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Thoracic outlet syndrome (TOS) is a constellation of symptoms caused by the compression of neurovascular structures at the superior aperture of the thorax, properly referred to as the thoracic inlet. However, there is no consistent clinical presentation or definition. Based on a comprehensive literature review, this article presents the etiology, epidemiology, and clinical diagnostics of TOS, as well as the possibilities and outcomes of surgical treatment. The diagnosis and treatment are contentious, and some even question the existence of TOS. Its symptoms are often confused with those of distal compression neuropathies or cervical radiculopathies. The various surgical approaches for this syndrome are evaluated according to their ability to facilitate wide exposure, their potential morbidity, and their beneficial results. Most patients suffering from any form of TOS can benefit from surgical treatment. The duration of symptoms, socioeconomic factors and most notably, a stringent diagnostic workup and an adequate operative approach are important.

Among the various intraoperative neurophysiologic monitoring (IONM) techniques, transcranial motor-evoked potential (Tc-MEP) has recently become the most widely used method to monitor motor function. However, we often find that Tc-MEP is not sufficiently detected at the start of surgery. Therefore, we aimed to analyze the reasons and risk factors for not detecting sufficient baseline signal of Tc-MEP from the beginning of spinal surgery.We categorized IONM data from 1058 patients who underwent spine surgeries at a single institution from 2014 to 2020 and categorized them into 2 groups: 1) "poor MEP" if Tc-MEP could not be sufficiently obtained and 2) "normal MEP" if Tc-MEP could be sufficiently obtained from the surgery. We analyzed the patient's age, gender, underlying disease, operation type, level numbers, baseline motor function, existence of pathologic reflex, myelopathy, and duration from the onset and clinical diagnosis.The rate of failure to obtain sufficient baseline Tc-MEP signals in spine surgery was 21.8% (231/1058). Multivariate analysis showed significant associations of existence of diabetes mellitus, myelopathy, thoracic spine surgery, baseline motor deficit and tumor, and trauma disease with loss of meaningful and interpretable signals in baseline Tc-MEP (P0.05). Only 15 of 231 patients (6.4%) showed a trend of signal recovery after decompression procedures.Various factors (myelopathy, diabetes mellitus, thoracic surgery, baseline motor deficit, tumor, and trauma) were closely related to not obtaining sufficient baseline signals for Tc-MEP. When operating on patients with these considerations, we need to consider the efficacy and usefulness of Tc- MEP.

The purpose of this study was to find out additional indications for multi-positional MRI in cervical degenerative spondylosis (CDS) patients.A total of 63 patients with cervical spondylotic myelopathy that underwent multi-positional MRI and X-ray were included. Muhle's grade, C2-7 angle, and C7 slope were measured. Patients were assigned to the stenosis group (Group S) when Muhle's grades were increased by more than two or maximum grade was reached. Other patients were assigned to the maintenance group (Group M). Receiver operating characteristic (ROC) analysis was performed. Statistical significance was accepted for p values of 0.05.A total of 24 patients were assigned to the S group and 39 patients to the M group. Mean C2-7 angle difference in extension (eC27A) between S and M groups was 10.97° (p = 0.002). The mean inter-group difference between C2-7 angle in extension and neutral positions (e-nC27A) was 14.39° (p = 0.000). Mean C7 slope difference in neutral position was - 6.53° (p = 0.002). Based on areas under ROC curves (AUCs), e-nC27A, eC27A, and negative C7 slope had AUCs of 0.934 (95% CI 0.876-0.992), 0.752 (95% CI 0.624-0.880), and 0.720 (95% CI 0.588-0.851), respectively. The optimal cutoff value of e-nC27A was 15.4 degrees, which had a diagnostic accuracy of 88.9%.Multi-positional MRI helps to find dynamic cord compressive lesion in CDS patients. The higher eC27A, e-nC27A values and smaller C7 slope were found to increase the likelihood of cervical dynamic stenosis. Among other factors, we recommend multi-positional MRI before surgery especially when a patient's e-nC27A is 15.4 degrees.Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.

Craniovertebral junction (CVJ) deformity is a challenging pathology that can result in progressive deformity, myelopathy, severe neck pain, and functional disability, such as difficulty swallowing. Surgical management of CVJ deformity is complex for anatomical reasons; given the discreet relationships involved in the surrounding neurovascular structures and intricate biochemical issues, access to this region is relatively difficult. Evaluation of the reducibility, CVJ alignment, and direction of the mechanical compression may determine surgical strategy. If CVJ deformity is reducible, posterior in situ fixation may be a viable solution. If the deformity is rigid and the C1–2 facet is fixed, osteotomy may be necessary to make the C1–2 facet joint reducible. C1–2 facet release with vertical reduction technique could be useful, especially when the C1–2 facet joint is the primary pathology of CVJ kyphotic deformity or basilar invagination. The indications for transoral surgery are becoming as narrow as a treatment for CVJ deformity. In this article, we will discuss CVJ alignment and various strategies for the management of CVJ deformity and possible ways to prevent complications and improve surgical outcomes.

Although cervical spinal deformity (CSD) can have a profoundly negative impact on an individual’s quality of life and there have been many advances in surgical treatment of CSD in recent years, there exists no comprehensive classification system of surgical treatment that categorizes anterior and posterior surgery separately according to the grade of surgery. The objective of this study is to introduce the new classification system of various surgical treatments for CSD. We developed a new classification system (SOF system) for CSD surgery that describes the sequence of surgical approach (S), the grade of osteotomy (O), and the information of fixation (F) using alphanumeric codes. This new classification system can provide a consistent description of the various osteotomies performed in CSD surgery. Especially, regarding research, there has been a clear benefit to this classification. Having a standardized classification that allows for common frame for cervical deformity correction surgery, communication between surgeons and the evaluation of the CSD surgeries make it possible to conduct global comparative research about surgical outcome.

Objective To investigate correlations between radiologic measurements and clinical outcomes in patients with basilar invagination (BI). Methods The medical records and radiologic data of 46 patients (27 women) that had undergone posterior atlantoaxial fusion or occipitocervical fusion for BI from January 2010 to June 2018 were retrospectively analyzed. Patients under 15 years old or with a polytraumatic, tumorous, or infectious pathology were excluded. The modified Ranawat method (MRM) and the Redlund-Johnell method (RJM) were used to obtain radiographic measurements of basilar invagination preoperatively, subacute postoperatively, and at 3-month and last follow-up. Visual Analogue Scale (VAS), Neck Disability Index (NDI) and Japanese Orthopedic Association (JOA) scores were also assessed. Correlations between MRM and RJM measurements and clinical outcomes were evaluated. Results Mean age of patients was 59.9±16.5 years, mean body mass index was 23.5±4.6 kg/m 2 , and Mean follow-up was 37.9±23.8 months. Postoperative radiologic measurements increased about 36% of preoperative radiologic measurements. Subsidence at the C1-2 joint occurred in most patients at 3 months postoperatively, but clinical outcomes did not deteriorate. JOA scores were linearly correlated with percentage increases in both radiologic measurements subacute postoperatively ( p Conclusion The subacute postoperative neurological outcomes of BI patients are significantly related with the amount of vertical reduction.

In this study, Mg+B wires were prepared by powder in tube method using Nb and Cu tubes as barrier and sheath, respectively, followed by cold drawing. Microstructural, textural, and mechanical properties of the Nb barrier at different drawing strains (ε d) were investigated. The results showed that the Nb barrier demonstrated a saturation hardness of 159.4 HV. The microstructure of the Nb barrier became elongated along the drawing direction increasing ε d. Sub-grains existing inside the deformed grains rotated from low-angle grain boundaries to high-angle grain boundaries and developed into new grains. The main textural components of the Nb barrier were {111} γ-fiber and {hkl}〈110 〉 α-fiber. Recrystallized grains exhibited a low maximum orientation distribution function intensity, weak {100}〈110 〉 α-fibers, and strong {111}〈110 〉 γ-fibers as compared to those of the deformed grains. The relationship between the microstructure evolution and mechanical properties of the Nb barrier and the changes in the cross-sectional area fractions of the materials constituting the Mg+B composite wire are discussed. The current study provides details about the misorientation profile inside deformed grains and continuous dynamic recrystallization mechanism of the cold-drawn Nb barrier.

OBJECTIVEThe authors sought to evaluate the usefulness of indocyanine green (ICG) angiography and Doppler sonography for monitoring the vertebral artery (VA) during craniovertebral junction (CVJ) surgery and compare the incidence of VA injury (VAI) between the groups with and without the monitoring of VA using ICG angiography and Doppler sonography.METHODSIn total, 344 consecutive patients enrolled who underwent CVJ surgery. Surgery was performed without intraoperative VA monitoring tools in 262 cases (control group) and with VA monitoring tools in 82 cases (monitoring group). The authors compared the incidence of VAI between groups. The procedure times of ICG angiography, change of VA flow velocity measured by Doppler sonography, and complication were investigated.RESULTSThere were 4 VAI cases in the control group, and the incidence of VAI was 1.5%. Meanwhile, there were no VAI cases in the monitoring group. The procedure time of ICG angiography was less than 5 minutes (mean [± SD] 4.6 ± 2.1 minutes) and VA flow velocity was 11.2 ± 4.5 cm/sec. There were several cases in which the surgical method had to be changed depending on the VA monitoring. The combined use of ICG angiography and Doppler sonography was useful not only to monitor VA patency but also to assess the quality of blood flow during CVJ surgery, especially in the high-risk group of patients.CONCLUSIONSThe combined use of ICG angiography and Doppler sonography enables real-time intraoperative monitoring of the VA by detecting blood flow and flow velocity. As the arteries get closer, they provide auditory and visual feedback to the surgeon. This real-time image guidance could be a useful tool, especially for high-risk patients and inexperienced surgeons, to avoid iatrogenic VAI during any CVJ surgery.

To develop and assess the reliability of new nomenclature system that systematically organizes osteotomy techniques and briefly describes the surgical approach, the surgical sequence, and the fixation technique for cervical spine deformity (CSD). We developed a new classification system (SOF system) for CSD surgery that describes the sequence of surgical approach (S), the grade of osteotomy (O), and the information of fixation (F) using alphanumeric codes. Twenty CSD osteotomies (8 anterior osteotomies, 12 posterior osteotomies) were included in this study to evaluate the inter- and intra-observer agreement based on operation records. Six observers performed independent evaluations of the operation records in random order. Each observer described 20 CSD surgeries using the SOF system twice (> 30 days between assessments) based on operation records to validate SOF system. Overall agreement (among all six observers at the initial assessment) on the anterior and posterior osteotomy was ICC = 0.96 and ICC = 0.91, respectively. Overall agreement (repeat observations after at least 30 days) on the anterior and posterior osteotomy was ICC = 0.96 and ICC = 0.91, respectively. This data showed that both inter- and intra-observer agreement revealed ‘excellent’. This study introduces the SOF system of the CSD surgery to understand the surgical sequence, the type of osteotomy and the fixation techniques. The investigation of the inter- and intra-observer agreement revealed ‘excellent agreement’ for both anterior and posterior osteotomies. Thus, SOF system can provide a consistent description of the various CSD surgeries and its use will provide a common frame for CSD surgery and help communicate between surgeons.

Although many studies have investigated the benefits of multimodal intraoperative monitoring (MIOM) during cervical spine surgery, the benefits of MIOM in craniovertebral junction (CVJ) surgery remain unclear. The objectives of the present study were to report our clinical experience in CVJ surgery with the use of MIOM and to identify risk factors that could affect MIOM changes during surgery of CVJ pathology.We reviewed the MIOM records of 146 patients who had undergone high cervical spinal surgery. The patients were grouped by the MIOM data recorded during surgery; the patients were included in either the MIOM or non-MIOM change group. The analyzed risk factors included demographic, myelopathy, preoperative Japanese Orthopedic Association (JOA) score, spinal cord diameter, and surgical factors. Univariate and multivariate analyses were performed to identify the risk factors for changes in MIOM data during surgery and postoperative neurological deficits.Our results revealed that the incidence of postoperative neurological complications was 4.1% after CVJ surgery; this rate was significantly greater in the MIOM change group than in the non-MIOM change group (21.7% vs. 0.8%; P0.01). Multiple regression analysis revealed that preoperative myelopathy, preoperative JOA score, and congenital anomaly/tumor were independently associated with MIOM changes during surgery.Postoperative neurological complications are not uncommon after CVJ surgery, and the incidence was significantly greater in the MIOM change group. Preoperative myelopathy, preoperative JOA score, and CVJ pathology related to congenital anomaly or tumor were independent risk factors for changes in MIOM data during surgery.

BACKGROUND Cervical spine deformity negatively affects patients' quality of life. Pedicle subtraction osteotomy (PSO) has reported to correct cervical deformity but it is challenging and carries a significant risk of morbidity. OBJECTIVE To report transdiscal C7 PSO with a strut graft for the correction of sagittal and coronal imbalance in patients with fixed cervical deformity. METHODS After standard exposure, the spine was instrumented from C2 to T3. T1 subtotal laminectomy, and C6 to C7 total laminectomies were necessary for C7 PSO. Osteotomy was initiated with removal of C6-7 and C7-T1 facet joints to isolate C7 pedicles and identify bilateral C7/C8 roots. Bilateral C7 pediculectomies and transdiscal PSO were performed. A rectangular strut allograft was then inserted into the PSO site. The location of the strut graft was used as a fulcrum of sagittal and coronal correction. The head fixator was released and the head was extended under intraoperative neuromonitoring, and then detailed sagittal and coronal balances were controlled by compressing or distracting between the pedicle screws above and below the osteotomy. RESULTS This technique was applied in 2 patients with fixed subaxial cervical deformities. Transdiscal PSO could add more amount of correction and provide the additional fusion surface. The strut graft prevented sagittal translation, foraminal narrowing, and excessive focal cord kinking during PSO. Both patients showed radiologic and clinical improvements after surgery, and no neurovascular complication occurred after the surgery. CONCLUSION Transdiscal C7 PSO with a strut graft placement provided a safe way of correcting sagittal and coronal imbalance simultaneously and reduced neurological complication by preventing sagittal translation, foraminal narrowing and spinal cord kinking.

Objective The study was aimed to compare the validity, reproducibility, precision, and efficiency of a picture archiving and communication system (PACS) and a smartphone application, which is an educative app to easily measure sagittal balance parameters (SagittalMeter Pro), for measuring spinopelvic sagittal parameters. Methods Three spine surgeons measured lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) on standing posteroanterior radiographs of 30 patients using PACS and SagittalMeter Pro. Measurements were repeated a week after the original measurements. Intraobserver and interobserver variabilities and reliabilities of each parameter (LL, PI, SS, and PT) were calculated for both techniques. Comparisons were performed using the paired t-test. Results are expressed as mean ± standard deviation and P values of Results PACS to SagittalMeter Pro differences between the mean absolute values of LL, PI, SS, PT were 0.50°, 0.82°, 0.81°, 0.34°, respectively, and intraobserver and interobserver variabilities were similar. Excellent intraobserver and interobserver reliabilities were obtained for PACS and SagittalMeter Pro as demonstrated by values >0.86 and >0.84, respectively. Measurement times for PACS and SagittalMeter Pro were 36.63 ± 7.55 and 14.57 ± 1.96 seconds, respectively, and this difference was significant (P = 0.001). Conclusions The study shows PACS and SagittalMeter Pro are equivalent in terms of their abilities to measure spinopelvic sagittal parameters, and that the time required to obtain measurements was significantly less for SagittalMeter Pro. We believe that SagittalMeter Pro may be helpful when planning spinal surgery.

OBJECTIVELittle is known about the risk factors for postoperative subaxial cervical kyphosis following craniovertebral junction (CVJ) fixation. The object of this study was to evaluate postoperative changes in cervical alignment and to identify the risk factors for postoperative kyphotic change in the subaxial cervical spine after CVJ fixation.METHODSOne hundred fifteen patients were retrospectively analyzed for postoperative subaxial kyphosis after CVJ fixation. Relations between subaxial kyphosis and radiological risk factors, including segmental angles and ranges of motion (ROMs) at C0–1, C1–2, and C2–7, and clinical factors, such as age, sex, etiology, occipital fixation, extensor muscle resection at C2, additional C1–2 posterior wiring, and subaxial laminoplasty, were investigated. Univariate and multivariate logistic regression analyses were conducted to identify the risk factors for postoperative kyphotic changes in the subaxial cervical spine.RESULTSThe C2–7 angle change was more than −10° in 30 (26.1%) of the 115 patients. Risk factor analysis showed CVJ fixation combined with subaxial laminoplasty (OR 9.336, 95% CI 1.484–58.734, p = 0.017) and a small ROM at the C0–1 segment (OR 0.836, 95% CI 0.757–0.923, p < 0.01) were related to postoperative subaxial kyphotic change. On the other hand, age, sex, resection of the C2 extensor muscle, rheumatoid arthritis, additional C1–2 posterior wiring, and postoperative segmental angles were not risk factors for postoperative subaxial kyphosisCONCLUSIONSSubaxial alignment change is not uncommon after CVJ fixation. Muscle detachment at the C2 spinous process was not a risk factor of kyphotic change. The study findings suggest that a small ROM at the C0–1 segment with or without occipital fixation and combined subaxial laminoplasty are risk factors for subaxial kyphotic change.

Purpose To evaluate differences between thicknesses of the ligamentum flavum (LF) and diameter of the spinal canal in different neck positions in patients with ossification of the posterior longitudinal ligament (OPLL) and patients with cervical degenerative spondylosis (CDS) using cervical dynamic magnetic resonance imaging (MRI). Methods Eighty-eight patients (66 CDS and 22 OPLL) who underwent neutral and dynamic MRI at our institute from February 2014 to July 2017 were the subjects of this retrospective study. Canal diameters and LF thicknesses were measured and Muhle's grades were determined in neutral and dynamic MRI from C2–C3 to C7–T1. Patients with CDS and OPLL were compared with respect to changes in morphometric parameters. Statistical analysis was performed using SPSS software and statistical significance was accepted for P values Results Mean ages in the CDS and OPLL groups were 68.2 ± 12.27 and 63.1 ± 9.36 years, respectively. Mean canal diameters were smaller in extension than in neutral at all measured levels, especially between C3–C4 and C6–C7 in patients with CDS. LF thickness in extension was significantly greater than in neutral and flexion positions in the CDS group, but not in the OPLL group. In addition, positional changes in Muhle's grades in the CDS group were significantly greater than in the OPLL group (P = 0.042). Conclusions Dynamic morphometric changes were found to be significantly greater in the CDS group than in the OPLL group. The study shows dynamic MRI may provide additional information in CDS patients.

Background Although C1 screw fixation is becoming popular, only a few studies have discussed about the risk factors and the patterns of C1 screw complications. Objective To investigate the incidence of C1 screw complications and analyze the risk factors of the C1 screw complications. Methods A total of 358 C1 screws in 180 consecutive patients were analyzed for C1 screw complications. Screw malposition, occipital neuralgia, major complications, and total C1 screw complications were analyzed. Results The distribution of C1 screw entry point is as follows: inferior lateral mass, 317 screws (88.5 %); posterior arch (PA), 38 screws (10.7 %); and superior lateral mass, 3 screws (0.8 %). We sacrificed the C2 root for 127 screws (35.5 %). C1 instrumentation induced 3.1 % screw malposition, 6.4 % occipital neuralgia, 0.6 % vascular injury, and 3.4 % major complications. In multivariate analysis, deformity (odds ratio [OR]: 2.10, P = .003), traumatic pathology (OR: 4.97, P = .001), and PA entry point (OR: 3.38, P = .001) are independent factors of C1 screw malposition. C2 root resection can decrease the incidence of C1 screw malposition (OR: 0.38, P = .012), but it is a risk factor of occipital neuralgia (OR: 2.62, P = .034). Advanced surgical experience (OR: 0.09, P = .020) correlated with less major complication. Conclusion The incidence of C1 screw complications might not be uncommon, and deformity or traumatic pathology and PA entry point could be the risk factors to total C1 screw complications. The PA screw induces more malposition, but less occipital neuralgia. C2 root resection can reduce screw malposition, but increases occipital neuralgia.

This paper describes magnetic field on power cable in underground transmission systems. Based on specification which is being used in domestic power utility, magnetic field was analyzed in accordance with line arrangement, line burial depth and phase spacing. Magnetic field magnitude and its trend were understood in each circuit type such as double circuits, triple circuits and quadruple circuits of underground transmission systems. In addition, magnetic field was analyzed according to phase arrangement changing in each circuit. Finally, the proper phase arrangement configuration type was suggested by the evaluation of analysis result. Magnetic field was calculated by using Biot-Savart's law. According to the evaluated magnetic fields based on phase layout configuration in each circuit, it figured out that each of magnetic fields was different. As a result, this paper proposes a proper phase layout configuration for generating minimum magnetic field. It is evaluated that the phase layout configuration in each circuit proposed in this paper can be used at actual underground transmission systems.

OF cable with excellent reliability and economic efficiency, has been used as the main cable of underground transmission in Korea. However, as XLPE cable is excellent in view points such as reduction of loss, convenience on the construction/operation, and manufacturing technology, it has been replaced as instead of OF cable. Also, when the aging occurs in some sections of OF cable, the section is replaced as XLPE cable without changing of whole cable line. However, there are some differences like electrical constants between both types of cables. Therefore if underground transmission system will be operated as combined connection composited of both cables, it should be proved that overvoltage is stable in steady and transient state. This paper describes the effectiveness of connection operation in combined OF and XLPE cable. For the evaluation of effectiveness, some important analysis such as sheath component voltage, lightning and switching overvoltage, single line-to-ground fault are carried out in steady and transient state. EMTP/ATPDraw is used for modeling and analysis of system.

Hybrid type combined transmission systems is being operated by AC and DC line at the same space will be expanded instead of the overhead line. However, such hybrid type combined system has problem like the arrangement selection of DC cable for effective system operation. In this paper, to select the proper arrangement of DC cable, induced voltage of DC cable influenced by AC cable was analyzed in case of several type arrangement of DC cable. Such induced voltage is in detailed analyzed not only in case of steady, but transient state. The arrangement which has the lowest induced voltage is selected as the proper one. EMTP/ATPDraw is used for modeling and analysis of hybrid type combined transmission system.

The assessment of control room habitability for Hanbit unit 5 was performed based on GL 2003-01 and Regulatory Guide 1.197. The integrated control room envelope (CRE) test was performed utilizing ASTM E741. Four tests were performed using each of the control room HVAC subtrains. The control room heating, ventilating, and air conditioning (HVAC) system lineup of pressurization mode test was based upon a lineup that encompassed the design basis radiological analyses. The other control room HVAC system lineup of isolation mode test was based on an operation mode that considers toxic gas. The measured inleakage for the isolation test mode remains within the toxicity limit. Radiation effect analysis showed that the measured inleakage satisfied the regulatory criteria, and the inleakage would not result in control room operator dose exceeding 50 mSv whole body and 500 mSv thyroid except train A pressurization test mode. The thyroid dose due to maximum measured unfiltered inleakage of 8976 lpm for train A is cor...

Plastic deformation behavior and microstructural evolution of an Al-core/Cu-sheath composite during multi-pass caliber rolling are investigated using the finite element simulations and experimental analyses. The simulated equivalent plastic strains generated by 1 to 7 pass caliber rolling are correlated with the hardness values and microstructures measured in the longitudinal cross sections of the specimens. The average strains developed in the Al-core and Cu-sheath are almost identical, which satisfy the quasi-isostrain condition in composites with inner soft and outer hard materials. Both the Al-core and Cu-sheath exhibit increasing hardness, but decreasing hardening rates with an increase in the number of passes. The increasing hardness with an increase in the number of caliber rolling passes is attributable to the combined effect of increased dislocation density and decreased grain size. The simulated results for the hardness were shown to be in good agreement with the experimental data for Cu and Al. It was concluded that the finite element method is well placed as a tool for describing and predicting deformation behaviors during caliber rolling.

Al/Cu clads were fabricated by hydrostatic extrusion at 523 K, and their microstructure and mechanical properties were evaluated. The cell size of the Al/Cu clads decreases from 12 mm to 600 µm after three passes of extrusion. Intermetallic compounds (IMCs) appeared at the interface of Al/Cu clad during annealing at 683 K, and their sizes increased as a function of the annealing process. X-ray microanalysis and scanning electron microscope studies showed that the intermetallic species were CuAl2, CuAl, and Cu3Al2, and the thickness of the IMC layers increased at different rates depending on the annealing time. The formation and growth of IMCs resulted in an increase of yield strength and a decrease in elongation of the clads under tensile testing.

Length of most underground power cable in nation is not so long. Therefore it is operated without conductor transposition due to low unbalanced ratio. However, if cable length is long, line constant of each cable will be different. Different line constant can induce unbalanced voltage and current of sheath. Also it can induce several induced interference. This paper describes the operation effectiveness through steady and transient analysis on transposition and untransposition of cable conductor. Especially sheath current and induced voltage are analyzed and compared in case of transposition and untransposition. EMTP is used for modeling and analysis.

The mechanical, electrical and thermal characteristics of insulating materials may significantly affect the performance and reliability of electrical devices using superconductors. General method to provide insulating layer between coated conductors is wrapping coated conductor with Kapton tape. But uniform and compact wrapping without failure or delamination in whole coverage for long length conductor is not a simple task and need careful control. Coating of insulating layer directly on coated conductor is desirable for providing compact insulating layer rather than wrapping insulating layers around conductor. Ceramic added polymer has been widely used as an insulating material for electric machine because of its good electrical insulating properties as well as excellent heat resistance and fairy good mechanical properties. The insulating layer of coated conductor should have high breakdown voltage and possesses suitable mechanical strength and maintain adhesiveness at the cryogenic temperature where it is used and withstand stress from thermal cycling. The insulating and mechanical properties of polymer can be improved by adding functional filler. In this study, insulating layer has been made by adding ceramic particles such as $SiO_2$ to a polymer resin. The size, amount and morphology of added ceramic powder was controlled and their effect on dielectric property of the final composite was measured and discussed for optimum composite fabrication.

An observational study. To evaluate the safeties of placing three different alternative C2 screws using the freehand technique under high riding vertebral artery (HRVA) and to analyze the C2 morphometry in patients with HRVA. A retrospective analysis of radiologic data was performed on patients that underwent C2 instrumentation from September 2004 to December 2017. Two hundred fifty-one patients were included, and 90 of these patients (35.9%) had a unilateral or bilateral HRVA. We placed three alternative C2 screws including superior pars, inferior pars, and translaminar screws. Computed tomography was used to assess cortical breeches of screw placement and obtain morphometric measurements of C2 pars and lamina, that is, superior pars height/length, inferior pars length, and laminar thickness/length. We used the modification of the all India Institute of Medical Sciences outcome to define cortical breach. In total, 117 alternative C2 screws were inserted in 90 patients; 7 superior pars screws (6%), 69 inferior pars screws (59.0%), and 41 translaminar (35%) screws. Although cortical breaches occurred during 31 screw placements (26.5%), these were unacceptable in only two cases (1.7%). No symptomatic neurovascular complication was observed after screw placement in any case. Mean height of C2 superior pars was 3.8 ± 1.8 mm and mean thickness of C2 lamina was 5.2 ± 1.1 mm. Mean lengths of superior pars, inferior pars, and lamina were 17.8 ± 3.0 mm, 13.6 ± 2.2 mm, and 26.7 ± 3.3 mm, respectively. Superior pars height and lamina thickness < 3.5 mm that was a minimal diameter of cervical screw were 49.6% and 6.8%, alternative C2 screw was not available in these cases. Placements of alternative C2 screws using the freehand technique were achieved accurately and safely in patients with HRVA. However, preoperative morphometric evaluation is essential to determine the best option for C2 instrumentation and C2 screw length to avoid neurovascular complications.

This letter introduces a method for designing hierarchical cellular metals employing multipass accumulative bundle extrusion and selective dissolving. The method provides several degrees of freedom for manipulating both the cell-wall properties and architecture of cellular materials. Cellular copper was produced and analyzed as an example of implementing the proposed method. The material hierarchy that can be formed and controlled by means of multipass accumulative extrusion assures strength and enables the material to perform the prescribed functions.

This paper describes the overvoltage through lightning surge analysis on underground system in DC combined distribution systems. It is considered that operating micro grid including distributed generation with smart grid can make possibility of composing new distribution system different from existing one. However, there are many papers about low voltage DC distribution in grids or buildings but not many about replacement or distributing 22.9kV AC distribution system to DC system. Among many research need for DC system development, overvoltage is studied in this paper. Overvoltage is simulated on DC cable when lightning strikes to overhead grounding wire which is installed at the nearest location from power cable section. Analysis as well as modeling is performed in EMTP/ATPDraw. It is evaluated that analysis results can be used to design of DC underground distribution power cable system.

It is anticipated that AC distribution system can be replaced by DC distribution system in the near future because of the operation of various distributed source or microgrid system. However DC distribution system replacing 22.9kV AC distribution line is not sufficiently studied still. This paper describes lightning overvoltage analysis among many research fields should be studied to realize DC overhead distribution systems. DC distribution system is modeled using EMTP and overvoltage is analyzed according to interval of arrestor location, earth interval of overhead grounding wire and grounding resistance. It is evaluated that analysis results can be effectively used to design of future DC distribution system.

OBJECTIVE The diagnosis of shunt malfunction can be challenging since neuroimaging results are not always correlated with clinical outcomes. The purpose of this study was to evaluate the efficacy of a simple, minimally invasive cerebrospinal fluid (CSF) lumbar tapping test that predicts shunt under-drainage in hydrocephalus patients. METHODS We retrospectively reviewed the clinical and radiological features of 48 patients who underwent routine CSF lumbar tapping after ventriculoperitoneal shunt (VPS) operation using a programmable shunting device. We compared shunt valve opening pressure and CSF lumbar tapping pressure to check under-drainage. RESULTS The mean pressure difference between valve opening pressure and CSF lumbar tapping pressure of all patients were 2.21±24.57 mmH2O. The frequency of CSF lumbar tapping was 2.06±1.26 times. Eighty five times lumbar tapping of 41 patients showed that their VPS function was normal which was consistent with clinical improvement and decreased ventricle size on computed tomography scan. The mean pressure difference in these patients was -3.69±19.20 mmH2O. The mean frequency of CSF lumbar tapping was 2.07±1.25 times. Fourteen cases of 10 patients revealed suspected VPS malfunction which were consistent with radiological results and clinical symptoms, defined as changes in ventricle size and no clinical improvement. The mean pressure difference was 38.07±23.58 mmH2O. The mean frequency of CSF lumbar tapping was 1.44±1.01 times. Pressure difference greater than 35 mmH2O was shown in 2.35% of the normal VPS function group (2 of 85) whereas it was shown in 64.29% of the suspected VPS malfunction group (9 of 14). The difference was statistically significant (p=0.000001). Among 10 patients with under-drainage, 5 patients underwent shunt revision. The causes of the shunt malfunction included 3 cases of proximal occlusion and 2 cases of distal obstruction and valve malfunction. CONCLUSION Under-drainage of CSF should be suspected if CSF lumbar tapping pressure is 35 mmH2O higher than the valve opening pressure and shunt malfunction evaluation or adjustment of the valve opening pressure should be made.

A new fault location algorithm based on stationary wavelet transform and its verification experiment results are described for HVDC submarine cables in this paper. For wavelet based fault location algorithm, firstly, 4th level approximation coefficients decomposed by wavelet transform function are superimposed by correlation, then the distance to the fault point is calculated by time delay between the first incident signal and the second reflected signal. For the verification of this algorithm, the real experiments based on various fault conditions and return types of fault current are performed at HVDC submarine cable test yard located in KEPCO(Korea Electric Power Corporation) Power Testing Center of South Korea. It proves that the fault location method proposed in this paper is very simple but very quick and accurate for HVDC submarine cable fault location.

This paper describes frequency response and propagation characteristics considering semiconducting screen in distribution cables. In CIGRE WG 21-05, Simplified Approach(SA) and Rigorous Approach(RA) which can revise the permittivity considering semiconducting screen propose for more detailed EMTP model and frequency dependant analysis. In this paper, the frequency dependent characteristics of complex permittivity are variously analysed by cole-cole function of RA. The attenuation, propagation velocity and surge impedance according to frequency range(1 kHz to 500 MHz) and cable length are also analysed by SA and EMTP simulation in distribution cables. The propagation velocity considering semiconducting screen is slower, and it is saturated over the range of 1 MHz. The signal is significantly attenuated as frequency range is high.

– The Induced sheath voltage is significantly increased at single point bonding section when the ground fault occurs on power cable system because there is no return path of fault current. For solving this problem, therefore, many researchers recommend the PGCC (Parallel Ground Continuity Conductor). In this paper, the characteristics of PGCC are extensively analyzed for reducing the level of induced sheath voltage at the single point bonded section for Korea underground power cable system Keywords: Parallel ground continuity conductor, Overvoltage, Underground cable 1. Introduction Generally, single point bonding section consists in arranging for the sheaths of the three cables to be connected together and earthed at one point only. In Korea, in each single point bonded section, the SVL (sheath voltage limiter) units should be connected between the unbounded ends of the cable sheaths. In this section, during a ground fault, the zero sequence fault current carried by the cable conductor cannot return by any path because single point bonded cable sheath is ground at one position only or the sheaths are separated by SVLs. Specially, the induced sheath voltage is significantly increased at this point when the ground fault occurs on power cable system because there is no return path of fault current. For solving this problem, therefore, many researchers recommend the PGCC (Parallel Ground Continuity Conductor) in single point bonded section. The PGCC is very effective for suppressing an induced sheath overvoltage because of providing an external fault current path. Accordingly, a single point bonded cable installation with PGCC which is earthed at both ends of the route is recommended. The spacing between PGCC and phase conductor should be closed to limit the voltage level during a single phase ground fault. The size of PGCC should be also adequate to carry the full expected fault current for the cable system. However, in Korea, the PGCCs are not applied for single point bonded section till now. The sheaths are just separated by SVLs. Recently, the installed SVLs in single point bonded section were exploded by single line to ground fault, which caused heavy damage to joint box. Therefore, in this paper, the characteristics of PGCC are extensively analyzed for reducing the level of induced sheath voltage at the single point bonded section for Korea underground power cable system. Firstly, the optimal installation section is estimated by evaluating of economical and technical efficiency. Next, the adequate conductor size of PGCC will be decided by maximum fault current considering an expected maximum circuit breaker capacity. The additional various cases are also considered including the dimension and the position of PGCC, spacing between PGCC and phase conductors, faulty phase, cable construction types and two PGCCs usage. Korea electric power company, KEPCO, has now plan for adopting PGCC which is suitable on Korea underground power cable system based on the results of this paper. Accordingly, the PGCC will expect to be applied on real power cable system in Korea, and it also contributes to safety service.

Mg alloy sheets exhibit the yield strength of 280 MPa and elongation of 18 % by rolling at 423 K. Elongation of Mg alloy sheets was improved up to 35 % when the sample was annealed at 673 K for 10 min. From the observation of microstructure, recrystallization and grain growth have happened during annealing processes. The intensity of 0002 pole figure increases slightly as a function of annealing temperature.

In this study, Al/Cu composite was produced by hydrostatic extrusion process at 523 K. Mechanical and electrical properties of Al/Cu composite were investigated during isothermal aging. Microstructure observation and composition analysis of the interface was carried out scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS), respectively. Three kinds of intermetallic composites are observed and they have increased in size as a function of annealing process. Their growth brings about the decrease in the hardness Al/Cu composite.

Generally, fault location in underground transmission cable system is very difficult because of many noises. Therefore, a method to remove the noise in power cable systems is proposed by applying noise cancellation technique based on the correlation of multiple scales of the transients using wavelet analysis. After the noise cancellation, the transient signals reflected from fault point and other end of cable can be used to locate the fault using single-ended approach when the single line-to-ground fault occurs in underground transmission cables. This paper proposes a fault location algorithm using noise cancellation technique in noisy environment. This algorithm is simple and straightforward. The simulation results of 225 fault conditions including different fault resistance, fault location and fault inception angle and real test results prove it can accurately locate the fault in very noisy situations when the single line-to-ground fault occurs in the system.

Lagrangian relaxation is the most widely adopted method for solving unit commitment (UC) problems. It consists of two steps: dual optimization and primal feasible solution construction. The dual optimization step is crucial in determining the overall performance of the solution. This paper intends to evaluate two dual optimization methods - one based on subgradient (SG) and the other based on the cutting plane. Large-scale UC problems with hundreds of thousands of variables and constraints have been generated for evaluation purposes. It is found that the evaluated SG method yields very promising results.

This paper describes switching surge analysis for reclosing decision in 345kV combined transmission line with GIL. Reclosing operation should be decided based on the detailed technical analysis in combined transmission line because this line includes power cable section which is week on insulation. Insulation of power cable can be breakdown at the week point in case of reclosing moment. Therefore the detailed analysis has to be carried out by considering several conditions such as charging rate, inserting resistance, arrester, length ratio of power cable section, grounding resistance, etc. Analysis is performed by EMTP/ATP.

The simplified fault location method which is described in this paper is tested at HVDC submarine cable test yard located in KEPCO Power Testing Center of Korea. The total length of tested submarine cable is 194 m, and it has 4 earth points, each point is grounded between shield layer and seawater under the sea respectively. The tested fault location method uses the time delay of the travelling wave signals reflected from the fault point. Firstly, the signals are measured by oscilloscope at the end of test cable when the grounding fault occurs on the system, then the distance to fault point can be calculated using the time delay of the first two signal and propagation velocity.