• Title/Summary/Keyword: Neck failure

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A Study on the Evaluation of Maintenance Capability for A Maintenance Battalion in the Mechanized Division (기계화사단 정비대대 능력 평가에 관한 연구)

  • 백종찬;강성진
    • Journal of the military operations research society of Korea
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    • v.22 no.1
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    • pp.142-155
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    • 1996
  • In this research, our objective is to develop a model which could evaluate the maintenance capability for a maintenance battalion in the mechanized division. To analyze the maintenance system, we obtained various data related to maintenance capability and described the maintenance process as a network type. This network type model is then translated to SLAM-II network model to simulate the system. The simulation model can be operated by using appropriate input data and simulation results are obtained. The simulation model can be applied in various way. Through the simulation we could find the bottle neck point in the maintenance process. Also the maximum capability of maintenance with on hand asset and the wartime supportability can be evaluated. The mode provides sensitivity analysis by changing various imput data such as the number of repairmen, repair time, failure rate and so on.

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Decannulation Difficult (기관 캐뉼 발거 곤란증)

  • 봉정표;임구일;유기원;이준규;박성원;홍기수
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.165-170
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    • 1998
  • Background and Objectives : Decannulation failure may result from factors such as inadequate ability 0 clear secretion, mucosal induration, granulation tissue, restenosis, tracheal wall depression and vocal cord palsy. We were to evaluate the effectiveness of surgical treatment on the basis of site and type of stenosis. Materials and Method : A series of 44 cases of decannulation difficulty between 1993 and 1997 were reviewed. The following data were collected on each of these patients : primary disease, indication for tracheostomy, site of stenosis, endoscopic findings of stenosis, surgical techniques used for treatment. Results : Primary diseases were 30 head trauma, 4 neck injury, 10 other diseases. Indication for tracheostomy were 37 prolonged intubation, 4 emergency tracheostomy, 3 laryngeal trauma. Endoscopic findings of stenosis were 24 granulation tissue, 16 laryngotracheal collapse, 4 combined with granulation tissue and collapse. Site of stenosis were 3 glottic, 9 subglottic, 24 stomal, 1 substomal, 7 mixed. 22 of 24 cases were decannulation using endoscopic treatment. Conclusion : The most common cause of failed decannulation was sternal granulation tissue. The most effective treatment of granulation tissue was endoscopic technique.

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Surgical Treatment of Cancer of Tongue and Floor of Mouth (설암 및 구강저암의 수술적 치료)

  • 홍기환;양윤수
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.270-276
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    • 1997
  • The records of 18 patients with squamous cell carcinoma of the tongue and floor of mouth treated surgically were reviewed. Surgical approaches, staging, treatment modalities, recurrence and vital status were evaluated. The distrubutions of involved sites were tongue(9 cases) and mouth floor(9 cases). Patients were treated by surgery primarily, combined chemotherapy and radiation, and by surgical salvage in the failure cases of radiation and chemotherapy. All ipsilateral necks of mouth floor cancer and advanced tongue cancer were treated with neck dissection. Cases of early tongue cancer could be excised with transoral route, and advanced cases needed transmandibular approach. Whereas, majorites of mouth floor cancer needed transmandibular approach, and other cases could be excised transoral and pull-through approaches. In the recontructions, we used primary closure, pectoralis major myocutaneous flap, forearm free flap, fibular osteocutaneous flap and skin graft. One year survival rate was 93% and 2 year survival rate was 60%.

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Sequence analysis of the schizosaccharomycs pombe homologue of the CDC3 gene in saccharomyces cerevisiae

  • Kim, Hyong-Bai
    • Journal of Microbiology
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    • v.33 no.4
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    • pp.350-354
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    • 1995
  • Saccharomyces cervisiae has a highly ordered ring of filaments that lies just inside the cytoplasmic membrane in the region of the mother-bud neck. Mutants defective in any one of the our cell division cycle genes (CDC3, CDC10, CDC11, CDC12) fail to form these filaments and exhibit a pleiotropic phenotype that includes failure to complete cytokinesis and abnormal bud growth. However, the role of the filament is not clear. In order to find out the role of filament, the similar gene in S pombe (called cdc103$\^$+) to the CDC3 was cloned and sequenced. Here I report the sequence analysis of the cdc103$\^$+/ ) to the CDC3 was cloned and sequenced. Here I report the sequence analysis of the cdc103$\^$+/. Comparison of the predicted amino acid sequences of cdc103$\^$+/ and CDC3 revealed that they share significant similarity (43% identity and 56% identity or similarity) to each other.

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Two Cases of Respiratory Failure After Recovery of Cholinergic Crisis in Organophosphate Poisoning: The Intermediate Syndrome (유기인제 중독에서 콜린성 위기 회복후 급성 호흡부전을 보인 Intermediate Syndrome 2예)

  • Cho, Dae-Kyoung;Lee, Seung-Eun;Baik, Jae-Joong;Chung, Yeon-Tae;Chung, Keun-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.247-254
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    • 1999
  • Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy, the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death. because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.

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A Prognostic Factor for Prolonged Mechanical Ventilator-Dependent Respiratory Failure after Cervical Spinal Cord Injury : Maximal Canal Compromise on Magnetic Resonance Imaging

  • Lee, Subum;Roh, Sung Woo;Jeon, Sang Ryong;Park, Jin Hoon;Kim, Kyoung-Tae;Lee, Young-Seok;Cho, Dae-Chul
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.791-798
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    • 2021
  • Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

Bone Mineral Density in Premenopausal Amenorrheic Women with Hypogonadism (폐경전 무월경 여성에 있어서 골밀도 측정에 관한 연구)

  • Park, Ki-Hyun;Lee, Byung-Seok;Lee, Bo-Yon;Cho, Dong-Jae;Song, Chan-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.19 no.1
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    • pp.49-56
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    • 1992
  • Bone mineral density was measured to assess whether the patients with premonopausal hypogonadism, comprised of 19 patients with hypogonadotropic hypogonadism(HH), 55 with premature ovarian failure(POF), 23 with hyperprolactinemia(HPLN), and 8 with Sheehan's syndrome. All aged from 20 to 39, were associated with some decrease in regional bone mass compared with that of 63 normal-associated with some decrease in regional bone mass compared with that of 63 normal-cycling control women matched with age and sex. Measurement of bone mineral density was carried out using Dual photon absorptiometry at four sites; femur neck, ward's triangle, trochanter and spine(L2-L4). Bone mineral density at all four sites were significantly decreased in patients with HH(p<0.01), POF(p<0.01). In hyperprolactinemic patients, the decrease in bone mass was significant at femur neck and Ward's triangle(p<0.05). The patients with POF were noted to be associated with significant bone loss when their duration of amenorrhea exceeded one year. In this study, the degree of loss of bone mass and the affected sites seemed to be different depending on the various types of hypogonadism and POF was noted have caused the appearance of loss of bone mass earlier than other thpes of hypogondism we experienced.

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Surgical Correction of Partial Atrioventricular Canal: One Case Report (부분방실관의 교정수술 치험 1예)

  • 이철범
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.49-59
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    • 1981
  • This is one case report of surgically treated partial atrioventricular canal. The 22 year-old male patient had no definitive history of frequent respiratory infection and cyanosis in his early childhood. Since his age of 7 years, dyspnea was manifested on exertion. First appearance of congestive heart failure was at his age of 16 years old. The physical examination revealed that the neck veins were distended and heaving of precordium. A thrill was palpable on the left 3rd-4th intercostal space extending from the sternal border toward the apex and Grade IV/VI systolic ejection murmur was audible on it. Neither cyanosis nor clubbing was noted. Liver was palpable about 5 finger breadths. Chest X-ray revealed increased pulmonary vascularity and severe cardiomegaly (C-T ratio = 74%). EKG revealed LAD, clockwise rotation, LVH and trifascicular block. Echocardiogram showed paradoxical ventricular septal movement, narrowed left ventricular outflow tract and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted in large left to right shunt (Qp : Qs = 5.7: 1), ASD and moderate pulfllonary hypertension. Finally, left ventriculogram revealed typical goose neck appearance of left ventrlcalar outflow tract. On Oct. 10, 1980, open heart surgery was performed. Operative findings were: 1. Large primum defect ($6{\times}5$ Cm in diameter) 2. Cleft on the anterior leaflet of mitral valve. 3. The upper portion of ventricular septum was descent but no interventricular communication. 4. Downward attachment of the atrioventricular valves on the ventricular muscular septum. 5. Medium sized secumdum defect ($2{\times}1$ Cm in diameter). The cleft was repaired with 4 interrupted sutures. The primum defect was closed with Teflon patch and the secundum defect was closed with direct suture closure. Postoperatively atrial flutter-fibrillation in EKG and Grade U/VI apical systolic murmur were found. The postoperative course was uneventful and discharged on 29th postoperative day in good general conditions.

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SEPSIS FROM ODONTOGENIC INFECTION : A CASE REPORT (패혈증으로 진행된 치성 감염 : 증례보고)

  • Oh, Seng-Seob;Park, Eun-Jin;Kim, Il-Kyu;Choi, Jin-Ho;Kim, Hyung-Don;Oh, Nam-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.375-378
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    • 1999
  • Incidence and mortality rate of maxillofacial infection is relatively low in the era of antibiotics. Despite the use of antibiotics, delayed treatment, underlying systemic diseases, drug-resistant microorganisms may result in life-threatening situations. The deep neck infection developed from odontogenic infection may result in sepsis, mediastinitis, aspiration pneumonia, asphyxia. Sepsis is the most dangerous complication which can quickly result in a number of lethal situations. The treatment of sepsis includes awareness of such complication, use of sensitive antibiotics, removal of infection source, and hemodynamic, respiratory and metabolic support. We experienced a patient who died of sepsis, which developed from odontogenic infection. The initial diagnosis was a buccal space cellulitis. However, in spite of medical and surgical treatment, this progressed to Ludwig's angina and then deep neck infection and finally sepsis. On the 10th hospital day, the patient died of multiorgan failure caused by sepsis.

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Mechanical Response of Changes in Design of Compression Hip Screws with Biomechanical Analysis (생체 역학적 분석에 의한 Compression Hip Screw의 디자인 요소에 대한 평가)

  • 문수정;이희성;권순영;이성재;안세영;이훈
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2004.10a
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    • pp.1172-1175
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    • 2004
  • At present, CHS(Compression Hip Screw) is one of the best prosthesis for the intertrochanteric fracture. There is nothing to evaluate the CHS itself with the finite element analysis and mechanical tests. They have same ways of the experimental test of the ASTM standards. The purpose of this study is to evaluate the existing CHS and the new CHS which have transformational design factors with finite element analysis and mechanical tests. The mechanical tests are divided into compression tests and fatigue test for evaluating the failure load, strength and fatigue life. This finite element method is same as the experimental test of the ASTM standards. Under 300N of compression load at the lag screw head. There are less differences between Group (5H, basic type) and Group which has 8 screw holes. However, there are lots of big differences between Group and Group which is reinforced about thickness of the neck range. Moreover, the comparison of Group and Group shows similar tendency of the comparison of Group and Group . The Group is reinforced the neck range from Group. After the experimental tests and the finite element analysis, the most effective design factor of the compression hip screws is the reinforcement of the thickness, even though, there are lots of design factors. Moreover, to unite the lag screw with the plate and to analyze by static analysis, the result of this method can be used with experimental test or instead of it.

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