International conference on construction engineering and project management
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2013.01a
/
pp.576-582
/
2013
Typical highway infrastructure systems include roadway pavement, drainage systems, tunneling, and other hardware components such as guardrails, traffic signs, and lighting. Tunnels in a highway system have provided significant advantages to overcoming various natural challenges including crossing underneath bodies of water or through mountainous areas. While only a few tunnel failure cases have been reported, the failure rate is likely to increase as these assets age and because agencies have not emphasized tunneling asset management. A tunnel system undergoes a deterioration life cycle pattern that is similar to other infrastructure systems. There are very few agencies in the United States implementing comprehensive tunnel asset management programs. While current tunnel asset management programs focus on inspection, maintenance, and operation safety, there is an increasing need for the development of a comprehensive life cycle tunnel asset management program. This paper describes a conceptual framework for a comprehensive tunnel asset management program. The framework consists of three basic phases including a strategic plan, a tactical plan, and an operational plan to provide better information to the decision makers. The strategic plan is a basic long term approach of tunnel asset management. The tactical plan determines specific objectives and the operational plan actually applies asset management objectives in practice. The information includes operational condition, structural condition, efficiency of the system, emergency response, and life cycle cost analysis for tunnel capital improvement project planning.
Background: Multi-loculated empyema makes treatment difficult, and more so when thoracentesis or chest tube drainage fails. Materials and methods: From December 1991 to December 1997, we performed closed rib resectional drainage for 18 cases of loculated empyema on the fibrinopurulent or early chronic phase. Results: Surgery was performed on patients with loculated empyema complaining of persistent symptoms due to failure of treatment by thoracentesis(8 cases) or chest tube drainage(10 cases). Predisposing factors of empyema were pneumonia in 13 cases, clotted hemothorax in 3 cases, cholecystectomy, and tuberculous pleurisy in 1 case. Causal organisms were cultured in 8 cases(42.1%), and methicillin-resistant staphylococcus aureus was found in 3 cases, pseudomonas aeruginosa in 2 cases, and enterococcus aerogens, α-hemolytic streptococcus, and acinetobacter baumannii were found in 1 case. Size of loculations was various, and computed chest tomogram showed multiple loculations of empyema numbering 1∼4(mean 1.78±1.00). Operating time was relatively short, about 55∼140 mins(mean 102.8±30.8). All toxic symptoms including fever disappeared postopratively and general conditions improved very quickly in all patients. Length of chest tube indwelling time and hospital stay after surgery were 3∼42 days(mean 11.4±11.5) and 6∼36 days(mean 12.9±8.1), respectively. Complications of prolonged drainage occurred in 2 cases and no death occurred. There were no recurrences and chest x-rays taken 3∼6 months after surgery showed normal findings in 14 cases and slight pleural thickening in 4 cases. Conclusions: Closed rib resectional drainage requires very simple techniques and has excellent outcomes and little complications, therefore, we think that it is the choice of operation for patients with loculated empyema on the fibrinopurulent or early chronic phase.
Due to the Four Major Rivers Restoration Project, Nakdong River Estuary Barrage's designed flood quantity has been largely increased, and this has caused to construct several drainage gates at the right side of Eulsukdo island to secure the safety of downstream river area. For successful functioning of Nakdong River Estuary Barrage, such as flood control, disaster prevention, and the securing of sufficient water capacity, drainage gates at the both sides of island have to operate systematically and reliably. To manage this under restricted personnel and resources, we have implemented the IOS (Integrated Operation System) by integrating previous facilities and resources via information and communication technologies. The IOS has been designed to have higher availability and fault tolerance to function continuously even with the partial system's failure under the emergency situation like flood. Operators can use the system easily and acknowledge alarms of facilities through its IWS (Integrated Warning System) earlier. Preparing for Integrated Water Resources Management and Smart Water Grid, the architecture of IOS conformed to open system standards which will be helpful to link with the other systems easily.
Kim, Jong-Bae;Chung, Won-Gyun;Noh, Hie-Jin;Jang, Sun-Ok;Yoo, Jae-Ha;Han, Sang-Kwon;Chung, Jae-Hyung;Kim, Byung-Wook
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.29
no.5
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pp.330-337
/
2003
This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.
This paper presents a field study of the stability of slope collapsed during road construction and proposes a reasonable countermeasure if the current slope is unstable. As a result of slope investigation, it was found that the slope includes five tension cracks and the sliding surface is started from the tension crack and propagated the surface soil layer through weathered rock layer. The slope stability analyses are conducted in case of dry and rainfall seasons. The results indicate that the slope is unstable status. A reinforcement method of slope failure should be selected according to the scale of failure. That is, the scale of slope failure, which is classified small, middle and large size determines the reinforcement method of slope. Since the slope interested in this study is large size failure slope, the reinforcement method to control slope failure is selected stabilizing piles, and seed spray and drainage of surface waterare also selected to remain the factor of safety. The SLOPILE (Ver. 3.0) program is applied in order to do stability analysis of slope reinforced by piles. As the result of analysis, the slope reinforced by a row of piles shows the stable state. It is clearly confirmed that the stabilizing of piles can improve the stability of slope.
Objective : Diffusion-weighted magnetic resonance imaging (DW-MRI) has proven useful in the study of the natural history of ischemic stroke. However, the potential of DW-MRI for the evaluation of chronic subdural hematoma (CSDH) has not been established. In this study, we investigated DW-MRI findings of CSDH and evaluated the impact of the image findings on postoperative outcomes of CSDH. Methods : We studied 131 CSDH patients who had undergone single burr hole drainage surgery. The images of the subdural hematomas on preoperative DW-MRI and computed tomography (CT) were divided into three groups based on their signal intensity and density : 1) homogeneous (iso or low) density on CT and homogeneous low signal intensity on DW-MRI; 2) homogeneous (iso or low) density on CT and mixed signal intensity on DW-MRI; and 3) heterogeneous density on CT and mixed signal intensity on DW-MRI. On the basis of postoperative CT, we also divided the patients into 3 groups of surgical outcomes according to residual hematoma and mass effect. Results : Analysis showed statistically significant differences in surgical (A to B : p<0.001, A to C : p<0.001, B to C : p=0.129) and functional (A to B : p=0.039, A to C : p<0.001, B to C : p=0.108) outcomes and treatment failure rates (A to B : p=0.037, A to C : p=0.03, B to C : p=1) between the study groups. In particular, group B and group C showed worse outcomes and higher treatment failure rates than group A. Conclusion : CSDH with homogeneous density on CT was characterized by signal intensity on DW-MRI. In CSDH patients, performing DW-MRI as well as CT helps to predict postoperative treatment failure or complications.
Karli, Arzu;Sensoy, Gulnar;Paksu, Sule;Korkmaz, Muhammet Furkan;Ertugrul, Omer;Karli, Rifat
Clinical and Experimental Pediatrics
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v.61
no.2
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pp.49-52
/
2018
Purpose: Tularemia is an infection caused by Francisella tularensis. Its diagnosis and treatment may be difficult in many cases. The aim of this study was to evaluate treatment modalities for pediatric tularemia patients who do not respond to medical treatment. Methods: A single-center, retrospective study was performed. A total of 19 children with oropharyngeal tularemia were included. Results: Before diagnosis, the duration of symptoms in patients was $32.15{\pm}17.8days$. The most common lymph node localization was the cervical chain. All patients received medical treatment (e.g., streptomycin, gentamicin, ciprofloxacin, and doxycycline). Patients who had been given streptomycin, gentamicin, or doxycycline as initial therapy for 10-14 days showed no response to treatment, and recovery was only achieved after administration of oral ciprofloxacin. Response to treatment was delayed in 5 patients who had been given ciprofloxacin as initial therapy. Surgical incision and drainage were performed in 9 patients (47.5%) who were unresponsive to medical treatment and were experiencing abcess formation and suppuration. Five patients (26.3%) underwent total mass excision, and 2 patients (10.5%) underwent fine-needle aspiration to reach a conclusive differential diagnosis and inform treatment. Conclusion: The causes of treatment failure in tularemia include delay in effective treatment and the development of suppurating lymph nodes.
Proceedings of the Korean Geotechical Society Conference
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2009.09a
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pp.736-744
/
2009
The abrupt failure of slope caused by a concentrated rainfall would be a disaster in this country. Specially, the soil slope may be collapsed by the rainfall seepage, however, there is not much information for the mechanism of slope failure during rainfall. As analyzing the stability of slope by rainfall, the conventional method is to put the ground-water level on the surface of slope. However, it may provide the over-reinforcement for the slope stability. Futhermore, although over-reinforcement for the slope was fulfilled, the possibility of potential slope failure still exists. In this study, the slope stability by the conventional design method and the causes of unstable slope during rainfall were investigated. To analyze the slope stability by rainfall, the computer program SEEP/W for the analysis of seepage was used. As changing the intensity and duration of rainfall in SEEP/W, the analysis were performed. After completion of analysis, the porewater pressure data from SEEP/W was applied to SLOPE/W. As a results of this analysis, it is not reasonable that the groundwater level is going up to the surface of slope during rainfall. Therefore, the conventional reinforcement for the slope stability is not obvious to satisfy the criterion safety factor during rainfall. The reasonable counterplan is to install drainage hole on the surface of slope in order to prevent erosion and debris flow.
Background : As the pleural inflammation progresses, exudative pleural fluid becomes loculated rapidly with pleural thickening. Complete drainage is important to prevent pleural fibrosis, entrapment and depression of lung function. Intrapleural urokinase instillation therapy has been advocated as a method to facilitate drainage of gelatinous pleural fluid and to allow enzymatic debriment of pleural surface. This study was designed to investigate the predictors of effectiveness of intrapleural urokinase in the treatment of loculated pleural effusion. Method : Thirty-five patients received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. Twenty-two patients had tuberculous pleural effusions, and 13 had non-tuberculous postpneumonic empyemas. A total of 240,000 units of urokinase was dissolved in 240 ml of normal saline and the aliquots of 80mL was instilled into the pleural cavity via pig-tail catheter per every 8hr. Effectiveness of intrapleural urokinase instillation therapy was assessed by biochemical markers, ultrasonography, and technical details. A greater than 50% improvement on follow-up chest radiographs was defined as success group. Result : Twenty-seven of 35 (77.1%) patients had successful outcome to urokinase instillation therapy. Duration of symptoms before admission was shorter in success group ($11.8{\pm}6.9day$) than in failure group ($26.62{\pm}16.5day$) (P<0.05). Amount of drained fluid during urokinase therapy was larger in success group ($917.1{\pm}392.7ml$) than in failure group ($613.8{\pm}259.7ml$) (P<0.05). Pleural fluid glucose was higher in success group ($89.7{\pm}35.9mg/dl$) than in failure group ($41.2{\pm}47.1mg/dl$) (P<0.05). Pleural fluid LDH was lower in success group ($878.4{\pm}654.3IU/L$) than in failure group ($2711.1{\pm}973.1IU/L$) (P<0.05). Honeycomb septated pattern on chest ultrasonography was observed in six of eight failure group, but none of success group (P<0.05). Conclusion : Longer duration of symptoms before admission, smaller amount of drained fluid during urokinase therapy, lower glucose value, higher LDH value in pleural fluid examination, and honeycomb septation pattern on chest ultrasonograph were predictors for failure group of intrapleural urokinase instillation therapy.
We present a rare case of critically compromised airway secondary to a massively dilated sequestered colon conduit after several revision surgeries. A 71-year-old male patient had several operations after the diagnosis of gastric cancer. After initial treatment of pneumonia in the pulmonology department, he was transferred to the surgery department for feeding jejunostomy because of recurrent aspiration. However, he had respiratory failure requiring mechanical ventilation. The chest computed tomography (CT) scan showed pneumonic consolidation at both lower lungs and massive dilatation of the substernal interposed colon compressing the trachea. The dilated interposed colon was originated from the right colon, which was sequestered after the recent esophageal reconstruction with left colon interposition resulting blind pouch at both ends. It was treated with CT-guided pigtail catheter drainage via right supraclavicular route, which was left in place for 2 weeks, and then removed. The patient remained well clinically, and was discharged home.
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