• Title/Summary/Keyword: failure cases

Search Result 2,181, Processing Time 0.039 seconds

Late Results of the Senning and Mustard Operations for TGA in Children (Senning 및 Mustard 수술후 장기 성적)

  • 서경필
    • Journal of Chest Surgery
    • /
    • v.22 no.1
    • /
    • pp.32-41
    • /
    • 1989
  • We scrutinized the 64 cases of TGA and Taussig-Bing anomaly who underwent Senning and Mustard operations from Jan. 1981 to May 1988. The ratio of male to female was 45; 19, and the age at operation varied from 2 months to 18 years [mean 18.9*32.9 months]. The in-hospital mortality was in 24 cases [37.5%] and the major causes were myocardial failure and congestive heart failure associated with arrhythmias. The risk factors for hospital mortality were complex TGA, prolonged bypass time and high postoperative CVP. In addition, mortality increased during the first year the procedure was used. Late mortality occurred in 6 cases and the major causes was congestive heart failure, and there was not any significant risk factor noted in late mortality. Early arrhythmia developed in 37.5%, all of which were transient and self limited and 7 cases of early mortality were related to the arrhythmias. Late arrhythmias developed in 8 cases, but 7 cases were transient. One case died with junctional tachycardia. Of significance the one case that died late by arrhythmia had a similar junctional tachycardia in the early postoperative period. The survival rate in all cases disregarding initial in-hospital mortality 1YSR 89.8% and 5YSR 84.3%, but because of short duration of follow up this is not significant. We concluded that early hospital mortality could be decreased by operating at an earlier age and by adjusting the appropriate operation method.

  • PDF

Early and Late Results after Mitral Valve Replacement (승모판막 치환후 조기및 장기추적결과)

  • 김명인
    • Journal of Chest Surgery
    • /
    • v.25 no.2
    • /
    • pp.149-157
    • /
    • 1992
  • Total 145 cases mitral vlave replacement were performed in Department of Thoracic and Cardiovascular Surgery in Chungnam National University Hospital during the period from May 1983 to July 1991. Sixty-one patients were male and 84 patients were female and the range of age was from 12 to 66 years old with the mean of 37.9[$\pm$11.6] years. Valvular lesions were 49 cases of mitral stenosis, 18 cases of regurgitation and 78 cases of combined lesion. Used valve were Ionescu-Shiley[42 cases], Bjork-Shiley[49 cases], Inact[6 cases], St. Jude Medical[11 cases] and CarboMedics[37 cases]. Mean size of valve was 29.8$\pm$1.68mm. Early morality was 13.8%[20 cases] and low output syndrome was most common cause[9 cases]. Age, functional classification and biventricular hypertrophy were risk factors. All survived cases were followed up without missing. Mean follow up period were 3 years and 3 months. Total 14 cases of death[9.7%] were observed and heart failure, unexplained sudden death and bleeding were the causes in that order. Common late complications were heart failure and bleeding related with anticoagulation. Actuarial survival rate at 5 years was 83$\pm$5.4% in overall, 78$\pm$7.2% in tissue valve group, 87$\pm$6.8% in mechanical valve group. The actuarial freedom rate from thromboembolism at 7 years was 89$\pm$8.3% in overall, 86$\pm$9.9% in tissue valve group and 97$\pm$1.9% in mechanical valve group. Actuarial freedom rate from bleeding at 5 years with anticoagulation was 88.9$\pm$4.2% in overall, 96$\pm$3.9% in tissue valve group, 86$\pm$4.6% in mechanical valve group. Reoperation was done in 3 cases with heart failure with tricuspid regurgitation and thromboembolism in 2 cases. The functional status of survived cases was I or II.

  • PDF

The Clinical Aspects of Pulmonary Tuberculosis Patient Failed in Retreatment (재치료실패 폐결핵환자의 임상 양태)

  • Im, Young-Jae;Song, Ju-Young;Jeong, Jae-Man;Kim, Young-Jun;Kim, Moon-Shik
    • Tuberculosis and Respiratory Diseases
    • /
    • v.40 no.4
    • /
    • pp.404-409
    • /
    • 1993
  • Background: There are many retreatment failure patients admitted in National Kongju Tuberculosis Hospital. But there is not satisfactory treatment method for them at present. We think that more attentions and active measures for them are needed. Method: We reviewed sex and age, duration of illness, previously used antituberculosis drugs, drug resistance, extent of disease, reasons for early stopping or irregular medication and schooling of 50 retreatment failure patients admitted in National Kongju Tuberculosis Hospital from April 1992 to February 1993. Results: 1) The male to female ratio was 3:2 and 62% of the patients were between 21 and 40 years of age. 2) Twenty eight cases (56%) had the duration of illness over 10 years. 3) All cases had used most of the antituberculosis drugs. 4) Drug sensitivity test showed resistance to RMP in 46 cases (96%), INH in 40 cases (83%) and other drugs in 3-32 cases (6-67%). 5) Forty eight cases (96%) had far advanced disease on chest P-A film. 6) Twenty eight cases (56%) in primary chemotherapy and twenty one cases (42%) in retreatment had the histories of premature stopping or irregular ingestion of the drug. The reasons for premature stopping or irregular ingestion of the drug were as follows; in primary chemotherapy, 29 cases (75%) were due to 'having no symptoms', while in retreatment, 6 cases (29%) were due to 'having no symtoms', 6 cases (29%) were 'too, busy' and 3 cases (14%) were for 'financial problem'. 7) Twenty seven cases (54%) had at least graduated from high school. Conclusion: Greater efforts are needed to prevent tratment failure. More supports and admission treatment for retreatment failure patients are needed to prevent infection and to treat properly.

  • PDF

Reoperation for Mitral valvular disease - Clinical analysis of 21 cases - (승모판막질환에 대한 재수술: 21례 보고)

  • 유병하
    • Journal of Chest Surgery
    • /
    • v.18 no.4
    • /
    • pp.649-654
    • /
    • 1985
  • After first successful mitral valvotomy by Harken and Bailey in 1948, improvement of surgical technique and cardiac device may last rapidly for several years, but there after many patients deteriorate because of various causes, so incidence of reoperation for cardiac valvular disease has increased time by time. This paper is concerned with 21 patients in whom a second operation has been carried out from Jan. 1963 to Aug. 1984 at the department of Thoracic and Cardiovascular department, National Medical Center. Of 21 patients, 7 were male and 14 were female, and ages ranged from 14 to 37 years The second operation are classified into groups of secondary closed mitral commissurotomy [3 cases], open commissurotomy following closed mitral commissurotomy [1 case], Valve replacement following closed mitral commissurotomy [14 cases] or bioprosthetic valve replacement [3 cases]. Main cause of reoperation was restenosis or steno insufficiency, and that of bioprosthetic valve failure was bacterial endocarditis [1 case], fibrous tissue overgrowth on the Xenograft [1 case] and technical failure [1 case]. Early operative mortality was absent, but during follow-up, 4 patients died, so late mortality was 19.0%, and main cause of death was congestive heart failure.

  • PDF

A Experimental Study on the Control of Premature Failure of RC Beams strengthened by Steel Plates (강판으로 보강된 RC보의 조기파괴제어에 관한 실헙적 연구)

  • 심종성;한만엽;김규선;이인범
    • Proceedings of the Korea Concrete Institute Conference
    • /
    • 1998.04b
    • /
    • pp.585-591
    • /
    • 1998
  • In the case of reinforced concrete beams strengthening by steel plate, sometimes these beams collapse due to the stress concentration at the ends of steel plates before the design expected failure. This kind of failure is called premature failure. This study analyzes the behavior of strengthened RC beams to control premature failure of these plated beams with either changing the geometries at the ends of plates or strengthening steel plates beside the ends. The results from the former cases show that, the effect of expanded plates sections at the ends was very small, and the beams which are rounded the ends of plates effectively increased the initial rip-off loads about 14% compared with control beam but the ultimate loads was almost same. However, the beams in the latter cases effectively increased the initial and the ultimate rip-off loads with changing failure mode, especially around 14~19% in the ultimate rip-off load comparing with control beam.

  • PDF

The Importance of Geotechnical Investigation Instructed by Failure (실패사례로 본 지반조사의 중요성)

  • Jung, Gyung-Ja;Lee, Doo-Haeng
    • Proceedings of the Korean Geotechical Society Conference
    • /
    • 2009.09a
    • /
    • pp.761-774
    • /
    • 2009
  • To address the importance of geotechnical investigation, failure cases are taken up for consideration. One of them awaken this country to the importance of exact geotechnical investigation at the cost of many lives. Other failures were also occurred as the result of insufficient geotechnical investigation or missing some facts given by geotechnical investigation. A case which shows the unpredicted and unaccustomed settlement at bridge abutment introduced to emphasize the importance of exploring unknown nature of local soils.

  • PDF

Surgical Treatment of Esophageal Cancer (식도암의 임상적 고찰)

  • 최진호
    • Journal of Chest Surgery
    • /
    • v.28 no.3
    • /
    • pp.287-292
    • /
    • 1995
  • From March 1989 to June 1994, 24 casesof esophageal cancer were treated surgically. Among 24, male was 22 cases, female was 2 cases, and the age ranged from 46 to 75, the mean was 59.8. Symptoms were dysphagia[86.9% , weight loss[65.2% and retrosternal pain or discomfort[47.8% . The tumor was located cervical esophagus in two, upper esophagus in three, middle esophagus in 12 and lower esophagus in 7. Among 24 patients, 22 were curative resection, partial esophagectomy with esophagogastrostomy[18 cases or colon interposition [3 cases , with total esophagectomy with musculocutaneous flap[1 case , with feeding jejunostomy or gastrostomy in two cases.Postoperative complications revealed 10 patients[45.4% , as followed ; pleural effusion and pneumonia in 5, passage disturbance in 4, empyema and wound infection in 3, esophagopleural fistula and sepsis in 2, anastomotic site leakage and respiratory failure in each 1. The operative mortality was 13.6 % [3/22 and causes of death were respiratory failure in 1 case and sepsis in 2 cases.During follow-up work, 8 cases died during follow-up period, mean survival time was 15.2 months in curative resection group. One year survival rate was 55.3% in resected group. Also, cancer recurrence revealed in 1 cases.

  • PDF

Clinical Analysis of Surgery for Aortic Disease (대동맥 질환 수술의 임상적 고찰)

  • 안정태
    • Journal of Chest Surgery
    • /
    • v.28 no.10
    • /
    • pp.906-911
    • /
    • 1995
  • From January 1991 to January 1995, 11 patients with aortic diseases underwent various surgical repairs. The age at operation ranged from 26 years to 63 years[ mean=50.9 years . The disease entities included 8 aortic dissections[ type I in 4, type II in 2 and type III in 2 cases , 2 Marfan`s syndrome with annuloaortic ectasia and 1 desecending thoracic aortic aneurysm The operative procedures we tried were 3 Bentall`s operation, 5 graft replacement of ascending aorta, and 3 graft interposition in descending thoracic aorta.Overall hospital mortality rate is 36.3%[4/11 . And causes of death are pump weaning failure in 2 cases and multiorgan failure in 2 cases. It was that 2 sternal dehiscence & mediastinitis, 1 acute renal failure, 2 hypoxic brain damages and 2 postoperative psychosis were complicated. Recently we tried surgical repair of aortic dissection five out of 6 cases using total circulatory arrest with deep hypothermia at 14$^{\circ}C$. Total circulatory arrest time ranged from 18 to 26 minutes[ mean 22.2 minutes , and mean aortic cross-clamping time was 48.2 minutes. One of 5 patient died on the 7th postoperative day due to multiorgan failure. Mortality of patients with TCA was 20%[1/5 , and it of remainders was 50%[3/6 . Our result for surgical repair using total circulatory arrest with deep hypothermia is satisfactory on the basis of our clinical data.

  • PDF

An Exploratory Study for the Telecommunications Service Failure Cases in South Korea (정보통신 서비스의 실패 요인: 한국의 텔레콤 서비스시장에서의 실패사례연구)

  • 안재현;권재원;김명수;이동주;이상윤;한상필
    • Journal of the Korean Operations Research and Management Science Society
    • /
    • v.27 no.3
    • /
    • pp.115-133
    • /
    • 2002
  • In this paper, 15 South Korean telecommunications service failure cases were analyzed. Through the in-depth case study, 8 factors were found to be the major causes contributing to the telecommunications service failure. They were (1) ineffective marketing, (2) poor demand forecasting due to misjudgment of customer preference, (3) failure to satisfy technical specifications, (4) loss of cost advantage due to the price cut of competing services or new entry with lower price, (5) loss of utility advantage due to the increased utility of competing services or new entry with higher utility (6) decrease of market attractiveness due to change of customer preference, (7) impact of government policy, and (8) insufficient or low quality of contents. Additional analysis was done to derive managerial implications to the new telecommunications service development strategy. The findings from the paper will provide valuable Insight to the successful Implementation of new service development and service provisioning processes.

Piping Failure Analysis In Domestic Nuclear Safety Piping System (국내 안전등급 배관에 대한 손상사례 분석)

  • Choi, Sun-Yeong;Choi, Young-Hwan
    • Proceedings of the KSME Conference
    • /
    • 2003.04a
    • /
    • pp.617-621
    • /
    • 2003
  • The purpose of this paper is to analyze piping failure trend of safety pipings In domestic nuclear power plants. First, database for the piping failure was constructed with 105 data fields. The database includes plant population data, event data, and service history data. 7 kinds of piping failures in domestic NPPs were investigated. Among the 7 cases, detailed root causes were investigated for 3 cases. The first one is pipe wall thinning in main feedwater pipings of Westinghouse 3 loop type plants. The root cause of the wall thinning was flow accelerated corrosion near welding area. The next one is leak event in chemical and volume control system(CVCS) due to vibration. Some cracks occurred in socket welding area. The events showed that the integrity or socket weld is very vulnerable to vibration. The last one is also a leak event in primary sampling line in Korean standard reactor due to thermal fatigue. Although the structural integrity was not maintained by the events, there was no effect on nuclear safety in the above 3 piping failure eases.

  • PDF