• Title/Summary/Keyword: Indwelling

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Simultaneous Neck Dissection in Transoral $CO_2$ Laser Surgery for Supraglottic Cancer (성문상부암에서의 경구강 $CO_2$ 레이저 수술과 동시경부청소술)

  • Kim, Sung-Won;Lee, Kang-Dae
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.18-23
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    • 2009
  • Objectives : In $CO_2$ laser surgery for supraglottic cancer, neck dissection is generally done in second stage. We investigated simultaneous neck dissection with primary resection could be available in laser supraglottic surgery. Material and Methods : We analyzed 13 patients with supraglottic cancer who were treated with transoral supraglottic laryngectomy and simultaneous neck dissection from 2001 to 2007. Tumor stage, extent of laser surgery, histological results, survival rate, local control rate, complications, and functional results were reviewed. Results : 5-year local control rate, survival rate and disease specific survival rate from the neck was 100%, 69.9%, 100% respectively. Tracheotomy was done in all 13 cases. One patient had a long tracheotomy indwelling (191 days). In the rest of 12 patients average decanulation time was 7.4 days(1-22 days). Nasogastric tube was inserted in 5 cases, and average oral intake was possible in 3.5 days(1-16 days). Average hospital days was 29.7 days. There was no serious complication associated with neck dissection. Conclusion : Simultaneous neck dissection with primary laser resection for supraglottic cancer is oncologic sound and can be performed without significant surgical morbidity.

Development of Communication Protocol Verification Tool for Vital Railway Signaling Systems

  • Hwang, Jong-Gyu;Jo, Hyun-Jeong;Lee, Jae-Ho
    • Journal of Electrical Engineering and Technology
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    • v.1 no.4
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    • pp.513-519
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    • 2006
  • As a very important part in development of the protocol, verifications for developed protocol specification are complementary techniques that are used to increase the level of confidence in the system functions by their specifications. Using the informal method for specifying the protocol, some ambiguity may be contained therein. This indwelling ambiguity in control systems can cause the occurrence of accidents, especially in the case of safety-critical systems. To clear the vagueness contained in the designed protocol, we use the LTS (Labeled Transition System) model to design the protocol for railway signaling. And then, we verify the safety and the liveness properties formally through the model checking method. The modal ${\mu}$-calculus, which is an expressive method of temporal logic, has been applied to the model checking method. We verify the safety and liveness properties of Korean standard protocol for railway signaling systems. To perform automatic verification of the safety and liveness properties of the designed protocol, a communication verification tool is implemented. The developed tools are implemented by C++ language under Windows XP. It is expected to increase the safety and reliability of communication protocol for signaling systems by using the developed communication verification tool.

Catheter Obstruction of Intrathecal Drug Administration System -A Case Report-

  • Rhee, Seok-Myeon;Choi, Eun-Joo;Lee, Pyung-Bok;Nahm, Francis Sahn-Gun
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.47-51
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    • 2012
  • Intrathecal drug administration system (ITDAS) can reduce the side effects while increasing the effectiveness of opioids compared to systemic opioid administration. Therefore, the use of ITDAS has increased in the management of cancer pain and chronic intractable pain. Catheter obstruction is a serious complication of ITDAS. Here, we present a case of catheter obstruction by a mass formed at the side hole and in the lumen. A 37-year-old man suffering from failed back surgery syndrome received an ITDAS implantation, and the ITDAS was refilled with morphine every 3 months. When the patient visited the hospital 18 months after ITDAS implantation for a refill, the amount of delivered morphine sulfate was much less than expected. Movement of the pump rotor was examined with fluoroscopy; however, it was normal. CSF aspiration through the catheter access port was impossible. When the intrathecal catheter was removed, we observed that the side hole and lumen of the catheter was plugged.

Evolution of Automatic Ordering System in Retail Market : Analyzing Inventory Data

  • Paik, SiHyun;Frazier, DeWayne P.;Mark, Isenhoff
    • International Journal of Advanced Culture Technology
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    • v.3 no.2
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    • pp.1-14
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    • 2015
  • The purpose of this paper is to reveal two problems in the existing inventory systems in retail market, and to suggest a Two-Bin System under Automatic Ordering System considering only base-stock. Large retailers already have a sophisticated inventory system based on an automatic ordering principle. However, why does the out-of-stock (OOS) happen in large discount stores in spite of having a good inventory system? This paper suggests two systems after finding the root causes concerning the previous question. For evaluating the performance of each system, the random 200 data set in each sample group was generated from MINITAB 16 and obeyed the Poisson distribution. The existing inventory system in retail market cannot help generating OOS due to indwelling contradiction in itself. The reasons are the ordering deadline and the relationship between ordering quantity and base stock. This paper also demonstrates that these previous studies on inventory fall into the closed loop. Also the paper shows that the performance of the replenishment policy was better than traditional methods dealing with ordering quantity and base stock.

Delftia acidovorans Isolated from the Drainage in an Immunocompetent Patient with Empyema

  • Chun, Jaeyoung;Lee, Jaechun;Bae, Jaeseok;Kim, Miyeon;Lee, Jae-Geun;Shin, Sang-Yop;Kim, Young Ree;Lee, Keun-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.239-243
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    • 2009
  • Delftia acidovorans is a gram-negative motile rod found ubiquitously in soil and in water. Confirmed isolation from clinical infections is rare, and has been documented mostly in immunocompromised patients or those with indwelling catheters. A 53-year-old man was referred for the evaluation of a huge mass-like lesion found incidentally by chest X-ray. The lesion occupied more than half of the right lung and was diagnosed as a large loculated pleural effusion by CT scan. Bloody pus was drained through a percutaneous catheter, and D. acidovorans, identified by the Vitek GN card and confirmed by amplification of 16S ribosomal RNA and sequencing analysis, was isolated repeatedly from the drained pus. The patient was treated with imipenem/cilastatin to which the organism was sensitive. This is a rare report of chronic empyema associated with D. acidovorans in the respiratory system of an immunocompetent patient.

A Study of Cause and Thoracotomy in Spontaneous Pneumothorax - A Report of 57 Cases - (자연기흉의 원인과 개흉술에 대한 임상적고찰)

  • 김성수
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.788-793
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    • 1989
  • We have observed 501 cases of spontaneous pneumothorax from January 1981 to June 1989 at the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Of these, 57 patients have undergone thoracotomy to treat the pneumothorax after closed thoracostomy. These 57 patients were based on this retrospective clinical analysis, and the results were as follows: The ratio of male to female was 4.2:1 in male predominance and the old aged patients, over 50 years old, occupied 47.3% of all patients. Primary spontaneous pneumothorax was 19 cases and secondary spontaneous pneumothorax was 38 cases. The underlying pathology in secondary spontaneous pneumothorax was tuberculosis emphysema and chronic obstructive pulmonary disease in 35 cases. The indications of thoracotomy were persistent air leakage in 23 cases recurrent pneumothorax in 21 cases, inadequate expansion in 13 cases. Rupture of bullae or blebs were most frequent operative and pathologic findings in persistent air leakage group and recurrent pneumothorax group. In inadequate expansion group, predominant finding was destructive lung lesion. Bullectomy and/or bullae ligation was most effective procedures in 36 cases [63%] for operative management of spontaneous pneumothorax. Duration of preoperative and postoperative chest tube indwelling day was 13.35 days and 8.05 days in persistent pneumothorax group, 8.92 days and 7.77 days in recurrent pneumothorax group, 13.23 days and 10.21 days in inadequate expansion group.

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Nontraumatic Pneumothorax -A Review of 56 Cases- (비외상성 기흉의 임상적 고찰)

  • 곽문섭
    • Journal of Chest Surgery
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    • v.2 no.2
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    • pp.133-140
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    • 1969
  • We observed 56 cases of nontraumatic pneumothorax clinically and statistically, which had been experienced at the deparment of chest surgery. St. Mary`s Hospital,Catholic Medical College in theserecent years. 1] In the underlying pathology of spontaneous pneumothorax, nontuberculous origin [60.7%], especially due to pulmonary emphysema or blebs[17.8%], especially due to pulmonary emphysema or blebs[17. 8%], tended to increase as the reports of foreign countries, but tuberculous origin was still high in our country[39.3%]. Considering the 14 cases, unknown underlying pathology, the most of them might have scattered blebs which were not revealed in chest Roentgen films. 2] The principle treatment done in our clinic was as follows; The patients, below 20% lung collapse were treated by bed rest and abdominal respiration. The patients, between 20% and 40% lung collapse were treated by repeated pleural aspiration or closed thoracotomy followed. The cases,over 40% lung collapse were treated by closed thoracotomy initially. 3] The average duration of indweIling catheter was 3 to 4 days in the closed thoracotomy. We used to not remove the indwelling catheter early to promote pleural adhesion. 4] Sometimes, the closed thoracotomy drainage induces bronchial irritation and asthmatic attacks, especially in old age group accompanying pulmonary emphysema. In these cases, respiratory difficulties and acidosis should be prevented and controlled with medical treatment including steroid therapy.

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Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients?

  • Chaiyakulsil, Chanapai;Pharadornuwat, Onsuthi
    • Clinical and Experimental Pediatrics
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    • v.64 no.3
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    • pp.123-129
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    • 2021
  • Background: The use of indwelling central venous access devices (CVADs) in children can result in complications such as infection, occlusion, and dislodgement. Purpose: To evaluate whether reinforcing CVAD care bundles by using a regular direct feedback system could reduce such complications in children. Methods: The intervention in this retrospective interrupted time-series study was initiated in January 2019. The study was divided into the preintervention (October-December 2018), 3-month postintervention (January-March 2019), and 6-month postintervention (April-June 2019) phases. Risk difference and Poisson regression analyses were used to illustrate the effectiveness of the intervention. Results: The hospital-wide central line-related bloodstream infection rate decreased from 10.0/1,000 catheter-days to 4.5/1,000 catheter-days at 3-month postintervention (P=0.39) and to 1.4/1,000 catheter-days at 6-month postintervention (P=0.047). The central line occlusion rate significantly decreased from 30% to 12.8% (P=0.04) and 8.3% (P=0.002) at 3 and 6 months, respectively. Approximately 7% of CVADs became dislodged during the preintervention phase versus 8.5% (P=0.364) and 3.3% (P=0.378) at 3 and 6 months, respectively. Conclusion: Reinforcing CVAD care bundles with direct feedback could significantly decrease CVAD-associated complications in terms of infection at 6-month postintervention, and occlusion at 3- and 6-month postintervention. Thus, reinforcement and regular direct feedback might improve care quality in children with CVADs.

Predictors of Post Stroke Depression in Community-indwelling Older Adults (재가노인의 뇌졸중 후 우울 예측요인)

  • Oh, Eunmi
    • Journal of Korean Gerontological Nursing
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    • v.20 no.3
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    • pp.167-176
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    • 2018
  • Purpose: Post Stroke Depression (PSD) is one of the most common complications for stroke survivors and is associated with negative health outcomes such as disability, death. The purpose of this study was to investigate the prevalence and predictors of PSD among older Korean adults living in the community. Methods: Data collection was done using the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Adults. Participants were 706 older adults who had a stroke. Logistic regression analysis was used to determine the predictors of PSD. Results: The prevalence of PSD which was assessed by the short form of the geriatric depression scale was 49.4%. In a logistic regression model, the predictors of PSD were self-rated health (OR=5.90, CI=3.70~9.40), economic state (OR=2.97, CI=2.07~4.24), independent activities of daily living (IADL) (OR=2.17, CI=1.30~3.63), Activities of Daily Living (ADL) (OR=2.02, CI=1.07~3.80), and education (OR=1.53, CI=1.05~2.24). Conclusion: PSD was common among older Korean adults living in the community. Poor self-rated health status, lower economic state, lower levels of Instrumental Activities of Daily Living (IADL) and ADL, lower levels of education should be considered when conducting activities related to prevention and management of PSD in older adults.

Umbilical Venous Catheter Complication Presenting as Chylous Ascites in a Newborn: Intraperitoneal Extravasation of Total Parenteral Nutrition Infusate

  • Lee, Hye Mi;Sung, Hyun Jung;Lee, Hyun-Seung
    • Neonatal Medicine
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    • v.25 no.4
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    • pp.196-201
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    • 2018
  • Umbilical venous catheterization (UVC) is a common practice in intensive neonatal care. However, a malpositioned UVC and its prolonged use may lead to various problems, including mechanical, infectious, and thrombotic complications in various organs such as the liver, lungs, and heart. Congenital chylous ascites is characterized by abnormally high levels of triglycerides in the peritoneal fluid of newborns, which originate from refluxed lymph within the abdominal cavity. Herein, we report a case of an UVC complication presenting as chyloperitoneum simulating congenital chylous ascites in a preterm neonate that resulted from total parenteral nutrition (TPN) extravasation from a malpositioned UVC. Biochemical analysis of intraperitoneal chylous fluid and TPN infusate could help confirm the origin of chyloperitoneum. This case suggests that TPN extravasation from UVC should be considered when chyloperitoneum develops in newborns with an indwelling catheter. UVC positions must also be carefully monitored at regular intervals to recognize associated complications early, particularly in cases with an inevitably malpositioned catheter related to the anatomy of the vessel course.