• Archives of Plastic Surgery
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• 제49권5호
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

• Journal of Chest Surgery
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• 제23권4호
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• pp.820-824
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• 1990

A very early and effective technique of sternal closure by plastic plates was successfully applied to a 7-months-old infant of tetralogy of Fallot in whom the standard closure of sternum was not possible due to massive generalized edema after cardiopulmonary bypass for total correction. This technique provides not only solid but also permanent closure of the sternum so that any early reoperation for closure of sternum and its accompanying risk of infection in many other known methods can be avoided.

• 대한한의학회지
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• 제44권2호
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• pp.170-180
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• 2023

Objectives: This is a case report on the treatment of one patient with acute angle-closure glaucoma using traditional Korean medicine. Methode: We assessed the progression of acute angle-closure glaucoma by analyzing Optical Coherence Tomography(OCT) results. Results: Acute angle closure glaucoma did not progress to OCT after treatment. Conculsion: We obtained results from OCT examinations indicating that the progression of acute angle-closure glaucoma had ceased after Korean herbal medicine treatment.

• Journal of Chest Surgery
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• 제28권11호
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• pp.977-982
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• 1995

Early repair of complex congenital heart malformation may lead to life-threatening respiratory and hemodynamic embarrassment on sternal closure. We performed delayed sternal closure in nine neonates to avoid a fatal outcome in these situations. Primary elective open sternum was used in 8 [66.7% and primary sternal closure in 4 [33.3% of the 12 patients studied. one patient with primary sternal closure underwent delayed sternal reopening in the intensive care unit. Of the 9 patients with open sternum, 2 patients died of low cardiac output and acute renal failure respectively before delayed sternal closure. 7 patients could undergo delayed sternal closures 3 days after initial operation. The mean age at open cardiac procedure was 14.3 days [range 3 to 30 and mean preoperative weight was 3.4kg [range 2.8 to 4.1 . The aortic cross-clamping time was longer in the group with open sternum than the group with closed sternum [p=0.042 . There was no morbidity and mortality related to delayed sternal closure. Given the low morbidity and potential benifits, this technique should be used in neonates after open heart procedures when postoperative mediastinal compression produces frank low cardiac output or respiratoy compromise during a trial of sternal closure.

• 보건행정학회지
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• 제20권3호
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• pp.123-137
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• 2010

The main purpose of this article is for deriving functions related to the prediction of the closure of the hospitals, and finding out how the discriminant functions affect the closure of the hospitals. Empirical data were collected from 3 years financial statements of 41 private hospitals closed down from 2000 till 2006 and 62 private hospitals in business till now. As a result, the functions related to the prediction of the closure of the private hospital are 4 indices: Return on Assets, Operating Margin, Normal Profit Total Assets, Interest expenses to Total borrowings and bonds payable. From these discriminant functions predicting the closure, I found that the profitability indices - Return on Assets, Operating Margin, Normal Profit Total Assets - are the significant affecting factors. The discriminant functions predicting the closure of the group of the hospitals, 3 years before the closure were Normal Profit to Gross Revenues, Total borrowings and bonds payable to total assets, Total Assets Turnover, Total borrowings and bonds payable to Revenues, Interest expenses to Total borrowings and bonds payable and among them Normal Profit to Gross Revenues, Total borrowings and bonds payable to total assets, Total Assets Turnover, Total borrowings and bonds payable to Revenues are the significant affecting factors. However 2 years before the closure, the discriminant functions predicting the closure of the hospital were Interest expenses to Total borrowings and bonds payable and it was the significant affecting factor. And, one year before the closure, the discriminant functions predicting the closure were Total Assets Turnover, Fixed Assets Turnover, Growth Rate of Total Assets, Growth Rate of Revenues, Interest expenses to Revenues, Interest expenses to Total borrowings and bonds payable. Among them, Total Assets Turnover, Growth Rate of Revenues, Interest expenses to Revenues were the significant affecting factors.

• 대한치과보철학회지
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• 제33권2호
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• pp.281-299
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• 1995

The purpose of this study was to evaluate the degree of occlusal contact under the fixed implant prosthesis of partially edentulous patients which was hased on occlusal concept of implant prosthesis. From the patients who have free-standing implant supported prosthesis of unilateral partially edentulous area, occlusal and occlusal contact point of th enatural tooth side and implant side of light closure and heavy closure were analyzed by T-scan system throuht pre-and post-adjustment and the degree of occlusal contact was estimated by Shimstock. The following results were obtained : 1. The occlusal force of natural tooth side(NF) from mid-sagittal axis was relatively constant at light and heavy closure through pre-and post-adjustment, but the occlusal force of implant side(IF) was decreased significantly at light closure(P<0.01) and heavy closure(P<0.05) of post-adjustment. 2. Natural tooth side-implant side moment(MIMoment) fo occlusal force from mid-sagittal axis was significant(p<0.05) through pre-and post-adjustment and the deviation from mid-sagittal axis was increased at light closure of post-adjustment, but was decreased at heavy closure of post-adjustment. 3. Comparing the NF and IF, IF was greater at heavy closure of pre-adjustment, and NF was greater at light closure of post-adjustment, and the NF and IF was relatively equally distributed at light closure of pre-adjustment and at heavy closure of post-adjustment. 4. The number of occlusal contact point of natural tooth side(NC) was relatively constant through pre-and post-adjustment, but the number of occlusal contact point of implant side(IC) was significantly decreased(P<0.05) at light closure of post-adjustment, and was not significant but was lesser at heavy closure of post-adjustment. 5. Difference of the NC and IC was greater at light closure of post-adjustment, but it was less at heavy closure of post-adjustment, and therefore occlusal contact point of natural tooth side and implant side was relatively equally distributed at heavy closure of postadjustment. 6. When bilaterally distribution of occlusal force and occlusal contact point was established, degree of occlusal contact of implant suporoted prosthesis with opoosing teeth at light clousre was $34.13{\pm}21.69{\mu}m$.

• 한국전산구조공학회논문집
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• 제13권4호
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• pp.427-436
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• 2000

이 논문은 불규칙 가진력을 받는 회전-고정보의 비선형 응답특성을 나타낸다. 불규칙 가진력은 두 번째 고유모드의 절점과 최대변위점에 가했다. 비선형 편미분 방정식과 경계조건으로 표현되는 이 문제를 Galerkin의 방법을 이용하여 연립 비선형 상미분방정식으로 변환하였다. 이 상미분방정식으로부터 Fokker-Planck방정식과 모멘트 방정식을 얻은 후 Gaussian closure 방법 및 non-Gaussian closure 방법을 이용하여 3 모드 근사시 각각 27개 및 209개의 자율 상미분방정식을 구하였다. Gaussian closure 방법과 non-Gaussian closure 방법으로 2 모드 및 3 모드 근사해석을 수행하였고 해석적 결과들은 Monte Carlo 시뮬레이션 결과와 비교되었다. 해석결과 2 모드 근사해와 3 모드 근사해가 거의 일치하였고 2 모드 내부공진만 고려하여도 해석결과에 별 영향을 주지 않는다는 것을 알 수 있다.

• 대한기계학회논문집A
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• 제31권4호
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• pp.432-440
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• 2007

In this study, we have investigated the closure behavior of fatigue cracks in SAPH440 steel plates under a mixed-mode I+II loading. A crack image capturing system as a direct measuring method was used to measure the closure levels at a crack tip. The crack closure levels in the fluctuation and stable sections were increased with the increase of the mode mixture ratio. The mode mixture ratio independent fatigue crack propagation rates equation was calculated by considering mixed-mode crack closure levels. The equation was examined according to the application method of crack opening ratio. The fracture surface analysis by C-scan method was also performed in order to investigate the closure mechanism and propagation mode of crack under the mixed-mode I+II loading. The crack closure under the mixed mode I+II is confirmed as a surface roughness closure by the quantitative analysis of fracture surface using the proposed surface roughness parameter.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2004년도 추계학술대회
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• pp.214-219
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• 2004

Crack tip behavior of single mode loading condition(mode I)depend on tensile loading component but one of mixed mode loading condition(mode I+II) have influenced on shear loading component like the practical structure. Because crack closure is caused by shear loading component under mixed-mode loading a research on the behavior in the stage of crack initiation and propagation require to be evaluate about crack closure effect by fatigue crack surface friction. For that reasion we examined the behavior at the crack tip by direct measuring method. Measured behavior at the crack tip was analyzed through vector crack tip displacement. As a result, crack propafation equation was corrected by considering with crack closure effect. In addition we compared fatigue fracture crack surface and crack closure level.

• International Journal of Fuzzy Logic and Intelligent Systems
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• 제12권4호
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• pp.290-295
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• 2012

Due to importance of the concepts of ${\theta}$-closure and ${\delta}$-closure, it is natural to try for their extensions to fuzzy topological spaces. So, Ganguly and Saha introduced and investigated the concept of fuzzy ${\delta}$-closure by using the concept of quasi-coincidence in fuzzy topological spaces. In this paper, we will introduce the concept of ${\delta}$-closure in intuitionistic fuzzy topological spaces, which is a generalization of the ${\delta}$-closure by Ganguly and Saha.