• Title/Summary/Keyword: Repairs

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The Evaluation of Usefulness of Two Times Elution a Day of $^{99m}Tc$ Using $^{99}Mo$-$^{99m}Tc$ Generator ($^{99m}Tc$ 발생기의 24시간 내 2회 용출의 유용성 평가)

  • Kim, Jeong-Ho;Seo, Han-Kyung;Jeong, Yeong-Hwan;Kim, Yeong-Su;Kim, Byung-Cheol;Gwon, Yong-Ju;Lee, Jeong-Ok;Park, Yeong-Sun;Kim, Dong-Yun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.83-86
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    • 2010
  • Purpose: The Molybdenum which is the raw material of $^{99}Mo$-$^{99m}Tc$ generator (generator) is produced from the nuclear reactor. However, output has dwindled as the two nuclear reactors supplying the bulk of radioactive material-one in Chalk River, Ontario and the other in Petten, the Netherlands-have been closed for repairs or maintenance. This resulted in the enhancement of its price. Therefore we have tried to seek the new method which could run generator to increase activity of $^{99m}Tc$ in this study. Materials and Methods: The $^{99m}Tc$ activity obtained from 5 times elution for 5 days from Monday to Friday using two generators was compared with 10 times elution. Appearance test, pH test, LAL test, sterility test, chemical impurity(Al) test, radio chemical purity test, ratio of $^{99}Mo$/$^{99m}Tc$ activity test have been done to check the stability of $^{99m}Tc$ eluting from generator respectively. Results: The $^{99m}Tc$ activity obtained from 5 times elution for 5 days was 168.2 GBq (4545 mCi) and 10 times was 230.5 GBq (6230 mCi). All quality control tests were within normal limit. Conclusion: We got to know that 2 times elution a day obtained more $^{99m}Tc$ activity than one time elution in this study.

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Clinical Analysis of Mitral Valve Repair with Artificial Chordae (인공 건삭을 이용한 승모판성형술의 임상적 고찰)

  • 이석기;김정중;오삼세;백만종;나찬영;김욱성
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.768-773
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    • 2004
  • Failure of mitral valve repair sometimes may be ascribed to severe or progressive alteration of the subvalvar apparatus. The aim of this study was to evaluate the effects of new chordae formation on mitral repair. Material and Method: From March 1997 to february 1999, 26 patients underwent mitral valve repairs with new chordae formation, we compared the symptoms and echocardiographic findings checked at preoperative state, and intraoperative period, discharge, and their last OPD visit. There were 45 male, and 11 female patients, and their mean age was 51.2$\pm$43.4 years. Etiology of the lesions was degenerative (18), rheumatic (6), infective (1) and ischemic (1). Chordal lesions were caused by rupture (18), elongation (6), and a combination of two causes (2). Associated lesions included atrial septal defect (2), tricuspid insufficiency (7), aortic insufficiency(4), and a combination of previous two factors (2). The number of mean artificial chordae was 3.6$\pm$1.6. Annuloplasty was per-formed in all cases. The CPB time was 182,1$\pm$63.7 minutes and the ACC time was 133.1$\pm$45.6 minutes. Aver-age follow up period was 49.2$\pm$7.1 months. Result: There was no early death. Early reoperation was performed in bud patients, one patient received mitral valve replacement because of an abnormality of annuloplasty and ano-ther received pericardiostomy due to postoperative pericardial effusion. During the follow up of 49.2$\pm$7.1 moths, there was no late mortality. Postoperative NYHA functional class checked at last OPD visit was class I in 22 patients (88%), class II in 2 (8%), and class III in 1 (4%). Regarding the late echocardiogram MR was absent in 20 patients (78%), 1 in 4 (15%), and II in 1 (4%). The postrepair mitral valve area was 2.2$\pm$0.35 $\textrm{cm}^2$ Conclusion: This study suggests that mitral valve repair using new chordae formation provides good early and mid term survivals and functional improvement. We think that the artificial chorda formation with polytetrafluoroethylene suture might be safe and effective technique for mitral valve repair.

Management of Vascular Injuries to the Extremities after Trauma (외상 후 사지 혈관손상의 치료)

  • Kim, Han Yong;Park, Jae Hong;Kim, Myoung Young;Hwang, Sang Won
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.46-52
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    • 2009
  • Background: Vascular injuries to the extremities are potentially devastating and they can lead to limb loss and mortality if they are not appropriately managed. The vascular trauma caused by traffic and industrial accidents has recently increased according to the developing industry and transport system in Korea. Early recognition and treatment of these injuries are mandatory to achieve satisfactory outcomes. Material and Method: We retrospective reviewed 43 patients with vascular injuries that were due to blunt and penetrating trauma and they underwent emergency operations from January of 1998 to December of 2006. Result: There were 38 men and 5 women patients with a mean age of $42.0{\pm}16.8$ years (range: 17~77). The cause of vascular injuries were 28 traffic accidents (65%), 6 industrial accidents (14%), 6 glass injuries (14%) and 3 knife injuries (7%). The average time from admission to the operating room was $319.0{\pm}482.2$ minutes (range: 27~2,400 minutes). The average time from admission to discharge was $53.1{\pm}56.0$ days (range: 2~265 days). The anatomic injuries included the femoral artery in 16 cases (37%), the popliteal artery in 8 cases (19%), the brachial artery in 8 cases (19%), and the subclavian and axillary arteries in 7 cases (16%). The associated injuries were 23 bone fractures (53%), 18 muscle injuries (42%) 5 nerve injuries (12%) and 11 vein injuries (26%). The operation methods were 20 end to end anastomoses (46%), 16 interposition grafts (36%), 2 repairs with using patches (5%) and 5 others (12%). The number of amputations and cases of mortality were 3 cases (7%) and 4 cases (9%), respectively. Conclusion: Minimizing ischemia is an important factor for maximizing salvage of extremities. Prompt diagnosis and treatment can reduce the amputation and mortality rates.

A Study of Efficient Measures for Installing and Managing Traditional Market Arcades (전통시장 아케이드의 설치 및 관리 효율화 방안 연구)

  • Kim, Young-Ki;Kang, Heon-Soo;Kim, Seung-Hee
    • Journal of Distribution Science
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    • v.10 no.3
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    • pp.15-30
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    • 2012
  • It has been 10 years since the facility modernization projects of traditional markets was rigorously undertaken. Although more than 835 traditional Korean markets nationwide have already completed these projects, there does not exist a specific set of standards of installation, future maintenance, and management. As a result, the complaints made by civil stakeholders in accordance of the actual facility installation caused problems and delays of related projects. In addition, while some local governments secured and implemented their own differing standards, others have not yet established their own separate standards for maintenance and management. Specifically, 694 traditional markets nationwide were supported for the cost of installing arcades by 2010. For the short period of time after the arcade-supported projects were deployed, the number of the traditional markets had been rapidly growing as a prime example of the facility modernization projects. The arcade facilities are being planned and installed merely for screening the rain or the sun. Without fundamental data for the newly landscaped environments or information on the actual conditions of usage and assessment, there is a lack of comprehensive approaches that could possibly organize the public environments. Furthermore, the amount of support needed for repairs, maintenance, and management from the central and local governments is gradually increasing. Thus, it becomes both crucial and necessary to complement the current set of standards. The purpose of this study is to examine the actual conditions of usage, maintenance, and management among those traditional market facilities that were installed with the supports of the facility-modernization projects, especially for arcades. This will be carried out through investigating the local problems, issues, and considering international case studies. The results of this study will provide measures for effective and efficient installation and management of traditional market arcades. Improvements in the use of public resources could be directed towards transforming public business, as well as public enhancement and functional maintenance and reinforcement. Under this condition, the arcade is not a simple area to avoid rain or sunlight; it becomes a public space. It is highlighted that the arcade should establish its public business not only to activate markets but also to refine street environments and revitalize local communities. A more specific way to improve is introduced through systematic supplementation. This is needed to attract effective participation from local residents and is done so by conducting a fair procedure from the first stage of business and by providing guidelines for establishing arcades as public facilities. The study points out to the problem of merchants-centered plans and street use. It presents the need to expand to involve residents and customers. Given that the arcade is a public facility and merchants' ability to maintain it is limited, manuals and systems for its maintenance needs to be introduced through multi-party agreement of merchants, government, residents and customers.

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Evaluation and Improvement Measures on the Status of the Installation and Operation of Facilities for Recycling Food Waste into Resources (음식물 자원화시설의 설치·운영에 대한 일반현황의 평가 및 개선 방안)

  • Ryu, Ji-Young;Kong, Kyu-Sik;Shin, Dae-Yewn;Phae, Chae-Gun
    • Journal of the Korea Organic Resources Recycling Association
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    • v.12 no.3
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    • pp.63-75
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    • 2004
  • This research sought to determine the status of the installation and operation of domestic public resource-making facilities of resource-making facilities and come up with corresponding improvement measures. Currently compost is most numerous set-up out of facilties already established ever since, then the rest of them are feeds, anaerobic degradation, sewage combination, and combination of compost and feeds in order. As such, food waste is processed more into compost than into feeds, presumably because relevant facilities, which were originally designed for processing into feeds, were converted into composting facilities due to little demand for the processed feeds. The finding says that many related firms had yet to register their businesses in accordance with feeds and fertilizers management laws, and that food waste resources-making facilities used various basic facilities but few of them treated food waste in linkage with leaching water, bad odors, and energy. Some of current facilities were found to be 7 years old and thus outdated. Due to lack of skilled operational manpower, many facilities had less than 300 days of normal operation yearly, and some needed minor and serious repairs periodically. In overall facilities, 87% of the planned food waste was rolled in, thus requiring measures to treat the whole planned volume. For costs of resource-making facilities, some with a capacity of below 50 tons topped 100 million won, and facilities with a capacity of over 50 tons required less installation costs. Overall, installation costs ranged from 10 million to 20 million, and to 200 million won per ton, and this suggests a need to establish the installation cost calculation criteria, as well as to reshape the facility criteria. With operating costs varying greatly according to the size and treatment methods of facilities, the finding indicates a need to rationalize the operating costs, and to plan appropriate-size installation and operation of facilities to ensure economic operation.

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The Evaluation of Usefulness of 99Mo-99mTc Generator Using(n,γ)99Mo Developed by Korea Atomic Energy Research ((n,γ)99Mo를 이용한 99Mo-99mTc발생기의 유용성 평가)

  • Seo, Han Kyung;Kim, Jeong Ho;Shim, Cheol Min;Kim, Byung Cheol;Choi, Do Cheol;Gwon, Yong Ju;Park, Yung Sun;Kim, Dong Yun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.48-52
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    • 2013
  • Purpose: The Molybdenum which is the raw material of $^{99}Mo-^{99m}Tc$ generator is produced from the nuclear reactor. However, output has dwindled as the two nuclear reactors supplying the bulk of radioactive material-one in Chalk River, Ontario and the other in Petten, the Netherlands-have been closed for repairs or maintenance. This resulted in the enhancement of its price. So $^{99}Mo-^{99m}Tc$ generator using$(n,{\gamma})^{99}Mo$ is developed by Korea Atomic Energy Research Institute (KAERI). Medicinal availability of this generator is evaluated in this study. Materials and Methods: The radioactivity of $^{99m}Tc$ eluted in generator 1, 2 and 3 unit developed by KAERI was measured. The quality control test of generator such as appearance test, pH test, LAL test, sterility test, chemical impurity (Al) test and radiochemical purity test were performed. Planar and SPECT/CT image sof SD rat (6 weeks, Female) at 2 hr after injection of $^{99m}Tc-HDP$ (hydroxymethylenediphosphonate) (TechneScan HDP, Malinckrodt Medical, Dutch) and $^{99m}Tc-DPD$ (diphosphono-1, 2-propanedicarboxylicacid) (TECEOS, CIS bio international, France) which were labeled with $^{99m}Tc$ eluted in KAERI and commercial generator (40.5 GBq, Malinckrodt Medical, Dutch) using SPECT/CT camera (Symbia, Siemense, Germany) were obtained respectively. Results: The mean radioactivity of $^{99m}Tc$ elution generator 1unit was 4.18 GBq (113 mCi), generator 2 unit was 4.73 GBq (128 mCi) and generator 3 unit was 3.33 GBq (90 mCi). All quality control tests were within normal limit except pyrogentest. Pyrogen test was positive. Planar and SPECT/CT images of rat injected $^{99m}Tc-HDP$ which was labeled with $^{99m}Tc$ eluted in commercial generator show increased uptake in bone, stomach and bowl. Planar images show increased uptake in liver and bone in case of $^{99m}Tc-DPD$. However, images of rat injected $^{99m}Tc-HDP$ and $^{99m}Tc-DPD$ which were labelled $^{99m}Tc$ eluted in KAERI generator show increased uptake in bone, liver and spleen. Conclusion: If shortcoming is removed such as pyrogen and liver appearance, domestic role as an alternative generator is thought to be able to fill and to secure the national medical service by supplying $^{99m}Tc$ when the supply of $^{99m}Tc$ be comes short.

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Importance of objectives of Housing unit in Home Economics by three systems of action of Home Economics teachers in middle school (중학교 가정과 교사가 인식하는 주생활 영역의 세 행동체계별 목표 중요도)

  • Lee Hee-Joon;Cho Jae-Soon
    • Journal of Korean Home Economics Education Association
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    • v.17 no.4 s.38
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    • pp.117-131
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    • 2005
  • The purpose of this research was to develop objectives of Housing contents in Technology$\cdot$Home Economics by three systems of action and to find out the importance of the objectives of the teachers have taught the class. The 303 teachers from 183 middle schools replied the mail questionnaire during September, 2003. The data were analyzed by SPSS/win. The 21 objectives for each system of action were developed based on the textbooks, teachers guides, and other related references. The importance of the objectives related to communicative system of action was the highest, respectively followed by the ones related to technical and emancipatory systems of action. Indoor Environment & Equipment was more likely to be important than Maintenance & Repairs as the objectives related to communicative system of action, while Usage of Living Space was less likely to be important than the other two sub-units. The importance of the objectives was somewhat differed by the general characteristics of the teachers. The older are the more important the objectives related to technical system of action. Female, Home Economics teachers, who learned philosophy of Home Economics were more likely to think than others objectives related to communicative and emancipatory systems of action to be important. This research showed the teachers' perspectives of the objectives of Housing contents were not the same among respondents and generally supported the previous results from other contents of Home Economics.

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The Study on U.S. GARA and Aircraft Products Liability (일반항공에서의 제조물책임에 관한 연구 - 미국 일반항공진흥법(GARA)을 중심으로 -)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.29 no.2
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    • pp.55-86
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    • 2014
  • The U.S. General Aviation Revitalization Act of 1994 (the "GARA") created a statute of repose that bars any claims arising from an aviation product or component more than 18 years after its date of delivery. The statute was enacted to protect general aviation aircraft manufacturers from the excessive product liability costs. The GARA included four exceptions: (a) medical emergency patients, (b) those not on the aircraft, (c) those based on written warranties, and (d) those causally related to a "knowing misrepresentation" made by the manufacturer to the FAA. The GARA also incorporates a provision for revised starting point of reckoning to which any repairs or replacements of an aviation product. This note aimed to discuss General Aviation and GARA in depth including the meaning of statue of repose, its exceptions. The various precedents about GARA were also reviewed in here as well. From the GARA, as a comparative legal issue in aviation product liability, there can be some suggestions for revision of Korean Products Liability Act. First, it seems to be reasonable to regulate the specific statute of repose provisions for various category of products. In GARA, the period of 18 years is reasonable concerning to the average aircraft life. Second, in order to avoid exhausting debate and for the judicial economy, it needs to clarify when the statute begins to run. GARA's 18 year limitation period begins to run on the different date whether it was delivered to its first purchaser or a person engaged in the business of selling the aircraft. Last but not least, proper exceptions should be added into the law for equity matter of the statute of repose does not apply. For example, a manufacturer is not protected by GARA if it knowingly misrepresents certain safety information to the FAA.

Anchor Hole Augmentation with Bone Cement in Arthroscopic Rotator Cuff Repair (관절경적 회전근 개 봉합술에서 골 시멘트를 이용한 봉합 나사 구멍 보강술)

  • Lee, Ho-Min;Tae, Suk-Kee;Park, Jeong-Min
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.237-243
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    • 2010
  • Purpose: In arthroscopic rotator cuff repair, the crucial step is secure fixation of Anchor to bone. However, osteoporosis of the tuberosity is frequently encountered in old patients, and can cause insecure fixation of anchors. The Aim of our study was to introduce a technique for anchor hole augmentation with bone cement when fixation failure of an anchor occurs, and to investigate the outcome. Materials and methods: Among 223 rotator cuff repairs performed between 2005 and 2009, anchor hole augmentation with polymethylmethacrylate was performed in 15 cases (all females; mean age of 65 years: range 49~77). Bone cement was injected into the anchor hole in a thick fluid state and the procedure was repeated to make a pot-like cement mantle. The anchor was inserted into the cement mantle while the cement hardened. The outcome was investigated, on average, at 16 months (6~32). Results: Radiographs showed cystic changes of the tuberosity. On follow-up radiographs and MRI, a change in the cement mantle was not noted. The final average UCLA score was 31 (28~35); 6 had excellent, 8 good and 1 fair results (p=0.008). Age-sex matched Constants score was 90 (74~98) (p=0.008). Conclusion: Anchor hole augmentation with bone cement is useful when fixation failure of an anchor is encountered due to bone atrophy. Anchor hole augmentation with bone cement does not negatively influence the outcome.

Supraclavicular Brachial Plexus block with Arm-Hyperabduction (상지(上肢) 외전위(外轉位)에서 시행(施行)한 쇄골상(鎖骨上) 상완신경총차단(上腕神經叢遮斷))

  • Lim, Keoun;Lim, Hwa-Taek;Kim, Dong-Keoun;Park, Wook;Kim, Sung-Yell;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.214-222
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    • 1988
  • With the arm in hyperabduction, we have carried out 525 procedures of supraclavicular brachial plexus block from Aug. 1976 to June 1980, whereas block with the arm in adduction has been customarily performed by other authors. The anesthetic procedure is as follows: 1) The patient lies in the dorsal recumbent position without a pillow under his head or shoulder. His arm is hyperabducted more than a 90 degree angle from his side, and his head is turned to the side opposite from that to be blocked. 2) An "X" is marked at a point 1 cm above the mid clavicle, immediately lateral to the edge of the anterior scalene muscle, and on the palpable portion of the subclavian artery. The area is aseptically prepared and draped. 3) A 22 gauge 3.5cm needle attached to a syringe filled with 2% lidocaine (7~8mg/kg of body weight) and epineprine(1 : 200,000) is inserted caudally toward the second portion of the artery where it crosses the first rib and parallel with the lateral border of the muscle until a paresthesia is obtained. 4) Paresthesia is usually elicited while inserting the needle tip about 1~2 em in depth. If so, the local anesthetic solution is injected after careful aspiration. 5) If no paresthesia is elicited, the needle is withdrawn and redirected in an attempt to elicit paresthesia. 6) If, after several attempts, no paresthesia is obtained, the local anesthetic solution is injected into the perivascular sheath after confirming that the artery is not punctured. 7) Immediately after starting surgery, Valium is injected for sedation by the intravenous route in almost all cases. The age distribution of the cases was from 11 to 80 years. Sex distribution was 476 males and 49 females (Table 1). Operative procedures consisted of 103 open reductions, 114 skin grafts combined with spinal anesthesia in 14, 87 debridements, 75 repairs, i.e. tendon (41), nerve(32), and artery (2), 58 corrections of abnormalities, 27 amputations above the elbow (5), below the elbow (3) and fingers (17), 20 primary closures, 18 incisions and curettages, 2 replantations of cut fingers. respectively (Table 2). Paresthesia was obtained in all cases. Onset of analgesia occured within 5 minutes, starting in the deltoid region in almost all cases. Complete anesthesia of the entire arm appeared within 10 minutes but was delayed 15 to 20 minutes in 5 cases and failed in one case. Thus, our success rate was nearly 100%. The duration of anesthesia after a single injection ranged from $3\frac{1}{2}$ to $4\frac{1}{2}$, hours in 94% of the cases. The operative time ranged from 0.5 to 4 hours in 92.4% of the cases(Table 3). Repeat blocks were carried out in 33 cases when operative times which were more than 4 hours in 22 cases and the others were completed within 4 hours (Table 4). Two patients of the 33 cases, who received microvasular surgery were injected twice with 2% lidocaine 20 ml for a total of $13\frac{1}{2}$ hours. The 157 patients who received surgery on the forearms or hands had pneumatic tourniquets (250 torrs) applied without tourniquet pain. There was no pneumothorax, hematoma or phrenic nerve paralysis in any of the unilateral and 27 bilateral blocks, but there was hoarseness in two, Horner's syndrome in 11 and shivering in 7 cases. No general seizures or other side effects were observed. By 20ml of 60% urcgratin study, we confirm ed the position of the needle tip to be in a safer position when the arm is in hyperabduction than when it is in adduction. And also that the humoral head caused some obstraction of the distal flow of the dye, indicating that less local anesthetic solution would be needed for satisfactory anesthesia. (Fig. 3,4).

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