• Title/Summary/Keyword: interrupted

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Interrupted Single-layer Suture Technique in Esophageal Anastomosis Using Monofilament Polypropylene Suture (Monofilament Polypropylene사를 이용한 단속단층 식도문합술)

  • 성시찬;편승환
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.711-717
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    • 1998
  • Background: Although various anastomotic techniques and suture materials have been used in esophageal anastomosis, anastomotic leakage and stenosis are still somewhat frequent and serious complications when compared to other intestinal anastomoses. We have used interrupted single-layer suture technique using monofilament polypropylene suture in various esophageal anastomoses, including repair of the esophageal atresia, since 1990. Methods and method: We retrospectively evaluated the efficacy of this technique on postoperative leakage and stenosis in several esophageal reconstructions. The esophageal reconstructions using this technique were performed in 90 patients at Dong-A University Hospital from April 1990 through December 1996. Results: Anastomotic leakage occurred in 5 patients(5.6%) with one operative death. Stenosis at the anastomotic site occurred in 15 patients(n=86, 17.4%), which was most common in esophagogastrostomy(22%) and least common in esophagocolostomy (5%). This result was comparable to other methods including the autosuture technique. Conclusions: We concluded that this suture technique in esophageal anastomosis can be used with reasonable results in various esophageal reconstructions including correction of the esophageal atresia.

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Modeling and Performance Analysis on the Response Capacity against Alert Information in an Intrusion Detection System (침입탐지시스템에서 경보정보에 대한 대응 능력 모델링 및 성능분석)

  • Jeon Yong-Hee;Jang Jung-Sook;Jang Jong-Soo
    • The KIPS Transactions:PartC
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    • v.12C no.6 s.102
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    • pp.855-864
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    • 2005
  • In this paper, we propose an intrusion detection system(IDS) architecture which can detect and respond against the generation of abnormal traffic such as malicious code and Internet worms. We model the system, design and implement a simulator using OPNET Modeller, for the performance analysis on the response capacity of alert information in the proposed system. At first, we model the arrival process of alert information resulted from abnormal traffic. In order to model the situation in which alert information is intensively produced, we apply the IBP(Interrupted Bernoulli Process) which may represent well the burstiness of traffic. Then we perform the simulation in order to gain some quantitative understanding of the system for our performance parameters. Based on the results of the performance analysis, we analyze factors which may hinder in accelerating the speed of security node, and would like to present some methods to enhance performance.

Implementation and Performance Evaluation of the Multicast Function for a Fully-Interconnected ATM Switch (완전 결합형 ATM 스위치의 멀티캐스트 기능 구현 및 성능 평가)

  • Jeon, Yong-Hui;Park, Jeong-Suk
    • The Transactions of the Korea Information Processing Society
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    • v.6 no.6
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    • pp.1581-1589
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    • 1999
  • In B-ISDN(Broadband Integrated Services Digital Networks), the efficient implementation of multicast function is very important since the demand for distributed type of service such as VOD(Video On Demand) system is expected to grow. In this paper, the multicast performance characteristics of fully-interconnected switch fabric used for our research is the proper architecture for a small-sized switch element, and it uses bit addressing method for addressing scheme and thus it is easy to implement multicast function without adding a function block. To incorporate the bursty nature of traffic in ATM networks, we used IBP(Interrupted Bernoulli Process) model as an input traffic model. We presented and analyzed the simulation results in terms of the multicast operation of the switch. Based. on this study, it its analyzed that congestion avoidance may be feasible if we use a proper traffic control scheme by finding an overload point due to multicast.

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Coronary Artery Bypass Graft (CABG) for Intracavitary Coronary Artery Disease - A case report- (심강내관상동맥(Intracavitary Coronary Artery)질환에 대한 관상동맥우회술 -수술치험 1예-)

  • Kim Su-Wan;Sung Kiick;Park Pyo Won;Jun Tae-Gook;Park Kay-Hyun;Lee Young Tak
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.504-506
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    • 2005
  • Intracavitary coronary artery is variant anomalous entrance to right ventricular cavity of left anterior descending artery. Since the disease is extremely rare, there has not been any report of it in Korea and is only found in $0.2\~0.3\%$ of all CABG patients. It is very difficult to be diagnosed by preoperative coronary arteriography (CAG) and secure suture is needed for right ventriculotomy after CABG due to bleeding from right ventricle. Horizontal mattress suture with pledget has been recommended but, it could compress the myocardium surrounding ventriculotomy and result in disturbed flow of left anterior descending artery branch and perforating artery. So we used simple interrupted suture and the patient was recovered as other CABG patients without complications.

Compamative Study of Tracheal Anastomotic Techniques. (기관 문합 수기의 비교 실험)

  • 송원영;이연재
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1219-1224
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    • 1997
  • Although several reports were presented recently about bronchial arterial revascularization in clinical lung transplantation, one factor peculiar to the lung transplantation is the ischemia of the donor bronchus. Poor bronchial healing occurs frequently following clinical lung transplantation and this has been major cause of mortality and morbidity. There have been many attempts to solve bronchial anastomotic complications. Telescoping technique, one of those attempts, was advocated by San Antonio Group recently. This experiment was per(armed to evaluate the effect of telescoping anastomotic technique upon th healing of the tracheo-bronchial anastomosis. We used rabbits(weighing about 800 g) as experimental animal. Method: Resection of middle one third of cervical trachea and reanastomosis was performed by simple interrupted anastomotic technique in Group 1(n=15) and by telescoping anastomotic technique in Group 2(n= 15). Result: Anastomotic sites in the telescoping technique group showed significant increase of fibrosis in the early postoperative days(< Sdays) and remarkable band-like fibrous union compared to the simple interrupted group.

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Trends in the utilization of dental outpatient services affected by the expansion of health care benefits in South Korea to include scaling: a 6-year interrupted time-series study

  • Park, Hee-Jung;Lee, Jun Hyup;Park, Sujin;Kim, Tae-Il
    • Journal of Periodontal and Implant Science
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    • v.48 no.1
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    • pp.3-11
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    • 2018
  • Purpose: This study utilized a strong quasi-experimental design to test the hypothesis that the implementation of a policy to expand dental care services resulted in an increase in the usage of dental outpatient services. Methods: A total of 45,650,000 subjects with diagnoses of gingivitis or advanced periodontitis who received dental scaling were selected and examined, utilizing National Health Insurance claims data from July 2010 through November 2015. We performed a segmented regression analysis of the interrupted time-series to analyze the time-series trend in dental costs before and after the policy implementation, and assessed immediate changes in dental costs. Results: After the policy change was implemented, a statistically significant 18% increase occurred in the observed total dental cost per patient, after adjustment for age, sex, and residence area. In addition, the dental costs of outpatient gingivitis treatment increased immediately by almost 47%, compared with a 15% increase in treatment costs for advanced periodontitis outpatients. This policy effect appears to be sustainable. Conclusions: The introduction of the new policy positively impacted the immediate and long-term outpatient utilization of dental scaling treatment in South Korea. While the policy was intended to entice patients to prevent periodontal disease, thus benefiting the insurance system, our results showed that the policy also increased treatment accessibility for potential periodontal disease patients and may improve long-term periodontal health in the South Korean population.

Anastomotic Complications after Esophageal Reconstruction (식도재건술후 문합부 합병증)

  • Lee, Chul-Burm;Hahm, Shee-Young;Kim, Hyuk;Jung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho;Baik, Hong-Kyu
    • Korean Journal of Bronchoesophagology
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    • v.6 no.1
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    • pp.62-71
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    • 2000
  • Background: For the purpose of reducing operating time and rate of anastomotic leakage, we have performed esophagovisceral anastomosis with an EEA stapler using the largest size possible. If any difficulty in the approach of the EEA stapler was encountered one-layer interrupted hand-sewn anastomosis. Because the rate of postoperative benign anastomotic stricture was higher than expected, a retrospective study was done on all patients who underwent esophageal reconstruction. Material and Method: Over a period of 3 years from January 1996 to December 1998, we performed esophageal reconstructions on 30 patients. Patients were divided into two groups ; EEA stapler group(Group Ⅰ) comprised of 21 patients and hand-sewn group(Group Ⅱ) comprised of 9 patients.Result:The hospital mortality was 6.67 %(2/30) and the anastomotic leakage rate was 3.33 %(1/30). Among the discharged patients, the rate of recurrent anastomotic tumor was 3.57 %(1/28) and the rate of benign anastomotic stricture stricture rate was 35 %(7/20) in Group Ⅰ and 12.5 %(1/8) in Group Ⅱ, which was not significant. Conclusion: Although nontumor benign stricture was significantly higher in Group Ⅱ than in Group Ⅰ(p=0.0492), the incidence of anastomotic complications did not differ between the two groups. The one-layer interrupted hand-sewn esophagovisceral anastomosis by maintaining a wide lumen and close approximation of mucosa to mucosal layers with evenly spaced sutures could be one of the preferred surgical method to reduce benign anastomotic strictures.

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Pulmonary artery rupture due to bacterial endocarditis complicated by patent ductus arteriosus. (동맥관개존증에 합병한 심내막염에 의한 폐동맥파열 실험 1례)

  • 조순걸
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.537-541
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    • 1985
  • Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.

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Effect of National Implementation of Telephone CPR Program to Improve Outcomes from Out-of-Hospital Cardiac Arrest: an Interrupted Time-Series Analysis

  • Lee, Yu Jin;Hwang, Seung-sik;Shin, Sang Do;Lee, Seung Chul;Song, Kyoung Jun
    • Journal of Korean Medical Science
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    • v.33 no.51
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    • pp.328.1-328.12
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    • 2018
  • Background: In cardiac arrest, the survival rate increases with the provision of bystander cardiopulmonary resuscitation (CPR), of which the initial response and treatment are critical. Telephone CPR is among the effective methods that might increase the provision of bystander CPR. This study aimed to describe and examine the improvement of neurological outcomes in individuals with out-of-hospital acute cardiac arrest by implementing the nationwide, standardized telephone CPR program. Methods: Data from the emergency medical service-based cardiac arrest registry that were collected between 2009 and 2014 were used. The effectiveness of the intervention in the interrupted time-series study was determined via a segmented regression analysis, which showed the risk ratio and risk difference in good neurological outcomes before and after the intervention. Results: Of 164,221 patients, 148,403 were analyzed. However, patients with unknown sex and limited data on treatment outcomes were excluded. Approximately 64.3% patients were men, with an average age of 63.7 years. The number of bystander CPR increased by 3.3 times (95% confidence interval [CI], 3.1-3.5) after the intervention, whereas the rate of good neurological outcomes increased by 2.6 times (95% CI, 2.3-2.9 [1.6%]; 1.4-1.7). The excess number was identified based on the differences between the observed and predicted trends. In total, 2,127 cases of out-of-hospital cardiac arrest (OHCA) after the intervention period received additional bystander CPR, and 339 cases of OHCA had good neurological outcomes. Conclusion: The nationwide implementation of the standardized telephone CPR program increased the number of bystander CPR and improved good neurological outcomes.

Big Data Visualization Analysis of Education Occupations with High Employment Rates by Age and Educational Background for Career-Interrupted Women (경력단절여성을 위한 연령 및 학력별 취업률이 높은 교육직종 빅 데이터 시각화 분석)

  • Lee, Jeongwon;Lee, Choong Ho
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.25 no.8
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    • pp.1019-1025
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    • 2021
  • Support policies such as education and training for re-employment of career-interrupted women are being implemented, but they are not being effectively employed. In addition, it is difficult for women with high educational background to re-enter, such as having to revise their previous careers or plan a new career for re-employment. In the previous studies, there was insufficient research to solve fundamental problems for re-employment, such as promising jobs with high employment opportunities. Therefore, when developing a curriculum for women with career interruptions, it was felt the need to select educational occupations that would be helpful in finding employment by age and educational background of the trainees. In this study, data on vocational training education of women with career interruptions were used to analyze the educational occupations with the highest employment rate by age and educational background.