• 제목/요약/키워드: Total insertion time

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Sommerlad씨 술식에 따른 미세수술 술기를 이용한 구개성형술의 경험 (A Clinical Experience of Cleft Palate Repair Using Operative Microscope: Sommerlad's Method)

  • 박명철;신승준;이일재
    • Archives of Plastic Surgery
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    • 제33권1호
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    • pp.61-66
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    • 2006
  • The purpose of this study is to introduce the method of palate repair that combines minimal hard palate dissection and radical retropositiong of levator musculature, which was presented by Sommerlad. As this method presents, additional use of the operating microscope enables atraumatic and radical dissection, and it might provide more improved speech function to the patients. A total of 17 patients with cleft palate underwent Sommerlad's method from December 2003 to August 2004. The mean follow-up period was 4.5 months. The use of a microscope provided high quality variable magnification and good illumination at the operating field. Repair was carried out through incisions at the margins of cleft with mucoperiosteal flap elevation. Muscles were rearranged and repaired properly. It was unable to evaluate the improvement of speech because the patients were too young to learn meaningful speech. Average operating time including anesthetic induction time, V-tube insertion and recovery from anesthesia was 2 hours 45 minutes which was not quite different from conventional method's operating time. Oronasal fistula developed in 2 patients of them. One of them was healed spontaneously. As meticulous and radical muscle dissection was possible with Sommerlad's method, we could minimize the trauma to the muscular and neurovascluar structure. In addition, we expect better faculty of speech as a result of this method although longer follow-up time was unavailable.

Prototype of a Peak to Average Power Ratio Reduction Scheme in Orthogonal Frequency Division Multiplexing Systems

  • Varahram, Pooria;Ali, Borhanuddin Mohd;Mohammady, Somayeh;Reza, Ahmed Wasif
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제9권6호
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    • pp.2201-2216
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    • 2015
  • Peak to average power ratio (PAPR) is one of the main imperfections in the broadband communication systems with multiple carriers. In this paper, a new crest factor reduction (CFR) scheme based on interleaved phase sequence called Dummy Sequence Insertion Enhanced Partial Transmit Sequence (DSI-EPTS) is proposed which effectively reduces the PAPR while at the same time keeps the total complexity low. Moreover, the prototype of the proposed scheme in field programmable gate array (FPGA) is demonstrated. In DSI-EPTS scheme, a new matrix of phase sequence is defined which leads to a significant reduction in hardware complexity due to its less searching operation to extract the optimum phase sequence. The obtained results show comparable performance with slight difference due to the FPGA constraints. The results show 5 dB reduction in PAPR by applying the DSI-EPTS scheme with low complexity and low power consumption.

CRIES, FLACC, PIPP를 이용한 고위험영아의 통증사정 (Pain Assessment using CRIES, FLACC and PIPP in High-Risk Infants)

  • 안영미;강희옥;신은진
    • 대한간호학회지
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    • 제35권7호
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    • pp.1401-1409
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    • 2005
  • Purpose: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. Method: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. Results: A significant difference was identified among the mean scores in CRIES($F_{(2, 91)}$=47.847, p=.000), FLACC($F_{(2, 91)}$=41.249, p=.000) and PIPP($F_{(2. 91)}$=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. Conclusions: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

Low-loss Electrically Controllable Vertical Directional Couplers

  • Tran, Thang Q.;Kim, Sangin
    • Current Optics and Photonics
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    • 제1권1호
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    • pp.65-72
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    • 2017
  • We propose a nearly lossless, compact, electrically modulated vertical directional coupler, which is based on the controllable evanescent coupling in a previously proposed graphene-assisted total internal reflection (GA-FTIR) scheme. In the proposed device, two single-mode waveguides are separate by graphene-$SiO_2$-graphene layers. By changing the chemical potential of the graphene layers with a gate voltage, the coupling strength between the waveguides, and hence the coupling length of the directional coupler, is controlled. Therefore, for a properly chosen, fixed device length, when an input wave is launched into one of the waveguides, the ratio of their output powers can be controlled electrically. The operation of the proposed device is analyzed, with the dispersion relations calculated using a model of a one-dimensional slab waveguide. The supermodes in the coupled waveguide are calculated using the finite-element method to estimate the coupling length, realistic devices are designed, and their performance was confirmed using the finite-difference time-domain method. The designed $3{\mu}m$ by $1{\mu}m$ device achieves an insertion loss of less than 0.11 dB, and a 24-dB extinction ratio between bar and cross states. The proposed low-loss device could enable integrated modulation of a strong optical signal, without thermal buildup.

Biliary Self-Expandable Metal Stent Could Be Recommended as a First Treatment Modality for Immediate Refractory Post-Endoscopic Retrograde Cholangiopancreatography Bleeding

  • Sun Young Moon;Jun Heo;Min Kyu Jung;Chang Min Cho
    • Clinical Endoscopy
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    • 제55권1호
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    • pp.128-135
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    • 2022
  • Background/Aims: Recent reports suggest that the biliary self-expandable metallic stent (SEMS) is highly effective for maintaining hemostasis when endoscopic hemostasis fails in endoscopic retrograde cholangiopancreatography (ERCP)-related bleeding. We compared whether temporary SEMS offers better efficacy than angioembolization for refractory immediate ERCP-related bleeding. Methods: Patients who underwent SEMS placement or underwent angioembolization for bleeding control in refractory immediate ERCP-related bleeding were included in the retrospective analysis. We evaluated the hemostasis success rate, severity of bleeding, change in hemoglobin levels, amount of transfusion, and delay to the start of hemostasis. Results: A total of 27 patients with SEMS and 13 patients who underwent angioembolization were enrolled. More transfusions were needed in the angioembolization group (1.0±1.4 units vs. 2.5±2.0 units; p=0.034). SEMS failure was successfully rescued by angioembolization. The partially covered SEMS (n=23, 85.1%) was generally used, and the median stent-indwelling time was 4 days. The mean delay to the start of angioembolization was 95.2±142.9 (range, 9-491) min. Conclusions: Temporary SEMS had similar results to those of angioembolization (96.3% vs. 92.3%; p=0.588). Immediate SEMS insertion is considered a bridge treatment modality for immediate refractory ERCP-related bleeding. Angioembolization still has a role as rescue therapy when SEMS does not work effectively.

희석된 헤파린과 생리식염수가 간헐적 말초정맥장치의 폐색, 유지기간 및 정맥염 발생에 미치는 영향 (Efficacy of 1:1000 Diluted Heparin versus 0.9% Normal Saline for Maintenance of Intermittent Intravenous Locks)

  • 박미미;김창희;조은숙;이미정;김혜숙
    • 기본간호학회지
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    • 제7권2호
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    • pp.208-221
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    • 2000
  • The objective of this research was to compare the flushing effects using 1:1,000 diluted heparin or 0.9% normal saline in relation to needle gauge and frequency of IV medications. The comparative categories were clotting, duration of patency, and incidence of phlebitis. The design of research was a Nonequivalent Control group, Post test, Nonsynchrorized Design. The independent variable was 0.9% normal saline flushing the IV locks and the dependent variables were clotting, duration of patency, and incidence of phlebitis. Subjects were medical-surgical inpatients over 15 years old and with peripherally placed IVs who were hospitalized in a university medical center. Exclusion criteria included foreigners and those who were rejected for this research. The final sample for data analysis included 295 IV sites in 194 patients; 154 were in the saline group and 141 were in the heparin group. Subjects were assigned to have IV locks is flushed with 0.9% normal saline in the experimental group and to have IV lock flushed with 1:1,000 diluted heparin(100 units) in the control group. In order to increase reliability, the nurses who were assigned to the units involved in the study received an explanation on the standard method for locking an IV, recording method for observational data and criteria for the detection of phlebitis. Data were collected for a period of 2 weeks, from March 16, 2000 to March 29, 2000. Total duration of IV was defined the time of IV insertion to the time of discontinuation. Phlebitis was defined as the presence of the following : pain, swelling. erythema at the insertion site. Chi-square was used to determine the association between the degree of clotting, duration of patency, and incidence of phlebitis for the diluted heparin or the normal saline and needle gauge and frequency of IV medications. The results are summarized as follows : (a) There was difference in the degree of clotting between two groups($X^2=5.882$, p=.015). (b) There was no difference in the degree of duration of patency between two groups($X^2=2.439$, p=.295). (c) There was no difference in the incidence of phlebitis between two groups($X^2=0.190$, p=.663). (d) There was difference in the degree of clotting($X^2=6.209$, p=.013) and in the degree of duration of patency($X^2=6.978$, p=.031) according the needle guage between the two groups. (e) There was difference in the incidence of phlebitis($X^2=5.008$, p=.025) according to the frequencies of IV injection between two groups.

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환경 특성에 맞는 성능 향상 기법을 사용하는 태스크 스케줄링 알고리즘 (A Task Scheduling Algorithm with Environment-specific Performance Enhancement Method)

  • 송인성;윤동성;박태신;최상방
    • 전자공학회논문지
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    • 제54권5호
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    • pp.48-61
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    • 2017
  • 클라우드 컴퓨팅의 IaaS 서비스는 유지비용 없이 원하는 만큼의 고성능 가상 머신을 사용할 수 있다는 장점 덕분에 대용량 병렬 프로그램을 실행하기 위한 고성능 컴퓨팅 환경으로 주목받고 있다. 이러한 고성능 컴퓨팅 환경에서 병렬 프로그램의 실행에 소요되는 시간은 태스크 스케줄링 알고리즘에 좌우된다. 클라우드 컴퓨팅 환경을 기반으로 하는 태스크 스케줄링 알고리즘에 관한 연구는 사용자 부담 비용을 최소화하는 알고리즘이 주류를 이루었으며, 병렬 프로그램의 실행을 최대한 빨리 끝내기 위한 알고리즘에 관한 연구는 거의 이루어지지 않았다. 본 논문에서는 사용자 부담 비용 등의 제약 없이 병렬 프로그램을 최대한 빨리 끝내기 위한 알고리즘인 HAGD 알고리즘과, HAGD 알고리즘이 사용하는 새로운 성능 향상 기법인 묶음 태스크 복제 기법을 제안한다. 묶음 태스크 복제 기법은 기존 태스크 복제 기법을 단순화하였으며, HAGD 알고리즘은 고성능 컴퓨팅 환경과 병렬 프로그램의 특성에 맞추어 태스크 삽입 기법 혹은 묶음 태스크 복제 기법을 사용한다. 성능 평가 결과, 제안하는 알고리즘이 환경 특성과 관계없이 우수한 표준화한 전체 실행 시간을 제공하는 것을 확인하였다.

Postcardiotomy Extracorporeal Membrane Oxygenation Support in Patients with Congenital Heart Disease

  • Joo, Seohee;Cho, Sungkyu;Lee, Jae Hong;Min, Jooncheol;Kwon, Hye Won;Kwak, Jae Gun;Kim, Woong-Han
    • Journal of Chest Surgery
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    • 제55권2호
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    • pp.158-167
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    • 2022
  • Background: This study investigated mortality and morbidity in patients requiring postcardiotomy extracorporeal membrane oxygenation (ECMO) support after operations for congenital heart disease (CHD). Methods: CHD patients requiring postoperative ECMO support between May 2011 and May 2021 were retrospectively reviewed. Patients were divided into non-survivors and survivors to hospital discharge. Survival outcomes and associations of various factors with in-hospital death were analyzed. Results: Fifty patients required postoperative ECMO support. Patients' median age and weight at the time of ECMO insertion were 1.85 months (interquartile range [IQR], 0.23-14.5 months) and 3.84 kg (IQR, 3.08-7.88 kg), respectively. Twenty-nine patients (58%) were male. The median duration of ECMO support was 6 days (IQR, 3-12 days). Twenty-nine patients (58%) died on ECMO support or after ECMO weaning, and 21 (42%) survived to hospital discharge. Postoperative complications included renal failure (n=33, 66%), bleeding (n=11, 22%), and sepsis (n=15, 30%). Prolonged ECMO support (p=0.017), renal failure (p=0.005), continuous renal replacement therapy (CRRT) application (p=0.001), sepsis (p=0.012), bleeding (p=0.032), and high serum lactate (p=0.002) and total bilirubin (p=0.017) levels during ECMO support were associated with higher mortality risk in a univariate analysis. A multivariable analysis identified CRRT application (p=0.013) and a high serum total bilirubin level (p=0.001) as independent risk factors for death. Conclusion: Postcardiotomy ECMO should be considered as an important therapeutic modality for patients unresponsive to conventional management. ECMO implementation strategies and management in appropriate patients without severe complications, particularly renal failure and/or liver failure, are crucial for achieving positive outcomes.

Efficacy and safety of intragastric balloon for obesity in Korea

  • Kwang Gyun Lee;Seung-Joo Nam;Hyuk Soon Choi;Hang Lak Lee;Jai Hoon Yoon;Chan Hyuk Park;Kyoung Oh Kim;Do Hoon Kim;Jung-Wook Kim;Won Sohn;Sung Hoon Jung
    • Clinical Endoscopy
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    • 제56권3호
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    • pp.333-339
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    • 2023
  • Background/Aims: Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea. Methods: We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed. Results: In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m2. Body mass index reduction was 3.72±2.63 kg/m2 at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain. Conclusions: IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.

Clinical and Functional Outcomes of the Exeter V40 Short Stem in Primary and Revision Arthroplasty: Does the Indication Affect Outcomes in the Short Term?

  • Nemandra Amir Sandiford;Scott M. Bolam;Irrum Afzal;Sarkhell Radha
    • Hip & pelvis
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    • 제35권1호
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    • pp.40-46
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    • 2023
  • Purpose: A variety of short Exeter stems designed specifically for use in performance of total hip arthroplasty (THA) in primary and revision settings have recently been introduced. Some have been used 'off label' for hip reconstruction. The aim of this study is to report clinical and radiological results from the Exeter V40 125 mm stem in performance of primary THA and revision THA. Materials and Methods: This study had a retrospective design. Insertion of 58 (24 primary, 34 revision) Exeter V40 125 mm stems was performed between 2015 and 2017. The minimum follow-up period was two years. Assessment of the Oxford hip score (OHS), EuroQol-5 Dimension (EQ-5D), and radiological follow-up was performed at one and two years. Results: In the primary group, the preoperative, mean OHS was 13.29. The mean OHS was 32.86 and 23.39 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were at 0.14, 0.59, and 0.35, preoperatively, at one-year follow-up and two-year follow-up, respectively. In the revision group, the mean preoperative OHS was 19.41. The mean OHS was 30.55 and 26.05 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were 0.33, 0.61, and 0.48 preoperatively, at one-year follow-up and two-year follow-up, respectively. No progressive or new radiolucent lines were observed around any stem at the time of the final follow-up in all patients in both groups. Conclusion: Encouraging results regarding use of Exeter V40 125 mm stems have been reported up to two years following surgery in primary and revision THA settings.