• Title/Summary/Keyword: Factors of failure

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Retrospective study on survival rate of 2158 osseointegrated implants placed in 770 patients in Sanbon dental hospital of Wonkwang University (원광대학교 산본치과병원에서 770명의 환자에 식립한 2158개의 골유착성 임플란트의 보철 전 초기 생존율에 관한 후향적 연구)

  • Seon, Hwa-Gyeong;Chee, Young-Deok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.4
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    • pp.278-288
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    • 2014
  • Purpose: The aim of the study was to evaluate preprosthetic initial survival rate and factors associated with survival of osseointegrated implants placed in edentulous area of maxilla and mandible and to suspect the possible causes leading to failure. Materials and Methods: A total of 2158 endosseous implants that had been inserted between 2004 through 2013 were placed in 770 patients. The clinical comparisons were performed to evaluate implant loss in relation to age and gender of patients, position, system, length and diameter of implant, and bone graft technique. Results: According to position, the survival rates were 98.23% in maxillary anterior site, 96.98% in maxillary posterior site, 97.85% in mandibular anterior site and 98.76% in mandibular posterior site (P < 0.05). According to diameter of implant, the survival rates were 100% under 3.0 mm, 97.09% between 3.0 to 3.5 mm, 98.19% between 3.5 to 4.0 mm and 98.29% between 4.0 to 4.5 mm but relatively lower survival rate was 75% in 5.0 mm-over (P < 0.05). The survival rates of implants were 89.51%, 98.28%, 98.34% and 99.27% in the group with isolated sinus graft, with isolated GBR, with sinus graft and GBR simultaneously and without bone graft, especially (P < 0.05). Conclusion: This study establishes a relationship between survival rate of implant and position, diameter of implant system and bone graft technique. In conclusion, there were low survival rates in maxillary posterior site, in dental implants with wide diameter of 5 mm-over, and in the group with isolated sinus graft.

Clinical Characteristics and Prognosis of Elderly Patients Receiving Prolonged Mechanical Ventilation in the Medical Intensive Care Unit at a University Hospital (한 대학병원 내과계 중환자실에서 장기간 기계환기를 받은 노인 환자들의 특징 및 예후)

  • Han, Min Soo;Moon, Kyoung Min;Lee, Yang Deok;Cho, Yongseon;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.445-450
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    • 2008
  • Background: As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital. Methods: We retrospectively examined forty-one elderly patients (${\geq}65$ years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital. Results: The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion. Conclusion: The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

Clinical Characteristics of Aspergilloma (국균종의 임상적 고찰)

  • Kim, Ki-Up;Gil, Hyo-Wook;Lee, Suk-Ho;Kim, Do-Jin;Na, Moon-Jun;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.46-53
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    • 2002
  • Background: Pulmonary aspergilloma is relatively common in korea. It arises from the colonization and proliferation of Aspergillus in preexisting lung parenchymal cavities, in particular tuberculosis. The most common symptom in this disorder is hemoptysis, which mayor may not be massive and life threatening. A routine chest radiography and computed tomography (CT) are the most important diagnostic procedures. A surgical resection of the aspergilloma has recently been recommended, because of the relatively low incidence of postoperative complications than in the past. A more concentrated sample of patients with aspergilloma, who either underwent a thoracotomy or tested positive for aspergillus antibodies, were reviewed. Method : The medical records of twenty-two patients with aspergilloma, who had a proven thoracotomy (9 cases), or who tested positive for the diagnostic procedure and/or aspergillus antibodies (13 cases) from January 1995 to December 2000, were reviewed retrospectively. Results : The most common underlying lung disease was a current or old healed tuberculosis, and 3 patients had cultures of mycobacterium other than tuberculosis (MOTT). The mean time until the aspergilloma was detected 5.91 years in the healed tuberculosis cases. The others cases involved a lung abscess, bronchiectasis and without lung disease. The extrapulmonary disease was alcoholism and diabetes. Hemoptysis was most common in 72.7%. A computed tomography (CT) is useful for diagnosis. The right upper lobe, especially the posterior segment, is the most common location. Bronchial artery embolization is ineffective for a long term follow-up. A lobectomy is most common in a thoracotomy, and intra-operative and post-operative complications are rare. During follow-up, the mortality rate, not from the aspergilloma but from respiratory failure, was 13.6%. Conclusion : Aspergilloma is a common cavitary lung disease, It mainly arises from tuberculosis, either current or healed, but extra-pulmonary disease including alcoholism or diabetes are other possible risk factors. Their most common problem in aspergilloma is hemoptysis. Surgery has a low risk of post-operative complications and is recommended in relatively preserved lung function or healthy patients. Medical maneuvers including embolization, and the local insertion of certain materials needs to be studied more closely.

An Analysis of the Hail Damages to Korean Forests in 2017 by Meteorology, Species and Topography (2017년 우박에 의한 산림피해의 기상, 수종 및 지형 특성 분석)

  • Lim, Jong-Hwan;Kim, Eunsook;Lee, Bora;Kim, Sunhee;Jang, Keunchang
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.19 no.4
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    • pp.280-292
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    • 2017
  • Hail is not a frequently occurring weather event, and there are even fewer reports of hail damages to forest stands. Since the 2000s, an increase in hail incidence has been documented in Europe and the United States. In Korea, severe hails occurred in Jeollanam-do province on May 31 and in Gyeongsangbuk-do province on June 1, 2017. Hail size was ranged from 0.5 to 5.0 cm in diameter in Jeollanam-do, and from 1.5 to 3.0 cm in Gyeongsangbuk-do. This study was aimed to analyze the hail damages to forests by species and topography based on damage-categorized maps created by using drones and aerial photographs, and to analyze relationships of the damages with meteorological factors. The total damaged forest area was 1,163.1ha in Jeollanam-do, and 2,942.3ha in Gyeongsangbuk-do. Among the 'severe' damaged area 326.7ha, 91% was distributed in Jeollanam-do, and concentrated in the city of Hwasun which covers 57.2% of the total 'severe' damaged area. The most heavily damaged species was Korean red pine(Pinus densiflora S. & Z.) followed by P. rigida. Most broad-leaved trees species including oaks were recovered without any dead trees found. Liliodendron tulipifera was the most severely damaged in terms of the rate of 'severe' degree individuals which are needed to be checked whether they will die or be recovered. Cause of the death of pines was considered as the combination of physical damage caused by the hail and long-lasting drought with high air temperature that occurred before and after the hail event. No pathogens and insects were found which might have affected to tree deaths. We suggested a dieback mechanism of the pine trees damaged by hail and drought.

An Influence of Modified Robicsek Sternal Wiring after Median Sternotomy on the Postoperative Sternal Wound Infection (정중 흉골 절개 후 시행한 변형 Robicsek 흉골 봉합법이 수술 후 흉골감염에 미치는 영향)

  • Chang, Won-Ho;Youm, Wook;Kim, Dong-Hyun;Oh, Hong-Chul;Han, Jung-Wook;Kim, Hyun-Jo
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.763-769
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    • 2009
  • Background: In the majority of cases, sternal instability and wound infection concomitantly present after a cardiac operation following conventional median sternotomy, and these complications have a major influence on the postoperative course. The aim of this study is to compare the results of the different sternal wiring techniques of sternal infection. Material and Method: Between April 2004 and December 2008, 157 adult patients underwent cardiac in group A, whereas 71 patients who had undergone modified Robicsek sternal wiring were included in group B. The incidences of sternal wound complications in the two groups were assessed. Result: The mean age of the group B patients was older than that of the group A patients ($61{\pm}10$ years vs $57{\pm}13$ years). The incidence of preoperative left ventricular dysfunction (ejection fraction <30%), chronic obstructive pulmonary disease, renal failure requiring dialysis and diabetes mellitus were significantly higher in Group B, whereas the other perioperative risk factors for infection were not significantly different between the two groups. Two patients in group A experienced superficial wound infection, whereas 4 patients in group B displayed superficial wound infection, but the difference was not statistically significant (p=0.255). Yet poststernotomy deep sternal wound infection appeared in 6 patients of group A, whereas none of the patients in group B displayed this malady. Conclusion: The modified Robicsek sternal wiring technique showed greater sternal stability even for the patient with a high risk for infection, and the technique caused a lower incidence of deep sternal wound infection.

Surgical Experience of Aortic Root Replacement (대동맥근부치환술의 임상경험)

  • Kim, Hyun-jo;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1197-1204
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    • 1997
  • Between April 1981 and June 1996, 65 patients had aortic root replacement at our institution. Disease entities were pure aortic annuloectasia in 31 patients(47.7%), Stanford type A aortic dissection with annuloectasia in 8(43.1%), atherosclerotic aneurysm with aortic regurgitation in 4(6.2%), and paravalvular leakage after aortic valve replacement in 2(3.1 %). 34 patients(52.3%) had the clinical stigmata of the Marfan syndrome. The operative procedures were Bentall operation in 61 patients(93.8%); 3 of conventional procedure and 58 of Cabrol's modification, aortic valve-sparing operation in 2(3.1 %), and root replacement with homograft in 2(3.1%). Hospital deaths occurred in 3 patients(4.8%) because of uncontrolled bleeding(1) and bypass weaning failure due to low cardiac output(2), and all had emergency operation with Cabrol's procedure. Postoperative complications developed in 19(29.2%) patients and most of them were transient. Surviving 62 patients have been followed up to cumulative total 315.0 patient-years(mean 60.2 $\pm$42.4 months). Late deaths occurred in 7 patients(11.3%), aneurysmal changes of remaining aorta were detected in 12 patients(19.4%). Actuarial survival rate at 10 years was 72.0 $\pm$ 9.7%, and the subsequent aortic operation-free rate at 10 years was 68.0$\pm$ 8.9% In a multivariate analysis, Marfan syndrome, emergency operation, preoperative dissection, combined arch replacement, and total circulatory arrest emerged as significant risk factors for hospital death or subsequent aortic operation. Over 60 years of age was the only risk factor for late death. Our 16 years'cummulative experience shows that aortic root replacement, mainly by means of Cabrol's procedure, can be applied successfully to variety of aortic root disease. However, long-term follow up will be needed to determine the late result of aortic valve-saving operation and root replacement with homograft. When dissection is present or the distal native aorta is diseased in'Marfan patients, close follow-up is necessary because of the subsequent aneurysmal change of remaining aorta.

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A Study on the Development of Assessment Index for Catastrophic Incident Warning Sign at Refinery and Pertrochemical Plants (정유 및 석유화학플랜트 중대사고 전조신호 평가지표 개발에 관한 연구)

  • Yun, Yong Jin;Park, Dal Jae
    • Korean Chemical Engineering Research
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    • v.57 no.5
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    • pp.637-651
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    • 2019
  • In the event of a major accident such as an explosion in a refinery or a petrochemical plant, it has caused a serious loss of life and property and has had a great impact on the insurance market. In the case of catastrophic incidents occurring in process industries such as refinery and petrochemical plants, only the proximate causes of loss have been drawn and studied from inspectors or claims adjustors responsible for claims of property insurers, incident cause investigators, and national forensic service workers. However, it has not been done well for conducting root cause analysis (RCA) and identifying the factors that contributed to the failure and establishing preventive measures before leading to chemical plant's catastrophic incidents. In this study, the criteria of warning signs on CCPS catastrophic incident waning sign self-assessment tool which was derived through the RCA method and the contribution factor analysis method using the swiss cheese model principle has been reviewed first. Secondly, in order to determine the major incident warning signs in an actual chemical plant, 614 recommendations which have been issued during last the 17 years by loss control engineers of global reinsurers were analyzed. Finally, in order to facilitate the assessment index for catastrophic incident warning signs, the criteria for the catastrophic incident warning sign index at chemical plants were grouped by type and classified into upper category and lower category. Then, a catastrophic incident warning sign index for a chemical plant was developed using the weighted values of each category derived by applying the analytic hierarchy process (pairwise comparison method) through a questionnaire answered by relevant experts of the chemical plant. It is expected that the final 'assessment index for catastrophic incident warning signs' can be utilized by the refinery and petrochemical plant's internal as well as external auditors to assess vulnerability levels related to incident warning signs, and identify the elements of incident warning signs that need to be tracked and managed to prevent the occurrence of serious incidents in the future.

A Qualitative Study for the Psychological Characteristics Affecting Never married Choice (비혼 선택에 영향을 미치는 심리적 특성 탐색을 위한 질적 연구)

  • Jeongha Lee;Jeongyoon Park;Nana Yoon
    • Korean Journal of Culture and Social Issue
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    • v.23 no.2
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    • pp.183-214
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    • 2017
  • The purpose of this study was to examine the psychological characteristics of affecting never married men and women through analyzing the content of in-depth interviews about the idea of marriage and the reason for never married choice. For achieving this purpose, the in-depth interview was conducted with 9 men and women aged mid-20s to late 30s who said to choose never married life for a long time, and then the content of interview was analyzed using consensual qualitative research. As a result of analyzing the content of in-depth interview, it was derived into 2 areas, 10 sub-areas, and 25 categories. The results of the study were as follows. Firstly, it was found that research participants negatively recognized the marriage and had unrealistic expectation rather than no expectation for marriage. Secondly, most of the research participants felt negative feelings about their parents' patriarchal role, and they did not want to live like their parents. They also reported that they did not see their marriage separated from their parents. Thirdly, most of the research participants felt difficulty in forming relationships with intimate person, and it became more difficult to have expectations about spouses and marriage due to repeated relationship conflict patterns. Fourthly, the research participants showed psychological aspect of experiential avoidance and seeking for individuality in terms of never married choice. Most of the research participants predicted the failure of married life, and reported that they were trying to prevent uncomfortable feelings and sufferings by choosing never married life. Also they reported that individuality considered more important than connection with others(togetherness) and individual value considered more important than collective value. Participants in this study showed negative evaluation or had negative influences on the marriage life of parents and acquaintances. This is more likely to be a passive factor in never married choice, so future research should examine the characteristics of active factors in never married choice.

Radiotherapy of Supratentorial Primitive Neuroectodermal Tumor (천막상부 원시신경외배엽 종양의 방사선요법)

  • Kim Il Han;Yoo Hyung Jun;Cho Young Kan;Kim Dae Yong
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.11-18
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    • 1997
  • Purpose : To evaluate the efficacy of combined treatment of surgery and chemoradiotherapy for supratentorial primitive neuroectodermal tumors (SPNET) and obtain the Prognostic factors and complications Materials and Methods .The a9e of 18 patients ranged from 1 to 27 years (median=5 years). There were 12 males and 6 females The extents of surgery were gross total (n:9), subtotal (n:8), biopsy only (n: 1). Craniospinal radiotherapy was delivered to all the patients except 2 patients who were treated only with the whole brain and primary lesion. Radiation dose were 3120-5800cGy (median=5460) to primary mass, 1500-4200cGy (median=3600cGy) to the whole brain and 1320-3600cGy (median= 2400 cGy) to the spinal axis. Chemotherapy was done in 13 patients. Median follow-up period was 45 months ranged from 1 to 89 months. Results : Patterns of failure were as follows; local recurrence (1), multiple intracranial recurrence (2), spinal seeding (3), craniospinal seeding (2) and multiple bone metastasis (1). Two of two patients who did not received craniospinal radiotherapy failed at spinal area. All the relapsed cases died at 1 to 13 months after diagnosis of progression. The 2- and 5-rear overall survival rates were $61\%\;and\;49\%$, respectively The a9e, sex, tumor location did not influence the survival but aggressive resection with combined chemotherapy showed better outcome. Among 9 survivors, complications were detected as radiation necrosis (n=1), hypopituitarism (n=2), cognitive defect(n=1), memory deficit (n=1), growth retardation (n=1). Conclusion : To improve the results of treatment of SPNET, maximal surgical resection followed by radiation therapy and chemotherapy is necessary. The extended radiation field including craniospinal axis may reduce the recurrence in spinal axis.

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A User Optimer Traffic Assignment Model Reflecting Route Perceived Cost (경로인지비용을 반영한 사용자최적통행배정모형)

  • Lee, Mi-Yeong;Baek, Nam-Cheol;Mun, Byeong-Seop;Gang, Won-Ui
    • Journal of Korean Society of Transportation
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    • v.23 no.2
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    • pp.117-130
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    • 2005
  • In both deteministic user Optimal Traffic Assignment Model (UOTAM) and stochastic UOTAM, travel time, which is a major ccriterion for traffic loading over transportation network, is defined by the sum of link travel time and turn delay at intersections. In this assignment method, drivers actual route perception processes and choice behaviors, which can become main explanatory factors, are not sufficiently considered: therefore may result in biased traffic loading. Even though there have been some efforts in Stochastic UOTAM for reflecting drivers' route perception cost by assuming cumulative distribution function of link travel time, it has not been fundamental fruitions, but some trials based on the unreasonable assumptions of Probit model of truncated travel time distribution function and Logit model of independency of inter-link congestion. The critical reason why deterministic UOTAM have not been able to reflect route perception cost is that the route perception cost has each different value according to each origin, destination, and path connection the origin and destination. Therefore in order to find the optimum route between OD pair, route enumeration problem that all routes connecting an OD pair must be compared is encountered, and it is the critical reason causing computational failure because uncountable number of path may be enumerated as the scale of transportation network become bigger. The purpose of this study is to propose a method to enable UOTAM to reflect route perception cost without route enumeration between an O-D pair. For this purpose, this study defines a link as a least definition of path. Thus since each link can be treated as a path, in two links searching process of the link label based optimum path algorithm, the route enumeration between OD pair can be reduced the scale of finding optimum path to all links. The computational burden of this method is no more than link label based optimum path algorithm. Each different perception cost is embedded as a quantitative value generated by comparing the sub-path from the origin to the searching link and the searched link.