• Title/Summary/Keyword: unnecessary repair

Search Result 28, Processing Time 0.029 seconds

Chordae Tendineae Approximation Technique for Severe Tricuspid Regurgitation with Severe Leaflet Tethering Using a Totally Endoscopic Beating-Heart Strategy: A Case Report

  • Dong Hee Jang;Jae Suk Yoo
    • Journal of Chest Surgery
    • /
    • v.56 no.1
    • /
    • pp.56-58
    • /
    • 2023
  • Untreated severe tricuspid regurgitation (TR) is associated with poor outcomes. Functional TR occurs secondary to dilatation of the annulus and tethering of the leaflets. Ring annuloplasty alone can correct most cases, but is insufficient in cases of severe annular dilatation due to severe leaflet tethering. In such cases, a tricuspid edge-to-edge technique may be an option. However, stitching of the leaflet tips alone is likely to result in tearing of the leaflets. Approximation of the durable chordae tendineae is considered helpful for this problem. Herein, we present the case of a 39-year-old man who had undergone open-heart surgery for acute type A aortic dissection 13 months earlier. A right mini-thoracotomy approach with a beating-heart strategy was used, which did not require unnecessary pericardial adhesiolysis and dissection. This technique had the advantage of reducing the operation time and the risk of bleeding. To summarize, we present a case of tricuspid valve repair in a high-risk patient with severe leaflet tethering that was successfully managed using these methods.

Degeneration Exists along the Entire Length of the Supraspinatus Tendon in Patients with a Rotator Cuff Tear

  • Jo, Chris Hyunchul;Chang, Mee Soo
    • Clinics in Shoulder and Elbow
    • /
    • v.18 no.2
    • /
    • pp.61-67
    • /
    • 2015
  • Background: The purposes of the study were to examine rotator cuff tendon degeneration with respect to harvesting location, to determine a rationale for debridement of the torn end, and thus, to determine adequate debridement extent. Methods: Twenty-four patients with a full-thickness rotator cuff tear were included in the study. Tendon specimens were harvested during arthroscopic rotator cuff repair from three locations; from torn ends after minimal regularization of fraying (native end group, NE group), from torn ends after complete freshening of the frayed end (freshened end group, FE group), and from the macroscopically intact portion just distal to the musculotendinous junction (musculotendinous junction group, MTJ group). Control samples were harvested from patients admitted for surgery for proximal humerus fracture. Harvested samples were evaluated using a semi-quantitative grading scale. Results: Mean total degeneration scores in the NE group ($13.3{\pm}3.21$), the FE group ($12.5{\pm}2.30$), and in the MTJ group ($10.8{\pm}3.10$) were significantly higher than those in the normal control group ($5.0{\pm}2.87$; all p<0.001). Mean total degeneration score in the NE group was significantly higher than that in the MTJ group (p=0.012), but was not from that of the FE group. Mean total degeneration score in the FE group was not significantly different from that of the MTJ group. Conclusions: Tendon degeneration exists throughout the entire tendon to the macroscopically intact portion of full-thickness rotator cuff tear. Therefore, aggressive debridement to grossly normal appearing, bleeding tendon is unnecessary for enhancing healing after repair.

A Study on a Remodelling Decision-Making Model for Existing School Facilities (기존학교시설(旣存學校施設)의 리모델링 의사결정(意思決定) 모델에 관한 연구(硏究))

  • Lee, Hwa-Ryong;Kim, Jin-Man;Kim, Jun-Tae
    • Journal of the Korean Institute of Educational Facilities
    • /
    • v.8 no.2
    • /
    • pp.5-12
    • /
    • 2001
  • As the exiting school facilities become old and unfit for new curriculum, the systematical remodelling process based on its educational and physical functions is required. due to the inadequate maintenance and repairing practices, unnecessary costs are expended. Therefore, this study aims to establish a remodelling decision-making model for improving the educational environment of the existing school facilities. According to the budget system, it proposes the concept of remodelling that includes the activities of extension, reconstruction, repair and improvement. This study classifies the performance evaluation for school facilities as that of safety, durability and educational function, and articulates the assessment standards, methods and elements. In the end, it suggests a rational model for remodelling decision-making that can provide efficient and comprehensive remodelling process, economic and sustainable school development.

  • PDF

Production of English final stops by Korean speakers

  • Kim, Jungyeon
    • Phonetics and Speech Sciences
    • /
    • v.10 no.4
    • /
    • pp.11-17
    • /
    • 2018
  • This study reports on a production experiment designed to investigate how Korean speaking learners of English produce English forms ending in stops. In a repetition experiment, Korean participants listened to English nonce words ending in a stop and repeated what they heard. English speakers were recruited for the same task as a control group. The experimental result indicated that the transcriptions of the Korean productions by English native speakers showed vowel insertion in only 3% of productions although the pronunciation of English final stops showed that noise intervals after the closure of final stops were significantly longer for Korean speakers than for English speakers. This finding is inconsistent with the loanword data where 49% of words showed vowel insertion. It is also not compatible with the perceptual similarity approach, which predicts that because Korean speakers accurately perceive an English final stop as a final consonant, they will insert a vowel to make the English sound more similar to the Korean sound.

Case Study on Engine Trouble analysis and Diagnosis Using MDA (MDA를 이용한 엔진 가속 불량 진단에 관한 연구)

  • Hwang, Sung-Wan;Cha, Suk-Soo
    • Journal of the Korean Society of Manufacturing Process Engineers
    • /
    • v.21 no.9
    • /
    • pp.105-109
    • /
    • 2022
  • In this study, the cause of the acceleration failure of Hyundai Motor's 2.0-liter CRDi engine was analyzed. We tried to find problems through MDA (Measuring Data Analyzer) based on data such as vehicle speed, air intake, and air-fuel ratio obtained during the actual driving process. As a result, it was analyzed that the failure of the EGR valve exceeded the NOx emission standard and caused a decrease in engine output. Through this study, it is possible to reduce the time and cost of unnecessary maintenance and repair, and it is expected that a rapid cause analysis will be possible in the case of new failure diagnosis in the future.

Revision of Failed Shoulder Instability Repair (실패한 견관절 불안정증의 봉합술에 대한 재수술)

  • Park, Jin-Young;Park, Hong-Geun;Oh, Jeong-Hwan
    • Journal of the Korean Arthroscopy Society
    • /
    • v.10 no.2
    • /
    • pp.135-140
    • /
    • 2006
  • Diagnosis and treatment of the unstable shoulder is one of the more difficult problems in orthopaedic surgery. There is confusion between the normal laxity with translation and subluxation of the humeral head relative to the glenoid and an abnormal amount of laxity, leading to pain and dysfunction. Unfortunately, there is no single treatment that applied to all lesions that cause the instability. It is imperative, therefore, that an accurate diagnosis be made, including the directions and degree of shoulder instability as well as any coexisting problems. Anatomical defects must be defined. Common factors that could most readily compromised instability repair are examined. These include techniques for making an accurate diagnosis with identification of the precise anatomical pathology, and the rationale for appropriate surgical treatment with the avoidance of technical complication such as unnecessary hardware or exposures that might lead to residual instability, arthritis, and nerve or vascular injuries. Additional injuries may be prevented by careful rehabilitation postoperatively to restore shoulder stability, flexibility, and endurance prior to an individual's return to stressful sports or work.

  • PDF

Development of Wall Thinning Distinction Method using the Multi-inspecting UT Data of Carbon Steel Piping (탄소강배관 다중 UT 측정두께를 활용한 감육여부 판별법 개발)

  • Hwang, Kyeong Mo;Yun, Hun;Lee, Chan Kyoo
    • Corrosion Science and Technology
    • /
    • v.11 no.5
    • /
    • pp.173-178
    • /
    • 2012
  • To manage the wall thinning of carbon steel piping in nuclear power plants, the utility of Korea has performed thickness inspection for some quantity of pipe components during refueling outages and determined whether repair or replacement after evaluating UT (Ultrasonic Test) data. When the existing UT data evaluation methods, such as Band, Blanket, PTP (Point to Point) Methods, are applied to a certain pipe component, unnecessary re-inspecting situations may be generated even though the component does not thinned. In those cases, economical loss caused by repeated inspection and problems of maintaining the pipe integrity followed by decreasing of newly inspected components may be generated. EPRI (Electric Power Research Institute) in USA has suggested several statistical methods, TPM (Total Point Method), LSS (Least Square Slope) Method, etc. to distinguish whether multiple inspecting components have thinned or not. This paper presents the analysis results for multiple inspecting components over three times based on both NAM (Near Area of Minimum) Method developed by KEPCO-E&C and the other methods suggested by EPRI.

A Case Study on the Evaluation of Residential Performance for Deteriorated Multi-family Housing (노후공동주택의 거주성능 평가에 관한 사례 연구)

  • Hyun Taek-Soo;Lee Byung-Tae
    • Journal of the Korean housing association
    • /
    • v.17 no.2
    • /
    • pp.77-85
    • /
    • 2006
  • This study aims to propose the comprehensive evaluation of performance multi-family housing. Most of the existing studies for the reproduction have evaluated by the safety of structure. Therefore those pass over the functional factors which is important for the evaluation of residential qualities. This study represents that the reproduction renovation should not be secured the safety of structure but established the quality of lift. And questionnaire asking expert's opinion also supplemented. As a result, the item for examination and the weight for evaluation are suggested in functional deterioration. The results of this study are summarized as follows: 1. Existent redevelopment criteria are not appropriate to decide the environmental comfort, the vital function of housing and the residential management finance. 2. The future criteria have to evaluate the existing environmental comfort, be reconstructed to put first general deterioration. 3. Evaluation elements was extracted throughout the document research, evaluation elements analysis system was separated in residential area, suburb of dwellings, community, and housing complexity environmental assesment, 4. Each category of influence ratio was extracted to assess total deterioration throughout the expert question survey. 5. Each category analysed (1) $0{\sim}30%$: function is good (unnecessary to improve) (2) $31{\sim}40%$: average (necessary of partial improvement) (3) $41{\sim}59%$: bad (necessary of total improvement) (4) $60{\sim}100%$: the worst (unable to improve throughout the repair)

A case report of an unusual temporomandibular joint mass: Nodular fasciitis

  • Han-Sol Lee;Kyu-Young Oh;Ju-Hee Kang;Jo-Eun Kim;Kyung-Hoe Huh;Won-Jin Yi;Min-Suk Heo;Sam-Sun Lee
    • Imaging Science in Dentistry
    • /
    • v.53 no.1
    • /
    • pp.83-89
    • /
    • 2023
  • Nodular fasciitis (NF) is a benign myofibroblastic proliferation that grows very rapidly, mimicking a sarcoma on imaging. It is treated by local excision, and recurrence has been reported in only a few cases, even when excised incompletely. The most prevalent diagnoses of temporomandibular joint(TMJ) masses include synovial chondromatosis, pigmented villonodular synovitis, and sarcomas. Cases of NF in the TMJ are extremely rare, and only 3 cases have been reported to date. Due to its destructive features and rarity, NF has often been misdiagnosed as a more aggressive lesion, which could expose patients to unnecessary and invasive treatment approaches beyond repair. This report presents a case of NF in the TMJ, focusing on various imaging features, along with a literature review aiming to determine the hallmark features of NF in the TMJ and highlight the diagnostic challenges.

Calcific Tendinitis of Shoulder Associated with Intraosseous Involvement -A Case Report- (골내 침범을 동반한 견관절 석회화 건염 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Park, Man-Jun;Kim, Jeong-Cheol
    • Clinics in Shoulder and Elbow
    • /
    • v.14 no.2
    • /
    • pp.242-247
    • /
    • 2011
  • Purpose: We present an atypical case of calcific tendinitis of the shoulder with intraosseous loculation. Materials and Methods: A 59 year-old female complained of acute exacerbation of chronic left shoulder pain and restricted range of motion. Simple radiographs showed a subacromial calcific deposit and magnetic resonance imaging revealed cortical erosion with intraosseous extension of calcific material mimicking infection or tumor. She was managed with arthroscopic excision of the calcific deposit, curettage of the intraosseous lesion and subsequent rotator cuff repair with a suture anchor. Results: Her acute pain promptly subsided. Her rehabilitation was uneventful and she gained full range of motion. Radiographs five months after the operation showed no recurrence of calcific material. Conclusion: Calcific tendinitis of the shoulder can present with a variety of images involving the adjacent bone. The correct recognition of this disorder may avoid unnecessary investigation and treatment.