• Title/Summary/Keyword: post-operation

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Long-Term Wildfire Reconstruction: In Need of Focused and Dedicated Pre-Planning Efforts

  • Harris, William S.;Choi, Jin Ouk;Lim, Jaewon;Lee, Yong-Cheol
    • International conference on construction engineering and project management
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    • 2022.06a
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    • pp.923-928
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    • 2022
  • Wildfire disasters in the United States impact lives and livelihoods by destroying private homes, businesses, community facilities, and infrastructure. Disaster victims suffer from damaged houses, inadequate shelters, inoperable civil infrastructure, and homelessness coupled with long-term recovery and reconstruction processes. Cities and their neighboring communities require an enormous commitment for a full recovery for as long as disaster recovery processes last. State, county, and municipal governments inherently have the responsibility to establish and provide governance and public services for the benefit and well being of community members. Municipal governments' comprehensive and emergency response plans are the artifacts of planning efforts that guide accomplishing those duties. Typically these plans include preparation and response to natural disasters, including wildfires. The standard wildfire planning includes and outlines (1) a wildfire hazard assessment, (2) response approaches to prevent human injury and minimize damage to physical property, and (3) near- and long-term recovery and reconstruction efforts. There is often a high level of detail in the assessment section, but the level of detail and specificity significantly lessons to general approaches in the long-term recovery subsection. This paper aims to document the extent of wildfire preparedness at the county level in general, focusing on the long-term recovery subsections of municipal plans. Based on the identified challenges, the researchers provide recommendations for better longer-term recovery and reconstruction opportunities: 1) building permit requirements, 2) exploration of the use of modular construction, 3) address through relief from legislative requirements, and 4) early, simple, funding, and the aid application process.

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Development of status monitoring tools for KASS system operation (KASS 시스템 운영을 위한 상태감시 도구 개발)

  • Minhyuk SON;ByungSeok LEE
    • Journal of Advanced Navigation Technology
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    • v.27 no.5
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    • pp.643-648
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    • 2023
  • The Korea Augmentation Satellite System is an SBAS system being developed with the goal of providing SoL (Safety of Life) in accordance with ICAO (International Civil Aviation Organization) standards by December 2023. Monitoring the status of the system is essential for the continuous provision of KASS services, and a status monitoring tool should be developed for this purpose. The development of a status monitoring tool was divided into SYSRT (SYStem Real Time monitoring tool), SMSPP (Subsystem Monitoring Statistics tool for Post Processing) depending on the purpose. Tool development was completed through a series of procedures: requirements definition, design, development, and verification. To verify the status monitoring tool, the KASS system's real data (August 2023) were used to verify it, and the results were statistically analyzed to derive operating time and operating rate. It plans to use these tools to support continuous service provision for SoL service starting after this year.

Development of MATLAB GUI Based Software for Generating Multi-GNSS Network RTK MAC Correction (MATLAB GUI 기반 다중 위성군 Network RTK MAC 보정정보 생성 소프트웨어 개발)

  • Bu-Gyeom Kim;Changdon Kee
    • Journal of Advanced Navigation Technology
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    • v.26 no.6
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    • pp.412-417
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    • 2022
  • In this paper, multi-GNSS network RTK MAC correction generation software developed based on MATLAB GUI is introduced. The software was developed as a post-processing software based on simulation data to evaluate the feasibility of an algorithm for generating correction for multi-GNSS including GPS, GLONASS, and Galileo. As a result of software operation, network RTK correction for each system of multi-GNSS is output in MATLAB file format. In this paper, to evaluate the performance of the developed software, the residual error was analyzed after applying the correction generated through the software to the user. As a result of the analysis, it was confirmed that effective network RTK correction could be generated by confirming that the residual errors of users were maintained at 10 cm or less.

Lung Biopsy after Localization of Pulmonary Nodules with Hook Wire (Hook Wire를 이용한 폐결절의 위치선정 및 생검)

  • Kim, Jin-Sik;Hwang, Jae-Joon;Lee, Song-Am;Lee, Woo-Surng;Kim, Yo-Han;Kim, Jun-Seok;Chee, Hyun-Keun;Yi, Jeong-Geun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.681-686
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    • 2010
  • Background: A chest computed-tomography has become more prevalent so that it is more common to detect small sized pulmonary nodules that have not been found in previous simple chest x-ray. If those detected nodules are undersized or located in pulmonary parenchyma, it is difficult to accomplish a biopsy since it is vulnerable to explore them either grossly or digitally. Thus, in our hospital, a thoracoscopic pulmonary wedge resection was performed after locating a lesion by means of hook wire with CT-guided. Material and Method: 31 patients (17 males and 14 female patients) from December in 2006 to June in 2010 became our subjects; their 34 pulmonary nodules were subjected to the thoracoscopic pulmonary wedge resection after locating a lesion by means of hook wire with CT-guided. Also we analyzed a possibility of hook wire dislocation, a frequency of conversion to open thoracotomy, time consumed to operation after location of a lesion, operation time, post operation complication, and histological diagnosis of the lesion. Result: 12 of 34 cases were ground glass lesion, whereas 22 cases of them were solitary pulmonary lesion. The median value of the lesion was 8mm in size (range: 3 to 23 mm), while the median value was 12.5 mm in depth (range: 1 to 34 mm). The median value of time consumed from location of the lesion to anesthetic induction was 86.5 minutes (41~473 minutes); furthermore the mean value of operation time was 103 minutes (25~345 minutes). Intrathoracic wire dislocation was found in one case, but a target lesion was successfully excised. Open thoracotomy was performed in four cases due to pleural adhesion. However, there was no case of conversion to open thoracotomy due to failure to detect a target lesion. In histological diagnosis, metastatic cancer were found in 15 cases, which were the most common, primary lung cancer were in 9 cases, non-specific inflammation were in 3 cases, tuberculosis inflammation were in 2 cases, lymph nodes were in 2 cases, active tuberculosis were in 1 case, atypical adenomatous hyperplasia was in 1 case and normal lung parenchymal finding was in 1 case, respectively. Conclusion: In our hospital, in order to accomplish a precise histological diagnosis of ground-glass lesion and pulmonary nodules in lung parenchyma, location of pulmonary nodules were exactly located with hook wire under chest computed-tomography, which was followed by lung biopsy. We concluded that this was an accurate, minimally invasive and valuable method to minimize the complications and increase of cost of medical service provided.

결장루형성술 환자 간호를 위한 일 연구

  • 모경빈
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.27-43
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    • 1970
  • This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

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Results of Surgical Management in Patients with Cardiac and Arterial Manifestations of Behcet's Syndrome (심장 및 동맥계를 침범한 베체트씨 증후군 환자의 수술 후 결과)

  • 원종윤;장병철;이도연;박상준
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.36-42
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    • 2002
  • Background: To evaluate the efficiency of surgical treatment in patients with cardiac valvular and arterial involvement of Behcet's syndrome. Material and Method: 12 patients underwent surgical treatment due to the valvular heart diseases and the various arterial diseases associated with Behest's syndrome over 7 years; 6 with valvular heart disease, 1 with annuloaortic ectasia, 1 with ascending aortic aneurysm, 4 with pseudoaneurysms in abdominal aorta(n=2), carotid artery(n=1), and popliteal artery(n=1). All 12 patients had received valvular replacement(n=6) and the artificial(n=5) or autologous(n=1) graft interposition. We followed the results of these surgical treatments. Result: Operations were technically successful in all 12 patients and peri-operative complication was not demonstrated. However, 10 patients had recurrences; 6 with valvular dehiscence, 3 with pseudoaneurysm at anastostomosis site, and 1 with aorto-duodenal fistula. The duration of recurrence was 1 to 55 months(mean: 15.7$\pm$ 16.2 months). 7 patients underwent the second operation and among them, 4 patients showed repeated recurrences. Overall, 5 patients died 2 to 25 months after the operation(mean: 13.6 months), because of the bleeding at the anastomosis site Five patients did not present recurrence after the first(n=2) or the second operation(n=3) and their follow up duration was 5 to 60 months(mean: 45.8$\pm$41.7 months). Five patients received immune-suppressive therapy after the first(n=2) and second operation(n=3). Three did not shown recurrence for the 13, 29 and 33 months. Conclusion: Post-operative prognosis of arterial manifestation of Behcet's syndrome was not encouraging and if possible, other treatment strategy should be considered.

Analysis and Improvement Measures on the Status of the Installation and Operation of Facilities for Recycling Food Waste into Compost (음식물쓰레기 퇴비화시설의 설치 및 운영 현황분석 및 개선방안)

  • Ryu, Ji-Young;Kong, Kyu-Sik;Shin, Dae-Yewn;Phae, Chae-Gun
    • Journal of the Korea Organic Resources Recycling Association
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    • v.12 no.3
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    • pp.95-111
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    • 2004
  • This research sought to determine the status of the installation and operation of composting facilities of domestic public resource-making facilities and come up with corresponding improvement measures. The composting facilities were the most extensively installed of related facilities with over a 0.5 ton treated volume per day. The monthly and yearly carry-in volume of food waste were found to stand at 1,101.7 tons per day and 930.9 tons per day, thus falling short of the average planned volume of 1,270.9 tons. Many composting facilities, which were installed in areas for which factory registration were not approved, did not get approvals. Composting facilities underwent operation stoppage mainly due to faulty fermentation and crushing equipment. Mainly metals contained in food waste caused faults to the crushing equipment, thus requiring a facility designing against faults and corrosion. The initial water content was found to stand at 50-60%, thus complying with the requirement. However, since the composting food waste had an appropriate mixture of sawdust, food waste, and returned compost, it should meet the initial conditions. For fermentation facilities, the duration time for fermentation was 15 days, and post-fermentation tanks required 21 days of duration time, thus establishing the minimum criteria. However, some facilities did not meet the requirements, taking more time in decomposition, thus suggesting a need to determine the duration time according to facilities. In composting food waste, microorganism-based thermal oxidizer-operated fermentation tanks should be used to ensure an economic operation. On the contrary, 14 out of 25 survey targets heated fermentation tanks in any form. These thermal facilities contain the growth of bacteria, lowering chemical reaction in composting; thus composting facilities should be basically designed to use microorganism-based thermal oxidizers in drying water. An average daily volume of food waste and supplementary materials that was injected in producing compost was 22.8 tons. This volume produced 7.3 tons of compost per day, decreasing 68%. Properties of produced compost were analyzed by its color, absence or presence of remaining decomposition heat, and smell, to assess the quality. As a result, the composting process was not properly installed nor operated in about 50% of composting facilities. Compost should be produced to be soil-friendly.

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Analysis of Risk Factors in Poststernotomy Sternal Wound Infection and Mediastinitis after Open-heart Surgery (흉골절개술을 이용한 개심술 후 발생한 흉골 감염 및 종격동염의 위험인자 분석)

  • Chang, Won-Ho;Park, Han-Gyu;Kim, Hyun-Jo;Youm, Wook
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.583-589
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    • 2003
  • With the purpose of identifying significant risk factors in poststernotomy sternal wound infection and mediastinitis, we underwent a retrospective analysis of the whole patients operated on at the our department of cardiovascular surgery for the two years. Material and Method: From March 200f to March 2003 at the depart-ment of cardiovascular surgery, medical school of Soonchunhyang University, major sternal wound infections had been developed in 12 (9.76%) of 123 consecutive patients. These patients underwent open-heart procedure through a midline sternotomy and survived long enough for infection to appear. For this group of patients, we evaluated possible risk factors such as age, sex, diabetes mellitus, chronic obstructive pulmonary disease, obesity, interval between hospital admission and operation, type of surgical procedure, elective or emergency surgical procedure, reoperation, duration of surgical procedures, duration of cardiopulmonary bypass, amount of blood transfused, post-operative blood loss, chest reexploration, rewiring of a sterile sternal dehiscence, duration of mechanical ventilation, and days of stay in the intensive care unit and analyzed these factors. Result: Analysis represented that age, sex, diabetes mellitus, type and mode of surgical procedure, reoperation, duration of operation, duration of cardio-pulmonary bypass, and interval between hospital admission and operation were not significantly associated with wound infection. For all other predisposing factors, p-values of less than .05 were demonstrated. Eight emerged as significant: early chest reexploration (p=0.001), sternal rewiring (p< 0.0001), chronic obstructive pulmonary disease (p<0.0001), blood transfusions (p<0.05), postoperative bleeding (p=0.008), days of stay in the intensive care unit (p< 0.0001), duration of mechanical ventilation (p=0.001), and obesity (p=.003). Conclusion: Contamination of pa-tients may occur before, during, and after the operation, and any kind of reintervention may predispose the patient to wound infection.

Surgical Treatment of MDR Pulmonary Tuberculosis (다제내성 폐결핵의 수술적 치료)

  • Seo, Young-Jun;Park, Hoon;Park, Chang-Kwon;Keum, Dong-Yoon;Yoo, Young-Sun
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.839-845
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    • 2003
  • Background: Even today when chemotherapy has been established as a treatment for tuberculosis and the prevalence of tuberculosis is gradually decreasing, multi-drug resistance tuberculosis still results in poor treatment performance and lowered survival periods. This research sought to analyze the surgery of multi-drug resistance tuberculosis, and determine the usefulness and danger of surgery in connection with this disease. Material and Method: Starting from February 1990 to February 2002, retrospective surveys were conducted targeted at 21 cases involving 20 patients who underwent surgery due to multi-drug resistance tuberculosis. The survey included 14 males cases and 6 females cases with the age averaging 42.8$\pm$12.1 years. 10.3$\pm$7.6 years on average passed after patients were initially diagnosed with tuberculosis. 13 patients (65%) tested positive in the pre-operative sputum AFB test, and all showed resistance against an average of 3.5 anti-tuberculosis agents including INH and RFP. Pre-operative radiologic examinations revealed cavitary lesions in 15 patients (75%), and three patients had lesions in the both lung fields, with the major lesions existing in the unilateral area. 13 patients (75%) failed negative conversion with medical treatment, while two patients (10%) with recurrent hemoptysis and five patients (25%) with lesions involving high recurrence-rate received the operation. Operations included nine cases (40%) of pneumonectomy, nine cases (45%) of lobectomy, and three cases of lobectomy with segmentectomy. The average follow-up period of patients stood at 23 months. Result: There was no post-operative death, and found were a total of eleven cases involving complications were found: three cases of long-term air leakage, three cases of bleeding requiring re-operation, two cases of empyemas due to broncho-pleural fistula, and one case of atelectasis, wound infection and chest wall fistula each. Eleven cases (85%) of negative conversion were completed immediately after the operation, and two cases failed negative conversion. Eleven months after the operation, the disease recurred in one case of negative conversion patients, and the patient was cured by completion pneumonectomy. Conclusion: If patients' lung function was sufficient and appropriate resection was possible, multi-drug resistance tuberculosis could achieve high-rate negative conversion and cure using combination of surgical and medical treatment, and also there were not many serious complications.

Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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