Journal of the korean academy of Pediatric Dentistry
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v.37
no.2
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pp.233-239
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2010
Space loss of dental arch can appear when the proper position of teeth within the dental arch changes by a certain cause, because the balance of force makes changes about tooth position as well as alignment. The causes of space loss include proximal caries, early extraction, congenital missing of a tooth and hypodontia, etc. Among those causes of space loss, congenital missing of a tooth is more rarely observed in the primary dentition than in the permanent dentition. Congenital missing in the primary dentition is associated with that in the permanent dentition. Furthermore, it can cause space problem, such as mesial tilting or drift of adjacent teeth, space loss for permanent successors and dental arch constriction, etc. Primary lateral incisors is the most commonly involved, in the maxilla rather than in the mandible, but primary canine is rarely reported. In this patient, who visited the department of pediatric dentistry at Yonsei university dental hospital, it was observed that the maxillary right primary canine was congenitally missing and an odontoma was found insteadly. However, neither the space loss for the congenitally missing primary canine nor midline deviation is remarkable during the 2-year-10-month observation period. In addition, any clinical or radiographical symptom did not occur in spite of odontoma. Therefore, surgical enucleation of odontoma is planned according to the eruption of permanent lateral incisor or canine, unless eruption failure of permanent lateral incisor or canine nor cystic change around the odontoma is occurred. Through further evaluation, space maintainer or orthodontic treatment may be necessary.
Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.
Purpose : The purpose was to evaluate the early result of revision of failed anterior cruciate ligament (ACL) reconstruction. Materials and Methods : From August 1997 to February 2002, this report presents the findings of 18 patients who had revision surgery for failed ACL reconstruction. There was an average of 39 $(7\~120)$months from index procedure to the time of revision. Allografts were used in 14 $(78\%)$cases and autografts were used in 4 $(22\%)$cases and the revision procedures were assisted by arthroscopic technique. The majority of chief complaints were instability in 16 $(89\%)$cases. Sixteen $(89\%)$ cases had 1 previous reconstruction, 2 $(11\%)$ cases had 2. Before and after revision, patients were evaluated by Lachman test, pivot shift test, KT 2000, radiographs, Lysholm score and HSS score and subjective satisfaction. Results : Average length of followup was 27 $(12\~60)$months. Preoperatively, all cases were positive in Lachman test and pivot shift test. After revision the majority of cases were negative. Objectively improving stability was confirmed by KT 2000 and all average KT 2000 was 7.75 $(3.5\~12.5)$mm preoperatively and 2.36 $(1.0\~6.0)$mm at final followup. Lysholm score and HSS score were also improved from 72.6 $(66\~77)$ and 72.5 $(68\~78)$ preoperatively to 89.2 $(80\~92)$ and 88.2 $(81\~92)$ at final followup. Most $(89\%)$ of patients were satisfied with their results. The most common causes of failed ACL reconstruction were malposition of femoral tunnel in 11 $(61\%)$cases. Conclusion : Arthroscopic revision ACL surgery with adequate graft for failed ACL reconstruction was successful in objectively and subjectively improving stability. However, considering the most common causes of failure after ACL reconstruction were errors in surgical technique, it is important that the primary ACL reconstruction should be performed with correct surgical technique.
Cardiac transplantation has been the treatment of patients with end-stage heart disease since it was first performed in 1967. In Korea the first case was performed in 1992 and 42 patients underwent heart trans- plantation so far. The purpose of this article is to report short-term result of cardiac transplantation at our center. Between April 1994 and September 1995, 14 patients had undergone orthotopic heart transplantations. There was 12 male and 2 female patients. Mea recipient age was 34 years(range 11 to 54 years) and mean donor age was 28.4 years(16 to 50 years). Mean graft ischemic time was 120.7minutes(80 to 280 minutes). The follow-up period after transplantation was 11 months(3 to 17 months). Recipient diagnosis included dilated cardiomyopathy in 10, ischemic cardiomyopathy in 2, valvular cardiomyopathy in 1, congenital complex heart disease in 1 patient. The preoperative status of the recipients were state I (50%) and ll (50%) by UNOS classification and class 111 (5 patients) and class IV (9) by NYHA functional class. All patients were treated with triple-drug immunosuppression (cyclosporine, azathioprine, steroid) and induction with RATG. The rejection episodes were 5 times in 3 patients during the follow-up. Causes of infection were aspergillosis (2), and hepes zoster (1), CMV pneumonitis (1). Permanent pace- maker was inserted in 1 patient. Currently 9 patients are alive with seven patients in WYHA functional class I and two in class l . The ejection fraction increased from preoperative value of 19.9 $\pm$ 3.4% to postoperative value of 69.0 $\pm$ 5.6%. The causes of death were cellular rejection (1),chronic graft failure due to size-mismatching (1),respirat- oxy insufficiency due to asthma attack (1), subarachnoid hemorrhage (1), and RIO humoral rejection (1).
Kim, Do-Kyun;Yoo, Kyung-Jong;Youn, Young-Nam;Yi, Gi-Jong;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick
Journal of Chest Surgery
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v.40
no.3
s.272
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pp.209-214
/
2007
Background: Failed percutaneous transluminal coronary angioplasty (PTCA) is occasionally required for emergency coronary artery bypass grafting (CABG). The aim of this study was to assess the outcome of patients receiving emergency CABG after failed PTCA. Material and Method: Between May 1988 and May 2005, 5712 patients underwent PTCA, where 84 (1.4%) failed. 27 patients underwent emergency CABG after failed PTCA. The mean age was $63.7{\pm}8.9\;(46{\sim}80)$ years, with 14 male patients (51.9%). Result: All patients underwent emergent surgical revascularization within 6 hours. 22 patients underwent conventional CABG and 5 underwent off-pump CABG. The causes of PTCA failure were coronary obstruction due to new thrombi formation during the procedure (n=4), coronary dissection (n=17), coronary artery rupture (n=3) and 3 due to other causes. The rate of in-hospital operative mortality after emergent operation was 18.5% (5/27). A univariate analysis revealed that patients who died more often had left anterior descending artery disease, a preprocedural shock status, postoperative use of multiple isotropics and postoperative use of intra-aortic balloon pump. The mean follow up duration was $53.6{\pm}63.4$ months. Conclusion: Although PTCA is known to be life saving, there is still a high risk for morbidity and mortality following emergency CABG after failed PTCA, despite the advancement in PTCA techniques. This result will help identify and more effectively treat patients selected for PTCA when emergency CABG is required.
This study One of the key elements of corporate competitiveness in the modern world of unlimited competition is human resource management. The reason that the world's leading companies are devoting a lot of investment and effort for good human resource development and management is that human resource can impact firm survival. In particular, there is little research on the internal and external environmental stimuli and job stress in the employee of small business which are often led to turnover, while they have suffered from chronic shortage of manpower. The purpose of this study is to determine the turnover factors in the small logistics companies and contribute to stable maintenance of workforce, facilitating human resource management and minimizing turnover. This study empirically analyzed the factors of the turnover in the organization of logistics companies from Busan Port, South Korea, which became one of the national infrastructure and the fifth world largest harbor. The conclusion proposed the development and direction of the human resource management which could promote the job environment improving the turnover factors and creating sustainable work condition through conducting preventive measures. The results indicated that the highest turnover rates was found in the category of field work, and the highest turnover group was from the 'less than one year', which implies that high turnover rates after and during job training might be greater cost to the companies than early turnover. The most common reasons for the high employee turnover were 'excessive workload' and 'dissatisfaction with wages'. Followed reasons including 'troubles with managers' and 'failure in organizational adaptation' can be understood in line with worse working conditions of the small logistic companies. It turned out that the preventive programs of the logistic enterprises had little effect through 'incentives system' and 'improving wage system' which are mainly conducted. The human resource managers appreciated the importance of 'wage raise' and 'benefits improvement'. This study is aimed at contributing to efficient human resource management through understanding of the turnover causes and human resource managers applying preventive measures. In particular, this can benefit small port logistics companies securing competitiveness and promoting persistent growth and development.
Purpose During Brain SPECT study, critical factor for proper study with $^{99m}Tc-ECD$ or $^{99m}Tc-HMPAO$ is one of the important causes to patent's movement. It causes both improper diagnosis and examination failure. In this study, we evaluated the effect of Dynamic Continuous Mode Acquisition compared to Step and Shoot Mode to raise efficacy and reject the data set with movement, as well as, be reconstructed in certain criteria. Materials and Methods Deluxe Jaszczak phantom and Hoffman 3D Brain phantom were used to find proper standard data set and exact time. Step and Shoot Mode and Dynamic Continuous Mode Acquisition were performed with SymbiaT16. Firstly, Deluxe Jaszczak phantom was filled with $Na^{99m}TcO_4$ 370 MBq and obtained in 60 minutes to check spatial resolution compared with Step and Shoot Mode and Dynamic Continuous Mode. The second, the Hoffman 3D Phantom filled with $Na^{99m}TcO_4$ 74 MBq was acquired for 15 Frame/minutes to evaluate visual assessment and quantification. Finally, in the Deluxe Jaszczak phantom, Spheres and Rods were measured by MI Apps program as well as, checking counts with the frontal lobe, temporal lobe, occipital lobe, cerebellum and hypothalamus parts was performed in the Hoffman 3D Brain Phantom. Results In Brain SPECT Study, using Dynamic Continuous Mode rather than current Step and Shoot Mode, we can do the reading using the 20 to 50 % of the acquired image, and during the test if the patient moves, we can remove unneeded image to reduce the rate of restudy and reinjection. Conclusion Dynamic Continuous Mode in Brain study condition enhances effects compared to Step and Shoot Mode. And also is powerful method to reduce reacquisition rate caused by patient movement. The findings further indicate that it suggest rejection limit to maintain clinical value with certain reconstruction factors compared with Tomo data set. Further examination to improve spatial resolution, SPECT/CT should be the answer for that.
Most concrete gravity-type dams in and out of the country were constructed by column method to control cracks caused by concrete hydration heat generated during construction, resulting in a certain level of leakage after impoundment through various causes, such as contraction joints and construction joints. However, due to the characteristics of concrete structures that shrink and expand according to temperature, concrete dams have vertical joints and drains to allow penetration. PVC waterproof shows excellent effects in completion of the dam, which however increases the possibility of interfacial failure due to different thermal expansion. Other causes of penetration may include problems with quality control during installation, generation of cracks due to heat of hydration of concrete, waterproofing methods, etc. In the case of Bohyunsan Dam in Yeongcheon, North Gyeongsang Province, the amount of drainage in the gallery was checked and underwater, and it was confirmed that there are many penetrations from drainage holes connected to vertical joints, and that some of the PVC waterproofs are not fully operated. As a new method to prevent penetration through vertical joints, D.S.I.M. (Dam Sealing Innovation Method) developed by World E&C was applied to Bohyunsan Dam and checked the amount of drainage in the gallery. As a result of first testing three most leaking vertical joints, the drain in the gallery was reduced by 87% on the average and then applied to the remaining 13 locations, which showed a 83% reduction effect based on the total drain in the gallery. Summing up these results, it was found that D.S.I.M. preventing water leakage from the upstream face is a valid construction method to reduce the water see-through and penetration quantity seen in downstream faces of concrete dams. If D.S.I.M. is applied to other concrete dams at domestic and abroad, it is expected that it will be very effective to prevent water leakage through vertical joints that are visible from downstream faces.
Journal of Korean Society of Disaster and Security
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v.14
no.4
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pp.47-60
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2021
Recently, as the occurrence frequency of sudden floods due to climate variability increased, the damage of aging chuteway slabs of spillway are on the rise. Accordingly, a wide array of field survey, hydraulic experiment and numerical simulation have been conducted to find the cause of damage on chuteway slabs. However, these studies generally reviewed the flow characteristics and distribution of pressure on chuteway slabs. Therefore the derivation of damage on chuteway slabs was relatively insufficient in the literature. In this study, the cavitation erosion and hydraulic jacking were assumed to be the causes of damage on chuteway slabs, and the phenomena were reproduced using 3D numerical models, FLOW-3D and COMSOL Multiphysics. In addition, the cavitation index was calculated and the von Mises stress by uplift pressure distribution was compared with tensile and bending strength of concrete to evaluate the possibility of cavitation erosion and hydraulic jacking. As a result of numerical simulation on cavitation erosion and hydraulic jacking under various flow conditions with complete opening gate, the cavitation index in the downstream of spillway was less than 0.3, and the von Mises stress on concrete was 4.6 to 5.0 MPa. When von Mises stress was compared with tensile and bending strength of concrete, the fatigue failure caused by continuous pressure fluctuation occurred on chuteway slabs. Therefore, the cavitation erosion and hydraulic jacking caused by high speed flow were one of the main causes of damage to the chuteway slabs in spillway. However, this study has limitations in that the various shape conditions of damage(cavity and crack) and flow conditions were not considered and Fluid-Structure Interaction (FSI) was not simulated. If these limitations are supplemented and reviewed, it is expected to derive more efficient utilization of the maintenance plan on spillway in the future.
A retrospective study of 94 hypercalcemic dogs was performed to find out most common causes that lead to hypercalcemia through investigating dogs referred to the Veterinary Teaching Hospital of Konkuk University from 2002 to 2004. During the study period, hypercalcemia was found in 94 dogs of 19 breeds, and they were evaluated as case group. Control group was made up of 94 dogs of 18 breeds without hypercalcemia admitted for the same study period. For general signalments, there were no significant differences between case and control group with the exception of age distribution. Shih-tzu(17.02%) and Yorkshire terrier(26.60%) was the most common breed in case and control group, respectively. The most common diseases associated with hypercalcemia were chronic renal failure (18.09%), acute renal failure(14.89%), and renal calculi(6.38%). Malignant neoplasia(lymphoma, hemangiosarcoma, chronic lymphocytic leukemia, mammary gland tumor, and multiple myeloma) and endocrinopathies(hyperadrenocorticism, hyperthyroidism, hypoadrenocorticism, and hypothyroidism) occupied 8.5% and 6.4%, respectively. This report is a first retrospective study of hypercalcemic dogs in South Korea.
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