 1998, was investigated and analysed for remedial measures. Various geological data were obtained by performing a surface geological survey, a ground penetrating radar(GPR) exploration, four geotechnical borings with field and laboratory tests, and the precipitation records were also reviewed. Based on the these data, the probable sliding plane was determined as a bedding plane with dip angle of 20 to 25 degrees between sandstone and shale layers at depth of 6 to 8 meters. By performing back analyses with the limit equilibrium method, the friction angle and cohesion of the sliding plane were determined as 18$^{\circ}$ and 0, respectively. Based on these results, a series of stability analyses such as stereo-graphic projection method, limiting equilibrium method and numerical method were carried out. The remedial measures for the unstable slope were selected based on the results of the limit equilibrium analyses by considering various conditions expected at the site. Ground grouting or anchoring method with proper surface drainage systems could be employed for the long term safety of the slope.

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Finite Element Analysis of Pressure Distribution by Ultrasound in Human Thigh Model (대퇴부 모델에서의 초음파 압력분포에 관한 유한요소 해석)

  • Choi, Ho-Seon
    • The Journal of Information Technology
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    • v.8 no.1
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    • pp.43-50
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    • 2005
  • Quantitative analysis for distribution of penetrating ultrasound in vivo is very important to determine the treatment region and method. In this paper, we constructed a simplified 2-D femoral region model that consists of skin-fat-muscle-bone layered system, and simulated the pressure distribution in the model in case of applying ultrasound using Finite Element Method(FEM). The ultrasound used in the simulation was assumed to be pulse wave and the pressure distribution was analyzed during only one period of pulse wave. In order to find the penetration depth, amplitude of pressure and sphere that ultrasound reaches in the model, we performed the simulation with varying the applied frequency, transducer size and amplitude of transducer's output. The result showed that applied frequency is inversely proportional to the penetration depth and amplitude of pressure but the amplitude of transducer's output is proportional to the amplitude of pressure in the model. Also, the sphere that ultrasound reaches was widened and the amplitude of pressure became larger as the transducer size became larger. This results were similar to that obtained from the previous model consisting of fat-muscle-bone layered system, but we observed that the pressure of ultrasound is decreased due to the decrements of pressure by the absorption coefficient of skin and the interference that depends on the reflection of ultrasound caused by the difference of acoustic impedance of skin and fat. Finally, we can infer that the model proposed in this study is closer to the realistic model than the previous ones. It shows that the results obtained from this study can be useful in designing the ultrasound treatment instrument or in setting up the treatment plan.

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Development of A Boom Sprayer for Effective Pest-and-Disease Control on Densed Paddy Stems (수도(水稻) 기부(基部) 방제용(防除用) 붐-형(型) 주간(株間) 살포(撒布) 장치(裝置) 개발(開發)에 관(關)한 연구(硏究))

  • Chung, Chang Joo;Chang, Young Chang
    • Journal of Biosystems Engineering
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    • v.10 no.1
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    • pp.13-23
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    • 1985
  • Spraying method from the paddy-field levee is known to give insufficient penetration of the spray droplets to the rice stem of the densely grown plants, which is generally encountered at the last stage of rice growth. This study was intended to investigate the spraying system to solve this existing problem. As an approach, it was attempted to develop the boom-with-nozzle, between-the-row application system. Several types of nozzles and their different arrangements in the boom were tested in the field to measure the penetration-reaching distance and the uniformity of spray droplet distribution. The results of the study are summarized as follows: 1. Field experiments by the spraying method from the paddy-field levee showed to have practically no penetration of the spray droplets to the portion of the plant stem with the normal flow volume generally applied and thus need for improving present spraying method. 2. It was found that, considering both the uniformity of the spray droplet distribution and performance rate, the most efficient type of nozzle in the between-the-row boom-type spraying system was one that has core-insert hollow-cone with some clearance between the cone and tip. 3. When tested by applying the spraying method of between-the-row, the nozzle pressure did not affect the uniformity of spray droplet distribution. However, the nozzle pressure had a positive effect on the penetrating-reaching distance of the facing side of the rice stem and did not affect much on that of the opposite face of the stem. It was also found that the maximum pressure to affect the penetration-reaching distance was about $10kg/cm^2$. 4. The uniformity of the spray droplet distribution in the between-the-row system was greatly affected by the height and orientation of the nozzles in the boom. Based on experimental work for the different type of the boom-with-nozzle arrangements, it is recommended that the position of nozzle is set at about 0.45 m above the ground and two nozzles in the boom are oriented to be faced with each other with some angle such that the droplet stream from the nozzle would not directly face with each other.

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The Effect of Fe and Fe2O3 Powder Mixing Ratios on the Pore Properties of Fe Foam Fabricated by a Slurry Coating Process (슬러리 코팅 공정으로 제조된 Fe 폼의 기공 특성에 미치는 Fe 및 Fe2O3 분말의 혼합 비율의 영향)

  • Choi, Jin Ho;Jeong, Eun-Mi;Park, Dahee;Yang, Sangsun;Hahn, Yoo-Dong;Yun, Jung-Yeul
    • Journal of Powder Materials
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    • v.21 no.4
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    • pp.266-270
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    • 2014
  • Metal foams have a cellular structure consisting of a solid metal containing a large volume fraction of pores. In particular, open, penetrating pores are necessary for industrial applications such as in high temperature filters and as a support for catalysts. In this study, Fe foam with above 90% porosity and 2 millimeter pore size was successfully fabricated by a slurry coating process and the pore properties were characterized. The Fe and $Fe_2O_3$ powder mixing ratios were controlled to produce Fe foams with different pore size and porosity. First, the slurry was prepared by uniform mixing with powders, distilled water and polyvinyl alcohol(PVA). After slurry coating on the polyurethane(PU) foam, the sample was dried at $80^{\circ}C$. The PVA and PU foams were then removed by heating at $700^{\circ}C$ for 3 hours. The debinded samples were subsequently sintered at $1250^{\circ}C$ with a holding time of 3 hours under hydrogen atmosphere. The three dimensional geometries of the obtained Fe foams with an open cell structure were investigated using X-ray micro CT(computed tomography) as well as the pore morphology, size and phase. The coated amount of slurry on the PU foam were increased with $Fe_2O_3$ mixing powder ratio but the shrinkage and porosity of Fe foams were decreased with $Fe_2O_3$ mixing powder ratio.