• Title/Summary/Keyword: failure event

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Early and Midterm Results of Coronary Artery Bypass Grafting in Patients with Ischemic Cardiomyopathy ${(LVEF{\leq}35%)}$ (허혈성 심근질환(좌심실박출지수${\leq}$35%) 환자에서 관상동맥우회술의 조기와 중기 결과)

  • Cho Sung-Woo;Lee Young-Tak;Choi Jin-Ho;Kim Si-Wook;Park Kay-Hyun;Park Pyo-Won;Sung Ki-Ick
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.604-610
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    • 2006
  • Background: Recent improvements in interventional procedure and medical therapy for congestive heart failure result in an increase of number of patients with ischemic cardiomyopathy considered for coronary artery bypass grafting. We retrospectively review the results of CABG in these patients with decreased LV function to know the early and mid-term follow-up results. Material and Method: Between January 2001 and June 2005, 1,143 patients underwent coronary artery bypass grafting and 144 of these patients had preoperative left ventricular function of equal to or less than 35% ${(LVEF{\leq}\;35%)}$. There were off-pump coronary artery bypass grafting (OPCAB) in 66 cases (45.8%), on-pump beating heart coronary artery bypass grafting in 34 cases (23.6%) and conventional coronary artery bypass grafting in 44 cases (30.6%). The combined operations including mitral annuloplasty were 48 cases in thirty five patients (24.3%). Result: The mean number of dstal anastomosis were $3.5{\pm}1.3$. The median postoperative duration of stay in intensive care unit and hospital was 2 days and 8 days, respectively. There were 6 early death (4.2%) and causes of deaths were ventricular tachycardia in 5 patients, small bowel infarction in one patient. Mean follow-up time was $21{\pm}14$ months $(4{\sim}54\;months)$. The 1-year was $95{\pm}2%$ and 3-year survival rate was $83{\pm}7%$, the 1-year and 3-year cardiac event-free survival were ${88{\pm}3%\;and\;69{\pm}7%}$, respectively. Conclusion: Based on satisfactory early and mid-term results in our study, CABG should be carried out as actively as possible in patients with ischemic cardiomyopathy. Postoperative aggressive management for ventricular arrhythmia would be helpful for better results.

Clinical Experiences of redo-CABG (관상동맥우회 재수술의 임상적 고찰)

  • Lim, Sang-Hyun;Kwak, Young-Tae;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick;Cho, Bum-Koo;Yoo, Kyung-Jong
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.779-784
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    • 2002
  • Recently, the number of coronary artery bypass surgery(CABG) is increasing according to the increasing incidence of coronary artery disease. However, CABG is not a definite corrective surgery; therefore, in some patients, redo-CABG may be required. We retrospectively reviewed our redo-CABG experiences to help future redo-CABG. Material and Method: From January 1991 to April 2001, 14 cases of redo-CABG were performed in Yonsei Cardiovascular Center(M:F=12:2) and mean age was 61,7 $\pm$ 7.1(47-72) years. Mean time from 1st. CABG to redo-CABG was 121.9 $\pm$ 50.5(6.1-179.6) months. Thirteen cases were conventional on-pump CABG and one case was off-pump CABG. In two patients, mitral valve re-replacement and mitral valve repair were performed each. All redo-CABG were performed through mid-sternotomy. During redo-CABG, left internal mammary artery and saphenous vein grafts were used in 6 patients, left internal mammary artery and left radial artery grafts were used in 2 patients, left internal mammary artery and gastroepiploic artery were used in one patient and only greater saphenous veins were used in 5 cases(In one case, cephalic vein was also used). The number of mean distal anastomosis was 2.1 $\pm$ 0.9(1-4). Result: There were no operative death and no perioperative myocardial infarctions and cerebrovascular accidents or other heart related complications. Mean follow up duration was 40.1 $\pm$ 38.6(1.1-118.5) months. During follow up period, angina was re-developed in one patient 13 months after operation. Two patients died of end-stage renal failure 14.8 months and 116.3 months after redo-CABG, respectively. During follow up period, coronary angiography was performed in 3 patients, and all grafts were patent. At last follow up, mean Canadian class was 1.3. Kaplan-Meier survival at 9 years was 90.0 $\pm$ 9.5% and event free survival at 9 years was 71.4 $\pm$ 6.9%. Conclusion: After redo-CABG, all patients improved their angina symptom and daily activity. And long-term survival after redo-CABG was excellent. Therefore, if patients have indications for redo-CABG, thenredo-CABG must be strongly recommended and performed.

Long-term Influence of Mild to Moderate Ischemic Mitral Regurgitation after Off-pump Coronary Artery Bypass Surgery (무심폐기하 관상동맥우회술에서의 중등도의 허혈성 승모판막부전증의 중요성)

  • Hong, Jong-Myeon;Cartier, Raymond
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.246-253
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    • 2010
  • Background: Our objective was to review the long-term prognosis of patients with preoperative mild to moderate ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting. Material and Method: We prospectively followed 1,000 consecutive and systematic off-pump coronary artery bypass grafting patients who were operated on between September 1996 and March 2004; follow-up was achieved for 97%. Sixty-seven patients (6.7%) had mild to moderate ischemic mitral regurgitation at the time of surgery. Operative mortality, actuarial survival and major adverse cardiac event free survival were compared to assess the effect of ischemic mitral regurgitation. Result: Average follow-up was $66{\pm}22$ months. Patients with ischemic mitral regurgitation were older (p<0.001), had lower ejection fractions (p<0.001) and more comorbidities. Significantly more female patients presented with ischemic mitral regurgitation (p=0.002). There was no significant difference in operative mortality and perioperative myocardial infarction in ischemic mitral regurgitation patients (p=0.25). Eight-year survival was decreased in ischemic mitral regurgitation patients ($39.6{\pm}11.8%$ vs $76.7{\pm}2.2$, p<0.001). However, after correcting for risk factors, mild to moderate ischemic mitral regurgitation was not found to be a significant independent risk factor for long-term mortality (p=0.42). Major adverse cardiac event free survival at 8 years was significantly lower in ischemic mitral regurgitation patients ($53.12{\pm}12%$ vs $77{\pm}2%$, p<0.001). After correction for risk factors, ischemic mitral regurgitation remained a significant independent cause of major adverse cardiac events (HR: 2.31), especially congestive heart failure and recurrent myocardial infarction. Conclusion: In our series, patients with preoperative mild to moderate ischemic mitral regurgitation had a higher prevalence of preoperative risk factors than patients without ischemic mitral regurgitation. They had comparable perioperative mortality and morbidity, but, in the long term, were found to be at elevated risk for recurrent cardiac events.

A Study on the Experience of Physical Therapy Accident in The Physiotherapist (물리치료사에 있어서 물리치료 사고의 경험에 관한 연구)

  • Kim, Jong-Dae
    • Journal of Korean Physical Therapy Science
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    • v.9 no.1
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    • pp.69-80
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    • 2002
  • The objective of research provides the physical therapy of good quality to the patients to search for the problem pant against a physical therapy accident and it simultaneously respects physical therapy company law, the possibility of preparing a system defensive ability in order to be. The data were collected from 2000 October 1 to December 30th, and analyzed by a frequency and a percentage, oneway ANOVA, Scheffe method, $x^2$ official approvals. Conclusion (1) the accident where the patient falls from inside the treatment 'room is many and occasionally' 29.3% (63 people) with was many most. (2) Because of a mistake by a part-time therapist in holiday or a colleague therapist to do, the fracture or bum accident happens 12.5% (27 people), by a assist nurse due to more showed 12.1% (26 people) experience degree in the patient. (3) From physical therapy process breakdown of the medical treatment machinery and tools or it is in malfunction to do and the experience which has a failure to physical therapy is one enemy 68.1% (147 people) was in item. Also it treats and the patient or in the protector it sends an explanation in advance not to be, the experience which it enforces 50% (108 people), of service hour treatment equipment the medical treatment directives broad way of the doctor is accurate in insufficiency and does not enforce the experience is 45.4% (98 people), the patient whom I am treating Hot Pack (electricity has pack inclusion) with to do, the art dealer (over at 1 buffoonery) the experience which it puts on 27.1% (58 people), The patient whom I am treating is the electrotherapy flag (electricity has pack exclusion) with to do, the art dealer (1 degree art dealer over) the experience which it puts on 16.3% (35 people), the experience boat song the patient against a fracture from physical therapy process 9 person (4.2%) was visible an experience degree. (4) With hospital infection to do, from the patient the experience and the therapist which receive a problem proposal were caused by with hospital infection and the answer back regarding the experience which tries to receive a treatment appeared 6% (13 people), 42% (9 people) with each. (5) It listened to the treatment hour patient or the appeal of the protector and especially it does not appear to be being important it was not and and the management which is special it did not take, also the experience where the condition of the patient is deteriorated after that was 10.3% (22 people). (6) The condition or state of the patient does not agree with the medical treatment instruction of the doctor not to be, amendment one experience was 67.5% (145 people). (7) The experience degree of the physical therapy accident which relates with physical therapy recording and a secret maintenance 59.7% (129 people) 'is many and occasionally it is,' it showed an answer back and e it showed a most high accident experience degree. (8) The business overweight of physical therapy company 43.3% (93 people) with was high most from recognition degree of the physical therapy company against a physical therapy accident. (9) Against the question which asks the responsibility subject matter of physical therapy accident the whole answer back volition 42.8% did it is a joint responsibility where the multi person relates. (10) The accident occurs most the hour unit which plentifully in the afternoon 64.3% (133 people) with appeared from the recognition degree against the frequency hour unit of physical therapy accident. (11) Physical therapy it bought and after the various medical treatment accident which relates against the attitude of the, patient side against the physical therapy company it understood and trillion it was many most with 33.3% to be finished. (12) After physical therapy accident the management against the physical therapy company of the hospital authorities concerned above all do not experience 70.6% (149 people), from event right and wrong submission 22.7% (48 people), warning management 2.8% (6 people), the event report requirement and money compensation were each 0.5% (1 person). (13) As the prevention book of physical therapy accident most it is important, the fact which it thinks that, the persons supplement of physical therapy company 58.8% (127 people) with was high most. (14) It related with a physical therapy accident and the medical law 43.5%, civil law 23.9%, was visible the answer back ratio of the criminal law 13.7% from the degree which probably is a relation law.

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An Analysis of the Hail Damages to Korean Forests in 2017 by Meteorology, Species and Topography (2017년 우박에 의한 산림피해의 기상, 수종 및 지형 특성 분석)

  • Lim, Jong-Hwan;Kim, Eunsook;Lee, Bora;Kim, Sunhee;Jang, Keunchang
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.19 no.4
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    • pp.280-292
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    • 2017
  • Hail is not a frequently occurring weather event, and there are even fewer reports of hail damages to forest stands. Since the 2000s, an increase in hail incidence has been documented in Europe and the United States. In Korea, severe hails occurred in Jeollanam-do province on May 31 and in Gyeongsangbuk-do province on June 1, 2017. Hail size was ranged from 0.5 to 5.0 cm in diameter in Jeollanam-do, and from 1.5 to 3.0 cm in Gyeongsangbuk-do. This study was aimed to analyze the hail damages to forests by species and topography based on damage-categorized maps created by using drones and aerial photographs, and to analyze relationships of the damages with meteorological factors. The total damaged forest area was 1,163.1ha in Jeollanam-do, and 2,942.3ha in Gyeongsangbuk-do. Among the 'severe' damaged area 326.7ha, 91% was distributed in Jeollanam-do, and concentrated in the city of Hwasun which covers 57.2% of the total 'severe' damaged area. The most heavily damaged species was Korean red pine(Pinus densiflora S. & Z.) followed by P. rigida. Most broad-leaved trees species including oaks were recovered without any dead trees found. Liliodendron tulipifera was the most severely damaged in terms of the rate of 'severe' degree individuals which are needed to be checked whether they will die or be recovered. Cause of the death of pines was considered as the combination of physical damage caused by the hail and long-lasting drought with high air temperature that occurred before and after the hail event. No pathogens and insects were found which might have affected to tree deaths. We suggested a dieback mechanism of the pine trees damaged by hail and drought.

An Experimental Study on the Detection of Loosened Areas in a Ground cavity Using a Micro Penetration Test (초소형 관입시험기를 이용한 지반공동 주변지반의 이완영역탐지를 위한 실험적 연구)

  • Kim, Ho-Youn;Kim, Young-Ho;Park, Yoon-Suk;You, Seung-Kyong;Han, Jung-Geun
    • Journal of the Korean Geosynthetics Society
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    • v.18 no.4
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    • pp.299-306
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    • 2019
  • In this study, a model experiment that simulates the behaviour of the ground composed of several compacted layer was intended to measure the loosened area in the event of a ground cavity through a LAD (Loosened area detector). It was confirmed that the size of the cone diameter was affected by the ground composed of fine grain + granulated soil layered through the model soil. In order to select the appropriate cone type, a scale effect experiment was conducted. From the test results, a micro-cone was chosen for the most suitable indoor model experiment. In the case of applying LAD in this study, the loosening condition of the ground was determined by the rapid change in penetration resistance caused by the difference in the boundary surface and relative density due to the compaction of the ground for indoor model testing. The range of loosened area occurring in the cavity was estimated through the penetration resistance characteristics on the ground, and the failure area was identified through the reduction rate of penetration resistance in the loosening area.

Blood-neural Barrier: Intercellular Communication at Glio-Vascular Interface

  • Kim, Jeong-Hun;Kim, Jin-Hyoung;Park, Jeong-Ae;Lee, Sae-Won;Kim, Woo-Jean;Yu, Young-Suk;Kim, Kyu-Won
    • BMB Reports
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    • v.39 no.4
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    • pp.339-345
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    • 2006
  • The blood-neural barrier (BNB), including blood-brain barrier (BBB) and blood-retinal barrier (BRB), is an endothelial barrier constructed by an extensive network of endothelial cells, astrocytes and neurons to form functional 'neurovascular units', which has an important role in maintaining a precisely regulated microenvironment for reliable neuronal activity. Although failure of the BNB may be a precipitating event or a consequence, the breakdown of BNB is closely related with the development and progression of CNS diseases. Therefore, BNB is most essential in the regulation of microenvironment of the CNS. The BNB is a selective diffusion barrier characterized by tight junctions between endothelial cells, lack of fenestrations, and specific BNB transporters. The BNB have been shown to be astrocyte dependent, for it is formed by the CNS capillary endothelial cells, surrounded by astrocytic end-foot processes. Given the anatomical associations with endothelial cells, it could be supposed that astrocytes play a role in the development, maintenance, and breakdown of the BNB. Therefore, astrocytes-endothelial cells interaction influences the BNB in both physiological and pathological conditions. If we better understand mutual interactions between astrocytes and endothelial cells, in the near future, we could provide a critical solution to the BNB problems and create new opportunities for future success of treating CNS diseases. Here, we focused astrocyte-endothelial cell interaction in the formation and function of the BNB.

COMS Electrical Power Subsystem Preliminary Design (통신해양기상위성 전력계 예비설계)

  • Gu, Ja-Chun;Kim, Ui-Chan
    • Journal of Satellite, Information and Communications
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    • v.1 no.2
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    • pp.95-100
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    • 2006
  • The COMS(Communication, Ocean and Meteorological Satellite) EPS(Electrical Power Subsystem) is derived from an enhanced Eurostar 3000 version. Eurostar 3000 EpS is fully autonomous operation in nominal conditions or in the event of a failure and provides a high level of reconfigure capability. This paper introduces the COMS EPS preliminary design result. COMS EPS consists of a battery, a solar arrat wing, a PSR(Power Supply Regulator), a PRU(Pyrotechnic Unit), a SDAM(Solar Array Drive Mechanism) and relay and fuse brackets. COMS EPS can offer a bus power capability of 3 kW. The solar array is made of a deployable wing with two panels. One type fo solar cells is selected ad GaAs/Ge triple junction cells. Li-ion battery is base lined with ten series cell module of five cells in parallel. PSR associated to battery and solar array wing generates a power bus fully regulated at 50 V. Power bus os centralized protection and distribution by relay and fuse brackets. PRU provides power for firing actuarors devices. The solar array wing is rotated by the SADM under control of the attitude orbit control subsystem. The control and monitoring of the EPS, especially of the battery, is performed by the PSR in combination with the on-board software.

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Design and Evaluation of a High-performance Journaling Scheme for Non-volatile Memory (비휘발성 메모리를 고려한 고성능 저널링 기법 설계 및 평가)

  • Han, Hyuck
    • The Journal of the Korea Contents Association
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    • v.20 no.8
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    • pp.368-374
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    • 2020
  • Journaling file systems (JFS) manage changes of file systems not yet committed in a data structure known as a journal to restore the file system in the event of an unexpected failure. Extra write operations required for journaling negatively affect the performance of JFS. The high-performance and byte-addressable non-volatile memory (NVM) was expected to easily mitigate these performance problems by providing NVM space as journal storage. However, even with such non-volatile memory technologies, performance problems still arise due to scalability problems inherent in processing transactions of JFS. To solve this problem, we proposes a technique for processing file system transactions for scalable performance. To this end, lock-free data structures are used and multiple I/O requests are allowed to simultaneously be processed on high-performance storage devices with multiple I/O channels. We evaluate the file system with the proposed technique by comparing the original ext4 file system and the recent proposed NVM-based journaling file system on a multi-core server, and experimental results show that our file system has better performance (up-to 2.9/2.3 times) than the original ext4 file system and the recent NVM-based journaling file system, respectively.

Experimental Analysis for Characteristics of Bank-Scour around Barrier (수리실험을 통한 보 연결부 제방 세굴 특성 분석)

  • Jeong, Seok Il;Lee, Seung Oh
    • Journal of the Korean Society of Safety
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    • v.32 no.4
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    • pp.34-39
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    • 2017
  • Typical flow regime of overflow at barrier or weir constructed in mid and small streams becomes as the submerged flow during most flood events. One of major causes of barrier failure has been reported as the levee-scour near the conjuction node between barrier and levee. However, most related design guidelines in Korea have not mentioned about the protection of levee around barrier or weir in detail. Furthermore, most previous researches have focused on the flow characteristics of overflow around several types of weirs but they did not have considered the material properties of levee itself. In this study, local scour near barrier was investigated with different material properties of levee under the submerged overflow condition which is assumed to reenact a flood event. Based on results from Fritz et al. and Mavis et al., a theoretical formula was also proposed in initial stage of laboratory experiments. And hydraulic experiments were carried out for the verification of the proposed formula. Levee was installed in the prismetic trapezoidal open channel and most parts were made of concrete except for movable section in which scour was expected to occur for the efficiency of experimental procedure. Each compaction of movable section in levee was followed by the basis of the KS F 2312. Further, after performing the experiments to find the optimum water content for each sediment, the specific amount of water was injected before flowing water. The difference between the proposed theoretical formula and experiment results was not much but considerable, which might be caused by the effect of compaction. For theoretical approach, it seemed that the formula did not take into account the compaction of levee, thus the correction coefficient for levee compaction determined in the literature was considered. Finally, the formula for the length of scour around barrier or weir was proposed, which can be useful to predict a levee in the reference design of revetment in mid and small streams. As shortly future study, scour length of levee around barrier or weir under different flow conditions such as perfect overflow condition will be studied and it will be able to contribute to suggest the design formula or criteria under all overflow conditions near barrier or weir.