• Title/Summary/Keyword: Mean Time To Repair

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Clinical Result of Layered Suture Bridge Technique in Arthroscopic Repair for Delaminated Rotator Cuff Tear (회전근 개 층간 분리 파열에서 관절경을 이용한 층상 교량형 봉합술의 임상 결과)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Cho, Byung-Ki;Park, Ji-Kang;Kim, Dong-Whan;Keum, Sang-Wook;Cha, Jung-Kwon
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.84-93
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    • 2013
  • Purpose: The purpose of this study was to evaluate the repair integrity and clinical outcomes of delaminated tears following arthroscopic layered suture bridge rotator cuff repair in a prospective fashion. Materials and Methods: A consecutive series of 67 patients with delaminated rotator cuff tears who underwent surgery using the arthroscopic Layered Suture Bridge Technique were followed prospectively. Of 67 shoulders, 26 patients were male and 40 patients were female (one patient had bilateral tears); the mean age was 58.8(40~76) years. The clinical evaluation was performed according to ASES, UCLA, and KSS (Korea Shoulder Scoring System) scores with an average follow up period of 33 months. Repair integrity was estimated using MRI, which was performed six months postoperatively. Results: The average clinical outcome in ASES, UCLA, and KSS scores showed significant improvement at the time of the final follow-up compared to preoperatively, from 50.2 to 92.3, 15 to 31.3, and 54.4 to 90.7, respectively (p<0.001 for all scores). Follow up by MRI showed that 16 shoulders had a type-I; 14, a type-II; five, a type-III; two, a type-IV; one, a type-V re-tear. The overall rate of re-tear (types IV and V) was 7.9%. Conclusion: Use of the Arthroscopic Layered Suture Bridge Technique can result in improved functional and structural outcome in cases of delaminated rotator cuff tear.

Early Adjusting Surgery after Blepharoptosis Repair (눈꺼풀처짐증 수술 후의 조기 재수술)

  • Song, Chul Hong;Jung, Jae Min;Park, Dae Hwan
    • Archives of Plastic Surgery
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    • v.33 no.1
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    • pp.95-100
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    • 2006
  • The challenge of accurately predicting eyelid height after blepharoptosis surgery is well-known problem even in complete hands. From May, 1988 to December, 2004, authors reviewed 182 cases(240 eyes) of blepharoptosis corrected by frontalis muscle transfer or levator resection and had experienced 10 cases(15 eyelids) of early reoperation around 1 week. The period from initial operation to reoperation are between six to eight days and mean period is seven days. Initial operative procedures were frontalis muscle transfer in 3 cases(4 eyelids) and levator resection in 7 cases(11 eyelids). Follow up period ranged from 6 months to 16 years. Early adjusting surgery was performed in accordance with the preoperative and postoperative degree of ptosis of patient and considering previous operative technique. The results are evaluated according to the criteria of an ideal correction by Souther and Jordan. Seven patients have good or satisfactory results(less than 1 mm asymmetry, good in 5 cases and satisfactory in 2 cases). Three patients(5 eyelids) recorded as poor results(more than 2 mm asymmetry). Even if early or late reoperation can be effective in correcting unsatisfactory results after correction of blepharoptosis, early reoperation is better than later reoperation because early reoperation can offer a reduction in time to final result, the ease with which it is performed, potential cost savings. The experience of surgeon is also important factor for the reatment of recurred blepharoptosis

A Study on Dual System for Fault Tolerance of PLC (PLC 오류를 포용하는 이중화 시스템에 관한 연구)

  • Ko, Jae-Hong
    • The Journal of the Korea institute of electronic communication sciences
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    • v.6 no.3
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    • pp.397-404
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    • 2011
  • In this research, wish to suggest method to embody system that can accommodate defect of PLC and find actual propriety. Defect permission control system minimizes production damage because enables repair and checking without discontinuance and improve believability about whole system. Propose duplexing of system to embody this fault tolerant system. Therefore, composed control system that can permit defect or breakdown duplexings of various module proposing this system, and confirms to simulation and actuality kiln of defect permission control system through an application experiment, and compares for mean time between defect by estimate and defect special quality and system configuration of failure(failure) to improve believability of PLC control system together. In proposed system expression method and system mode and relation with operation mode, error discovery mode and switching tube of duplexing mode, and PLC's central processing unit of node study algorithm about master-standby conversion driving and continuous operation of 2 channels method that have 2 that is not one and deduced continuous operation method and result about defect permission in this algorithm and applies this result to actuality kiln control system and confirms continuous operation about PLC defect permission.

Long term results in the unilateral cleft lip repair by Mulliken's method (Mulliken 방법을 이용한 일측성 구순열의 장기 추적 결과)

  • Kim, Seok-Kwun;Moon, In-Sun;Lee, Chang-Ho;Heo, Jung;Kwon, Yong-Seok;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.174-182
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    • 2009
  • Purpose: The Mulliken's method is a one of the very excellent technique to correction of the unilateral cleft lip. It could decrease the need of additional operation and second operation by the early simultaneous correction of unilateral cleft lip and nasal deformity, at a time. Numerous procedures were advocated for the correction of nasal deformity, but with general dissatisfaction of the results, it became obvious that no one procedure is the ideal one. The authors have been operating on unilateral cleft lip by Mulliken's method and long term follow - up of postoperative result was evaluated. Methods: The authors have done long term follow - up of result in the 75 cases unilateral cleft lip patient, during 1 ~ 7 years. That was repaired by simultaneous correction of cleft lip and nasal deformity by Mulliken's method at the period from June, 1997 to December, 2007. The patients were unilateral complete cleft lip 39 cases, unilateral incomplete cleft lip 36 cases. In the severe complete cleft lip cases, lip adhesion operation was done before definite operation. The mean age of unilateral cleft lip operation was 3.2 months. Five anthropometric parameters, which were upper lip, cutaneous lip and vermilion mucosa height, nasal tip protrusion, columella length were measured by Sliding Vernier Caliper. The anthropometric analysis was performed preoperative and postoperative at 6 months, 3, 5 and 7 years and the results were com pared with those of age - matched, normal children. T - tests were used to analyze the differences between the measurements. Results: Long - term postoperative results were evaluated by anthropometrically. Most patients showed adequate growth of upper lip height, vermilion mucosa height and columella length. But nasal tip protrusion was relatively short compare with normal value. Incomplete cleft lip group was nearly normal growth results than complete cleft lip group. Conclusion: In conclusion, we could make harmonious Cupid's bow, natural philtrum and lip, appropriate nasal shape by Mulliken's method. But nasal tip protrusion was under the normal values on complete and incomplete group. And incomplete group was more good results than complete group. We have experienced repair of cleft lip by Mulliken's method with 75 cases of unilateral cleft lip patients and conclude that it was very useful and good method.

A Study on Development of the Reliability Evaluation System for VVVF Urban Transit (VVVF 도시철도 차량의 신뢰성 평가 시스템 개발에 관한 연구)

  • Bae Chul-Ho;Kim Sung-Bin;Lee Ho-Yong;Chang Suk-Hwa;Suh Myung-Won
    • Transactions of the Korean Society of Automotive Engineers
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    • v.13 no.5
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    • pp.7-18
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    • 2005
  • Over the past twenty years, the maintenance system has been developed and its importance has been increased. For the effective maintenance of the urban transit, we have developed the maintenance system based on the concept of RCM(Reliability Centered Maintenance). RCM analysis is a systematic approach to developing a cost-effective maintenance strategy based on the various components's reliability of the system in question. It is performed according to process that includes the following steps; definition of function and functional failures of the systems, construction of RB D(Reliability Block Diagram), performance of FMEA(Failure Modes & Effects Analysis) and calculation of the reliability index. The final process of RCM is to determine appropriate failure maintenance strategies. This paper aims to define the procedure of maintenace based on the concept of RCM for urban transit. The key for a successful maintenance system is an automated scheduling to the maximum extent possible and timely executions. The developed system issues maintenance plan and repair request based on analyzed data and maintenance experience.

Analysis of Binding Media Used in Mural Painting of Temple Wall by Pyrolysis/GC/MS and IR (열분해/GC/MS와 IR을 이용한 사찰 벽화 시편 교착제 분석)

  • Park, Jongseo;Lee, Jeong Won
    • Journal of Conservation Science
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    • v.33 no.5
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    • pp.345-354
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    • 2017
  • A mural was discovered in the Ssanggyesa temple located in Jindo island, during repair of the Daeungjeon Hall. A study was conducted to determine the binding medium used for preparing the mural. Pyrolysis/GC/MS and IR spectrometry were used to analyze a painting specimen. Direct approach and on-line methylation approach were attempted for the pyrolysis/GC/MS. In IR analysis, the spectra of the specimen were found to be different from those of Asian lacquer, yellow lacquer, animal glue, and acrylic emulsion resin. They were also not identical to the standard IR spectra of drying oils such as linseed oil. Pyrolysis/GC/MS results of the specimen were different from those of Asian lacquer, yellow lacquer, animal glue, and acrylic emulsion resin. In the mean time, palmitic acid, octadecanoic acid, nonanedioic acid, and octadecenoic acid, which are characteristic pyrolysis products of dried drying oil, were detected. In addition, the pyrolysis/GC/MS chromatograms of the specimen and dried drying oil were also very similar. Therefore, it was concluded that the painting was prepared using drying oil as a binding medium.

Early and Midterm Results of Hybrid Endovascular Repair for Thoracic Aortic Disease (흉부대동맥 질환에서 시행된 하이브리드 혈관내 성형술의 중단기 성적)

  • Youn, Young-Nam;Kim, Kwan-Wook;Hong, Soon-Chang;Lee, Sak;Chang, Byung-Chul;Song, Seung-Jun
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.490-498
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    • 2010
  • Background: A hybrid procedure using an open surgical extra-anatomic bypass of aortic arch vessels and thoracic endovascular aortic repair (TEVAR) is less invasive than open surgery, and provides a suitable proximal landing zone. Here we report our experience with a hybrid TEVAR procedure at a single center. Material and Method: We retrospectively reviewed consecutive patients with thoracic aortic disease who received a hybrid TEVAR procedure between August 2008 and January 2010. Patients' data were prospectively collected and mean follow-up was $10.8{\pm}5.5$ months (range 3~20). Result: Nine patients (7 males and 2 females) with a mean age of $63.8{\pm}15.8$ years (range 38~84) underwent a hybrid procedure. Five patients had an arch or a proximal descending aortic aneurysm, two had a dissecting aneurysm of the descending aorta, and two had an aneurysm of the ascending arch and descending aorta. Mean expected mortality calculated by logistic EuroSCORE was 21%. Six patients underwent debranching and rerouting from ascending aorta to arch vessels, 2 had carotid-carotid bypass grafting, and 1 underwent carotid-axillary bypass grafting. Mean operation time was $221.4{\pm}84.0$ min (range 94~364). Deployment success of endovascular stent grafting was 100% with no endoleak on completion angiography. There was no mortality, and a small embolism in the branch of the right opthalmic artery in one patient. During follow-up, one intervention was required for the endoleak. Actuarial survival at 20 months was 100%. Conclusion: Early and mid-term results are encouraging and suggest that hybrid TEVAR procedures are less invasive and safer and represent an effective technique for treating thoracic aortic disease.

Efficacy and Rebleeding Risk of Preoperative Ventriculostomyin Aneurysmal Subarachnoid Hemorrhage

  • Lee, Young-Jin;Min, Kyung-Soo;Lee, Mou-Seop;Kim, Dong-Ho;Kim, Young-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.41 no.2
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    • pp.100-104
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    • 2007
  • Objective : Despite the widespread use of preoperative ventriculostomy in aneurysmal subarachnoid hemorrhage [SAH], there is no general consensus regarding the risk of bleeding associated with its use before aneurysm repair. This study was conducted to define the efficacy and rebleeding risk of ventriculostomy in aneurysmal SAH. Methods : The authors reviewed 339 consecutive patients with aneurysmal SAH who were treated at our hospital between January 1998 and December 2004. Results : Preoperative ventriculostomy was performed on 73 patients for acute hydrocephalus after aneurysmal SAH. The Hunt-Hess[H-H] grades of patients who underwent ventriculostomy were higher. Out of the 73 patients who underwent preoperative ventriculostomy, 58 [79%] demonstrated immediate clinical improvement after ventriculostomy. Of those same 73 patients 22 [30%] suffered aneurysmal rebleeding, whereas only 11 [4%] of the 266 patients who did not undergo ventriculostomy showed preoperative aneurysm rebleeding. The causes of rebleeding in the 22 patients who underwent ventriculostomy before surgery were related to the ventriculostomy procedure itself, subsequent cerebrospinal fluid [CSF] drainage, angiography and patient care procedures, such as endotracheal suction and nursing care. The mean time interval between SAH and surgery in the patients who underwent ventriculostomy was not statistically different from those who did not receive preoperative ventriculostomies [44.66 compared with 42.13 hours; p=0.73]. Conclusion : The preoperative ventriculostomy improved patients' clinical condition but increased the risk of rebleeding after aneurysmal SAH. When necessary, however, rapid change in transmural pressure during ventriculostomy must be avoided, careful management during ventricular drainage is needed, and surgery should be performed as soon as possible to prevent or reduce the incidence of rebleeding.

Open Heart Surgery During the first 3 Months of Life (3개월 이하의 영아에서의 개심술)

  • 서경필
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.180-185
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    • 1993
  • From February 1982 to December 1991, 49 neonates and 105 infants in less than 3 months of age underwent open heart surgery in Seoul National University Hospital. There were 98 males and 56 females, and their mean ages were 16 days in neonatal group and 67 days in early infant group. Their body weight and height were less than 3 percentile of normal developmental pattern. In order of decreasing incidence, the corrected conditions included Transposition of great arteries with or without ventricular septal defect [43], isolated ventricular septal defect [34], Total anomalous pulmonary venous return [21], Pulmonary atresia with intact ventricular septum [9] and others [47]. Various corrective or palliative procedures were performed on these patients; Arterial switch operation [36], patch closure for ventricular septal defect [34], Repair of total anomalous pulmonary venous return [21], RVOT reconstruction for congenital anomalies with compromised right ventricular outflow tract [17]. Profound hypothermia and circulatory arrest were used in 94 patients [ 61% ]: 42 patients [ 85.7% ] for neonatal group and 52 patients [ 49.5% ] for early infant group. The durations of circulatory interruption were within the safe margin according to the corresponding body temperature in most cases [ 84% ]. The hospital mortality was 36.4% ; 44.9% in neonatal group and 32.4% in infant group 1 to 3 months of age. The mortality was higher in cyanotic patients [ 46.6% ], in those who underwent palliative procedures [ 57.8% ], in patients whose circulatory arrest time was longer than safe periods [ 60% 0] and in patients who had long periods of cardiopulmonary bypss and aortic crossclamping. In conclusion, there has been increasing incidence of open heart surgery in neonates and early infants in recent years and the technique of deep hypothermia and circulatory arrest was applied in most of these patients, and the mortality was higher in cyanotic neonates who underwent palliative procedures and who had long cardiopulmonary bypass , aortic cross-clamping and circulatory arrest.

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Clinical Outcomes After Arthroscopic Double-Row Rotator Cuff Repair and Evaluation of Cuff Integrity by CT Arthrography (관절경적 2열 고정 회전근개 복원술 후의 임상 결과 및 CT 관절조영술을 이용한 건의 치유 평가)

  • Jo, Chris H.;Kim, Je-Kyoon;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baek;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.