Between Oct. 1985 and July 1995, 230 patients underwent mitral valve replacement. There were 77 men and 153 women whose mean age was 35.7 years, range 9 to 62 The concomitant operations were 40 aortic valve replacements(17.4%), 25 tricuspid annuloplasties(10.4%), 8 aortic valve replacements & tricuspid annuloplasties(3.5%), 2 tricuspid valve replacements(0.9%) and others, We used 139 mechanical (76 51. Jude medical, 33 CarboMedics, 30 Sorin) and 91 tissue 386 Carpentier-Edwards, 5 lonescu-Shiley) valves. The early postoperative complications occurred in 28 cases. There were 8 low cardiac output syndrome, 5 pleural effusion, 3 significant arrhythmia, 2 cardiac rupture and others. There were 6 early hospital deaths (2.6%) due to low cardiac output syndrome(2), arrhythmia(2) and ventricul r rupture(2). The cuAmulative notal follow-up period was 764. 4 patient-years with a mean of 4).9 months. The long term follow-up information was available for 212 patients(94.6%). There were 21 cases of valve-related complications. Prosthetic valve failure(10), anti-coagulation related bleeding (5), prosthetic valve endocarditis (4), and thromboembolism (2) occurred at rates of 1.3, 0.7, 0.5, and 0.3%Ipt-yr respectively. Late death occurred In 5 cases (0.7%/pt-yr) associated with prosthetic valve endocarditis (2), heart failure (2) and anti-coagulation related bleeding (1). There was no difference in the rate of freedom from prosthetic valve failure between the mechanical and tissue valve group at 6 years (100%), but there was significant difference at 9 years between the tissue (34.4%) and mechanical valve (100%) group (p=0.032). Actuarial survival rates were 98. 8% in tissue valve. 9).7% in mechanical valve group and 96.6% in total patients at 9 years.
Purpose : Pulmonary interstitial emphysema (PIE) primarily occurs in preterm infants suffering from respiratory distress syndrome (RDS) and kept under mechanical ventilator care. Therefore, this study aimed to examine various risk factors for PIE, to identify conditions that can decrease the possibility of PIE development. Methods : PIE classification was conducted for 183 patients diagnosed to have RDS and receiving mechanical ventilator care with pulmonary surfactant between March 2000 and February 2007. The characteristics of each patient were analyzed through retrospective examination of their medical histories. Results : Among 183 patients, 17 had PIE; all factors, including birth weight, gestational age, RDS grade III or above, chorioamnionitis, and premature rupture of membranes, were statistically significant (P<0.05). The period of mechanical ventilator use was statistically significant, but the peak mean airway pressure and peak partial pressure of inspired oxygen were not. PIE mainly occurred on the right side or both sides rather than the left side and mostly developed within 72 h. The PIE group showed higher mortality rate than the control group, and the major cause of mortality was pneumothorax. Conclusion : Risk factors for PIE in infants suffering from RDS and kept under mechanical ventilator care include low gestational age, low birth weight, chorioamnionitis, and premature rupture of membranes. If any risk factors are noted, the infant must be observed closely for at least 72 h after birth.
Economic feasibility is one of the most important factors in energy production from regenerative biomass. From the aspect, biogas from anaerobic digestion of wastewater sludge is regarded as the most economical because of its cheap substrate and additional income from the disposal of waste sludge. Sludge hydrolysis has been regarded as the rate limiting step of anaerobic digestion and many sludge pre-treatment technologies have been developed to accelerate anaerobic sludge digestion for enhanced biogas production. Various sludge pre-treatment technologies including biological, thermo hydrolysis, ultrasonic, and mechanical methods have been applied to full-scale systems. Sludge pre-treatment increased the efficiency of anaerobic digestion by enhancing hydrolysis, reducing residual soilds, and increasing biogas production. This paper introduces the characteristics of various sludge pre-treatment technologies and the energy balance and economic feasibility of each technology were compared to prepare a guideline for the selection of feasible pre-treatment technology. It was estimated that thermophilic digestion and thermal hydrolysis were most economical technology followed by Cell rupture$^{TM}$, OpenCEL$^{TM}$, MicroSludge$^{TM}$, and ultrasound. The cost for waste sludge disposal shares the biggest portion in the economic analysis, therefore, water content of the waste sludge was the most important factor to be controlled.
Titanium and its alloys are finding increasing use in medical devices and dental implants. The strong selling point of titanium is its resistance to the highly corrosive body fluids in which an implant must survive. This corrosion resistance is due to a tenacious passive oxide or film which exists on the metal's surface and renders it passive. Potentiodynamic polarization measurement is one of the most commonly used electro-chemical methods that have been applied to measure corrosion rates. And the potentiodynamic polarization test supplies detailed information such as open circuit, rupture, and passivation potential. Furthermore, it indicates the passive range and sensitivity to pitting corrosion. This study was designed to compare the corrosion resistance of the commonly used dental implant materials such as CP Ti, Ti-6A1-4V, Co-Cr-Mo alloy, and 316L stainless steel. And the effects of galvanic couples between titanium and the dental alloys were assessed for their useful-ness-as. materials for superstructure. The working electrode is the specimen , the reference electrode is a saturated calomel electrode (SCE), and the counter electrode is made of carbon. In $N_2-saturated$ 0.9% NaCl solutions, the potential scanning was performed starting from -800mV (SCE) and the scan rate was 1 mV/sec. At least three different polarization measurements were carried out for each material on separate specimen. The galvanic corrosion measurements were conducted in the zero-shunt ammeter with an implant supraconstruction surface ratio of 1:1. The contact current density was recorded over a 24-hour period. The results were as follows : 1. In potential-time curve, all specimens became increasingly more noble after immersion in the test solution and reached between -70mV and 50mV (SCE) respectively after 12 hours. 2. The Ti and Ti alloy in the saline solution were most resistant to corrosion. They showed the typical passive behavior which was exhibited over the entire experimental range. Therefore no breakdown potentials were observed. 3. Comparing the rupture potentials, Ti and Ti alloy had the high(:st value (because their break-down potentials were not observed in this study potential range ) followed by Co-Cr-Mo alloy and stainless steel (316L). So , the corrosion resistance of titanium was cecellent, Co-Cr-Mo alloy slightly inferior and stainless steel (316L) much less. 4. The contact current density sinks faster than any other galvanic couple in the case of Ti/gold alloy. 5. Ag-Pd alloy coupled with Ti yielded high current density in the early stage. Furthermore, Ti became anodic. 6. Ti/Ni-Cr alloy showed a relatively high galvanic current and a tendency to increase.
Quality changes of crown daisy and kale were investigated during storage at 10$^{\circ}C$ after washing with cooled electrolyzed acid water at 3 times in 2 min. Total count and coliform count of crown daisy and kale after immersion in electrolyzed acid water were decreased to 1/130 and 1/1,170 of non-immersed crown daisy and to l/870 and l/470 of non-immersed kale. However total count and coliform count were increased to the similar levels of non-immesed and tap water immersed one after 6 days of storage. Weight loss of crown daisy and ka1e were lower than others for 3 days of storage but higher than that of one after that time. Decay rate of crown daisy and kale immersed electrolyzed acid water showed lower than that of non-immersed and tap water immersed one for 6 days. In case of kale, rupture strength was higher than others at just after immersion and showed similar values after initial storage period. Color value of both crown daisy and kale showed high L, b and low a value in the order of electrolyzed acid water, tap water and non-treatment. Chlorophyll content of crown daisy and kale were lower than those of others just after immersion in electrolyzed acid water, but showed rapid reduction in the order of non-treatment. tap water and electrolyzed acid water after 6 days. Overall organoleptic properties of crown daisy and kale in immersion electrolyzed acid water were higher than those of others.
The effects of temperature and strain rate on the I-SCC behaviors of Zircaloy-4 were investigated by constant load test at 30$0^{\circ}C$ and constant elongation rate test at 300, 350 and 40$0^{\circ}C$ in 3.34mg $I_2$/㎤. The results showed that I-SCC susceptibility increased as the strain rate decreased or the temperature increased. The empirical relation between the stress and the time to failure at 30$0^{\circ}C$ was given by 1/ $t_{f}$∝exp (0.3$\sigma$/$\sigma$$_{UTS}$-31.5) When the I-SCC susceptibility was expressed by the ratio of fracture energy in iodine atmosphere to that in the inert atmosphere, severe I-SCC susceptibility was found near 7.6$\times$10$^{-6}$ sec at 30$0^{\circ}C$ and the maximum point of I-SCC susceptibility tended to shift to the higher strain rate with increasing the temperature. The quasi-cleavage fracture was observed in I-SCC fracture surface. From these results, it was certain that the film repture step was involved as an important process in the I-SCC mechanism of Zircaloy-4.4.
Background: Open surgical repair of abdominal aortic aneurysms was initiated by Dubost in 1952. Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized for curative intent. We retrospectively analyzed surgical outcome, complications, and mortality-related factors for patients with abdominal aortic aneurysms over a 6 year period. Material and Method: We analyzed 18 patients who underwent surgery for abdominal aortic aneurysms between March 2002 and March 2008. The indications for surgery were rupture, a maximal aortic diameter >60 mm, medically intractable hypertension, or pain. Result: The mean age was $66.6{\pm}9.3$ years (range, $49\sim81$ years). Twelve patients (66.7%) were males a 6 patients were females. Extension of the aneurysm superior to the renal artery existed in 6 patients (33.3%), and extension to the iliac artery existed in 13 patients (72.2%). Five patients (27.8%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $72.2{\pm}12.9$ mm (range, $58\sim109$ mm). Surgery was performed by a midline laparotomy, and 6 patients underwent emergency surgery. The mean total ischemic time from aorta clamping to revascularization was $82{\pm}42$ minutes (range, $35\sim180$ minutes). The mortality rate was 16.7%; the mortality rate for patients with ruptured aneurysms was 60%, and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included one each of renal failure, femoral artery and vein occlusion, and wound infection. The patients who were discharged had a long-term survival of $34{\pm}26$ months (range, $4\sim90$ months). Rupture and emergency surgery had a statistically significant mortality-related factor (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have a high mortality, but unruptured cases are repaired with relative safety. Successfully operated patients had long-term survival. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, aggressive application should be determined with care. Experience and systemic support of each center is important in the treatment plan.
Purpose: There are various known methods for arthroscopic rotator cuff repair. The purpose of this retrospective study is to report on the clinical results and anatomical results of UU repair surgery, which is a new repair method. Materials and Methods: We enrolled 156 patients (88 men and 68 women) who underwent UU repair for rotator cuff tears from January 2009 to May 2010 in our hospital. Their average age was 55 years old (range: 38~75 years old) and the average follow-up period was 12 months (range: 6~23 months). For determining the results, we evaluated the VAS for pain, the daily living index (ADL) in the ASES scores, the UCLA and KSS scores, and all these tests were conducted at the first hospital visit and 6 months and 1 year after surgery and at the final follow-up. During the follow-up period, MRI was performed 3 and 6 months after surgery only in the patients who consented to MRI scans to confirm the presence of re-rupture. Results: The average scores of the VAS as a pain indicator decreased from 7.0 before surgery to 2.7 after surgery (p<0.05). The UCLA and KSS scores increased from 22.2 to 32.5 and from 83.7 to 91.5, and the changes was significant (p<0.05). For the active joint range of motion, the average forward flexion was improved from 125 to 175 degrees, the average lateral external rotation was improved from 38 to 58 degrees, and the average abduction was improved from 104 to 169 degrees. Out of a total of 156 patients, re-rupture was observed in 4 cases (3%) of 117 cases (75%) for which MRI was performed (with consent) between 3 and 6 months after surgery. Conclusion: UU repair surgery as arthroscopic repair of rotator cuff tear is a good repair method that shows excellent clinical results and a low re-rupture rate.
Park, Yoon-Ki;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
Journal of Yeungnam Medical Science
/
v.2
no.1
/
pp.221-227
/
1985
Thirty-four patients with suspected ectopic pregnancy whose serum hCG levels had been measured by beta-hCG EIA before surgery were evaluated retrospectively. The results were as follows: 1. Final diagnosis of thirty-four patients with suspected ectopic pregnancy comprised twenty- eight tubal pregnancy, five ruptures of hemorrhagic corpus luteum and, one tubo-ovarian abscess. One of the five patients with rupture of hemorrhagic corpus luteum was accompanied by missed abortion. 2. Range of serum hCG levels in twenty-eight patients with tubal pregnancy was 59-21,980 mIU/ml and that of four patients with rupture of hemorrhagic corpus luteum and one patient with tubo-ovarian abscess was 0.6-6.6mIU/ml. Serum hCG level of a patient with rupture of hemorrhagic corpus luteum who was accompanied by missed abostion was 200 mIU/ml. 3. Serum hCG levels in twenty-two of twenty-eight patients with tubal pregnancy were lower than 3,000 mIU/ml. Low serum hCG level below 100mIU/ml and high serum hCG level above 6,500 mIU/ml were noticed in four and six patients with tubal pregnancy, respectively. 4. Mean serum hCG levels (${\pm}SD$) of twelve patients with tubal pregnancy who had intra-abdominal free blood of less than 500ml and sixteen patients with tubal pregnancy who had intra-abdominal free blood of more than 500ml were 4,131 (${\pm}7,801$) mIU/ml and 3,208 (${\pm}5,081$) mIU/ml, respectively. There was no statistical difference in the mean level of serum hCG between both group (P>0.05). 5. Mean serum hCG levels (${\pm}SD$) of thirteen patients with unruptured tubal pregnancy and fifteen patients with ruptured tubal pregnancy were 2,628 (${\pm}5,448$) mIU/ml and 4,449 (${\pm}6,938$) mIU/ml, respectively. Mean level of serum hCG was statistically higher in ruptured tubal pregnancy (P<0.01). 6. Positive rate of urine pregnancy test in the diagnosis of ectopic pregnancy was 64% (16/25) and mean range of serum hCG level of nine patients with false negative result were 353 mIU/ml and 59-933 mIU/ml.
Kang, Dong Hun;Kang, Chan;Hwang, Deuk Soo;Song, Jae Hwang;Choi, Bo Sung
Journal of the Korean Orthopaedic Association
/
v.53
no.6
/
pp.522-529
/
2018
Purpose: To compare the clinical outcomes of ultrasound-guided percutaneous repair (USPR) and open repair in a ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with USPR (group A) and 18 patients with open repair (group B) from January 2015 to February 2017 were analyzed retrospectively. The postoperative clinical evaluations were performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon total rupture score (ATRS), and visual analogue scale for the overall satisfaction and cosmetic satisfaction with the scar, and the starting time of single heel raises. The complications were also evaluated. Results: The Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, starting time of single heel raises were similar in both groups (all p>0.05). Group A showed a significantly higher overall patient's satisfaction and cosmetic satisfaction in than group B (all p<0.05). Two cases of Achilles tendon elongation were encountered in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection were experienced in group B. Conclusion: USPR showed good clinical outcomes and high satisfaction as well as a low rate of complications, such as sural nerve injury. Therefore, USPR can be considered as an effective surgical treatment option for Achilles tendon ruptures.
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