• 제목/요약/키워드: Failure Period

검색결과 1,394건 처리시간 0.023초

Analysis of failed mechanical thrombectomy with a focus on technical reasons: Ten years of experience in a single institution

  • Sinho Park;Dong Hoon Lee;Jae Hoon Sung;Seung Yoon Song
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • 제25권1호
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    • pp.13-18
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    • 2023
  • Objective: Mechanical thrombectomy (MT) is an effective treatment for patients suffering from acute ischemic stroke secondary to large vessel occlusion. However, recanalization failure rates of interventions were about 20% in literature studies. We report our experience of unsuccessful MT with a focus on technical reasons. Methods: From December 2010 to June 2021, six hundred eight patients with acute ischemic stroke due to large artery occlusion received MT using a stent retriever with or without an aspiration catheter in our institution. We divided the reasons for failure into six categories. We analyzed the reasons for failure by dividing our experience time into 3 periods. Results: A total of 608 cases of thrombectomy for large vessel occlusion were identified in the study period. The successful recanalization rate was 90.4%. In most of the cases (20/57, 35%), the thrombus persisted despite several passes, and the second most common cause was termination of the procedure even after partial recanalization (10/57, 18%). Similar proportions of in-stent occlusion, distal embolization, and termination due to vessel rupture were observed. On analysis of three periods, the successful recanalization rate improved over time. Conclusions: MT fails due to various reasons, and intracranial artery stenosis is the main cause of MT failure. With the development of rescue techniques, the failure rate has gradually decreased. Further development of new devices and techniques could improve the recanalization rates.

Latarjet operation carries three times the risk of failure in seizure versus non-seizure recurrent anterior dislocation of the shoulder joint: outcome of a systematic review with meta-analysis

  • Alok Rai;Dushyant Chouhan;Sandeep Kumar Nema;Arkesh Madegowda;Rudra Narayan;Bikram K. Kar
    • Clinics in Shoulder and Elbow
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    • 제27권2호
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    • pp.160-168
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    • 2024
  • Background: Recurrent anterior shoulder dislocation (RASD) in cases of seizure disorders (SDs) total 50%-80% of all SD-associated shoulder instabilities. Based on the extent of bone loss, treatment options include bony and soft-tissue reconstructions, arthroplasty, and arthrodesis. The primary objective of this paper was to review the treatment options for RASD in SDs. Methods: Several bibliographic databases were searched for RASD treatment options in SD patients. The demographic outcome measures, the failure rate (defined as the relative risk of recurrence of dislocation postoperation), and the postoperative seizure recurrence rate were recorded. Results: We pooled 171 cases (187 shoulders) from 11 studies. Of these, one, five, two, two, and one reports studied Bankart's operation with remplissage (27 cases/29 shoulders), the Latarjet procedure (106/118), bone block operation (21/23), arthroplasty (11/11), and arthrodesis (6/6), respectively, in treating SD-associated RASD. The relative risk of failure between SD and non-SD patients was 3.76 (1.36-10.38) after the Latarjet operation. The failure rates were 17% and 13% for Bankart's operation with remplissage and the Latarjet procedure in SD patients, respectively, but 0% each for bone block operation, arthroplasty, and arthrodesis. The total rate of seizure recurrence after operation was 33% of the pooled cases. Conclusions: SD recurrence in the postoperative period, the size of the bone block, and the muscular attachments to a small coracoid autograft are the determinants of failure among various reconstructive operations in SD-associated RASD.

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

  • 김택진
    • Journal of Chest Surgery
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    • 제24권11호
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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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Estimating Failure Rate Using Warranty Claim Data with Delayed Report of Customers (고객의 지연보고를 고려한 보증수리내역자료에서의 고장률 추정)

  • Park, J.H.;Kim, Y.H.;Baek, J.H.;Lie, C.H.
    • IE interfaces
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    • 제23권2호
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    • pp.176-181
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    • 2010
  • Warranty claim data analysis is a useful tool for the manufacturer because it contains many useful informations regarding reliability of the product in the real-world environments. Because of the nature of uncertainty and the incompleteness of data, some bias patterns are observed on warranty claim rate known as 'spikes'. Two types of spikes are considered. One is due to manufacturing-related failures. The other is caused by customer's behavior. This paper proposes a model by considering two types of spikes. Warranty claim data is analyzed with the proposed model. To represent spikes observed on the early warranty period, we classify failures into manufacturing-related failures and usage-related failures. Uniform distribution is assumed for the time delayed to diagnose and report by customers. By reducing maximum value of the delayed time by customers, the proposed model characterizes customer's rush in the vicinity of the warranty expiration limit. Experimental results by using the real warranty claim data show that the proposed model is better than the existing one in respect to MSE(Mean Squared Error). Moreover it is expected to estimate the failure rate more realistically with proposed model because it considers the delayed time to diagnose and report by customers.

The Acute Intermittent Peritoneal Dialysis in Acute Renal Failure of Newborn and Young Infants (신생아와 유아의 급성신부전증에 실시한 급성복막투석)

  • Park, Yong-Hoon;Moon, Han-Ku
    • Journal of Yeungnam Medical Science
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    • 제3권1호
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    • pp.375-382
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    • 1986
  • We studied the effects of the acute intermittent peritoneal dialysis in severe acute renal failure of 1 newborn infant and 2 young infants during 18 months period from February 1985 to April 1986. The predisposing illnesses were severe acute gastroenteritis with dehydration. Reye's syndrome, and bilateral nephrolithiasis with hyperuricemia. The concomittent illnesses were severe hypernatremia, hyponatremia, hyperkalemia, hypocalcemia, hypoglycemia, DIC(disseminated intravascular coagulopathy), paralytic ileus, metabolic acidosis and gastrointestinal bleeding. As a dialvsate, Imperinol $solution^R$, 1.5% was used in all cases. The cycles of dialysis were 8, 16, and 41 times in each cases. Observed complications during dialysis were leakage, and abdominal wall and scrotol swelling in 2 cases, hyperglycemia in 1 case, and peritonitis in 1 case. Acinetobacter calcoaceticus was cultured in peritoneal fluid of peritonitis. These complications were treated by stopping dialysis in leakage and abdiminal wall swelling, insulin therapy in hyperglycemia, and intraperitoneal and systemic antibiotics therapy in peritonitis. We experienced improvements of severe acute renal failure with variable concomittant illnesses by acute intermittent peritoneal dialysis despite of the treatable complications of dialysis in all cases.

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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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    • 제22권1호
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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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The Lived Experience of Caregivers of Chronic Renal Failure Patient (만성신부전환자의 주보호자로 살기)

  • Kim, Kyoung-Mi;Kong, Byung-Hye
    • Korean Journal of Adult Nursing
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    • 제17권5호
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    • pp.709-718
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    • 2005
  • Purpose: The research aims to understand the lived experience of the caregivers of chronic renal failure(CRF) patients and its essential meaning. The results of the study can be used as basic materials for developing comprehensive intervention methods of care givers of CRF patients. Method: The research used van Manen's hermeneutic and phenomenological research methods in order to describe the lived experience and to understand its meaning. It concentrates on the understanding the essence of experience and consists of existential survey, hermeneutic and phenomenological reflection and hermeneutic writings. Participants in this research were five women care givers of CRF patients who had hemolysis at C university hospital in a metropolitan city, the period of data collection was from July 27 to Sep. 4, 2004 and major data of results in the following 5 essential themes. "sole responsibility for the patient enduring everything", "creating their own field", "heavy and painful life without hope of their private life", "wishing not to be inherited and consoling each other". Conclusion: The above findings point out that the experience of care givers of CRF patient affected and changed all parts of an individual life and his or her family life. Therefore, it suggests that total family nursing care must be considered in order to provide the holistic caring for CRF patients and their care givers.

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Surgical Management of Ventricular Septal Defect in Infancy (영아기의 심실중격결손에 대한 이라완전교정술과 단계교정술의 비교)

  • 김병호
    • Journal of Chest Surgery
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    • 제27권1호
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    • pp.24-30
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    • 1994
  • Eighteen infants with a large ventricular septal defect[VSD] underwent primary surgical repair from January 1986 to December 1992. Operation was done because of failure to thrive, medically intractable heart failure, recurrent pneumonia, increased pulmonary vascular resistance[PVR]. Four patients[22.2%] died in the early postoperative period. Relief of heart failure and normalization of growth and weight gain was evident in all survivor. There was no late postoperative death. The results of primary surgical repair of VSD in infancy are compared with those of palliative pulmonary artery banding[PAB] and of VSD closure after PAB. Twenty-seven patients with isolated VSD or with VSD associated with atrial septal defect, patent ductus arteriosus, or coarctation of the aorta underwent initial palliative PAB. There were 3 early postoperative deaths[11.1%]. Severe elevation of PVR persisted in two patients. Closure of VSD and pulmonary artery debanding was done in twenty patients, with 2 early postoperative deaths[10.0%]. Placement of the PAB too close to the pulmonary annulus necessitated trasannular patching in one patient, but any problem caused by migration of the band was not developed. It is concluded that primary surgical repair of VSD in infancy is reasonable and that PAB is indicated only for those patients less than 6 months old with a complicated defect or in an emergency situation.

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Maintenance Method of Mail Sorting Machine Based on FMEA (FMEA 기반 우편 기계 유지 보수 방법)

  • Park, Jeong-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제11권5호
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    • pp.1601-1607
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    • 2010
  • This paper presents FMEA (Failure Mode Effect Analysis) for maintenance of mail sorting machine which is for automatic sorting of mail. We suggest the update method of regular diagnosis item and period for maintenance of mail sorting machine using the risk priority number which is calculated by severity, occurrence, and detection of failure mode of mail sorting machine, and shows FMEA adoption example of letter sorting machine. This paper also describes the current maintenance system and status of mail sorting machine in the domestic postal logistics environment, and FMEA adoption step. The proposed maintenance using FMEA will be adapted for more easy and efficiency maintenance of mail sorting machine.

Development of a Piping Integrity Evaluation Simulator Based on the Hardware-in-the-Loop Simulation (하드웨어-인-더-루프 기반의 배관 평가 시뮬레이터의 개발)

  • Kim, Yeong-Jin;Heo, Nam-Su;Cha, Heon-Ju;Choe, Jae-Bung;Pyo, Chang-Ryul
    • Transactions of the Korean Society of Mechanical Engineers A
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    • 제25권7호
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    • pp.1031-1038
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    • 2001
  • In order to verify the analytical methods predicting failure behavior of cracked piping, full-scale pipe tests are crucial in nuclear power plant piping. For this reason, series of international test programs have been conducted. However, full-scale pipe tests require expensive testing equipment and long period of testing time. The objective of this paper is to develop a test system which can economically simulate the full-scale pipe test regarding the integrity evaluation. This system provides the failure behavior of cracked pipe by testing a wide-plate specimen. The system provides the failure behavior of cracked pipe by testing a wide-plate specimen. The system was developed for the integrity evaluation of nuclear piping based on the methodology of hardware-in-the-loop (HiL) simulation. Using this simulator, the piping integrity can be evaluated based on the elastic-plastic behavior of full-scale pipe, and the high cost full-scale pipe test may be replaced with this economical system.