• Title/Summary/Keyword: Failure Late

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Late Results of the Senning and Mustard Operations for TGA in Children (Senning 및 Mustard 수술후 장기 성적)

  • 서경필
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.32-41
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    • 1989
  • We scrutinized the 64 cases of TGA and Taussig-Bing anomaly who underwent Senning and Mustard operations from Jan. 1981 to May 1988. The ratio of male to female was 45; 19, and the age at operation varied from 2 months to 18 years [mean 18.9*32.9 months]. The in-hospital mortality was in 24 cases [37.5%] and the major causes were myocardial failure and congestive heart failure associated with arrhythmias. The risk factors for hospital mortality were complex TGA, prolonged bypass time and high postoperative CVP. In addition, mortality increased during the first year the procedure was used. Late mortality occurred in 6 cases and the major causes was congestive heart failure, and there was not any significant risk factor noted in late mortality. Early arrhythmia developed in 37.5%, all of which were transient and self limited and 7 cases of early mortality were related to the arrhythmias. Late arrhythmias developed in 8 cases, but 7 cases were transient. One case died with junctional tachycardia. Of significance the one case that died late by arrhythmia had a similar junctional tachycardia in the early postoperative period. The survival rate in all cases disregarding initial in-hospital mortality 1YSR 89.8% and 5YSR 84.3%, but because of short duration of follow up this is not significant. We concluded that early hospital mortality could be decreased by operating at an earlier age and by adjusting the appropriate operation method.

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Salvage of late flap compromise in deep inferior epigastric perforator flaps: To revise or not to revise

  • Hong, Seung Heon;Lee, Kyeong-Tae;Pyon, Jai-Kyong
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.97-101
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    • 2020
  • Although the success rate of deep inferior epigastric perforator (DIEP) flaps has increased, late flap failures still occur and have a low salvage rate. The present article describes a case of salvage of a case of late flap failure using the pedicle vein as a vein graft source. A 50-yearold woman underwent a bilateral DIEP free flap procedure. On postoperative day 6, she experienced flap compromise and underwent emergency flap revision. In the flap revision, flap venous drainage and the superficial inferior epigastric vein were completely obstructed. A Fogarty catheter was used to remove a thrombus from the completely obstructed pedicle vein, and this pedicle vein was used as a graft source and was ligated in retrograde fashion to the flap vein stump. After injection of urokinase into the arterial branch, venous flow to the flap was restored. At a 6-month follow-up visit in the outpatient clinic, only partial fat necrosis at the flap was noted. By dissecting various perforators in the initial operation, decisions regarding immediate revision can be made with more confidence. Additionally, the combined procedures performed in this case may be helpful even for practitioners treating cases of late flap compromise.

Long-term clinical results of isolated mitral valve replacement with the Ionescu-Shiley bovine pericardial valve (이오네스큐 판막의 장기 임상성)

  • 김종환
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.212-222
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    • 1984
  • A total of and consecutive 291 patients underwent isolated mitral valve replacement using the Ionescu-Shiley bovine pericardial xenograft valve during the 5-year period between October 1978 and June 1983. Thirty-two patients were the children under 15 years of age. There were 15 deaths within 30 days after surgery [operative mortality, 5.2%]. All early survivors except 6 children were placed on the long-term oral anticoagulation longer than postoperative 3 months. A total follow-up period extended for 398.2 patient-years, and 12 patients died [late mortality, 4.1%, or 3.0%/patient- year]. Ten patients experienced the thromboembolic complication [2.51%/patient-year], occurring in 8 patients within the first 3 postoperative months, and 4 died. Three patients had the late prosthetic valve endocarditis [0.75%/patient-year] and 2 died. The incidence of overall valve failure according to the criteria was 3.01%/patient-year, or 12 patients, and 2 had replacement of the failed bioprostheses [primary tissue failure, 0.5%/patient-year]. The long-term survival rate was 87.8%\ulcorner2.6% at 5 years postoperatively, and 84% of the late survivors were in NYHA Class I at the end of the follow- up. The probability remaining free from thromboembolism and overall valve failure was 89.8%\ulcorner6.3% and 81.2%\ulcorner.8% at 5 years respectively. These clinical results confirm the safety of mitral valve replacement. The only remaining clinical problem is the structural and functional durability of the bovine pericardial xenograft valve, and its use in young patients may be stopped in preference to the mechanical prosthetic valves.

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IDENTIFICATION OF SOME FAILURE COSTS AND THEIR PERCEIVED ROOT CAUSES IN CONSTRUCTION

  • Saad Al-Jibouri;Martijn Oude Vrielink
    • International conference on construction engineering and project management
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    • 2009.05a
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    • pp.184-189
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    • 2009
  • In 2008 the total estimated failure costs in the Netherlands was estimated to be 11.4% of the industry's turnover compared to 7.7% seven years earlier. Failure costs can be the consequence of rework as a result of failure to conform to the product requirements and specifications or due to inefficient processes and bad management practices. Many construction companies however are unaware of the exact nature of these costs, their root causes or how to control them. This paper describes work carried out in the Netherlands to identify the different types of failure costs in construction and their root causes. The research described builds on previous findings by another research institution and expands it to include information collected from project cases and a survey of a number of project managers in the construction industry. The paper describes the analysis of the results from cases and the survey to identify the root causes of failure costs. Research shows, for example, that many failure costs are related to the client taking late decisions and making changes to the project requirements.

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Surgical Outcomes of Centrifugal Continuous-Flow Implantable Left Ventricular Assist Devices: Heartmate 3 versus Heartware Ventricular Assist Device

  • Kinam Shin;Won Chul Cho;Nara Shin;Hong Rae Kim;Min-Seok Kim;Cheol Hyun Chung;Sung-Ho Jung
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.184-194
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    • 2024
  • Background: Left ventricular assist devices (LVADs) are widely employed as a therapeutic option for end-stage heart failure. We evaluated the outcomes associated with centrifugal-flow LVAD implantation, comparing 2 device models: the Heartmate 3 (HM3) and the Heartware Ventricular Assist Device (HVAD). Methods: Data were collected from patients who underwent LVAD implantation between June 1, 2015 and December 31, 2022. We analyzed overall survival, first rehospitalization, and early, late, and LVAD-related complications. Results: In total, 74 patients underwent LVAD implantation, with 42 receiving the HM3 and 32 the HVAD. A mild Interagency Registry for Mechanically Assisted Circulatory Support score was more common among HM3 than HVAD recipients (p=0.006), and patients receiving the HM3 exhibited lower rates of preoperative ventilator use (p=0.010) and extracorporeal membrane oxygenation (p=0.039). The overall early mortality rate was 5.4% (4 of 74 patients), with no significant difference between groups. Regarding early right ventricular (RV) failure, HM3 implantation was associated with a lower rate (13 of 42 [31.0%]) than HVAD implantation (18 of 32 [56.2%], p=0.051). The median rehospitalization-free period was longer for HM3 recipients (16.9 months) than HVAD recipients (5.3 months, p=0.013). Furthermore, HM3 recipients displayed a lower incidence of late hemorrhagic stroke (p=0.016). In the multivariable analysis, preoperative use of continuous renal replacement therapy (odds ratio, 22.31; p=0.002) was the only significant predictor of postoperative RV failure. Conclusion: The LVAD models (HM3 and HVAD) demonstrated comparable overall survival rates. However, the HM3 was associated with a lower risk of late hemorrhagic stroke.

The Life Span of LED by the Rising Glass Transitions Temperature of Epoxy (에폭시 유리전이 온도상승에 따른 LED 수명의 변화)

  • Ban, Jae-Sam;Jung, Yong-Ho;Yang, Hyun-Sam;Kim, Sun-Jin
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.1
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    • pp.109-113
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    • 2012
  • The LED failure rate greatly depends on the physical properties of packaging materials (epoxy). The glass transitions temperature (Tg) of the epoxy is one of the most important physical properties. Therefore, in the present study, various epoxies with high Tg were prepared and their failure shapes were analyzed. In addition, the failure shapes depending on the amount of epoxy and the wire bonding structure were measured. As a consequence, the lower failure rate was obtained with the smaller amount of epoxy. The safety of LED was improved with increasing the Tg of the epoxy.

Clinical Evaluation of Mitral Valve Replacement (승모판 치환술의 임상적 고찰)

  • Kim, Sang-Hyeong;Jeong, Jeong-Gi
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.861-869
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    • 1991
  • From August, 1986 to December, 1989, mitral valve replacement was performed in 93 patients. Of the valve implanted, 42 were Duromedics, 35 St. Jude Medical, 15 Carpenter-Edwards and 1 Ionescu-Shiley. The hospital mortality rate was 3.2%[3 patients] and the late mortality rate was 4.3% [4 patients]. The causes of hospital death were LV rupture in 1, renal failure in 1 and hypoxic brain damage in l. The causes of late death were congestive heart failure in 1 and sudden death in 3. Follow-up was done on 78 surviving patients; mean follow-up period was 29.22$\pm$9.09 months. The actual survival rate was 91.8% at 4 years. We concluded, therefore, that good clinical results could be achieved with mitral valve replacement in short-term follow-up, and long-term follow-up is also necessary.

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영상전화의 현황과 전망

  • 변재호;오길환;김방룡
    • Journal of Korea Technology Innovation Society
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    • v.1 no.3
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    • pp.386-401
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    • 1998
  • Videophone service was developed and marketed by AT&T in the late 1960s and early 1970s. The market did not respond to the service offering, and the service was withdrawn. However, Videophone returned in the late 1980s and early 1990s. Due to the technological advance, establishment of ITU standards and fall of videophone price, many analysts are very optimistic about videophone market. But on the other hand, some analysts anticipate that recent videophone will only replicate the past with the same results: namely, market failure. First, this article reviews the history of videophone service, the recent development trend and reasons for its market failure. Second, this article reviews prospects for videophone service. Finally authors examine some of the technological and service features that might shift the value of videophone service.

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Clinical Results of Mitral Valve Replacement (승모판 치환술의 임상 성적)

  • Na, Guk-Ju;Kim, Sang-Hyeon;Kim, Gwang-Hyu
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1113-1121
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    • 1995
  • From August, 1986 to December, 1993, mitral valve replacement was performed in 178 patients. Of the valve implanted, 114 were St.Jude Medical, 47 Duromedics, 16 Carpenter-Edward and 1 Ionesc-Shiley. The hospital mortality rate was 2.8%[5 patients and the late mortality rate was 7.5%[13 patients . The causes of hospital death were LV rupture in 1, renal failure in 1, cardiac tamponade in 1, valve malfunction in 1 and hypoxic brain damage in 1. The causes of late death were sudden death in 6, congestive heart failure in 4, brain ischemic injury in 3. Follow-up was done on 155 surviving patients : mean follow-up period was 50.94$\pm$8.04 months. The actual survival rate was 88.2% at 8 years. We concluded, therefore, that good clinical results could be achieved with mitral valve replacement in mid-term follow-up, and long-term follow-up is also necessary.

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Clinical Analysis of Bioprosthetic Heart Valves (인공 조직 판막의 임상 성적)

  • 김택진
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1074-1080
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    • 1991
  • A total and consecutive 62 patients between 13 and 58 years of age receiving biological prosthetic heart valves at the Korea University Hospital from January 1978 through October 1983 were analyzed. Out of 71 valves replaced, 64 were Carpentier-Edwards valves, 4 were Ionescu-Shiley valves, 2 were Angell-Shiley valves, 1 was Hancock valve. Early mortality within 30 days after operation was noted in 4 cases[6.4%]. There were no cases of valve-related early death. The 58 early survivors were followed-up for a total 387 patient-year over a period of 3 years to 12 years[Mean$\pm$S.D: 6.37$\pm$2.51 years] at the follow-up end of April 1991. During follow-up, seven patients died and late mortality rate was 12%. There were two major late complications: the one is thromboembolism[1.6% /patient-year], the other is primary tissue failure[2.76% /patient-year]. Ten patients underwent re-replacement of 13 tissue valves because of primary tissue failure[nine Carpentier-Edwards, two Ionescu-Shiley, two Angell-Shiley]. There was operative mortality. The probabilities of freedom from primary tissue failure were 95.4% and 75.3% at 5 and 10 years after operation respectively, The actuarial survival rates were 86.2% and 81.8% at 5 and 10 years after initial surgery respectively.

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