• Title/Summary/Keyword: Mean Time To Repair

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Thoracoscopic Diaphragmatic Plication Using Three 5 mm Ports (흉강경하 횡경막 주름성형술: 작업창없이 3개의 포트를 이용한 수술법)

  • Kim, Do-Hyung;Kim, Kil-Dong;Hwang, Jung-Joo;Choi, Jin-Ho;Lee, Jun-Wan
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.513-517
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    • 2010
  • Background: Diaphragmatic plication through a thoracoscopic approach has been an effective modality to treat diaphragmatic enventration. However, the conventional technique for thoracoscopic plication has some disadvantages. We have developed an improved and simplified technique with utilizing the head up position, $CO_2$ insufflation and figure-of-eight sutures. Material and Method: Between October 2005 and September 2009, 9 patients with diaphragmatic paralysis underwent repair using our modified technique. The mean patient age was $38.5{\pm}53.0$ years (range: 2~76 years). Result: The mean operation time was $46.7{\pm}15.9$ min (range: 30~85 min). None of the patients died due to this procedure, but there was one case of prolonged air leakage, and a case of re-expansion pulmonary edema, which required 3 days of ventilator support after the procedure. The mean hospital stay was $6.22{\pm}2.04$ days (range: 4~11 days). The mean follow-up duration was $27.2{\pm}11.6$ months (range: 2~43 months). All the patients had their symptoms relieved and there was no recurrence of eventration except for one patient who developed more than 2 cm elevation of the diaphragm compared to the immediate post-operation status. Conclusion: With our technique, thoracoscopic diaphragmatic plication was feasible via using only three 5 mm ports and without a working window and the midterm results were favorable. Therefore, we advocate thoracoscopic diaphragmatic plication as a preferred technique to the conventional open plication technique.

Study of the Development of the Pulmonary Arteries following the Blalock-Taussig Shunt in Tetralogy of Fallot (활로씨 사징증 환자에서 Blalock-Taussig 단락술후 폐동맥의 발달에 관한 연구)

  • 정경영
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.594-600
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    • 1989
  • Primary intracardiac repair of tetralogy of Fallot with low mortality and early good results, has been accomplished in recent years. But palliative procedures have been reserved for those hypoplastic pulmonary arteries, a hypoplastic left ventricle or anomalies of the coronary artery would make total correction difficult. And the Blalock-Taussig shunt operation is recognized as a standard and popular palliative procedure. I undertook a retrospective determination of the effect of the Blalock-Taussig shunt operation on the development of the main pulmonary artery and the right and left pulmonary arteries. Between January, 1980, and April, 1987, at the Severance Hospital, 16 patients were studied by cardiac catheterization and angiocardiography, before undergoing Blalock-Taussig shunting procedures for the palliation of severe symptoms of tetralogy of Fallot, and some time later, usually prior to a second procedure. The mean interval between catheterizations was 22.25 months. Patients with tetralogy of Fallot and pulmonary atresia or with an occluded shunt were not included. The primary and secondary angiograms of each patient were reviewed, and measurements of the diameter of the main pulmonary artery, the right and left pulmonary arteries, and the descending thoracic aorta were taken. The results are as follows; 1. The hematocrit decreased from 56.39% to 50.34%[p< 0.05], and the arterial oxygen saturation increased from 62.00 % to 81.31 %[p< 0.001] following shunt procedures 2. The ratio of the diameter of the right pulmonary artery plus the left pulmonary artery to the diameter of the descending thoracic aorta increased 1.30 k 0.28 times [p< 0.01]; but the ratio of the diameter of the main pulmonary artery to the diameter of the descending thoracic aorta increased 1.10 * 0.33 times, which was not. significant[p< 0.05]. 3. The interval between shunting and second catheterization was not related to the magnitude of change in the pulmonary arteries[r=0.141, p >0.05]. 4. The changes in the ratio of the diameter of the right pulmonary artery plus the diameter of the left pulmonary artery to the diameter of the descending thoracic aorta was inversely related to the initial ratio[r=0.757, p >0.001], but the change in the ratio of the diameter of the main pulmonary artery to the descending thoracic aorta was not related[r=0.059, p >0.05]. 5. There were no differences in enlargement of the pulmonary artery on the side of the shunt [ipsilateral] versus enlargement on the opposite side [p >0.05], nor according to the size of the shunt[p >0.05]. In conclusion, this study suggests that the Blalock-Taussig shunt is effective for the development of the right and left pulmonary arteries but not effective for the main pulmonary artery.

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The Spectrum of CT Findings of COVID-19 Pneumonia: Acute Alveolar Insult and Organizing Pneumonia as Different Phases of Lung Injury and Repair (COVID-19 폐렴의 다양한 CT 영상 소견: 급성 폐포 손상과 기질화 폐렴)

  • Yun Su Kim;Ung Rae Kang;Young Hwan Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.359-370
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    • 2021
  • Purpose To analyze the findings and serial changes in chest CT lesions in 123 symptomatic patients with coronavirus disease 2019 (COVID-19). Materials and Methods From February 19 to April 7, 2020, a total of 123 confirmed COVID-19 patients (male, 44; female, 79; mean age, 59.2 ± 18.6) were enrolled in this retrospective study. A total of 234 CT scans were reviewed for the following patterns: acute alveolar insult (AAI) patterns: ground-glass opacity (GGO), crazy-paving appearance, mixed pattern, and consolidation; organizing pneumonia (OP) patterns: perilobular patterns, band opacity, curvilinear opacity, reversed halo opacity, and small nodular consolidation; resolving patterns: pure GGO, remnant curvilinear, small nodular consolidation, and serial changes of lung abnormalities. We compared the proportions of AAI pattern, OP pattern, or resolving pattern with time progression and analyzed the association between the patterns and disease severity using Pearson chi-square and Fisher's exact test. Results Predominant CT patterns were AAI pattern (87%) in the early hospital period group (0-10 days, after the onset of symptoms), OP pattern (45.7%) in the later hospital period group (after 10 days), and resolving pattern in discharge and follow-up group (47.2% and 84.8%, respectively). The difference in the proportions of predominant CT patterns with time progression was statistically significant (p < 0.001, Pearson's chi-square test). No statistically significant association was observed between the patterns and disease severity (p = 0.055, Fisher's exact test). No fibrous changes in the lesions were observed on follow-up CT scans. Conclusion The serial CT scans of COVID-19 patients showed the spectrum of COVID pneumonia CT manifestations as different phases of lung injury and repair.

Comparison of the Proliferation pattern of Cultured Rat Calvaria Cell on the Resorbable Barrier Membrane (흡수성 차폐막에 배양된 구개관세포의 증식양상의 비교)

  • Lee, Chang-Hoon;Lee, Man-Sup;Kwon, Young-Hyuk;Park, Joon-Bong;Herr, Yeek
    • Journal of Periodontal and Implant Science
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    • v.33 no.2
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    • pp.193-213
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    • 2003
  • The purpose of this study is to evaluate the phenomenon of attachment and spreading of the cultured rat calvarial cell inoculated on their surface of different kinds of biodegradable membrane which had been used on tissue regeneration on periodontal defects by using scanning electron microscope. In this experiment 30 Sprague-Dawley male rats (mean BW 150gm) were used to harvest abundant number of cell in the short period. The rats were sacrificed by decapitatioan to obtain the calvaria for bone cell culture. Calvarial cells were cultured with Dulbecco's Modified Essential Medium contained with 10% Fetal Bovine Serum under the conventional conditions. Biodegradable barrier membrane were collected with collagen type, and were divided into 3 different kind of surface such as scattered, polarized and fine-net type as their surface texture. Microcover plate which usually used for cell culture was used as control for smooth surface. All the membrane were seeded with cultured calvarial cell on their surface. The number of cell inoculated on the membrane were $1{\times}10^6$ Cells/ml. After the culture as designed time, all the membrane were washed with 0.1 M Phosphate Buffered saline and fuxed with 2.5% Glutaraldehyde. And all specimen were treated with $OsO_4$, and Tannic acid before drying the cell for coating the cell with gold. Scanning Electron Microscope was used to observation. The following results were obtained. I. During the whole period of experiment, the phenomenon of cell attachment and spreading were revealed similar pattern to compare with smooth surface culture plate and ordinary culture dish. 2. The shape of cell attachment and spreading on the surface of barrier membrane were observed no remarked difference pattern between smooth surface culture plate and ordinary culture dish. 3. The cytoplasmic process of cultured calvaria cell extent to the deep portion of barrier membrane like as their own proper shape. 4. There were no remarkable relationships between the degree of cultured cell spreading and surface structure of barrier membrane. 5. Slight starified layer of cultured calvaria cell were observed on the scattered type of resorbable membrane, Conclusively, this study thus suggest that cultured bone cell inoculated onto the biodegradable barrier membrane may have an important role of carrier for many cell which could be used as new tissue regeneration, and those tissue engeering technique may become an new method in the approach to the repair of bone defects.

Tuberoplasty for Irreparable Massive Rotator Cuff Tears (봉합할 수 없는 광범위 회전근 개 파열에 대한 결절 성형술)

  • Yi, Jin-Woong;Cho, Nam-Su;Cho, Seung-Hyun;Cho, Hyung-Jun;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.7-13
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    • 2009
  • Purpose: To evaluate the clinical and radiological results of arthroscopic tuberoplasty for irreparable massive rotator cuff tears. Materials and Methods: Eleven patients underwent arthroscopic tuberoplasty for irreparable massive rotator cuff tears between December 2004 and April 2007. The mean follow-up period was 17.3 months, and the average age at the time of surgery was 61.7-year-old. Five cases underwent arthroscopic tuberoplasty and 6 cases had arthroscopic subacromial decompression and tuberoplasty, simultaneously. Results: The average Constant score improved from 61.8 to 86.9 and the average UCLA score changed from 14.8 to 31.8 with 6 excellent, 3 good and 2 poor results (p=0.003). The active forward flexion improved from $111.8^{\circ}$ to $154.1^{\circ}$(p=0.011). The acromiohumeral interval increased from 3.94 mm preoperatively to 4.22 mm postoperatively (p=0.12). In the poor UCLA score group, the acromiohumeral interval changed from 1.67 mm preoperatively to 0.94 mm postoperatively. Conclusion: Arthroscopic tuberoplasty may be a second option to relieve the pain of irreparable massive rotator cuff tears and improve the range of motion. However, good results could not be expected if the acromiohumeral interval is < 2 mm preoperatively and decreased postoperatively.

Reliability Analysis Using Field-Data of 5.56 mm Rifle (야전운용제원을 이용한 5.56 mm 소총 신뢰도 분석)

  • Shin, Tae-Sung;Seo, Hyun-Soo;Lee, Ho-Jun;Choi, Si-Young;Gil, Hyeon-Jun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.6
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    • pp.584-591
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    • 2020
  • Reliability is an important factor in weapons systems. Low reliability causes the weapons system to fail to function properly, which directly leads to the weakening of combat capability. This paper classifies the structure of the 5.56 mm rifle, which is currently used by the Korean army, into a total of seven assemblies and describes the eight functions necessary for the rifle to operate normally. In addition, the concept of reliability was defined as the MRBF, and the Poisson process model and TTT plot were explained as a reliability analysis theory for the repair function system. Next, the field-data obtained by defining failure as the replacement of parts other than periodic exchange of parts were refined, and the reliability was analyzed by entering the refined field operation specifications into the Minitab program. As a result, the reliability of the rifle was determined to be 251.73. The assembly parts that required improvement was identified as the barrel, lower body, and butt stock assembly, and 10 detailed parts needed to be improved. Finally, the limits of the reliability analysis using the field-data currently available for small caliber firearms were considered.

Clinical Characteristics of Patients Treated in an Emergency Center for Vascular Trauma (일개 응급센터에 내원한 외상성 혈관손상 환자의 임상적 특성)

  • Park, Yong Myeon;Yeom, Seok Ran;Jeong, Jin Woo;Han, Sang Kyun;Jo, Suck Ju;Ryu, Ji Ho;Kim, Yong In;Chung, Sung Woon
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.5-11
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    • 2009
  • Purpose: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. Methods: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. Results: The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis. Conclusion: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'ritical pathway'to improve the outcomes of patients with blunt abdominal vascular injury.

The Effect of Lip Adhesion in Unilateral Complete Cleft Lip (일측성 완전구순열에서 구순접합술의 효과)

  • Ryu Sun-Youl;Kim Tae-Hee;Hwang Ung;Kook Min-Suk;Kim Sun-Kook;Han Chang-Hun
    • Korean Journal of Cleft Lip And Palate
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    • v.7 no.1
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    • pp.1-16
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    • 2004
  • In the recent time, early correction of the congenital anomalies has become the focus of contemporary cleft lip care, The reason of that is mostly psychologic factor of children are respected, Although the propound object of lip adhesion is not esthetic improvement, that able to satisfy sufficiently parents of cleft children, In the unilateral or bilateral clefts, a preliminary lip adhesion has been advocated as a mean of narrowing the cleft at an early phase, of improving the nasal contour, of molding the alveolar arch, and of easing and improving the result of a definitive lip repair. The present study was earned out to investigate the effect of lip adhesion. We performed the Millard's high-half underminded adhesion and Seibert's lip adhesion followed by modified Millard's cheiloplasty for five infants had unilateral complete cleft lip. The lip adhesion reduced the actual deformity by molding the maxillary alveolar segments into better relationship and allows a easy cheiloplasty so that led to more perfect final lip result, Both Millard's high-half underminded adhesion and Seibert's lip adhesion were available methods to adhere a wide cleft lip, Especially, Seibert's lip adhesion had more advantages such as enhancement of the force of adhesion, correction of the deviated columella and acquirement of the esthetic upper lip continuity. These results suggest that the lip adhesion followed by cheiloplasty for wide unilateral complete cleft lip patients provide more favorable final result by molding the maxillary alveolar segments into better relationship.

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A Research on the Probabilistic Calculation Method of River Topographic Factors (하천 지형인자의 확률론적 산정 방식 연구)

  • Choo, Yeon-Moon;Ma, Yun-Han;Park, Sang-Ho;Sue, Jong-Chal;Kim, Yoon-Ku
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.10
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    • pp.509-516
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    • 2020
  • Since the 1960s, many rivers have been polluted and destroyed due to river repair projects for economic development and the covering of small rivers due to urbanization. Many studies have analyzed rivers using measured river topographic factors, but surveying is not easy when the flow rate changes rapidly, such as during a flood. In addition, the previous research has been mainly about the cross section of a river, so information on the longitudinal profile is insufficient. This research used informational entropy theory to obtain an equation that can calculate the average river slope, river slope, and river longitudinal elevation for a river basin in real time. The applicability was analyzed through comparison with measured data of a river's characteristic factors obtained from a river plan. The parameters were calculated using informational entropy theory, nonlinear regression analysis, and actual data. The longitudinal elevation entropy equation for each stream was then calculated, and so was the average river slope. All of the values were over 0.96, so it seems that reliable results can be obtained when calculating river characteristic factors.

The Study of Infinite NHPP Software Reliability Model from the Intercept Parameter using Linear Hazard Rate Distribution (선형위험률분포의 절편모수에 근거한 무한고장 NHPP 소프트웨어 신뢰모형에 관한 연구)

  • Kim, Hee-Cheul;Shin, Hyun-Cheul
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.9 no.3
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    • pp.278-284
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    • 2016
  • Software reliability in the software development process is an important issue. In infinite failure NHPP software reliability models, the fault occurrence rates may have constant, monotonic increasing or monotonic decreasing pattern. In this paper, infinite failures NHPP models that the situation was reflected for the fault occurs in the repair time, were presented about comparing property. Commonly, the software model of the infinite failures using the linear hazard rate distribution software reliability based on intercept parameter was used in business economics and actuarial modeling, was presented for comparison problem. The result is that a relatively large intercept parameter was appeared effectively form. The parameters estimation using maximum likelihood estimation was conducted and model selection was performed using the mean square error and the coefficient of determination. The linear hazard rate distribution model is also efficient in terms of reliability because it (the coefficient of determination is 90% or more) in the field of the conventional model can be used as an alternative model could be confirmed. From this paper, the software developers have to consider intercept parameter of life distribution by prior knowledge of the software to identify failure modes which can be able to help.