• Title/Summary/Keyword: Common-cause failure

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Analysis of Characteristics and Prognostic Factors in Adult Patients Receiving Mechanical Ventilation in the Medical Intensive Care Unit of a University Hospital (한 대학병원 내과계 중환자실의 기계환기 시행 환자의 현황 및 예후인자의 분석)

  • Song, Jin Woo;Choi, Chang-Min;Hong, Sang-Bum;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.292-300
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    • 2008
  • Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.

Repeated failure of implants at the same site: a retrospective clinical study

  • Kang, Dong-Woo;Kim, So-Hyun;Choi, Yong-Hoon;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.27.1-27.9
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    • 2019
  • Background: Implants are becoming the first choice of rehabilitation for tooth loss. Even though they have a high success rate, failures still occur for many reasons. The objective of this study is to analyze the reasons for recurring failure at the same site and the results of re-implantation. Methods: Thirteen patients (11 males and 2 females, mean age 60 ± 9.9 years) who experienced implant surgery failure at the same site (same tooth extraction area) two or more times in the Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, between 2004 and 2017 were selected. The medical records on a type, sites, diameter, and length of implants; time and estimated cause of failure; and radiographs were reviewed. Data were collected and analyzed retrospectively, and the current statuses were evaluated. Results: A total of 14 implants experienced failure in the same site more than two times. Twelve implants were placed in the maxilla, while 2 implants were placed in the mandible. The maxillary molar area was the most common site of failure (57.1%), followed by the mandibular molar, anterior maxilla, and premolar areas (14.3% each). The first failure occurred most commonly after prosthetic treatment (35.7%) with an average period of failure of 3.8 months after loading. Ten cases were treated as immediate re-implantation, while the other 4 were delayed reimplantation after an average of 3.9 months. The second failure occurred most commonly after prosthetic treatment (42.9%), with an average of 31 months after loading; during the healing period (42.9%); and during the ongoing prosthetic period (14.3%). In 3 cases (21.4%), the treatment plan was altered to an implant bridge, while the other 11 cases underwent another implant placement procedure (78.6%). Finally, a total of 9 implants (64.3%) survived, with an average functioning period of 60 months. Conclusions: Implants can fail repeatedly at the same site due to overloading, infection, and other unspecified reasons. The age and sex of the patient and the location of implant placement seem to be associated with recurring failure. Type of implant, bone augmentation, and bone materials used are less relevant.

Milk-alkali syndrome secondary to the intake of calcium supplements (칼슘 제제 복용 후 발생한 우유알칼리증후군)

  • Lee, In Hee;Noh, Sin Young;Kang, Gun Woo
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.48-51
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    • 2016
  • Milk-alkali syndrome (MAS), a triad of hypercalcemia, metabolic alkalosis, and renal failure, is associated with ingestion of large amounts of calcium and absorbable alkali. MAS is the third most common cause of hypercalcemia in hospital, after primary hyperparathyroidism and malignant neoplasm. MAS is not often reported in the Korean literature. We describe MAS secondary to intake of calcium citrate for the treatment of osteoporosis with thoracic spine compression fracture. A 70-year-old man presented to our hospital with a 1-week history of general weakness and lethargy. He was found with acute kidney injury (serum creatinine, 4.6 mg/dL), hypercalcemia (total calcium, 14.8 mg/dL), and alkalosis. Laboratory evaluation excluded both hyperparathyroidism and malignancy. Mental status and serum calcium level was normalized within a week after proper hydration and intravenous administration of furosemide. However, he developed aspiration pneumonia, pseudomembranous colitis, and sepsis with multi-organ failure. Despite intensive treatment including inotropics, mechanical ventilation, and renal replacement therapy, he expired with no signs of renal recovery on the 28th hospital day.

An Experimental Study for the Fatigue Strength Assessment of Longi-web Connections (Longi-web 연결부의 피로강도 평가에 관한 실험적 연구)

  • Kang, Sung-Won;Kim, Jeong-Hwan;Kim, Kwang-Seok;Kang, Joong-Kyoo;Heo, Joo-Ho;Kim, Myung-Hyun
    • Journal of the Society of Naval Architects of Korea
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    • v.45 no.1
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    • pp.87-92
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    • 2008
  • In the load-carrying fillet weldments, which are common in ship structures, fatigue cracks can occur at the weld root, in addition to the weld toe. In particular, fatigue cracks originating from the weld root are difficult to detect and cause a significant reduction in the fatigue strength of a weldment. Therefore, it is important to note the fatigue failure mode of load-carrying fillet weldment. In this study, a series of fatigue test was carried out for the fatigue strength evaluation of longi-web connections that are typical kinds of the load-carrying fillet weldment.

Failure Analysis and Solution of ESD for Amplifier Used in Telecommunication (통신용 증폭기의 ESD 고장분석과 대책)

  • Hwang, Soon-Mi;Jung, Young-Baek;Kim, Chul-Hee;Lee, Kwan-Hoon
    • Journal of Applied Reliability
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    • v.11 no.3
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    • pp.251-265
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    • 2011
  • Low-noise amplifier(LNA) is a component that amplifies the signal while lowering the noise figure of high-frequency signal. LNA holds a very important position in RF system so that it is widely used for telecommunication. Electro static discharge(ESD) is the most common cause of malfunction for low-powered components, such as Large Scale Integration and IC type LNA is weak in ESD. This thesis studies static effect of communication LNA. It analyzes ESD effect, which occurs within LNA circuit, and describes testing standard and methods. In order to find out LNA's susceptiblity to electro static, two well-recognized communication IC type LNA models were selected to be tested. Then static-induced malfunction was carefully analyzed and it suggests architectural problem and improvement from the LNA's ESD point of view.

Seed and Root Rots of Ginseng (Panax quinquefolius L) Caused by Cylindrocarpon destructans and Fusarium spp.

  • Reeleder, R.D.;Roy, R.;Capell, B.
    • Journal of Ginseng Research
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    • v.26 no.3
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    • pp.151-158
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    • 2002
  • Ginseng (Panax quinquefolius L.) has become one of the most valuable herb crops grown in North America. However, traditional cropping practices are favourable to disease and significant losses due to root disease are common, despite frequent use of fungicides. Seedlots are often contaminated with pathogens, however, little is known about the causes of seed decay and the role of seed pathogens as incitants of root rots. It was shown that both Fusarium spp. and Cylindrocarpon destructans were able to rot seeds and that C. destructans was more virulent than Fusarium spp. on seedling roots. A modified rose bengal agar MRBA) medium (1 g KH$_2$PO$_4$; 0.5 g MgSO$_4$; 50 mg rose bengal; 10 g dextrose; 5 g Bacto peptone; 15 g Bacto agar; 30 mg streptomycin sulfate; 250 mg ampicillin; 10 mg rifampicin; 500mg pentachloronitrobenzene; 500 mg dicloran; and 1 L distilled water) was superior to potato dextrose agar in detecting C. destuctans in diseased roots. Isolation of C. destructans from diseased seedlings arising from seeds sown in replant soil supported the hypothesis that this pathogen is a cause of ginseng replant failure in North America.

Rhinovirus Associated Severe Respiratory Failure in Immunocompetent Adult Patient

  • Kim, Kiwook;Song, Yeon Han;Park, Joo-Hyun;Park, Hye Kyeong;Kim, Su Young;Jung, Hun;Lee, Sung-Soon;Koo, Hyeon-Kyoung
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.132-135
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    • 2014
  • Rhinovirus infection is typically associated with the common cold and has rarely been reported as a cause of severe pneumonia in immunocompetent adults. A 55-year-old previous healthy woman, who consumed half a bottle of alcohol daily, presented with respiratory failure after one week of upper respiratory infection symptoms. Radiography revealed bilateral, diffuse ground glass opacity with patchy consolidation in the whole lung field; bronchoalveolar lavage fluid analysis indicated that rhinovirus was the causative organism. After five days of conservative support, the symptoms and radiographic findings began to improve. We report this rare case of rhinovirus pneumonia in an otherwise healthy host along with a review of references.

A Korean Case of Neonatal Nemaline Myopathy Carrying KLHL40 Mutations Diagnosed Using Next Generation Sequencing

  • Suh, Yoong-a;Sohn, Young Bae;Park, Moon Sung;Lee, Jang Hoon
    • Neonatal Medicine
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    • v.28 no.2
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    • pp.89-93
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    • 2021
  • Nemaline myopathy is a genetically heterogeneous neuromuscular disorder and one of the most common congenital myopathies. The clinical manifestations usually vary depending on the age of onset. Neonatal nemaline myopathy has the worst prognosis, primarily due to respiratory failure. Several genes associated with nemaline myopathy have been identified, including NEB, ACTA1, TPM3, TPM2, TNNT1, CFL2, KBTBD13, KLHL40, KLHL41, LMOD3, and KBTBD13. Here, we report a neonatal Korean female patient with nemaline myopathy carrying compound heterozygous mutations in the gene KLHL40 as revealed using next generation sequencing (NGS). The patient presented with postnatal cyanosis, respiratory failure, dysphagia, and hypotonia just after birth. To identify the genetic cause underlying the neonatal myopathy, NGS-based gene panel sequencing was performed. Compound heterozygous pathogenic variants were detected in KLHL40: c.[1405G>T];[1582G>A] (p. [Gly469cys];[Glu528Lys]). NGS allows quick and accurate diagnosis at a lower cost compared to traditional serial single gene sequencing, which is greatly advantageous in genetically heterogeneous disorders such as myopathies. Rapid diagnosis will facilitate efficient and timely genetic counseling, prediction of disease prognosis, and establishment of treatments.

Comparative Study for the Efficacy of Small Bore Catheter in the Patients with Iatrogenic Pneumothorax

  • Noh, Tae-Ook;Ryu, Kyoung-Min
    • Journal of Chest Surgery
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    • v.44 no.6
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    • pp.418-422
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    • 2011
  • Background: It has recently become most general to use the small bore catheter to perform closed thoracostomy in treating iatrogenic pneumothorax. This study was performed for analysis of the efficacy of treatment methods by using small bore catheter such as 7 F (French) central venous catheter, 10 F trocar catheter, 12 F pigtail catheter and for analysis of the appropriateness of each procedure. Materials and Methods: From March 2007 to February 2010, Retrospective review of 105 patients with iatrogenic pneumothorax, who underwent closed thoracostomy by using small bore catheter, was performed. We analyzed the total success rate for all procedures as well as the individual success rate for each procedure, and analyzed the cause of failure, additional treatment method for failure, influential factors of treatment outcome, and complications. Results: The most common causes of iatrogenic pneumothorax were presented as percutaneous needle aspiration(PCNA) in 48 cases (45.7%), and central venous catheterization in 26 cases (24.8%). The mean interval to thoracostomy after the procedure was measured as 5.2 hours (1~34 hours). Total success rate of thoracostomy was 78.1%. The success rate was not significantly difference by tube type, with 7 F central venous catheter as 80%, 10 F trocar catheter as 81.6%, and 12 F pigtail catheter as 71%. Twenty one out of 23 patients that had failed with small bore catheter treatment added large bore conventional thoracostomy, and another 2 patients received surgery. The causes for treatment failure were presented as continuous air leakage in 12 cases (52.2%) and tube malfunction in 7 cases (30%). The causes for failure did not present significant differences by tube type. Statistically significant factors affecting treatment performance were not discovered. Conclusion: Closed thoracostomy with small bore catheter proved to be effective for iatrogenic pneumothorax. The success rate was not difference for each type. However, it is important to select the appropriate catheter by considering the patient status, pneumothorax aspect, and medical personnel in the cardiothoracic surgery department of the relevant hospital.

A Case of Pyrazinamide Induced Fulminant Hepatic Failure (Pyrazinamide에 의한 전격성 간부전 1예)

  • Moon, Dae Sung;Jang, Tae Won;Oak, Chul Ho;Jung, Maan Hong;Yoo, Chan Hui;Song, Jun Young;Kim, Sung Eun;Kim, Ja Kyung;Jang, Lee La;Lee, Eun Young;Jung, Gyu Sik
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.435-439
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    • 2007
  • Standard antituberculous therapy, including isoniazid (INH), rifampin, ethambutol, and pyrazinamide (PZA), is widely used to treat active tuberculosis. The most important side effect is hepatotoxicity. In a standard four-drug regimen, PZA was the most common cause of drug-induced hepatitis and was dose-related. The incidence of drug-induced hepatitis is high at doses of 40~70 mg/kg per day but has fallen significantly since the recommended dose was reduced. Liver toxicity induced by PZA is rare at doses of 25 mg/kg per day or less. PZA-induced fulminant hepatic failure is also rare but fatal. We report a case of fulminant hepatic failure caused by a re-challenge of PZA.