Background: Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized as an option to achieve a cure. We retrospectively analyzed over a 6 year period the surgical outcomes, the complications and the mortality-related factors for patients with abdominal aortic aneurysms. Material and Method: We analyzed 36 patients who underwent surgery for abdominal aortic aneurysms between May 2001 and June 2005, and between April 2007 and November 2009. The indications for surgery were rupture, a maximal aortic diameter > 50 mm, and medically intractable hypertension or pain. Result: The mean patient age was $69.67{\pm}6.97$ years (range: 57 to 84 years). Thirty two patients (88.9%) were males and 4 patients (11.1%) were females. Extension to the iliac artery existed in 28 patients (77.8%). Thirteen patients (36.1%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $73.7{\pm}13.3$ mm (60 to 100 mm). Surgery was performed by a midline laparotomy and 10 patients (27.8%) underwent emergency surgery. The mortality rate was 8.3%; the mortality rate for the patients with ruptured aneurysms was 23.1 % and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included wound infection (3 cases), sepsis (2 cases), renal failure (2 cases) and pneumonia (1 case). Unstable vital signs, pre-operative transfusion, ruptured aneurysm, emergency surgery, comorbidity (DM and syncope) and complications (sepsis and renal failure) were the statistically significant mortality-related factors (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have high mortality, but the unruptured cases are repaired with relative safety. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, an elective operation of the unruptured aneurysms could decrease the procedure's morbidity and the inconvenient for repeat evaluation with good surgical results.
Kim, Cu-Rie;Kim, Dong-Soon;Seo, Hyun-Joo;Shin, Hong-Beom;Kim, Eui-Joong;Shim, Hyun-Joon;Ahn, Young-Min
Sleep Medicine and Psychophysiology
/
v.15
no.2
/
pp.94-99
/
2008
The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.
KSCE Journal of Civil and Environmental Engineering Research
/
v.33
no.5
/
pp.2021-2031
/
2013
Due to the rapid economic growth within the nation, the quality of life of individuals have improved dramatically. The scope of living activities of individuals have also extended, resulting in a rapidly increasing demand for automobiles. The number of vehicles registered in Korea is rapidly increasing and will reach 188.71 million as of December 2012. Compared to the registered residents of 50.94 million provided by the Ministry of Public Administration and Security, the registered population reflects about 4 people per every automobile. Due to the high demands for vehicles, the demands for parking lots in collective housing and businesses are also increasing. In reality, the current state of expansion of parking lots are underground, due to the limited available space on ground level. Specifically, the slope of a parking lot cannot exceed 17% linear slope and 14% curved slope according to the 'parking lot laws', however studies show that the driver feels at risk for safety when stopped on the parking ramp while driving in the parking lot. This study seeks to examine the suitability of parking lot ramps, concerning the safety aspects of the driver. First, the ramp type was categorized as linear or curved, then test drives were performed based on variations of slopes, slant distances, directions and points. A survey was administered to the driver after the completion of the test drive, in order to element design for an ideal ramp. In the case of curved ramp, the results of the estimate suggests a counterclockwise, slope at a maximum of 12% incline. The maximum slope for a linear ramp was analyzed to be between 13~14%, suggesting that slope greater than 15% need to be eliminated. In conclusion, it is anticipated that the element design parking ramp reported in this study will help to serve as a reference for future parking lot related guidelines, and provide cost effective traffic safety mechanisms in future parking lot businesses to follow.
Kim, Do-Sung;Kwon, Yong-Jung;Kim, Dong-Hyuk;Kim, Chang-Hwan;Suh, Min-Hwan;Park, Seong-Joon;Yeon, Myung-Hun;Lee, Doo-Beom
Journal of the Korean Institute of Landscape Architecture
/
v.39
no.4
/
pp.98-106
/
2011
Establishing conservation programs to protect and maintain populations of endangered species are not only a global trend, but also a pursuit endorsed by the Korean Environmental Conservation Act. This study evaluates the feasibility of alternative habitat patches for the endangered butterfly Parnassius bremeri. A portion of habitat of P. bremeri is expected to be fragmented and damaged due to the scheduled construction of the Sangju-Yongduk Highway. A trans fer of the habitat patches of P. bremeri is also scheduled. In order to select an alternative habitat patch, the Mark-Release-Recapture (MRR) method was used to simulate a patch transfer model. The connectedness between habitat are as and the survival of local populations were evaluated for each candidate habitat. It was found that metapopulations with patch distances of <250m showed a 50% connectedness and survival rate in local populations. P. bremeri were expected to migrate at an average distance of 300m. In addition, P. bremeri formed a metapopulation that exhibited intimate patch dynamics that promoted persistence among these patches. Possible candidate habitats including those recommended by local governing bodies were evaluated along with habitats that may counter problems arising from the damage done to the original habitat and habitats that may have a compensatory value equal to that of the original habitat. Based on these criteria, Ansa-myeon township office was selected due to its high scores. This scoring was based on a consideration of a wide range of variables that mark a successful transfer of habitat. These include the amount of funding available, the governing bodies of the possible alternative habitat, and the Expected collaborative effort of local citizens. This decision was collaborated on by incorporating the expertise of various fields of study including biology, ecology, biogeography, ecological engineering, landscape architecture, and social sciences. Therefore, it is suggested that in order to evaluate an alternative habitat for organisms, many social issues as well as ecological issues must be considered.
Park, Shin-I;Kwon, Hae Oak;Lee, Jun Ho;Jung, Su Jin
Clinical and Experimental Pediatrics
/
v.48
no.10
/
pp.1121-1125
/
2005
Purpose : Rotavirus is the main cause of infantile diarrheal disease worldwide, especially in patients 3-24 months of age. Infants younger than 3 months of age are relatively protected by transplacental antibody. So the purpose of this study is to evaluate the clinical features and severity of neonatal rotaviral gastroenteritis less than 1 month of age. Methods : A retrospective chart review was established of 62 neonates less than 1 month of age and with a diagnosis of rotaviral gastroenteritis who had been admitted to Pochon CHA University between June 2002 through July 2004. The rotavirus was examined by stool latex agglutination. Results : During 2 years, the total number of admitted patients for rotaviral gastroenteritis was 688 and among these, less than 1 month of age accounted for 9%(62). The occurrence was generally even distribution from January to July($7.14{\pm}1.0$) but since then decreased($2.4{\pm}1.8$). The most common chief complaint was mild fever(46%) when admitted which subsided within 1 hospital day in most patients. 4 patients had seizure and cyanosis with no typical symptoms of rotaviral gastroenteritis. During admission, all the patients had diarrhea. 17% of the patients had leukocytosis and positive C-reactive protein. In one patient, stool occult blood test was positive but there was no necrotizing gastroenteritis evidence. The mean period of hospital day was $5.8{\pm}2.5$ and breast-milk feeding was 62.9%. Conclusion : Neonatal rotaviral gastroenteritis is not a rare disease. Most patients have fever and diarrhea and improve through conservative therapy but a few patients may have severe complications so we must be more cautious about the hygiene for prevention.
District heating was first introduced in Korea in 1985. As the service life of the underground thermal piping network has increased for more than 30 years, the maintenance of the underground thermal pipe has become an important issue. A variety of complex technologies are required for periodic inspection and operation management for the maintenance of the aged thermal piping network. Especially, it is required to develop a model that can be used for decision making in order to derive optimal maintenance and replacement point from the economic viewpoint in the field. In this study, the analysis was carried out based on the repair history and accident data at the operation of the thermal pipe network of five districts in the Korea District Heating Corporation. A failure probability model was developed by introducing statistical techniques of qualitative analysis and binomial logistic regression analysis. As a result of qualitative analysis of maintenance history and accident data, the most important cause of pipeline damage was construction erosion, corrosion of pipe and bad material accounted for about 82%. In the statistical model analysis, by setting the separation point of the classification to 0.25, the accuracy of the thermal pipe breakage and non-breakage classification improved to 73.5%. In order to establish the failure probability model, the fitness of the model was verified through the Hosmer and Lemeshow test, the independent test of the independent variables, and the Chi-Square test of the model. According to the results of analysis of the risk of thermal pipe network damage, the highest probability of failure was analyzed as the thermal pipeline constructed by the F construction company in the reducer pipe of less than 250mm, which is more than 10 years on the Seoul area motorway in winter. The results of this study can be used to prioritize maintenance, preventive inspection, and replacement of thermal piping systems. In addition, it will be possible to reduce the frequency of thermal pipeline damage and to use it more aggressively to manage thermal piping network by establishing and coping with accident prevention plan in advance such as inspection and maintenance.
In this investigation, results of laboratory tests on four reinforced concrete flat plate interior connections with elongated rectangular column support which has been used widely in tall residential buildings are presented. The purpose of this study is to evaluate an effect of column aspect ratio (${\beta}_c={c_1}/{c_2}$=side length ratio of column section in the direction of lateral loading $(c_1)$ to the direction of perpendicular to $c_1$) on the hysteretic behavior under earthquake type loading. The aspect ratio of column section was taken as $0.5{\sim}3\;(c_1/c_2=1/2,\;1/1,\;2/1,\;3/1)$ and the column perimeter was held constant at 1200mm in order to achieve nominal vertical shear strength $(V_c)$ uniformly. Other design parameters such as flexural reinforcement ratio $(\rho)$ of the slab and concrete strength$(f_{ck})$ was kept constant as ${\rho}=1.0%$ and $f_{ck}=40MPa$, respectively. Gravity shear load $(V_g)$ was applied by 30 percent of nominal vertical shear strength $(0.3V_o)$ of the specimen. Experimental observations on punching failure pattern, peak lateral-load and story drift ratio at punching failure, stiffness degradation and energy dissipation in the hysteresis loop, and steel and concrete strain distributions near the column support were examined and discussed in accordance with different column aspect ratio. Eccentric shear stress model of ACI 318-05 was evaluated with experimental results. A fraction of transferring moment by shear and flexure in the design code was analyzed based on the test results.
Journal of Dental Rehabilitation and Applied Science
/
v.27
no.3
/
pp.317-326
/
2011
The mental foramen and anterior loop of the mandibular canal are important landmarks for mandibular surgical procedures. The purpose of this study was to analyze the shape and position of the mental foramen and anterior loop of the mandibular canal on the computed tomography (CT) images, and apply the results clinically. CT images of 96 patients (33 male, 36 female, age range 17~43 years, mean $24.6{\pm}4.99$ years) were enrolled. The horizontal and vertical position of the mental foramen, as well as the distance from the root apices were measured. The distance of the anterior loop of the mandibular canal to the root apices, and the buccal angle were measured. The mental foramen was found mostly below the second premolar observed in 81 cases (46.0%), between the first and second premolars in 67 cases (38.0%), and between the second premolar and first molar in 19 cases (10.2%). The mean distance between the mental foramen and the lower border of the mandible was $12.20{\pm}1.77$ mm, the mean distance between the mental foramen and root apex was $5.16{\pm}0.98$ mm. The mean distance of the anterior loop of the mandibular canal was $5.80{\pm}2.00$ mm. The buccal angle measured at $47.7{\pm}9.07^{\circ}$. The distance between the root apex and mental foramen measured as $5.16{\pm}0.98$ mm on panoramic radiography, and $6.2{\pm}3.07$ mm on CT. The mean distance between the mental foramen and mandibular canal was $5.39{\pm}1.62$ mm. When performing surgical procedures such as installing dental implants, it is important to minimize surgical trauma, especially the risk of damage to the mental nerve. To optimize the surgical outcome, a careful assessment of the shape and position of the mental foramen and the anterior loop of the mandibular canal must be made. CT images are useful for finding such anatomic structures.
In this study, the distributions of internal climates such as air temperature, humidity, dust, ammonia gas, and air velocity were systematically measured at a mechanically ventilated broiler houses during summer season, with local weather data. The analysis was focused on the suitability, stability, and uniformity of internal climate, resulting in serious stress on chickens and decrease of productivity In the mechanically ventilated broiler house, the difference between measured and recommended air temperatures(suitability) was 10.4C in maximum during the summer time. The difference of air temperature in the house between day and night was $8.7^{\circ}C$ in maximum. And maximal hourly range of internal air temperature at 0.4m height from the floor was $3.7^{\circ}C$ suggesting it maintained thermal uniformity in the broiler house. The $NH_3$ and dust concentrations were pretty low because ventilation was fully performed. The air speed at chicken location was measured 2.2m/s and 1.7m/s, respectively without and with chicken existence.
Park Jee-Min;Shin Jae-Il;Kim Pyung-Kil;Lee Jae-Seung
Childhood Kidney Diseases
/
v.6
no.2
/
pp.155-168
/
2002
Purpose; Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. Methods: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. Results: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1(2-18) years old. FANA(95.0%), anti-ds DNA antibody(87.5%), malar rash(80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria(75.0%), nephrotic syndrome(55.0%), and microscopic hematuria alone(15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was $51.8{\pm}40.5$ months. During $51.8{\pm}40.5$ months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. Conclusion: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.
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