• Title/Summary/Keyword: Delayed operation

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Necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis treated with delayed operation (지연 수술로 호전된 간문맥 내 가스와 장관 기종을 동반한 괴사성 장염)

  • Yoo, Ji Yeon;Yoo, Young Wook;Kim, Jihye;Yoo, Sang Hoon;Ha, Soyoung
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.13-16
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    • 2015
  • Portal vein gas and pneumatosis cystoides intestinalis are uncommon conditions and have been associated with poor prognosis. They are most commonly caused by necrotizing enterocolitis but may have other causes, and they can be associated with necrotizing and ischemic colitis, intra-abdominal abscess, small bowel obstruction, diverticulitis, colon cancer, and acute pancreatitis. With the more frequent use of computed tomography (CT) scans, portal vein gas and pneumatosis cystoides intestinalis have been increasingly detected in recent years. Because of its high mortality rate, necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis may be treated with emergent exploratory laparotomy. We report a case of necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis in a 47-year-old man treated with intensive medical management and delayed operation due to unstable condition and surgical mortality. He had good clinical results without complications after the delayed operation.

The Efficacy of Microvascular Decompression in Hemifacial Spasm over the Course of Time

  • Kang, Young-Soo;Lee, Hyuk-Gee;Ryu, Kee-Young;Cho, Jae-Hoon;Kang, Dong-Gee;Kim, Sang-Chul
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.265-270
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    • 2006
  • Objective : Microvascular decompression[MVD] at root exit zone[REZ] of the facial nerve has been largely popularized and it has become the standard treatment for patients with hemifacial spasm[HFS]. This sturdy is performed to evaluate the efficacy of MVD over the course of time. Methods : From 1994 to 2003, 50 patients with HFS who underwent MVD were followed up for more than 6 months. We retrospectively analyzed results with medical records and telephone researches. Results : The mean age of patients at the time operation was 57.6 years and 84% of the patients were female. The mean duration of follow-up after operation was 3.4 years [range $0.5{\sim}7.8\;years$]. One day after MVD, 54% of patients had complete relief of spasm immediately. Continuous improvements of HFS were observed during the follow-up period and these improvements were statistically significant with time (P< 0.05). Until 6 months after operation, complete relief of spasm was observed in 84% of patients. The delayed relief of spasm was observed in 35.7% of our patients who experienced complete relief. Conclusion : The efficacy of MVD in HFS is improves with time. Continuous follow-up evaluations for the duration of more than at least 6 months after MVD are important for the decision of its clinical results because delayed relief of spasms occurs.

Investigation of degradation mechanism of phosphorescent and thermally activated delayed fluorescent organic light-emitting diodes through doping concentration dependence of lifetime

  • Song, Wook;Kim, Taekyung;Lee, Jun Yeob;Lee, Yoonkyoo;Jeong, Hyein
    • Journal of Industrial and Engineering Chemistry
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    • v.68
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    • pp.350-354
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    • 2018
  • Lifetime study of blue phosphorescent and thermally activated delayed fluorescent organic light-emitting diodes was carried out to understand the dominant degradation process during electrical operation of the devices. Doping concentration dependence of the phosphorescent and thermally activated delayed fluorescent organic light-emitting diodes was studied, which demonstrated long lifetime at low doping concentration in the phosphorescent devices and at high doping concentration in the thermally activated delayed fluorescent devices. Detailed mechanism study of the two devices described that triplet-triplet annihilation is the main degradation process of phosphorescent organic light-emitting diodes, whereas triplet-polaron annihilation is the key degradation factor of the thermally activated delayed fluorescent devices.

The Consequence of Delayed Diagnosis of an Occult Hip Fracture (잠행 고관절 골절의 진단 지연의 결과)

  • Je, Sangbong;Kim, Hyejin;Ryu, Seokyong;Cho, Sukjin;Oh, Sungchan;Kang, Taekyung;Choi, Seungwoon
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.91-97
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    • 2015
  • Purpose: Occult hip fracture is not evident on radiographs and the diagnosis is often missed or delayed. This study was undertaken in order to identify the clinical characteristics and complications of patients with a delayed diagnosis of an occult hip fracture. Methods: We retrospectively reviewed patients with occult hip fracture who had normal findings on initial radiographs, the diagnosis was made on additional studies between August 2006 and February 2012. Patients who were diagnosed as having occult hip fractures at the first visit were categorized as non-delayed group and those who were not diagnosed at the first visit were categorized as delayed group. Results: Non-delayed group included 43 patients (86%). In the remaining 7 patients (delayed group), the diagnosis was delayed by a mean of 9.6 days (range 3~19 days). Patients who were diagnosed with an occult fracture on the initial visit presented later than those with a delayed diagnosis (41/43 .vs. 3/7, p=0.002). Other clinical features were no difference between the two groups. Patients in the delayed diagnosis group were more likely to have fracture displacement (4/7 .vs. 0/43)15patients in non-delayed group (34.9%) needed operative treatment, whereas all delayed patients (100%) needed operative treatment. Conclusion: A delayed diagnosis of occult hip fractures was associated with increased rate of displacement and operation. In patients suspected of having occult hip fractures, additional studies should be recommended.

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An Adaptive Relaying Algorithm on Utilities' Electrical Feeders for Improving the Reliable Operation of Wind Farm Interconnected with Utility Grid (계통 연계 풍력발전단지의 운전효율 향상을 위한 배전 계통의 적응형 보호 계전 알고리즘)

  • Jang, Sung-Il;Kim, Ji-Won;Choi, Don-Man;Kim, Kwang-Ho;Kim, Hyung-Rae
    • Proceedings of the KIEE Conference
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    • 2003.07a
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    • pp.338-341
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    • 2003
  • This paper proposes the adaptive relaying algorithm of protective devices applied in the neighboring distribution feeders for reliable and efficient operations of a wind farm interconnected with distribution networks by dedicated lines. Generally, it would be highly possible that the wind turbine generators are influenced by abnormal grid conditions such as disturbances occurring in the neighboring distribution feeders as well as the dedicated power line. The delayed operation time of protective devices for satisfying the coordination might overly expose the interconnected wind turbine generators to the fault and cause damage to them. In order to reduce the damages on the interconnected wind farm about the faults happening in distribution networks, this paper describes the proper delayed operation time of protective relay.

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Delayed Traumatic Intracerebral Hemorrhage in Patient with Hemoperitoneum Operation (혈복강 수술 환자에게서 발생한 지연성 외상성 뇌실질내 출혈)

  • Kim, Sohyun;Bae, Keumseok;Pyen, Jinsu;Kim, Jongyun;Cho, Sungmin;Noh, Hany;Whang, Kum;Oh, Jiwoong
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.233-237
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    • 2013
  • Delayed traumatic intracerebral hemorrhage (DT-ICH) is a rare event in head trauma patients. However, it develops unexpectedly and results in very severe brain damage. Thus, close monitoring of the neurologic status is needed for every trauma patient. Sometimes, however, neurologic monitoring cannot be done because of sedation, especially in cases of abdominal surgery. In this case report, we describe the case of a 37-yr-old, male patients who had hemoperitoneum because of spleen and renal injury. At the initial operation, massive bleeding was found, so gauze-packing surgery was done first. After the first operation, we sedated the patient for about two days, after which the packed gauze was removed, and the abdominal wound was closed. Immediately after the second operation, we found pupil dilation. Emergent CT was performed. The CT revealed DT-ICH with severe brain edema and midline shifting. However, the patient condition deteriorated progressively despite emergency operation, he expired 2 days after hematoma evacuation.

Time Course of Symptom Disappearance after Microvascular Decompression for Hemifacial Spasm

  • Oh, Eun-Tak;Kim, Eun-Young;Hyun, Dong-Keun;Yoon, Seung-Hwan;Park, Hyeon-Seon;Park, Hyung-Chun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.245-248
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    • 2008
  • Objective : This study is to investigate time course of symptom disappearance in patients whose spasm relieved completely after microvascular decompression (MVD). Methods : Of 115 patients with hemifacial spasm (HFS) who underwent MVD from April 2003 to December 2006, 89 patients who had no facial paralysis after operation and showed no spasm at last follow-up more than 1.5 years after operation were selected. Symptom disappearance with time after MVD was classified into type 1 (symptom disappearance right after operation), type 2 (delayed symptom disappearance) and type 3 (unusual symptom disappearance). Type 2 was classified into type 2a (with postoperative silent period) and type 2b (without silent period). Results : Type 1, type 2a, type 2b and type 3 were 38.2%, 48.37%, 124% and 1.1%, respectively. Delayed disappearance group (type 2) was 60.7%. Post-operative symptom duration in all cases ranged from 0 to 900 days, average was 74.6 days and median was 14 days. In case of type 2, average post-operative symptom duration was 115.1 days and median was 42 days. Five and 3 patients required more than 1 year and 2 years, respectively, until complete disappearance of spasm. In type 2a, postoperative silent period ranged from 1 to 10 days, with an average of 24 days. Conclusion : Surgeons should be aware that delayed symptom disappearance after MVD for HFS is more common than it has been reported, silent period can be as long as 10 days and time course of symptom disappearance is various as well as unpredictable.

The Analysis on Degree of Discomfort Caused by Delayed Extubation of Nasotracheal Tube - A Pilot Study (경비기관내튜브의 발관 지연에 따른 환자의 불편감 정도 분석 -A Pilot Study)

  • Shim, Jung-Hwan;Yi, Young-Eun;Kim, Hyun-Jeong;Yum, Kwang-Won;Park, Yun-Ki;Seo, Kwang-Suk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.1
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    • pp.1-5
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    • 2007
  • Background: It is well known that nasotracheal intubation is comfort for patient compared to oral intubation. We sometimes delay extubation when it is thought that the patient can not maintain airway, or there may be other emergency associated with airway. And we sometimes experience complaint of discomfort of nasotracheal tube. But, we could not find any report on degree of discomfort of delayed nasotracheal intubation. Methods: Eighteen patients in whom extubation of nasotraceal tube was delayed after operation because of difficulties of airway mamagement were selected. We surveyed the discomfort of nasotracheal tube with 0 to 10 visual analogue scale (VAS) and compared with the pain of operation site (VAS). Result: The VAS of nasotracheal intubation was $6.7{\pm}3.4$, and VAS of the primary operation site was $3.5{\pm}2.4$, and VAS of flap harvest site was $5.5{\pm}2.7$. 10 of the patients complained of nasotracheal suction extremely and 6 patients complained of respiratory difficulties. Conclusions: Nasotracheal intubation was discomfort and there must be intervention.

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A Study on Improving SQUID Proxy Server Performance by Arbitral Thread and Delayed Caching (중재 쓰레드와 지연 캐싱에 의한 스퀴드 프록시 서버 성능 향상에 관한 연구)

  • Lee, Dae-Sung;Kim, Yoo-Sung;Kim, Ki-Chang
    • The KIPS Transactions:PartC
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    • v.10C no.1
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    • pp.87-94
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    • 2003
  • As the number of the Internet users increases explosively, a solution for this problem is web caching. So, many techniques on improving cache server performance have been suggested. In this paper, we analyze the cause of the bottleneck in cache servers, and propose an arbitral thread and delayed caching mechanism as a solution. We use an arbitral thread in order to provide a quick service to user requests through eliminating the ready multi-thread search problem in case of disk writing operation. We also use delayed caching in order to provide stable system operation through avoiding overloaded disk operation and queue threshold. Proposed cache server is implemented through modification on SQUlD cache server, and we compare its performance with the original SQUID cache server.

Delayed use of Operating Rooms in a University Hospital (한 대학병원의 수술실 이용 지연요인과 개선방안에 관한 연구)

  • Kim, Kyung-Ae;Yu, Seung-Hum;Kim, In-Sook;Sohn, Tae-Yong;Park, Eun-Cheol
    • Korea Journal of Hospital Management
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    • v.7 no.3
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    • pp.44-62
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    • 2002
  • Advanced surgical technology demands more precise, meticulous, and time-consuming procedures. In addition, the patient's preference of tertiary health providers makes over crowding of the University Hospitals. Therefore, it has been necessary to maximize utilization of the operating room of such hospitals to accommodate these requirements. This study, targeting 1,302 surgical cases performed in 22 operating rooms at a university hospital in Seoul from October 8 to November 1, 2001, analyzed reasons for delay, and factors that caused delayed use of operating rooms. This study also assessed that the rate of operating room use would increase if the sources for possible reform were improved. 1. Among total of 1,302 cases of surgery, the incidence of surgeries in which there were no time delays and no factors for delay were discovered is 71.4% or 930 cases: the incidence in which surgeries were delayed was 28.6% or 372 cases. 2. As results of logistic regression for delay, procedures involving women were delayed 1.4 times more frequently than those of men. Compared to Department A, Department B was 1.8 times more likely to be delayed, and Department H was 0.4 times less likely to be delayed. Regional anesthesia was 2.4 times more likely to be delayed than general anesthesia, and surgeries that PCA was applied were 0.6 times less likely to be delayed than those when it was not. Surgeries performed on the Thursday were 1.7 times more likely to be delayed than those performed on the Monday. Compared to surgeries performed between 07:00-07:59, those performed between 08:00-08:29 were 4.3 times higher. 3. The reasons for delay were related to surgeon, surgical department, patient, anesthesia, administrative system, sick ward, and support services. Among these, 5,755 minutes for 276 delayed cases could be resolved easily, and resolving delays of 3,320 minutes for 131 cases would be more difficult. Among the causes for delay that could be improved, delays due to patient's transfer and surgeon's factor were the most common, 21.6% and 17.4% respectively. 4. If resolvable delays are improved, pre-anesthesia room is administered, and regional anesthesia and PCA are done ahead of time, use of emergency operating rooms will increase, we can increase overall utilization by 4.09%, we will save 744 minutes a day, we can reduce the time the operation room is used after 4 PM by 35%, and we can resolve the operation cancellations due to insufficient operating rooms. For the increase in the use of operating rooms, we need to maximally decrease the delays that could be improved, by allocating block time based on used totals hours of elective cases, giving accurate information on surgery schedule, voluntary cooperation by staff participating in surgeries in reducing delay time, and the hospital management's will to improve delay.

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