• Title/Summary/Keyword: Immediate operation

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An Approach to Detect Health Risk of Dioxins

  • Pavittranon, Sumol;Sinhaseni, Palarp
    • Toxicological Research
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    • v.17
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    • pp.323-327
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    • 2001
  • March 19, 1999, the renovation qf the runway of the Bo-Fai ai1field in Hua Hin, Prachubk-erikhan, Thailand, unearthed chemicals which were left over from the project "anch Hand Operation" held during the Vietnam war era. The chemical mixtures were analyzed by the US EPA, the Department oj Medical Sciences (DMSc), Ministry oj Public Health (MoPH) and the Pollution Control Department (PCD), the Ministry oj Science Technology and Environment (MOSTE) of Thailand, The samples were found to contain several defoliants used in the operation. They were 2,4-D, 2,4,5-T, Dicamba, Cocydelic acid, and Dioxins. Due to the complexity of the issue, the multiplicity of possible health effects, and the socio-economic implications for imports and exports, the Thai Society of Toxicology submitted a proposal to request World Health Organization (WHO), Geneva. The assistance is for the area of chemical safety and called for immediate action to explore the magnitude qf risk involved with Dioxins. In this paper we present our approach to health risk assessment which takes into an account the epidemiological studies of high-risk group exposed to the Ranch Hand operation. Dioxins are endocrine disruption chemicals which public concerns are developed due to presumption that a hazard exists (www.eva.gov/dioxins/html) for which current methodologies are deemed insufficient. The recent concepts of how oxidative stress toxicants may affect health end points and biomarkers of exposure of exposed individuals are discussed. While research activities are undergoing, The Thai Society of Toxicology do not anticipate significant risk to local residents and the environment due to our concurrence with opinion from the international experts invited by the World Health Organization proposed to the local experts at a workshop in Bangkok.n Bangkok.

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Mitral Valve Replacement -Report of Five Cases- (승모판막 이식수술 -5예 보고-)

  • 송요준
    • Journal of Chest Surgery
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    • v.7 no.2
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    • pp.189-200
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    • 1974
  • The mitral valve replacement with Beall prosthetic valve was performed on three patients, and double valve replacement. aortic and mitral valve, was performed in this department.1) The preoperative studies about the first case were compatible with mitral steno-insufficency.The diseased mitral valve was replaced with the medium sized Beall prosthetic valve under the cardiopulmonary hypass using hypothermic hemodilution technique. The total perfusion time was eighty minutes. Immediate postoperative course was smooth, but this patient was died of asphyxia due to tracheomalacia complicated after tracheostomy 3 months after operation. Autopsy on this patient revealed that no thrombus and no ball variance could be found, and endothelization on the valve cuff was satisfactory. 2) The preoperative studies on the second case were compatible with mitral insufficiency. The diseased mitral valve was replaced with the medium sized Beall prosthetic valve under the cardiopulmonary bypass using hypothermic hemodilution technigue. The total perfusion time was 123 minutes. This patient was discharged in good condition and follow-up study after 16 months revealed the patient had enjoyed healthy life. 3) The preoperative studies about the third case were compatible with aortic insufficiency and mitral stenoinsufficiency. The diseased valves were replaced with type 2 sutureless Magovern aortic valve and the medium sized Beall mitral prosthesis under cardiopulmonary bypass using hypothermic hemodilution technIque and coronary artery perfusion. The total perfusion time was 155 minutes. This patient was discharged in good condition, but thromboembolism was developed 2 months after discharge. 4) The preoperative studies about the fourth case were compatible with mitral insufficiency. The diseased mitral valve was replaced with the medium sized Beall prosthetic valve. The total perfusion time was 132 minutes. The atrioventricular block developed just after operation but converted to normal sinus rhythmn on the third postperative day. The preoperative NYHA functional classification IV was converted to Class 1 or 11 at the time of discharge and this patient enjoyed healthy life. Attendum; The fifth case, nineteen years old male with mital insufficiency underwent Beall valve replacement and his course was uneventful 2 weeks after operation.

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Mass Reduction and Functional Improvement of the Left Ventricle after Aortic Valve Replacement for Degenerative Aortic Stenosis

  • Shin, Su-Min;Park, Pyo-Won;Han, Woo-Sik;Sung, Ki-Ick;Kim, Wook-Sung;Lee, Young-Tak
    • Journal of Chest Surgery
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    • v.44 no.6
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    • pp.399-405
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    • 2011
  • Background: Left ventricular (LV) hypertrophy caused by aortic valve stenosis (AS) leads to cardiovascular morbidity and mortality. We sought to determine whether aortic valve replacement (AVR) decreases LV mass and improves LV function. Materials and Methods: Retrospective review for 358 consecutive patients, who underwent aortic valve replacement for degenerative AS between January 1995 and December 2008, was performed. There were 230 men and 128 women, and their age at operation was $63.2{\pm}10$ years (30~85 years). Results: There was no in-hospital mortality, and mean follow-up duration after discharge was 48.9 months (2~167 months). Immediate postoperative echocardiography revealed that LV mass index and mean gradient across the aortic valve decreased significantly (p<0.001), and LV mass continued to decrease during the follow-up period (p<0.001). LV ejection fraction (EF) temporarily decreased postoperatively (p<0.001), but LV function recovered immediately and continued to improve with a significant difference between preoperative and postoperative EF (p<0.001). There were 15 late deaths during the follow-up period, and overall survival at 5 and 10 years were 94% and 90%, respectively. On multivariable analysis, age at operation (p=0.008), concomitant coronary bypass surgery (p<0.003), lower preoperative LVEF (<40%) (p=0.0018), and higher EUROScore (>7) (p=0.045) were risk factors for late death. Conclusion: After AVR for degenerative AS, reduction of left ventricular mass and improvement of left ventricular function continue late after operation.

A Database Design for Remote Maintenance of Navigation and Communication Equipments in a Vessel (선박 항해통신장비 원격유지보수를 위한 데이터베이스 설계)

  • Kim, Ju-young;Ok, Kyeong-suk;Kim, Ju-won;Cho, Ik-soon
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.11
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    • pp.2052-2060
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    • 2017
  • The SOLAS ship should carry at least 83 different types of equipment based on the SFI group codes and each of which consists of several to dozens of components. During ship operation, it is necessary to ensure the normal operation of such equipment, and remote maintenance is highly demanded for immediate repair in the event of a equipment fault. This study proposes to find suitable classification system and to derive database structure for remote maintenance of navigation and communication equipment. As a result of this study, the classification system of equipment should be layered into equipment type, model, and component, and main table in the database consists of FMEA, service history, case data through Q&A, Preventive Maintenance. A database was constructed for 140 navigation and communication equipment models and 750 components. In order to evaluate the practical effects, service engineer evaluated the usefulness using the cloud app.

THE RELATIONSHIPS BETWEEN THE POSTOPERATIVE STABILITY AND THE CHANCES IN THE TONGUE POSITION, THE HYOID BONE POSITION AND THE UPPER AIRWAY SIZE AFTER ORTHOGNATHIC SURGERY IN PATIENTS WITH MANDIBULAR PROGNATHISM (하악전돌증 환자의 악교정수술 후 안정성과 혀 위치, 설골 위치 및 상기도 크기 변화간의 관계)

  • Chin, Kyeong-Su;Shon, Woo-Sung
    • The korean journal of orthodontics
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    • v.23 no.4 s.43
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    • pp.693-705
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    • 1993
  • The purpose of this study was to investigate the functional adaptation of the tongue, the hyoid bone, the digastric muscle and the upper airway and the variables predicting postoperative stability following orthognathic surgery in patients with mandibular prognathism. 18 patients were selected(8 men and 10 women) for this study, who had received orthognathic surgery. Their lateral cephalograms, those were taken preoperatively, immediate postoperatively and over 6 months follow-up, were traced and analysed. The results were as follows : 1. The downward displacement of the hyoid bone and extended head posture were recognized, right after operation. Statistically significant correlations were found between the changes of the mandibular position and the digastric muscle and the change of head posture during operation. 2. The tongue was displaced downward following the hyoid displacement postoperatively. Statistically significant correlations were found between the change of the mandibular position and the change of the distance of the tongue and hard palate, and between the change of head posture and the changes of the upper airway sizes, the digastric muscle and the hyoid position during over 6 month's follow-up. 3. The change of the distance of the tongue and hard palate was the most significant factor for prognosis during over 6 month's follow-up. 4. There were no variables before operation to predict the postoperative stability and the constriction of the upper airway.

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Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children (소아에서 위장관내 이물질의 임상적 고찰)

  • Choi, Eunsoo;Lee, Hyo Gyun;Choi, Soo Jin Na;Chung, Sang Young
    • Advances in pediatric surgery
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    • v.20 no.1
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    • pp.12-16
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    • 2014
  • Foreign body ingestion is a common problem among paediatric populations. Most of the ingested foreign bodies spontaneously pass through the gastrointestinal tract, but approximately less then 10% of them remain without being discharged, and trigger complications. Therefore, proper evaluation and treatment according to the situation is required. In this study, clinical progress and complications were analyzed according to the clinical features and treatment in children who ingested foreign bodies. Among pediatric patients under 18 who were admitted to Chonnam National University Hospital after ingesting foreign bodies between January 2008 to June 2012, only the patients who had their foreign body in the gastrointestinal tract were included in this study. Based on medical records, age, type of foreign body, time spent till admission, and whether the endoscopy was done or not, complication were researched retrospectively. According to symptoms and plain abdomen X-ray findings, treatment was chosen and conducted among endoscopy, observation and emergency operation. Among 273 patients, 9 (3.3%) of them had surgical removal. Seven (2.6%) of them had an emergency operation on the day of admission, and the rest 2 (0.7%) had operation during observation. Removal through initial endoscopic approach was tried in 157 (57.5%) patients. Eleven (70.8%) of them had their foreign body removed at the initial trial, and 5 (4.9%) of them at the second trial. Among 109, who were on observation status, 9 (8.3%) of them needed endoscopic removal, and 2 (1.8%) of them suffered from surgical removal. It is thought to be better to approach slowly considering the type, size and symptoms in foreign body ingestion of pediatric patients, rather than immediate and invasive removal.

Relationship of Glucose Control and Wound Infection in Diabetics after Lumbar Spine Surgery

  • Kim, Byung-Ook;Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.44-47
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    • 2005
  • Objective: The purpose of this study is to investigate the elevated blood glucose levels in the postoperative period are associated with an increased risk of deep wound infection in diabetic individuals undergoing lumbar spine surgery. Methods: Of 2896 patients who underwent lumbar spine operations by one surgeon between 1993 and 2002, 329(11.4%) were diabetics. The rate of deep wound infections in diabetic patients was 6.4%, versus 3.2% for nondiabetics. 152 patients had their operation before implementation of the protocol and 177 after implementation. Charts of the diabetic patients were reviewed. Mean blood glucose levels were calculated from documented results of finger-stick glucometer testing. Results: Twenty-one diabetic patients suffered deep wound infection. Infected diabetic patients had a higher mean blood glucose level through the first 2 postoperative days than noninfected patients($230{\pm}6.9$ versus $175{\pm}3.8mg/dL$; p<0.003) and had a long operation time($216{\pm}57.9$ versus $167.5{\pm}42.2$ minute; p<0.05). Multivariable logistic regression showed that mean blood glucose level for the first 2 postoperative days, long operation time, and use of the instrumentation(p<0.02) were all related predictiors of deep wound infection. Institution of a protocol of postoperative continuous intravenous insulin to maintain blood glucose level less than 200mg/dL was began in september 1997. This protocol resulted in a decrease in blood glucose levels for the first 2 postoperative days and a concomitant decrease in the proportion of patients with deep wound infection, from 8.3%(11/132) to 5.1%(10/195) (p<0.02). Conclusion: The incidence of deep wound infection in diabetic patients is reduced after implementation of a protocol to maintain mean blood glucose level less than 200mg/dL in the immediate postoperative period.

The Comparative Study of Effect on Speech before and after Orthognathic Surgery of Patients (악교정 환자의 악교정 수술전후 발음양상에 대한 비교연구)

  • Kwon, Kyung-Hwan;Kim, Soo-Nam;Lee, Dong-Keun;Cho, Yong-Min;Lee, Suk-Hyang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.2
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    • pp.191-205
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    • 2000
  • The purpose of this study was undertaken to determine the effects of orthognathic surgery on speech. The hyposis stated herein is that functional behaviors of the dentofacial complex, such as speech production, may be adversely affected by deviations of a structural nature(especially, Class III malocclusion). Twenty adults with Class III malocclusion(13 female and 7 male) were studied preoperative, immediate postoperative and either 6 or 12 months postoperative lateral cephalograms. They had mandibular prognathism and had undergone mandible setback operation. The position of tongue, soft palate(Uvula), hyoid bone, respiratory track width, and pharyngeal depth were assessed on lateral cephalograms with 23 cephalometric variables, ANOVA, Paired t-tests and Pearson's product-moment correlation coefficient tests were used to evalute the operative changes in all cephalometric parameters. A experienced speech and language pathologists performed narrow phonetic transcriptions of tape-recorded words and sentences produced by each of the ninth patients and the recording tapes were analyzed by phonetic computer program(Computerized Speech Lab(CSL) Model 4300BI(U.S.A.)) These judges also recorded their ratings of each patient's overall consonants, hypernasality, hyponasality, and articulation proficiency. The results obtained are as follows; 1. There were significant changes in distance of posterior pharyngeal wall to tongue (TI-TW2, TS-TW3) after the surgery at 6 months postoperatively(each p<0.01 p<0.05). 2. The posterior tongue point(TI, TS, PPT) moved posteriorly after surgery and remained to its changed position at 6 months postoperatively(p<0.05). The displacement of tongue was correlated with the movement of mandibular setback amount(p<0.05). The hyoid bone moved posteriorly superiorly after immediate postoperative period. There was significant changes in hyoid bone movement after immediated postoperative period(p<0.05), but returned to its original position during the follow-up period(p>0.05) 3. The soft palate was displaced posteriorly superiorly after immediated operative period and remained to its changed position at 6 months postoperatively(p<0.05). ANS-PNS-SPT angle increasing, PPU-PPPo distance narrowing was showed after surgery, and remained its appearance 6 months postoperatively(p<0.05). 4. There were significant changes in formant value and squre diagram of vowel sound after the orthognathic surgery and the follow-up period. There were significant changes in /ㅅ/sound and posterior tongue sound. 5. The posterior movement of tongue and the posteriosuperior movement of soft palate was correlated with mandibular setback amount after orthognathic surgery. On the vowel squre diagram, the author found that the place of articulation after operation moved downward, backward, upward. 6. In assessing speech abnormalities, dental occlusion should be considered as a contributing factor. The vast majority of subjects with preoperative misarticulations eliminated or reduced their errors following orthognathic surgery. There was significant difference in speech impovement between pre- and postoperation.

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Deterrent Strategy in the era of North Korea's WMD and Missile Threats : Challenges and the Ways to go (북 핵·미사일 시대의 억제전략 : 도전과 나아갈 방향)

  • Lee, Sang-Yup
    • Strategy21
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    • s.41
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    • pp.232-260
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    • 2017
  • The purpose of this paper is to open a debate about what kind of deterrent strategy the ROK military should pursue in the era of NK's weapons of mass destruction and missile threats. I argue that the ROK military needs a comprehensive deterrent strategy that reflects the international security situations and trends and that builds on clear understanding of the basic concepts and how deterrence operates. The paper starts with surveying the basic knowledge of deterrence from the perspectives of both theory and practice. Then, it provides explanations on why deterrence against NK can be particularly difficult given the security environment in and around the Korean peninsula. For example, South Korea and North Korea hardly share 'common knowledge' that serves as a basic element for the operation of deterrence. Deterrence against North Korea involves complex situations in that both deterrence and compellence strategies may be relevant particularly to North Korea's WMD and missile threats. It also involves both immediate and general deterrence. Based on the discussion, I suggest several ideas that may serve as guidelines for establishing a deterrent strategy against NK. First, our threats for deterrence should be the ones that can be realized, particularly in terms of the international norms. In other words, they must be considered appropriate among other nations in the international community. Second, there should be separate plans for the different kinds of threats: one is conventional, local provocations and the other is WMD/missile related provocations. Third, we should pursue much closer cooperative relations with the U.S. military to enhance the effectiveness of immediate deterrence in the Korean peninsula. Fourth, the ROK military should aim to accomplish 'smart deterrence' maximizing the benefits of technological superiority. Fifth, the ROK military readiness and structure should be able to deny emerging North Korean military threats such as the submarine-launched ballistic missiles and intercontinental ballistic missiles. Lastly, in executing threats, we should consider that the current action influences credibility and reputation of the ROK, which in turn affect the decisions for future provocations. North Korea's WMD/missile threats may soon become critical strategic-level threats to South Korea. In retrospect, the first debate on building a missile defense system in South Korea dates back to the 1980s. Mostly the debate has centered on whether or not South Korea's system should be integrated into the U.S. missile defense system. In the meantime, North Korea has become a small nuclear power that can threaten the United States with the ballistic missiles capability. If North Korea completes the SLBM program and loads the missiles on a submarine with improved underwater operation capability, then, South Korea may have to face the reality of power politics demonstrated by Thucydides through the Athenians: "The strong do what they have the power to do, the weak accept what they have to accept."

Status of Nuclear Power Plant Decommissioning Cost Analysis in USA (미국의 원전해체 비용평가 기초자료 및 동향 분석)

  • Shin, Sanghwa;Kim, Soonyoung
    • Journal of the Korean Society of Radiology
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    • v.12 no.2
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    • pp.139-148
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    • 2018
  • Assessment of NPP(Nuclear Power Plant) decommissioning cost is very important for safe decommissioning of nuclear power plants. In the United States, which has the most NPP decommissioning experience, the cost evaluation study has been conducted since the 1970s in order to decommissioning nuclear facilities. The US NRC has conducted studies on decommissioning technology, safety and cost for a variety of reactor type and nuclear installations. In the total decommissioning costs, the end of operation licenses accounted for the largest portion, followed by spent fuel management and site restoration. In case of immediate decommissioning, spent fuel management cost increased compared to delayed decommissioning, and delayed deocmmissioning increased the cost of terminating the operation license. However, in general, delayed decommissioning does not show any significant benefit as compared with immediate decommissioning. It is necessary to consider the evaluation according to the site conditions when evaluating the cost of decommissioning domestic nuclear power plants. Also, in Korea, IAEA recommendations were applied to reorganize the radioactive waste classification system. Therefore, it is necessary to develop a method to appropriately use the decommissioning data of the preceding US Nuclear Power Plant in the new classification system when estimating the amount of radioactive waste generated during decommissioning. In particular, the establishment of the evaluation methodology for the waste to be disposed of will be an important factor in securing the accuracy of the decommissioning cost. In addition, it is necessary to construct information data that can be applied to facility characteristics and work characteristics in order to evaluate the cost of demolition of domestic nuclear power plants.