• Title/Summary/Keyword: Operation Deviation

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Surgical Repair of Single Ventricle (Type III C solitus) (단심실 -III C Solitus 형의 수술치험-)

  • naf
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.281-288
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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Surgical Repair for Ebstein's Anomaly (Ebstein 기형의 수술 -2례 보고-)

  • naf
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.289-296
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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Evaluation of Job Performance of Radiology Students by using Field-based Radiography Course (현장중심 교육과정을 적용한 방사선과 재학생의 직무수행도 평가 -일반촬영)

  • Kwon, Soonmu;Kim, Kyoungah;Park, Changhee
    • Journal of the Korean Society of Radiology
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    • v.10 no.7
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    • pp.551-557
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    • 2016
  • National competency standards, which are the contents of the knowledge, skills and attitudes required to perform a job in industry, is organized by the country. the job performance was evaluated based on the National competency standards from the third-year grade of radiology students by using field-based training courses. according to the evaluation results, students showed over 93% satisfactory ratio of job performance in all radiography projection methods. Therefore, it can be predicted that field-based training courses for students made a positive effect on improving their job performance. Exposure methods with CR equipment were evaluated the best rating, yet it has various problems. The standard deviation between students was very high, and the CR operation skill of students was insufficient. Film methods was evaluated also showed problems, due to the exposure condition setting and developing operation. although DR method was rated good to the students, it was evaluated that the operation skill of DR and the ancillary equipment operation skill was shortage. By supplementing the evaluation factors below proficiency levels to a course management in each exposure method, it could help students course achievement. Also, it could help students to improve job performance of clinical areas after graduation.

A Study on Establishment of Technical Guideline of the Installation and Operation for the Biogas Utilization of Power Generation and Stream - Results of the Field Investigation (바이오가스 이용 기술지침 마련을 위한 연구(I) - 현장조사 결과 중심으로)

  • Moon, HeeSung;Bae, Jisu;Park, Hoyeun;Jeon, Taewan;Lee, Younggi;Lee, Dongjin
    • Journal of the Korea Organic Resources Recycling Association
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    • v.26 no.1
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    • pp.55-64
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    • 2018
  • The purpose of this study is to provide a design and operation technical guideline for meeting the appropriate design criteria to biogas utilization treating organic wastes. In accordance with the government's mid-to long-term policies on bio-gasification and energization of organic wastes, the expansion of the waste-to-energy (WTE) facilities is being remarkably promoted. However, because of the limitation of livestock manure containing low-concentration of volatile solids, there has been increased in combined bio-gasification without installing new anaerobic digestion facilities. The characteristics and common problems of each treatment processes were investigated for on-going 11 bio-gasification facilities. The seasonal precision monitoring of chemicophysics analysis on anaerobic digestor samples was conducted to provide guidelines for design and operation according to the progress of biogas utilization. Consequently, Major problems were investigated such as large deviation of organic materials depending on seasons, proper dehumidification of biogas, pretreatment of hydrogen sulfide, operation of power generation and steam. This study was conducted to optimize biogas utilization of type of organic waste(containing sewage sludge and food waste, animal manure), research the facilities problem through field investigation.

A Study on the Effect which the Method of Deep Breathing with the Use of Incentive Spirometer has on the function of pulmonary Ventilation - In Upper Abdominal Operation Patients - (Incentive Spirometer를 사용한 심호흡 방법이 폐환기 기능에 미치는 효과에 관한 연구 -상복부 수술 환자를 대상으로-)

  • 김종혜;변영순
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.268-280
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    • 1991
  • The nursing intervention for the prevention of the pulmonary complication and of the function lowering of pulmonary ventilation which emerge with high generation frequency during the nursing of operation patient is necessary for performing the qualitative nursing for operation patient. So, this researcher tried this study so as to obtain the data which can be utilized for the trial of nursing intervention, by grasping the effect that the deep breathing with Incentive Spirometer has on the function of pulmonary ventilation, analysing the factor to have influence on the function of pulmonary ventilation, and applying the effective method of deep breathing to the clinic. By making 42 patients who underwent the operation of upper abdomen after admitting G Hospital in Seoul from Mar. 7, 1991 to Apr.30, 1991 as the object, they were classified into the experiment group that the deep breathing was made with the use of Incentive Spiromenter and the comparison group that the deep breathing exercise was made without the use of Incentive Spirometer. And then, by measuring Tidal Volume and Forced Vital Capacity with Respirometer and $O_2$ Saturation with Pulse Oximeter at preoperation postoperation 24 hours, 72 hours, and 120 hours data were collected. The collected data were analyzed with of, average, standard deviation, x$^2$-test, t-test and ANOVA by SPSS. The result of this study is as follows : 1. As for the hypothesis that the function of pulmonary ventilation at postoperation 24 hours, 72 hours and 120 hours will be better in the experiment group that the deep breathing was made with the use of Incentive Spirometer, in comparison with the comparison group that deep breathing was made without the use of Incentive Spirometer, experiment group and comparison group didn't show the significant difference in Tidal Volume, Foreced Vital Capacity and $O_2$ Saturation at postoperation 24 hours and 72 hours. But experiment group and comparison group showed the significant difference in Tidal Volume at postoperation 120 hours (p<0.01). So, this hypothesis was supported partially. 2. The variables that there were the significant differences about the function of pulmonary ventilation in experiment group at postoperation 24 hours stastically were smoking existence (p<0.05), and the variables that there were not significant differences about the function of pulmonary ventilation were distinction of sex, age, anesthetic duration, smoking extent, body weight, surface area of body, existence of narcotic use, regular exercise existence, and past experience existence of respiratory disease. As above result, it appeared that the method of deep breathing with the use of the Incentive Spirometer is more effective for the function recovery of pulmonary ventilation, in comparison with the deep breathing without use of Incentive Spirometer and that smoking existence was the factor to have influence on the function of pulmonary ventilation. In the aspect of clinic, the trial of nursing intervention of deep breathing with use of Incentive Spirometer is expected. And, in the aspect of study, the study through various operative site patients about the effect of Incentive Spirometer use at the clinic will have to be confirmed.

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A Study on the boiler efficiency with selecting the uppermost burners in the 870MW opposite wall fired boiler (870MW 대향류 보일러에서 최상부층 버너 선택운전에 따른 보일러 효율변화 고찰)

  • Woo, Gwang-Yoon;Kim, Soo-Seok;Park, In-Chan;Ham, Young-Jun;Lee, Eung-Yoon
    • Plant Journal
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    • v.13 no.2
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    • pp.46-51
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    • 2017
  • In this study, the boiler efficiency and the change of boiler combustion state with the burner operation of the uppermost layer of 870MW opposite fired coal boiler were measured. Test results showed that the boiler efficiency was high in the order of the uppermost layer simultaneous operation of the front and rear burners, the front burner, and the rear burner operation. When the front and rear burners were operated simultaneously, the heat absorption rate of water walls in the boiler furnace was uniform at four side, and the temperature deviation of the left and right steam on the convection front surface decreased. As the heat absorption rate of the boiler improved, the loss of boiler exhaust gas decreased and the coal supply amount decreased by 8 tons/hour compared to the operation of the rear burner. This will contribute not only to the reduction of fuel cost but also to the reduction of greenhouse gas emissions.

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An Constraint Based Approach to Planning Collision-Free Navigation of Multi-AUVs with Environmental Disturbances (환경 외란을 고려한 다중 자율잠수정의 제한적 기법 기반 주행 계획기)

  • Ji, Sang-Hoon;Ko, Woo-Hyun;Jung, Yeun-Soo;Lee, Beom-Hee
    • Journal of the Korea Institute of Military Science and Technology
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    • v.11 no.2
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    • pp.53-65
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    • 2008
  • This paper proposes the qualitative method for planning the operation of multi-AUVs with environmental disturbances, which is considered to be a very difficult task. In this paper we use an extension collision map as a collision free motion planner. The tool was originally developed for the multiple ground vehicles with no internal/external disturbance. In order to apply the method to a water environment where there are tides and waves, and currents, we analyze the path deviation error of AUVs caused by external disturbances. And we calculate safety margin for the collision avoidance on the extension collision map. Finally, the simulation result proves that the suggested method in this paper make multi-AUVs navigate to the goal point effectively with no collision among them.

A numerical study on the optimum operation condition for axial oxygen concentration in 8 inch silicon growth by cusp MCZ (8인치 실리콘성장을 위한 커스프 MCZ계에서 축방향 산소분포에 대한 연구)

  • 이승철;윤종규
    • Journal of the Korean Crystal Growth and Crystal Technology
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    • v.7 no.3
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    • pp.406-417
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    • 1997
  • A numerical study was conducted on the optimum magnetic field intensity and asymmetric factor for uniform axial oxygen concentration in 8 inch silicon single crystal growing process by magnetic Czochralski method. For constant shape of cusp field, a change of coil and crucible position were compared. In case of symmetric cusp field, magnetic field intensity variation shows concave downward with crystal growing for uniform, axial oxygen concentration. A numerical results show similar value of standard deviation of average oxygen concentration for uniform oxygen concentration between coil and crucible position change. In case of asymmetric cusp field. asymmetric factor is increased with crystal growing to have uniform oxygen concentration.

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Evaluation of Nursing Information Systems in a General Hospital (병원 간호업무 전산화에 대한 평가)

  • Seo, Nam-Rye;Lee, Myung-Ha
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.111-126
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    • 2001
  • The purpose of this study is to provide a basic data by evaluation the problems about nursing information system and identifying the need of improvement of it. Data were collected from April 6 to 15, 2000 through questionnaires taken by 218 nurses working in a general hospital using nursing information systems. The two structured questionnaires were used for the collecting the data. The data obtained were analyzed by using frequency, percentage, mean, standard deviation, t-test, one-way ANOVA, Pearson's correlation coefficients, and Cronbach's alpha coeffcients. The results are as follows: 1. In the problem of nursing information system, ${\lceil}$There are no appropriate programs for independent nursing information systems because there are no nurse informatists in the information department${\rfloor}$ scored highest. Also, ${\lceil}$There is a lack of manual for operation of the nursing information system${\rfloor}$, ${\lceil}$There is difficulty getting help when the system is in trouble${\rfloor}$, ${\lceil}$General information about using computers and managing problems are lacking${\rfloor}$, ${\lceil}$Unsatisfactory matters about the nursing information systems are not improved quickly.${\rfloor}$ received high scores. 2. In the need for improvement of the nursing information system, ${\lceil}$Nursing education and research${\rfloor}$ was the highest area of the system. 3. The problems of the nursing information system showed high positive correlation with the need for improvement of the system(p=.00).

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Self-organized Learning in Complexity Growing of Radial Basis Function Networks

  • Arisariyawong, Somwang;Charoenseang, Siam
    • Proceedings of the IEEK Conference
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    • 2002.07a
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    • pp.30-33
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    • 2002
  • To obtain good performance of radial basis function (RBF) neural networks, it needs very careful consideration in design. The selection of several parameters such as the number of centers and widths of the radial basis functions must be considered carefully since they critically affect the network's performance. We propose a learning algorithm for growing of complexity of RBF neural networks which is adapted automatically according to the complexity of tasks. The algorithm generates a new basis function based on the errors of network, the percentage of decreasing rate of errors and the nearest distance from input data to the center of hidden unit. The RBF's center is located at the point where the maximum of absolute interference error occurs in the input space. The width is calculated based on the standard deviation of distance between the center and inputs data. The steepest descent method is also applied for adjusting the weights, centers, and widths. To demonstrate the performance of the proposed algorithm, general problem of function estimation is evaluated. The results obtained from the simulation show that the proposed algorithm for RBF neural networks yields good performance in terms of convergence and accuracy compared with those obtained by conventional multilayer feedforward networks.

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