• Title/Summary/Keyword: Delayed repair

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The Effect of Different Starting Periods of Passive Exercise on the Clinical Outcome of Arthroscopic Rotator Cuff Repair

  • Back, Young-Woong;Tae, Suk-Kee;Kim, Min-Kyu;Kwon, Oh-Jin
    • Clinics in Shoulder and Elbow
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    • v.17 no.2
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    • pp.57-63
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    • 2014
  • Background: To compare the effect of different starting periods of rehabilitative exercise (early or delayed passive exercise) on the rate of retear and other clinical outcomes after the arthroscopic repair of the rotator cuff. Methods: In total, 103 patients who underwent arthroscopic repair of the rotator cuff were included in the study. Determined at 2 weeks post-operation, patients who were incapable of passive forward elevation greater than $90^{\circ}$ were allotted to the early exercise group (group I: 79 patients; 42 males, 37 females), whilst those capable were allotted to the delayed exercise group (group II: 24 patients; 14 males, 10 females). The group I started passive exercise, i.e. stretching, within 2 weeks of operation, whilst group II started within 6 weeks. The results were compared on average 15.8 months (11-49 months) post-operation using the passive range of motion, the Visual Analog Scale (VAS) pain score, and the University of California at Los Angeles (UCLA) and Constant scores. Stiffness was defined as passive forward elevation or external rotation of less than $30^{\circ}C$ compared to the contralateral side. Follow-up magnetic resonance imaging (MRI) was carried out on average 1 year post-operation and the rate of retear was compared with Sugaya's criteria. Results: There were no differences between the two groups in gender, age, smoking, presence of diabetes, arm dominance, period of tear unattended, pre-operative range of motion, shape and size of tear, degree of tendon retraction, and tendon quality. There were no significant differences in clinical outcomes. Whilst stiffness was more frequent in group II (p-value 0.03), retear was more frequent in group I (p-value 0.028) according to the MRI follow-up. Conclusions: During rehabilitation after the arthroscopic repair of the rotator cuff, the delay of passive exercise seems to decrease the rate of retear but increase the risk of stiffness.

A Case of Chest Traumatic Bronchial Rupture, Manifested by Bronchial Web in Bronchoscopy (Web 양상으로 발현한 외상성 기관지 파열 1예)

  • Shim, Jae-Jeong;Han, Seung-Hwan;Lee, Jin-Goo;Cho, Jae-Yeun;In, Kwang-Ho;Kim, Kwang-Taek;Yoo, Sae-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.574-578
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    • 1994
  • The incidence of traumatic rupture of the tracheobronchial tree has been increased considerably with advent of widespread mechanization and high speed era. Rupture of the bronchus is an unusual result of nonpenetrating trauma to chest. Early diagnosis and primary repair not only restore normal lung function but also avoid difficulties and complications associated with delayed diagnosis and repair. These complications are pneumonia, atelectasis and lung abscess secondary to the bronchial obtruction. We experienced a case of partial rupture on left main bronchus caused by nonpenetrating blunt chest trauma with rib fractures 1 year ago. He was suffered from progressively developing dyspnea on exercise and treated as bronchial asthma at other hospital. Bronchoscopic finding was the narrowed lumen of left main bronchus at 1cm from carina by web-like membrane. We confirmed by bronchogram and repaired by end to end anastomosis, which is rare delayed finding in bronchial rupture without pulmonary complications. We report a case of nonpenetrating traumatic bronchial rupture, manifested by bronchial web in bronchoscopy.

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Iatrogenic Ureteral Injury: When and How to Treat? (의인성 요관손상: 언제, 어떻게 치료할 것인가?)

  • Seo, Kang Il;Lee, Jong Bouk
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.8-14
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    • 2008
  • Iatrogenic ureteral injury is a complication that can occur during a variety of pelvic or abdominal surgeries. The most frequent causes are gynecological ones, followed by colon and vascular surgeries. Management of ureteric injury depends on the time of diagnosis and the severity of organ damage. Injuries diagnosed intraoperatively should be treated immediately. Occasionally, intraoperative ureteral injury is overlooked, and symptoms of the late diagnosis of ureteral injury are usually nonspecific; therefore, the diagnosis is delayed for days or weeks postoperatively. Management of injuries diagnosed postoperatively is more complex. There are differing opinions on whether an initial conservative or immediate operative intervention is the best line of action. Delayed repair is suggested on the grounds that it will reduce inflammation and tissue edema. However, many authors are in favor of early repair, perhaps because tissue planes are easier to find before fibrosis becomes too dense. Ureteral injuries occurring at the level of the pelvic brim should be best managed with an end-to-end anastomosis, preferably around a ureteric stent. More distal injuries also should be ideally managed with an end-to-end anastomosis, after excision of the crushed or compromised segments. However, if the remaining distal segment is short, ureteral reimplantation is the procedure of choice. The Boari flap technique for ureteral reimplantation is invaluable in cases with a short proximal segment. Delayed recognition of iatrogenic ureteral injury may be associated with serious complications, so prompt recognition of ureteral injuries is important. Recognition of the injury before closure is the key to easy, successful, and complications-free repair. Increased awareness of the risk for ureteral damage during certain operative maneuvers is vital to prevent injury, and to decrease the incidence of iatrogenic injury. A sound knowledge of abdominal and pelvic anatomy is the best prevention.

Bronchial Rupture Caused by Trauma -Report of 3 Cases- (외상성 기관지 파열 -3례 보고-)

  • Lee, Jo-Han;Hong, Jong-Myeon;An, Jae-Ho
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.513-517
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    • 1995
  • The injuries to the bronchi have been reported with increasing frequencies. The most common cause of such injuries is compression or crushing chest trauma. Early diagnosis and emergent repair should be done for the good prognosis. We report 3 cases who had bronchial injuries after traffic accident. Our operative procedures were a primary bronchial repair for 17 months old boy, a pneumonectomy for delayed recognition and a bronchoplasty procedure 63 days after trauma. All these bronchial ruptures were successfully treated and discharged.

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Optimal System Burn-in for Maximizing Reliability of Non-series Systems (비 직렬 시스템의 신뢰도 최적화를 위한 시스템 번인)

  • Kim, Kyungmee O.
    • Journal of Korean Institute of Industrial Engineers
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    • v.33 no.2
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    • pp.273-281
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    • 2007
  • The decision of how long performing system burn-in must be answered with a probabilistic model of a system lifetime at which infant mortality failures created during assembly processes are quantified. In this paper, we propose such a model which is modified from previous results. Using the system model, we derived system reliability in terms of component and system burn-in times for the two cases of minimal repair at system failure and of component replacement and connection repair at their failure times. The procedure is illustrated with a bridge system and the optimal system burn-in times are obtained for maximizing system reliability. The result suggests that an assumption of minimal repair at system failure may underestimate the optimal burn-in time in practice.

Delayed surgical repair of the deltoid following acromioplasty: a case report

  • Zohaib Sherwani;Chase Kelley;Hassan Farooq;Nickolas G. Garbis
    • Clinics in Shoulder and Elbow
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    • v.25 no.4
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    • pp.334-338
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    • 2022
  • Currently, the literature contains few studies that describe any potential complications following arthroscopic acromioplasty. Because part of the anterior deltoid originates from the anterior acromion, there is a risk for violation and subsequent iatrogenic rupture or avulsion during this procedure. This type of injury can be a devastating problem for patients that may lead to poor function and debilitating pain. We present a patient with deltoid insufficiency following arthroscopic acromioplasty who elected to proceed with operative management with a planned arthroscopic evaluation of the shoulder followed by an open deltoid repair. At the final follow-up visit 2.5 years postoperatively, the patient reported improved pain from baseline and no residual disability and was able to perform most activities of daily living without difficulty. This case serves as an example of a surgical repair for a deltoid avulsion following arthroscopic acromioplasty. As there is still a lack of standard guidelines, our suture repair technique can be considered one method of treatment for this type of injury.

A Study on the Forecasting Model of the Required Cost for the Long-term Repair Plan in Apartment housings (공동주택의 장기수선계획 소요비용 예측모델 연구)

  • Lee, Kang-Hee;Yoo, Uoo-Sang;Chae, Chang-U
    • KIEAE Journal
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    • v.11 no.3
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    • pp.63-68
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    • 2011
  • Building deterioration would be proceeded by various causes such as physical, social, economic degradation. The deterioration would be inevitably prevented or delayed to get the decent function and performance in various building part and components. The maintenance and management are continued to provide the decent living condition for the household. The maintenance means mainly a repair, including the on-time and longterm plan. The longterm repair would be conducted by the systemic preparation in management activity and a required cost. Therefore, the annual due for the longterm repair plan is important to prepare the repair cost in a required time. In this paper, it aimed at analyzing the longterm repair cost and modelling to forecast the required cost in total area, number of household and time elapse in apartment housing. The estimation model of a repair cost is used with a power function which has a good statistics. Results of this study are shown that the sample has a longterm repair due in a $2,032won/m^2{\cdot}yr$ averagely which is higher than $912won/m^2{\cdot}yr$ in domestic. Second, the longterm repair due is proportionally correlated with the time elapse in both a total area and the number of household. Third, the estimation model for the longterm repair amount is suitable for the power function which is most in any other estimation models. Fourth, the ration of the longterm plan repair due a year to the cumulated longterm amount is about 26%.

Delayed Bronchoplasty in Complete Transection of Left Main Bronchus after Blunt Trauma (외상성 좌측주기관지 절단환자의 지연수술 치험)

  • 김명천;이재영;조규식;박주철;유세영
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.182-185
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    • 1998
  • Recently, The non-penetrating injury of bronchus has been increased, especially by traffic accident. Early diagnosis and primary repair of bronchial injury not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. This report describes about a case of total collapse and consolidation of left lung with the complete transection of nearly bifurcated portion of left main bronchus , lasted for 2weeks after traffic accident. This was diagnosed by fiberbronchoscopy and 3-D chest computed tomography(CT). She underwent the sleeve resection and end to end anastomosis, and postoperative PEEP for 2 days, suctioning twice by fiberbronchoscopy, continue postural drainge and physiotherapy were applied. She had almost full expansion of the left lung at discharge.

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Delayed Repair of Completely Transected Left Main Bronchus-A report of one case- (좌측 주기관지 외상성 단절의 지연복원 -1례 보고-)

  • Ryu, Han-Yeong;Park, Lee-Tae;Han, Seung-Se
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.572-576
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    • 1990
  • A complete transection of left main bronchus was repaired by end to end anastomosis 5 months after the chest trauma in the Yeungnam University Hospital. The patient was a 36 years old male who had been injured bluntly by a heavy package on the left chest. The initial symptoms and signs were dyspnea, chest pain and subcutaneous emphysema on the left neck, but on admission at our hospital his chief complaint was only mild left chest discomfort. The preoperative chest X-ray findings 5 months after the trauma revealed total collapse of the left lung, deviation of trachea to the left, elevation of left diaphragm, abrupt discontinuation in the course of an air-filled left main bronchus and bronchoscopy showed that the left main bronchus was completely occluded, without any signs of inflammation, approximately 4 cm from the carina. The operation was performed through standard posterolateral thoracotomy incision at the fifth intercostal space. There was not any suppuration within the transected lung but plenty of white mucus which was removed by forceful suction. The transected bronchial edges were debrided and anastomosed primarily by end to end with interrupted nonabsorbable sutures. The suture line was reinforced with a pleural flap. The postoperative course was uneventful and pulmonary function following operation improved progressively and proved the delayed repair to have a reasonable decision.

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A HISTOMORPHOLOGIC STUDY ON THE RESORPTION AND SHEDDING OF PRIMARY TEETH (유치의 흡수와 탈락에 관한 조직형태학적 연구)

  • Kim, Cheol-Hoon;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.10 no.1
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    • pp.67-76
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    • 1983
  • The state of pulp and dental hard tissue during the process of resorption and shedding of 104 non-carious primary teeth was assessed by histomorphologic study. The teeth were extracted from the Korean school children aged 5 to 15 and classified into preshedding, shedding, delayed shedding groups according to the age of the child at the time of extraction, The results were as follows: 1. The inflammatory cell infiltration in primary pulp tissues occurred in 61.5% of observed teeth and were increased in the order of preshedding, shedding and delayed shedding stages. 2. The odontoclasts were appeared in 43.3% of observed teeth and were increased in the order of preshedding, shedding and delayed shedding stages. 3. The polymorphonuclear leukocytes and odontoclasts couldn't be observed in the exfoliated primary pulp tissues before the process of resorption has involved the root surface about 1.8mm subjacent to the cemento-enamel junction. 4. The intact root surface was the longest and largest in the preshedding stage. 5. The resorption process of primary teeth roots occurred mainly in the stage of preshedding and shedding stages. 6. There was a tendency of repair of resorbing root surfaces in the delayed shedding stage.

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