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Treatment of Cerebral Arteriovenous Malformations by Preoperative Embolization and Microsurgery
김규홍,노명호,이운기,최정훈,이인창,배상도,Kim, Kyu Hong,Rho, Myung Ho,Lee, Woon Gi,Choi, Jeong Hoon,Lee, In Chang,Bae, Sang Do The Korean Neurosurgical Society 2000 Journal of Korean neurosurgical society Vol.29 No.4
Objective : To determine the role of preoperative embolization on postoperative neurological outcome in the treatment of cerebral AVMs, we retrospectively evaluated an effectiveness of combining preoperative embolization and microsurgery for arteriovenous malformations(AVM) of the brain. Method : Two groups(10 patients who underwent preoperative superselective embolization and surgery versus 27 patients who underwent surgery only) were compared and categorized by Spetzler-Martin grade, the size of AVM and postoperative clinical outcome using Glasgow Outcome Scale. The 37 patients included 23 males and 14 females, ranging in age from 11 to 74 years(mean 36 years). Results : The arteriovenous malformations in preoperative embolization and surgery group had a larger average greatest diameter(4.45cm versus 3.83cm) and were of higher Spetzler-Martin grade(80% versus 52% grade III through V). At 1 week after surgery, the preoperative embolization and surgery group represented a better outcome(60% versus 44% with Glasgow Outcome Scale score of 5). And over 6 months after surgery, the embolization and surgery group displayed more favorable clinical outcome(80% versus 63% with Glasgow Outcome Scale score of 5). Conclusion : Combined treatment with superselective preoperative embolization using N-butyl cyanoacrylate and direct surgery may help neurosurgeon treating the high grade AVMs thus improving the postsurgical outcome.
김규홍,최정훈,배상도,Kim, Kyu Hong,Choi, Jung Hoon,Bae, Sang Do 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.10
Objectives : To assess the surgical results for patients with multiple intracranial aneurysms and factors related to prognosis of patients. Materials and Methods : We retrospectively analyzed the clinical characteristics of 47 patients with multiple intracranial aneurysms and assessed the types of surgical treatment and prognosis of 44 patients who received surgical treatment from January 1986 to March 1999. Results : The 47 patients presented altogether 108 aneurysms with male to female ratio of 1 : 3.7, and average age 54.9 years(range 33-81 years). Common locations for multiple aneurysms were P-com(31%), MCA(30%) and Acom( 15%). The postoperative good and poor outcomes were 30 cases(68%) and 11 cases(25%), respectively and there were 3 deaths(7%). The analyzed results for 44 surgically treated patients were as follows ; 1) The size of aneurysm was relevant to frequency of rupture ; the lowest for lesions less than 1cm(21%), rising to 85% for lesions greater than 3cm(p<0.05). 2) The surgical outcome was significantly correlated with preoperative clinical status of the patients(p<0.05). 3) The good outcome was associated with surgery within 7 days(especially 24 hours) after clinical onset of symptoms but not with type of operation and laterality of aneurysms. Conclusion : With regard to the surgical treatment for multiple aneurysm cases, surgeons should consider the salient factors in a good prognosis such as patient's preoperative status, size of aneurysm, timing of surgery, and type of operation.
미끄럼 벽면 경계조건을 고려한 C/SiC TPS 벽면의 비평형 공력가열 현상 분석
김규홍(Kyu Hong Kim) 한국항공우주학회 2004 한국항공우주학회지 Vol.32 No.1
Stuttgart IRS에서 개발된 URANUS 코드에 사용되어 온 미끄럼 경계조건을 단순화시킨 새로운 미끄럼 경계조건을 개발하였다. 기존의 미끄럼 경계조건과 장단점 비교를 위해 MIRKA 재돌입 비행체의 실제 비행 조건에서 ablator와 C/SiC 두개의 충으로 구성된 열 방어 시스템(Thermal Protection System)을 해석하였다. 이를 통해 새로운 미끄럼 경계조건이 기존의 미끄럼 경계조건의 정확성을 그대로 유지하면서 계산 효율성을 상당히 향상시켰음을 확인하였다. A new slip boundary condition is developed by simplifying the previous slip model in URANUS code that has been developed in IRS in Stuttgart. For comparison of the new model and the previous model, Thermal Protection System (TPS) which consists of ablator and C/SiC layers, is calculated in the condition of experimental data obtained from MIRKA reentry capsule. Through numerical calculations, it is certified that efficiency is improved significantly without compromising accuracy of boundary condition.
다차원 유동의 정확한 수치해석 : 다차원 고차 내삽 기법
김규홍(Kyu Hong Kim),김종암(Chongam Kim),노오현(Oh-Hyun Rho) 한국전산유체공학회 2003 한국전산유체공학회 학술대회논문집 Vol.2003 No.-
The new multi -dimensional higher order interpolation scheme called MHIS is developed. Firstly, multi-dimensional TVD condition is derived based on one-dimensional TVD condition. Using multi-dimensional TVD condition, 2nd, 3rd and 5th order MHIS are presented. By help of multi-dimensional TVD condition, it is possible to captured a discontinuity monotonically even in a multi-dimensional flow. It is verified through several test cases that the accuracy and the robustness of MHIS are enhanced in regions of shock discontinuities as well as boundary-layers.
김규홍(Kyu-Hong Kim),김종암(Chongam Kim),노오현(Oh-Hyun Rho) 한국전산유체공학회 2002 한국전산유체공학회 학술대회논문집 Vol.2002 No.-
The M-AUSMPW+ scheme that can capture shock waves exactly with monotonic characteristics is modifided from AUSMPW + by analyzing the cause of oscillation in shock regions. Firstly shock-capturing characteristics of general FVS including the AUSM-type schemes are investigated in detail, according to the difference between a cell-interface and a sonic transition position. The cause of oscillation is the improper numerical dissipation that could not represent the real physics. The M-AUSMPW+ could capture shocks exactly without oscillatory behaviors in considering the sonic transition position and an cell-interface position.