• Title/Summary/Keyword: Delayed operation

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Concomitant or Delayed Intra-abdominal Operation in Immediate Breast Reconstruction with TRAM Flap (횡복직근피판술을 이용한 즉시 유방재건과 동시 혹은 후에 시행한 복강 내 수술)

  • Kim, Kyu-Nam;Lee, Taik-Jong
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.22-25
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    • 2010
  • Purpose: As patients who take immediate breast reconstructions with TRAM flap have increased, concomitant or delayed other elective intra-abdominal operations in these patients also have increased. There are few reports of concomitant or delayed intra-abdominal operation in TRAM flap patients. We report our experiences and outcomes of these operations which is safe and feasible. Methods: We reviewed the charts and postoperative follow-up results of 11 patients among 471 consecutive patients who took immediate breast reconstruction with TRAM flap from December of 2002 to September of 2006. Four patients took concomitant intra-abdominal operation and 7 patients took delayed intra-abdominal operation between 1 to 52 months after TRAM flap Results: There were no significant postoperative abdominal and systemic complications. One patient who took concomitant intra-abdominal operation presented partial skin necrosis of abdomen, but recovered completely with conservative treatments. Two patients took transfusion in peri-operative periods. Conclusion: Concomitant or delayed intra-abdominal operation in immediate breast reconstruction with TRAM flap could be performed safely and feasibly when it is necessary. Furthermore, it could be helpful to patients and surgeons.

Assessment on Aging Management of Delayed Neutron Monitoring System Tubing for Continued Operation of Wolsong Unit 1 (월성1호기 계속운전 관련 결함연료위치탐지계통 배관의 열화관리평가)

  • Song, Myung Ho;Kim, Hong Key;Lee, Young Ho
    • Transactions of the Korean Society of Pressure Vessels and Piping
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    • v.7 no.2
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    • pp.14-20
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    • 2011
  • The end of design lifetime for Wolsong unit 1 will be reached on 20th November in 2012. So the license renewal documents for the continuous operation of Wolsong unit 1 is under reviewing now. Major components of primary system such as pressure tubes, feeder pipes including delayed neutron monitoring system tubing are being replaced and many components of secondary system are also being repaired. In this paper, the assessment on the wear degradation of delayed neutron monitoring system tubing(on the other hand, DN tube was called) was performed for the ageing management of the same component. The wear defects of this component was one of causes that resulted in heavy water leakage accidents. Therefore design specifications of Wolsong uint 1 and heavy water leakage accidents of pressurized heavy water reactors were reviewed and causes of wear defect for DN tubes were analyzed. Wear propagation equations based on the heavy water leakage history were made and the proper repairing time was possible to be expected if the continued operation was considered. Finally design change items of DN tubes that were conducted for the long term operation of Wolsong unit 1 are introduced.

Protection for a Wind Turbine Generator in a Large Wind Farm

  • Zheng, Tai-Ying;Kim, Yeon-Hee;Kang, Yong-Cheol
    • Journal of Electrical Engineering and Technology
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    • v.6 no.4
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    • pp.466-473
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    • 2011
  • This paper proposes a protection algorithm for a wind turbine generator (WTG) in a large wind farm. To minimize the outage section, a protection relay for a WTG should operate instantaneously for an internal fault or a connected feeder fault, whereas the relay should not operate for an internal fault of another WTG connected to the same feeder or an adjacent feeder fault. In addition, the relay should operate with a delay for an inter-tie fault or a grid fault. An internal fault of another WTG connected to the same feeder or an adjacent feeder fault, where the relay should not operate, is determined based on the magnitude of the positive sequence current. To differentiate an internal fault or a connected feeder fault from an inter-tie fault or a grid fault, the phase angle of the negative sequence current is used to distinguish a fault type. The magnitude of the positive sequence current is then used to decide either instantaneous operation or delayed operation. The performance of the proposed algorithm is verified under various fault conditions with EMTP-RV generated data. The results indicate that the algorithm can successfully distinguish instantaneous operation, delayed operation, or non-operation depending on fault positions and types.

Design and Evaluation of a Protection Relay for a Wind Generator Based on the Positive- and Negative-Sequence Fault Components

  • Zheng, Taiying;Cha, Seung-Tae;Kim, Yeon-Hee;Crossley, Peter A.;Lee, Sang Ho;Kang, Yong Cheol
    • Journal of Electrical Engineering and Technology
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    • v.8 no.5
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    • pp.1029-1039
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    • 2013
  • To avoid undesirable disconnection of healthy wind generators (WGs) or a wind power plant, a WG protection relay should discriminate among faults, so that it can operate instantaneously for WG, connected feeder or connection bus faults, it can operate after a delay for inter-tie or grid faults, and it can avoid operating for parallel WG or adjacent feeder faults. A WG protection relay based on the positive- and negative-sequence fault components is proposed in the paper. At stage 1, the proposed relay uses the magnitude of the positive-sequence component in the fault current to distinguish faults requiring non-operation response from those requiring instantaneous or delayed operation responses. At stage 2, the fault type is first determined using the relationships between the positive- and negative-sequence fault components. Then, the relay differentiates between instantaneous operation and delayed operation based on the magnitude of the positive-sequence fault component. Various fault scenarios involving changes in position and type of fault and faulted phases are used to verify the performance of the relay. This paper concludes by implementing the relay on a hardware platform based on a digital signal processor. Results indicate that the relay can successfully distinguish the need for instantaneous, delayed, or non-operation.

A Clinical Case Study of Operation-delayed Cauda Equina Syndrome Patient Improved by Korean Traditional Treatment (한방요법으로 호전된 수술이 지연된 마미 증후군 환자의 증례보고)

  • Jung, Hae-Chang;Jeong, Su-Hyeon
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.2
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    • pp.181-187
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    • 2015
  • Objectives The objective of this study is to report clinical effect of korean traditional treatments for Operation-delayed Cauda Equina Syndrome patient. Methods The patient was treated by korean traditional treatments including acupuncture, physical treatment, herbal medication. The improvement of the clinical symptoms was observed by Modified Visual analog scale (Modified VAS), SSCES (Scoring System for Cauda Equina Syndrome), function of urination and function of defecation. Results After treatments, Modified VAS, SSCES, function of urination and function of defecation were improved in this case. Conclusions On the basis of these results, we suggest that korean traditional treatment might be an effective method to improve the clinical symptoms of Operation-delayed Cauda Equina Syndrome patient.

Delayed Splenic Rupture Following Minor Trauma in a Patient with Underlying Liver Cirrhosis (간경화증 환자에서 경도 외상 후 발생한 지연 비장 파열)

  • Jeung, Kyung-Woon;Lee, Byung-Kook;Ryu, Hyun-Ho
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.52-55
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    • 2011
  • The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.

Multi-bit Sigma-Delta Modulator for Low Distortion and High-Speed Operation

  • Kim, Yi-Gyeong;Kwon, Jong-Kee
    • ETRI Journal
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    • v.29 no.6
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    • pp.835-837
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    • 2007
  • A multi-bit sigma-delta modulator architecture is described for low-distortion performance and a high-speed operation. The proposed architecture uses both a delayed code and a delayed differential code of analog-to-digital converter in the feedback path, thereby suppressing signal components in the integrators and relaxing the timing requirement of the analog-to-digital converter and the scrambler logic. Implemented by a 0.13 ${\mu}m$ CMOS process, the sigma-delta modulator achieves high linearity. The measured spurious-free dynamic range is 89.1 dB for -6 dBFS input signal.

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Results of Microvascular Decompression in Hemifacial Spasm (편측안면경련에서 미세혈관감압술의 성적)

  • Kwak, Hyoung Jun;Kim, Jae Hyoo;Lee, Jung Kil;Kim, Tae Sun;Jung, Shin;Kim, Soo Han;Kang, Sam Suk;Lee, Je Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.501-508
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    • 2001
  • Objectives : Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. Patients and Methods : From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. Results : The ratio of male to female was 1:1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). Conclusion : In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.

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Delayed Sternal Closure After Heart Surgery in Neonate (신생아 개심술후 지연 흉골봉합)

  • 성시찬
    • Journal of Chest Surgery
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    • v.28 no.11
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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.

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Delayed Rupture of Flexor Pollicis Longus by Plate for Fracture of the Distal Radius (요골골절에 사용된 금속판에 의한 장무지 굴곡건의 지연성 파열)

  • Hwang, So-Min;Ahn, Sung-Min;Oh, Kyoung-Seok;Kim, Jin-Hyeong;Lee, Jun-Ho
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.751-754
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    • 2008
  • Purpose: Delayed rupture of flexor pollicis longus as a sequelae of the plate inserted for distal radius fracture is a very rare. This is the first case reported and published in Korea. Methods: A 48 years old female patient visited hospital, complaining flexor disturbance of interphalangeal joint of left thumb, which suddenly occurred without any external wound. We found that she had received operation of fixing plate for fracture of left distal radius 10 years ago. As operational opinion, we have checked that flexor pollicis longus tendon has been ruptured with oblique ways being stimulated by extended plate to palmar side over long period. Results: Authors performed tenorrhaphy of flexor pollicis longus without tendon graft and presented a successful active flexion of the left thumb interphalangeal joint 1 year after the operation. Conclusion: If the extruded part of the end plate is observed during the operation or follow-up, it is considered to be necessary to get rid of the plate as early as possible after the fracture healing.