• Title/Summary/Keyword: Spectrum revision

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Analysis of Risk Factors and Management of Cerebrospinal Fluid Morbidity in the Treatment of Spinal Dysraphism

  • Lee, Byung-Jou;Sohn, Moon-Jun;Han, Seong-Rok;Choi, Chan-Young;Lee, Dong-Joon;Kang, Jae Heon
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.225-231
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    • 2013
  • Objective : Spinal dysraphism defects span wide spectrum. Wound dehiscence is a common postoperative complication, and is a challenge in the current management of cerebrospinal fluid (CSF) leaks and wound healing. The purpose of this study is to evaluate the risks of CSF-related morbidity in the surgical treatment of spinal dysraphism. Methods : Ten patients with spinal dysraphism were included in this retrospective study. The median age of the cohort was 4.8 months. To assess the risk of CSF morbidity, we measured the skin lesion area and the percentage of the skin lesion area relative to the back surface for each patient. We then analyzed the relationship between morbidity and the measured skin lesion area or related factors. Results : The overall median skin lesion area was 36.2 $cm^2$ (n=10). The percentage of the skin lesion area relative to the back surface ranged from 0.6% to 18.1%. During surgical reconstruction, 4 patients required subsequent operations to repair CSF morbidity. The comparison of the mean area of skin lesions between the CSF morbidity group and the non-CSF morbidity group was statistically significant (average volume skin lesion of $64.4{\pm}32.5cm^2$ versus $27.7{\pm}27.8cm^2$, p<0.05). CSF morbidity tended to occur either when the skin lesion area was up to 44.2 $cm^2$ or there was preexisting fibrosis before revision with an accompanying broad-based dural defect. Conclusion : Measuring the lesion area, including the skin, dura, and related surgical parameters, offers useful information for predicting wound challenges and selecting appropriate reconstructive surgery methods.

Chronotype in Relation to Bipolarity, Suicidal Ideation, and Auditory Evoked Potentials in Patients with Major Depressive Disorder : Preliminary Study (주요우울증 환자에서 일주기 형태에 따른 양극성 경향, 자살 사고, 청각유발전위와의 관련성 : 예비 연구)

  • Park, Young-Min;Lee, Seung-Hwan
    • Korean Journal of Biological Psychiatry
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    • v.21 no.1
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    • pp.14-20
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    • 2014
  • Objectives The current study investigated the putative relationship between chronotype and suicidality or bipolarity in patients with major depressive disorder (MDD). Method Nineteen outpatients who met the criteria for MDD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision were recruited for the current study. The subjects were divided into two subgroups based on their Basic Language Morningness (BALM) scores (dichotomized according to the median BALM score). The Loudness Dependence of Auditory Evoked Potentials (LDAEP) was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents. In addition, K-Mood Disorder Questionaire (K-MDQ), Beck Scale for Suicidal Ideation (BSS), Beck Hopelessness Scale (BHS), Barratt Impulsiveness Scale (BIS) were applied. Results The K-MDQ, BSS, BHS, BIS score was higher for the eveningness group than for the morningness group. However, the LDAEP, Hamilton Depression Rating Scale, Hamilton Anxiety Scale scores did not differ significantly between them. There were negative correlations between the total BALM score and the total K-MDQ, BSS, and BHS scores (r=-0.64 and p=0.0033, r=-0.61 and p=0.0055, and r=-0.72 and p=0.00056, respectively). Conclusions Depressed patients with eveningness are more vulnerable to the suicidality than those with morningness. Eveningness is also associated with bipolarity.

Review on U.S. Army Helicopter Mishap Analysis for Revision of Crashworthiness Requirements (내추락성 요구도 개정을 위한 미 육군 헬기 사고사례 분석 고찰)

  • Hwang, Jungsun;Lee, Sangmok
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.41 no.9
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    • pp.734-739
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    • 2013
  • Representative crashworthiness requirement documents for military helicopter are MIL-STD-1290 and the Aircraft Crash Survival Design Guide(ACSDG) which were lastly revised in the 1980's. Taking analysis results of diverse U.S. Army helicopter mishaps into account, we can say that adequate guidelines do not exist to ensure crashworthiness of new generation aircraft. In this paper, U.S. Army helicopter mishap analysis conducted by U.S. Army Research, Development and Engineering Command(RDECOM) is readjusted to review the basis of new crashworthiness design criteria for military helicopter, in other words, Full Spectrum Crashworthiness Criteria(FSCC). This analysis effort is a part of FSC development. This effort was to research and quantify the dynamics of military aircraft crashes to be used as the quantitative basis for new design criteria.

Thromboprophylaxis in Abdominoplasty: Efficacy and Safety of a Complete Perioperative Protocol

  • Marangi, Giovanni Francesco;Segreto, Francesco;Poccia, Igor;Campa, Stefano;Tosi, Daniele;Lamberti, Daniela;Persichetti, Paolo
    • Archives of Plastic Surgery
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    • v.43 no.4
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    • pp.360-364
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    • 2016
  • Background Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. Methods A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. Results Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). Conclusions The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.