• Title/Summary/Keyword: Intermittent Failure

Search Result 72, Processing Time 0.033 seconds

Factors affecting treatment outcomes in patients with oral lichen planus lesions: a retrospective study of 113 cases

  • Park, Shin-Young;Lee, Hyo-Jung;Kim, So-Hyun;Kim, Sung-Beom;Choi, Yong-Hoon;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of Periodontal and Implant Science
    • /
    • v.48 no.4
    • /
    • pp.213-223
    • /
    • 2018
  • Purpose: Oral lichen planus (OLP) is a chronic oral mucosal disease that has been recognized as an immune condition. The purpose of this study was to evaluate factors affecting the clinical outcomes of topical corticosteroid application on OLP lesions using dexamethasone gargle and ointment. Methods: The charts of patients who were clinically diagnosed with OLP and treated with dexamethasone from July 2003 to August 2017 at the Section of Dentistry of Seoul National University Bundang Hospital were thoroughly evaluated to identify subjects who were suitable for this retrospective study. For each patient, age at the index date, gender, medical history, and dental records related to OLP lesions and dexamethasone treatment were reviewed. Results: In total, 113 of the 225 patients were included in the present study. Among them, 79 patients were female (69.9%) and 34 were male (30.1%), with a mean age of 57.6 years. The average duration of dexamethasone treatment was 4.7 months and the mean follow-up period was 2.24 years. Improvements were observed within 1 year after dexamethasone treatment in most cases, and 17.7% of patients had a new OLP lesion after treatment. New OLP lesions were more frequently gingival than mucosal, although mucosal OLP lesions were more common than gingival OLP lesions in all age groups. In age- and gender-adjusted multivariate logistic regression, a history of malignant disease was found to be a significant factor affecting the formation of new lesions. Gingival OLP lesions and intermittent use of dexamethasone showed near-significant associations. In Kaplan-Meier failure analysis, history of malignancy, menopausal status, age, and the site of the OLP lesion were significant factors affecting clinical outcomes. Conclusions: The treatment outcomes of OLP were significantly influenced by age, history of malignancy, menopausal status, and the site of the OLP lesion, but not by factors related to dexamethasone treatment.

Transient Torsional Vibration Analysis of Ice-class Propulsion Shafting System Driven by Electric Motor (전기 모터 구동 대빙급 추진 시스템의 과도 비틀림 진동 분석)

  • Barro, Ronald D.;Lee, Don Chool
    • Transactions of the Korean Society for Noise and Vibration Engineering
    • /
    • v.24 no.9
    • /
    • pp.667-674
    • /
    • 2014
  • A ship's propulsion shafting system is subjected to varying magnitudes of intermittent loadings that pose great risks such as failure. Consequently, the dynamic characteristic of a propulsion shafting system must be designed to withstand the resonance that occurs during operation. This resonance results from hydrodynamic interaction between the propeller and fluid. For ice-class vessels, this interaction takes place between the propeller and ice. Producing load- and resonance-induced stresses, the propeller-ice interaction is the primary source of excitation, making it a major focus in the design requirements of propulsion shafting systems. This paper examines the transient torsional vibration response of the propulsion shafting system of an ice-class research vessel. The propulsion train is composed of an electric motor, flexible coupling, spherical gears, and a propeller configuration. In this paper, the theoretical analysis of transient torsional vibration and propeller-ice interaction loading is first discussed, followed by an explanation of the actual transient torsional vibration measurements. Measurement data for the analysis were compared with an applied estimation factor for the propulsion shafting design torque limit, and they were evaluated using an existing international standard. Addressing the transient torsional vibration of a propulsion shafting system with an electric motor, this paper also illustrates the influence of flexible coupling stiffness design on resulting resonance. Lastly, the paper concludes with a proposal to further study the existence of negative torque on a gear train and its overall effect on propulsion shafting systems.

Membranous Nephropathy Associated with Epstein-Barr Virus Infection in a Child (소아에서 엡스타인-바 바이러스 감염과 관련한 막성 신병증 1례)

  • Lee, Eun-Hee;Lim, Dong-Hee;Yim, Hyung-Eun;Yoo, Kee-Hwan;Won, Nam-Hee;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
    • /
    • v.12 no.1
    • /
    • pp.88-92
    • /
    • 2008
  • Infection of Epstein-Barr virus(EBV) gives rise to a broad spectrum of clinical manifestations in children. Although renal involvement is rare, diverse renal manifestations are known from hematuria to acute renal failure. Secondary membranous nephropathy(MN) associated with systemic EBV infection is an uncommon renal pathology and only two cases have been reported. We are adding another case of MN associated with EBV infection in a child. An 8-year-old girl was admitted for renal biopsy. She had been followed up for microscopic hematuria and intermittent proteinuria for 5 months. There had been no specific findings in serology and radiology. Tonsil biopsy had been done due to exudative tonsillar hypertrophy and enlarged multiple cervical lymph nodes. And it showed EBV-associated lymphoproliferative findings. Serologic tests for EBV showed positive evidence of recent infection; viral capsid antigen(VCA) IgM was borderline positive, VCA IgG and early antigen IgG were positive, and EB nuclear antigen IgG was negative. In Situ Hybridization of tonsil for EBV mRNA was positive. Because her proteinuria and hematuria were aggravated at that time(protein 3 +, RBC >60/HPF), renal biopsy was done. Renal biopsy showed the findings of MN, characterized by thickened capillary walls with epimembranous spikes on light microscopy and subepithelial, mesangial and subendothelial electron dense deposits on electron microscopy. On immunofluorescence microscopy, IgG, C1q, kappa and lambda chains were positive. After steroid administration, proteinuria and hematuria resolved gradually within 6 months.

  • PDF

Sudden Death Caused by Clostridium perfringens Type D Enterotoxemia in Feedlot Cattle (비육 우의 Clostridium perfringens D 형 장독 혈증에 의한 폐사)

  • Jang, Seong-Jun;Do, Sun-Hee;Ki, Mi-Ran;Hong, Il-Hwa;Park, Jin-Kyu;Cho, Yu-Jeong;Ji, Ae-Ri;Park, Se-Il;Park, Sang-Joon;Kim, Tae-Hwan;Kwak, Dong-Mi;Jeong, Kyu-Shik
    • Journal of Life Science
    • /
    • v.20 no.5
    • /
    • pp.639-643
    • /
    • 2010
  • Sudden deaths have occurred in feedlot cattle with marked necro-hemorrhagic enteritis of the jejunum, ileum and colon. Suckling beef calves are the most frequently affected. Over-consumption of large amounts of milk, inadequate colostrum intake, chilling and stress are conducive to the development of enterotoxemia. Enterotoxemia caused by Clostridium perfringens type D mostly occurs following a sudden change of diet, particularly to feeds made richer in order to grow the cattle to market weight in feedlots. During July 2006, sudden deaths of cattle occurred in the Youngcheon regional area of Gyeongbuk province. There were no significant clinical signs except anorexia, depression, intermittent diarrhea and mild respiratory failure. Histological findings revealed a prominent intranuclear inclusion as well as infiltration of the globular leukocytes in various organs including the heart, kidneys, liver, spleen and lymph nodes. Spleen and lymphatic tissues showed lymphatic necrosis and a starry sky appearance. In the submucosa of the small intestines, basophilic aggregation was detected with massive infiltration of the globular leukocytes and eosinophils. Gram staining for the tissue sections containing inclusions of the small intestines revealed a positive histochemical reaction. Taken together, we suggest that Clostridium perfringens type D-induced enterotoxemia is determined to be the cause of sudden death of feedlot cattle.

Multi-Hop Vehicular Cloud Construction and Resource Allocation in VANETs (VANET 망에서 다중 홉 클라우드 형성 및 리소스 할당)

  • Choi, Hyunseok;Nam, Youngju;Lee, Euisin
    • KIPS Transactions on Computer and Communication Systems
    • /
    • v.8 no.11
    • /
    • pp.263-270
    • /
    • 2019
  • Vehicular cloud computing is a new emerging technology that can provide drivers with cloud services to enable various vehicular applications. A vehicular cloud is defined as a set of vehicles that share their own resources. Vehicles should collaborate with each other to construct vehicular clouds through vehicle-to-vehicle communications. Since collaborating vehicles to construct the vehicular cloud have different speeds, directions and locations respectively, the vehicular cloud is constructed in multi-hop communication range. Due to intermittent wireless connectivity and low density of vehicles with the limited resources, the construction of vehicular cloud with multi-hop communications has become challenging in vehicular environments in terms of the service success ratio, the service delay, and the transmitted packet number. Thus, we propose a multi-hop vehicular cloud construction protocol that increases the service success ratio and decreases the service delay and the transmitted packet number. The proposed protocol uses a connection time-based intermediate vehicle selection scheme to reduce the cloud failure probability of multi-hop vehicular cloud. Simulation results conducted in various environments verify that the proposed protocol achieves better performance than the existing protocol.

Double-Chambered Right Ventricle in an Old Standard Poodle Dog

  • Yunho Jeong;Yoonhwan Kim;Eunchan Lee;Ju-Hyun An;Sooyoung Choi;Jin-Young Chung;Jin-Ok Ahn
    • Journal of Veterinary Clinics
    • /
    • v.40 no.2
    • /
    • pp.130-134
    • /
    • 2023
  • A 12-year-old Standard Poodle presented with intermittent weakness and occasional dyspnea at the Veterinary Medicine Teaching Hospital of Kangwon National University. A grade of 4 out of 6 systolic murmur with an irregular tachycardic rhythm was auscultated on both sides of the chest. Systolic blood pressure was 140 mmHg. Panting was noticed in the hospital, but there was no crackle sound. Blood analysis revealed mild increases in liver panel levels (alanine aminotransferase 149 [reference interval, 19-70] U/L; and alkaline phosphatase, 185 [reference interval, 15-127] U/L) and severe increases in cardiac biomarker levels (n-terminal pro-brain natriuretic peptide, 4169 [reference interval, 50-900] pmol/L; and cardiac troponin I, 0.22 [reference interval, 0.03-0.12] ng/mL). On electrocardiography, irregularly irregular supraventricular tachycardic rhythm with an f-wave and no distinct p-wave was observed. Generalized cardiomegaly with an enlarged right atrium and left ventricle was confirmed on thoracic radiography. Moreover, hepatomegaly and an enlarged caudal vena cava were observed. Echocardiographic evaluation revealed a fibromuscular diaphragm in the right ventricle. Because of the obstructive lesion in the right ventricle, the right atrium and ventricle were enlarged (right atrial area index, 38.82 cm2/m2 [reference interval, 4.2-10.2 cm2/m2]; right ventricle end-diastolic area index, 14.152 cm2/m2 [reference interval, 4.9-10.92 cm2/m2]). Accordingly, the patient was diagnosed with double-chambered right ventricle (DCRV). Pimobendan, furosemide, enalapril, diltiazem, and S-adenosylmethionine (SAMe) were prescribed, and all symptoms were relieved. DCRV is a right-sided congenital heart defect resembling pulmonic valve stenosis. If symptoms are not severe, medical therapy can be facilitated without surgery or the balloon dilation.

A Study on the Effects of the Early Use of Nasal CPAP in the Weaning of Mechanical Ventilators (인공호흡기 이탈시 비강내 CPAP 조기 사용 효과에 관한 연구)

  • Kim, Yeoung Ju;Jung, Byun Kyung;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.12
    • /
    • pp.1200-1206
    • /
    • 2003
  • Purpose : This study was conducted for the use of nasal continuous positive airway pressure (CPAP), by comparing the early use of non-invasive nasal CPAP with low intermittent mandatory ventilation(low IMV) and endotracheal CPAP in weaning a mechanical ventilator from infants with moderate respiratory distress syndrome(RDS). Methods : Thirty infants in the study group, with moderate RDS from November 2001 to June 2002, were administered surfactants and treated with the mechanical ventilator, and applied the nasal CPAP in weaning. Thirty infants of the control group, from January 1999 to September 2001, were applied low IMV and endoctracheal CPAP in weaning. Results : There were no significant differences in the characteristics, the severity of clinical symptoms, the initial laboratory findings and settings of the mechanical ventilator. After weaning, the study group showed no significant changes in $PaCO_2$. However, the control group showed a slight $CO_2$ retension after one and 12 hours. Twenty eight infants(93.3%) of the study group and 24 infants(80%) of the control group were successfully extubated. The primary cause of failure was apnea. There were no significant differences in the duration of weaning and the mechanical ventilator treatment between the groups. Complications in weaning were related to the fixation of nasal CPAP and the mechanical problems caused by endotracheal tube. Conclusion : Aggressive weaning is possible for moderate RDS, in which the nasal CPAP was used without the low IMV and the endotracheal CPAP process. It had no difficulties. In conclusion, the nasal CPAP is an adequate weaning method for moderate RDS.

Weaning Following a 60 Minutes Spontaneous Breathing Trial (1시간 자가호흡관찰에 의한 기계적 호흡치료로부터의 이탈)

  • Park, Keon-Uk;Won, Kyoung-Sook;Koh, Young-Min;Baik, Jae-Jung;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
    • /
    • v.42 no.3
    • /
    • pp.361-369
    • /
    • 1995
  • Background: A number of different weaning techniques can be employed such as spontaneous breathing trial, Intermittent mandatory ventilation(IMV) or Pressure support ventilation(PSV). However, the conclusive data indicating the superiority of one technique over another have not been published. Usually, a conventional spontaneous breathing trial is undertaken by supplying humidified $O_2$ through T-shaped adaptor connected to endotracheal tube or tracheostomy tube. In Korea, T-tube trial is not popular because the high-flow oxygen system is not always available. Also, the timing of extubation is not conclusive and depends on clinical experiences. It is known that to withdraw the endotracheal tube after weaning is far better than to go through any period. The tube produces varying degrees of resistance depending on its internal diameter and the flow rates encountered. The purpose of present study is to evaluate the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube. Methods: We analyzed the result of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube in 18 subjects from June, 1993 to June, 1994. They consisted of 9 males and 9 females. The duration of mechanical ventilation was from 38 hours to 341 hours(mean: $105.9{\pm}83.4$ hours). In all cases, the cause of ventilator dependency should be identified and precipitating factors should be corrected. The weaning trial was done when the patient became alert and arterial $O_2$ tension was adequate($PaO_2$ > 55mmHg) with an inspired oxygen fraction of 40%. We conducted a careful physical examination when the patient was breathing spontaneously through the endotracheal tube. Failure of weaning trial was signaled by cyanosis, sweating, paradoxical respiration, intercostal recession. Weaning failure was defined as the need for mechanical ventilation within 48 hours. Results: In 19 weaning trials of 18 patients, successful weaning and extubation was possible in 16/19(84.2 %). During the trial of spontaneous breathing for 60 minutes through the endotracheal tube, the patients who could wean developed slight increase in respiratory rates but significant changes of arterial blood gas values were not noted. But, the patients who failed weaning trial showed the marked increase in respiratory rates without significant changes of arterial blood gas values. Conclusion: The result of present study indicates that weaning from mechanical ventilation following a 60 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method. Extubation can be done at the same time of successful weaning except for endobronchial toilet or airway protection.

  • PDF

Clinical Analysis of the Recent Results of Coronary Artery Bypass Grafting (관상동맥 우회술의 최근성적에 대한 임상적 고찰)

  • Han, Sung-Ho;Kim, Hyuck;Lee, Chul-Bum;Chung, Won-Sang;Jee, Heng-Ok;Kang, Jung-Ho;Kim, Young-Hak
    • Journal of Chest Surgery
    • /
    • v.35 no.7
    • /
    • pp.523-529
    • /
    • 2002
  • Background: Previous reports present that the early results of coronary artery bypass grafting (CABG) has been improving with the accumulation of surgical experience. We conducted a retrospective analysis of the patients who received CABG to evaluate the recent results of CABG. Material and Method: Between January 1996 and August 2001, 154 patients underwent CABG at Hanyang University Hospital. There were 47 patients(group I) who were operated between 1996 and 1998, and 107 patients(group II) who were operated thereafter. The preoperative diagnosis, operative procedure, mortality, and complications were analyzed retrospectively. Result: There were 35 males and 12 females in group I, and 78 males and 29 females in group II, which shows similar ratio of sexes between the two groups. The average age of patients for group I and group II was $55.9{\pm}6.2$ years and $61.0{\pm}8.0$ years, respectively, showing a significant increase in group II(p<0.05). The average left ventricular ejection fraction(LVEF) for group I and group II was $54.6{\pm}11.8$% and $56.9{\pm}13.0$%, respectively. The number of patients who had previous MI in group I and group II were 13 patients(27.7%) and 14 patients(13.1%), respectively, which shows a significant difference (p<0.05). All procedures were performed using the cardiopulmonary bypass(CPB) and moderate systemic hypothermia. Myocardial protection was achieved using intermittent hypothermic ischemia under ventricular fibrillation state or cold crystalloid cardioplegic solution for most of group I patients, whereas cold blood cardioplegic solution was used for group II patients. The mean CPB times for group I and group II were $149.2{\pm}48.7$ minutes and $113.1{\pm}30.6$ minutes, respectively. The mean aortic cross clamp times for group I and group II were $81.3{\pm}26.5$ minutes $72.2{\pm}23.9$ minutes, respectively. These figures show that CPB and aortic cross clamp times were significantly reduced in group II(p<0.05). The use of the left internal thoracic artery(LITA) was increased from 42%(20/47) for group I to 81% (87/107) for group II. The mean number of grafts also significantly increased from $2.5{\pm}0.6$ for group I to $3.0{\pm}1.1$ for group II(p<0.05). Intra-aortic balloon pump(IABP) was applied in 7 cases in group I and 17 cases in group II. Of these, 28.6%(2/7) and 52.9%(9/17) were broadly applied preoperatively in patients with LVEF<40% or congestive heart failure. The operative mortalities for group I and II were 10.6%(5/47) and 0.9%(1/107), respectively, which shows significant decrease for group II(p.0.05). Conclusion: This report suggest that CABG using CPB can recently be performed more safely in virtue of the accumulation of surgical experience with reduction in CPB and aortic cross clamp times and improved surgical techniques and myocardial protection. And we think that the optimal treatment of patients with left ventricular dysfunction associated with congestive heart failure and the extended application of IABP, especially have contributed to the reduction of operative mortality and morbidity.

Significance of brain magnetic resonance imaging(MRI) in the assessment of occupational manganese exposure (직업적 망간 폭로에 있어서 뇌자기공명영상의 의의)

  • 정해관
    • Investigative Magnetic Resonance Imaging
    • /
    • v.2 no.1
    • /
    • pp.14-30
    • /
    • 1998
  • Manganese is an essential element in the body. It is mainly deposited in the liver and to a lesser degree in the basal ganglia of the brain and eliminated through the bile duct. Rapid turnover of managanese in the body makes it difficult to evaluate the manganese exposure in workers, esecially in those with irregular or intermittent exposure, like welders. Therefore, conventional biomarkers, including blood and urine manganese can provide only a limited information about the long-tern or cumulative exposure to manganese. Introduction of magnetic resonance imaging (MRI) made a progress in the assessment of manganese exposure in the medical conditions related to manganese accumulation, e. g. hepatic failure and long-term total parenteral nutrition. Manganese shortens spin-lattice(T1) relaxation time on MRI due to its paramagnetic property, resulting in high signal intensity (HSI) on T1-weighted image(T1W1) of MRI. Manganese deposition in the brain, therefore, can be visualizedas an HSI in the globus pallidus, the substantia nigra, the putamen and the pituitary. clinical and epidemiologic studies regarding the MRI findings in the cases of occupational and non-occupational manganese exposure were reviewed. relationships between HSI on T1W1 of MRI and age, gender, occupational manganese exposure, and neurological dysfunction were analysed. Relationships betwen biological exposure indices and HSI on MRE werealso reviewed. Literatures were reviewed to establish the relationships between HSI, Manganese deposition in the brain, pathologic findings, and neurological dysfunction. HSI on T1W1 of MRI reflects regional manganese deposition in the brain. This relationship enables an estimation of regional manganese deposition in the brain by analysing MR signal intensity. Manganese deposition in the brain can induce a neuronal loss in the basal ganglia but functional abnormality is supposed to be related to the cumulative exposure of manganese in the brain, use of brain MRI for the assessment of exposure in a group of workers seems to be hardly rationalized, while ti can be a useful adjunct for the evaluation of manganese exposure int he cases with suspected manganese-related health problems.

  • PDF