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Types of Thromboembolic Complications in Coil Embolization for Intracerebral Aneurysms and Management

  • Kim, Hong-Ki;Hwang, Sung-Kyun;Kim, Sung-Hak
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.226-231
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    • 2009
  • Objective : We describe our clinical experiences and outcomes in patients who had thromboembolic complications occurring during endovascular treatment of intracerebral aneurysms with a review of the literature. The types of thromboembolic complications were divided and the treatment modalities for each type were described. Methods : Between August 2004 and March 2009 we performed endovascular embolization with Guglielmi detachable coils for 173 patients with 189 cerebral aneurysms, including ruptured and unruptured aneurysms at our hospital. Sixty-eight patients were males and 105 patients were females. The age of patients ranged from 22-82 years (average, 58.8 years). We retrospectively evaluated this group with regard to complication rates and outcomes. The types of thromboembolic complications were classified into the following three categories: mechanical obstruction, distal embolic stroke, and stent-induced complications, which corresponded to types I, II, and III, respectively. A comparison of the clinical results was made for each type of complication. Results : Only eight patients had a thromboembolic complication during or after a procedure (4.6%). Of the eight patients, two had a mechanical obstruction as the causative factor; the other three patients had distal embolic stroke as the causative factor. The remaining three patients had stent-induced complications. In cases of mechanical obstruction, recanalization occurred due to the use of intra-arterial thrombolytic agents in one of two patients. Nevertheless, a poor prognosis was seen. In the cases of stent-induced complications, in one of three patients in whom a thrombus developed following stent insertion, a middle cerebral artery territory infarct developed with a poor prognosis despite the use of wiring and an intra-arterial thrombolytic agent. In the cases of distal embolic stroke, all three patients achieved good results following the use of antiplatelet agents. Conclusion : Treatment for thromboemboic complications due to mechanical obstruction and stent-induced complications include antiplatelet and intra-arterial thrombolytic agents; however, this cannot guarantee a sufficient extent of effectiveness. Therefore, active treatments, such as balloon angioplasty, stent insertion, and clot extraction, are helpful.

CONSIDERATIONS OF INTERMAXILLARY FIXATION METHODS IN THE MANAGEMENT OF MANDIBULAR FRACTURES (하악골 골절의 치료에 있어 악간 고정법에 관한 고찰)

  • Song, Kyung-Ho;Lee, Seul-Ki;Chung, Jae-An;Shin, Jin-Eob;Kim, Jwa-Young;Song, Sang-Hoon;Yang, Byoung-Eun;Choi, Young-Jun;Kim, Seong-Gon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.6
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    • pp.513-519
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    • 2007
  • Typical surgical methods for the treatment of mandibular fractures include intermaxillary-fixation (IMF) for obtaining temporary intraoperative occlusion. Traditionally IMF has been achieved with arch-bars or interdental eyelet wiring. However, these techniques are time-consuming procedures, can produce periodontal damage, and are not well tolerated by the patient even under local anesthesia. Moreover, daily maintenance of oral hygiene is difficult for patients with an arch bar. Recently, intermaxillary fixation using intraoral skeletal anchorage screws (SAS) has been introduced for the treatment of mandibular fractures. This method solves the problems above, but they have the potential for tooth damage, screw fractures and intraoperative occlusal instability. In this study, patients with mandiblular fractures were divided into three groups. Group 1 was treated by IMF using archbars(both maxilla and mandible), Group 2 was treated with SAS(maxilla) and arch-bar (mandible), Group 3 was treated with SAS(both maxilla and mandible). The aim of this study was to evaluate the influence of the different IMF methods on periodontal tissue health and intraoperative occlusal rehabilitation about each groups, and to discuss the most favorable IMF method.

Microplate Fixation without Maxillomandibular Fixation in Double Mandibular Fractures

  • Song, Seung Wook;Burm, Jin Sik;Yang, Won Yong;Kang, Sang Yoon
    • Archives of Craniofacial Surgery
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    • v.15 no.2
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    • pp.53-58
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    • 2014
  • Background: Maxillomandibular fixation (MMF) is usually used to treat double mandibular fractures. However, advancements in reduction and fixation techniques may allow recovery of the premorbid dental arch and occlusion without the use of MMF. We investigated whether anatomical reduction and microplate fixation without MMF could provide secure immobilization and correct occlusion in double mandibular fractures. Methods: Thirty-four patients with double mandibular fractures were treated with open reduction and internal fixation without MMF. Both fracture sites were surgically treated. For bony fixations, we used microplates with or without wire. After reduction, each fracture site was fixed at two or three points to maintain anatomical alignment of the mandible. Interdental wiring was used to reduce the fracture at the superior border and to enhance stability for 6 weeks. Mouth opening was permitted immediately. Results: No major complications were observed, including infection, plate exposure, non-union, or significant malocclusion. Five patients experienced minor complications, among whom the only one patient experienced a persistant but mild malocclusion with no need for additional management. Conclusion: This study showed that double mandibular fractures correction with two-or three-point fixation without MMF simplified the surgical procedure, increased patient comfort, and reduced complications, due to good stability and excellent adaptation.

AN EXPERIMENTAL STUDY ON THE CHANGE OF CONDYLE HEAD AFTER MANDIBULAR RAMUS OBLIQUE OSTEOTOMY (하악지 사선골절단술 후 하악두의 변화에 관한 실험적 연구)

  • Cha, Seon-Kyung;Kim, Yeo-Gab
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.65-76
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    • 1992
  • This study was designed to observe the adaptive changes of mandibular condyles to displacement of mandibular condyle in adult animals. In this study, 16 rabbits weighting about 3.5 kg was selected. Four rabbits were preserved for control group and 8 animals were divided into 3 groups, 2 weeks, 4 weeks and 8 weeks. The experimental animals were performed oblique osteotomy on both mandibular ramus and internal wiring at mandibular border. The experimental animals were sacrificed consecutively on the 2 weeks, 4 weeks and 8 weeks after oblique osteotomy and mandibular condyles were dissected out carefully to produced tissue specimen. The specimens were fixed with 10% N formaline solution for 24 hours and rinsed with phosphate buffer solution. It was decalcified with 5% nitric acid for 15 days. Thereafter the specimens were dehydrated in alcohol series and embedded paraffin as usual manner. The mebedded specimen were sectioned in $4-6{\mu}m$ microtome, stained with hematoxylin-eosin and azan stain and observed through light microscope. The following results were observed from this experiment. When there was postional change of condyle head after mandibular ramus oblique osteotomy in adult rabbit, 1. The density of chondrocyte was generally increased at condylar cartilage and the thickness of condylar cartilage was increased posterosuperior aspect of the mandibular condyle slightly. 2. The density of chondrocyte was increased at proliferative zone so fibrous articular zone, porliferative zone and hypertrophic zone was clearly distinguished. 3. Active endochondral bone formation was occurred at mandibular condyle.

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Reactive Ion Etching and Magnetically Enhanced Reactive Ion Etching Process of Low-K Methylsilsequioxane Insulator Film using $CF_4$ and $O_2$ ($CF_4$$O_2$를 이용한 저유전율 물질인 Methylsilsequioxane의 RIE와 MERIE 공정)

  • Jung, Do-Hyun;Lee, Yong-Soo;Lee, Kil-Hun;Kim, Kwang-Hun;Lee, Hee-Woo;Choi, Jong-Sun
    • Proceedings of the KIEE Conference
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    • 2000.07c
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    • pp.1491-1493
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    • 2000
  • Continuing improvement of microprocessor performance involves in the device size. This allow greater device speed, an increase in device packing density, and an increase in the number of functions that can reside on a single chip. However this has led to propagation delay, crosstalk noise, and power dissipation due to resistance-capacitance(RC) coupling become significant due to increased wiring capacitance, especially interline capacitance between the metal lines on the same metal level. So, MSSQ which has the permittivity between 2.5-3.2 is used to prevent from these problems. For pattering MSSQ(Methylsilsequioxane), we use RIE(Reactive Ion Etching) and MERIE(Magnetically enhanced Reactive Ion Etching) which could provide good anisotropic etching. In this study, we optimized the flow rate of $CF_{4}/O_2$ gas, RF power to obtain the best etching rate and roughness and also analyzed the etching result using $\alpha$-step profilemeter, SEM, infrared spectrum and AFM.

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Evaluation of wireless communication devices for remote monitoring of protected crop production environment (시설재배지 환경 원격 모니터링을 위한 무선 통신 장비 평가)

  • Hur, Seung-Oh;Ryu, Myong-Jin;Ryu, Dong-Ki;Chung, Sun-Ok;Huh, Yun-Kun;Choi, Jin-Yong
    • Korean Journal of Agricultural Science
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    • v.38 no.4
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    • pp.747-752
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    • 2011
  • Wireless technology has enabled farmers monitor and control protected production environment more efficiently. Utilization of USN (Ubiquitous Sensor Network) devices also brought benefits due to reduced wiring and central data handling requirements. However, wireless communication loses signal under unfavorable conditions (e.g., blocked signal path, low signal intensity). In this paper, performance of commercial wireless communication devices were evaluated for application to protected crop production. Two different models of wireless communication devices were tested. Sensors used in the study were weather units installed outside and top of a greenhouse (wind velocity and direction, precipitation, temperature and humidity), inside ambient condition units (temperature, humidity, $CO_2$, and light intensity), and irrigation status units (irrigation flow and pressure, and soil water content). Performance of wireless communication was evaluated with and without crop. For a 2.4 GHz device, communication distance was decreased by about 10% when crops were present between the transmitting and receiving antennas installed on the ground, and the best performance was obtained when the antennas were installed 2 m above the crop canopy. When tested in a greenhouse, center of a greenhouse was chosen as the location of receiving antenna. The results would provide information useful for implementation of wireless environment monitoring system for protected crop production using USN devices.

A CLINICAL STUDY ON THE EMERGENCY PATIENTS WITH ACTIVE ORAL BLEEDING (구강내 과다출혈로 내원한 응급환자에 관한 임상적 연구)

  • Yoo, Jae-Ha;Kang, Sang-Hoon;Kim, Hyun-Sil;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.5
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    • pp.383-389
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    • 2002
  • This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.

Design and Fabrication of a 1.75D Ultrasonic Transducer (1.75D 초음파 트랜스듀서의 설계 및 제작)

  • Lee, Wonseok;Roh, Yongrae
    • The Journal of the Acoustical Society of Korea
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    • v.32 no.3
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    • pp.199-207
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    • 2013
  • In this paper, a $64{\times}8$ channel 1.75D ultrasonic transducer made of piezoelectric single crystals was designed, fabricated, and evaluated. First, a structure of the transducer was selected to be suitable for wiring on a planar array, and components were fabricated to correspond to the structure. Detailed structure of the transducer was designed through finite element analyses. As main performance factors, the crosstalk between neighboring elements was reduced through the control of kerf width and material, and desired frequency bandwidth of the transducer was achieved by designing the optimal thicknesses of the piezoelectric single crystal and matching layers. An experimental prototype of the transducer was fabricated following the design, and its performance was measured. Then the experimental results were compared with those of the finite element analysis, which led to the evaluation of the transducer developed in this work.

A Study on Smart Home Power-Control System with Power-Saving Green Adapter (전력절감 그린어뎁터를 이용한 스마트홈 전력 통제시스템)

  • Yoo, Seung-Jae;Park, Hee-Dong;Kim, Song-Gang
    • Convergence Security Journal
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    • v.13 no.4
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    • pp.85-92
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    • 2013
  • Today we have an obligation to pass the beautiful earth and enrich people's lives to next generations. According to the keynote, governments have a lot of resources to support the smart grid policies. Also the demand of the implementation of smart home applied the concept of smart grid is increasing rapidly. But the construction of smart home is centered on a new public housing except the pre-existing house which is counted for most of more than 90% of total. In this study, we suggest the implementation solution to make smart-homelike for the pre-existing houses without additional wiring or construction. We develop the technology reducing the unnecessary standby power 800mW to 20mW drastically. If we apply this technology, by the power off of main IC the actual power depends on the consumption of minimal devise located on the AC input side. Then the standby power becomes approximately 20mW(110ac).

A Design of Power Line Communication system using Wavelet OFDM (Wavelet OFDM 기법을 이용한 전력선 통신 시스템 설계)

  • Moon, Ki-Tak;Kim, Joo-Seok;Jang, Dong-Won;Kim, Kyung-Seok
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.35 no.11C
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    • pp.871-876
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    • 2010
  • Currently the development of powerline communication technology has become possible due to the high-speed communications. But the communication lines used for power line communication, not wires carrying power wiring is because when sending high-frequency wireless communication system unintentionally be influenced. To compensate for these shortcomings by using notch filters to reduce interference has been studied. Wavelet-based OFDM on the other hand by the method has been used to reduce interference. Wavelet-based OFDM has been used in the existing powerline OFDM scheme using FFT instead of the general structure of the CMFB filters to generate a signal. By doing so, subtly signals per frequency band, cut it, is to realize how efficient highways. It brought a deep filter characteristics, a flexible notch filter can be achieved without an external circuit has an advantage. In this paper, Using Wavelet OFDM powerline communication system is designed and presented the results of simulations.