• Title/Summary/Keyword: Medical device failure

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A Case of Peritoneal Dialysis-related Peritonitis Caused by Aeromonas Hydrophila in the Patient Receiving Automated Peritoneal Dialysis

  • Kim, Hyun Jin;Park, Hyun Sun;Bae, Eunsin;Kim, Hae Won;Kim, Beom;Moon, Kyoung Hyoub;Lee, Dong-Young
    • Electrolytes & blood pressure
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    • v.16 no.2
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    • pp.27-29
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    • 2018
  • Peritoneal dialysis (PD)-related peritonitis is a major cause of injury and technique failure in patients undergoing PD. Aeromonas hydrophila is ubiquitous in the environment, and is a Gram-negative rod associated with infections in fish and amphibians in most cases; however, it can also cause opportunistic infections in immunocompromised patients. We report a case of A. hydrophila peritonitis in a 56-year-old male on automated PD. Peritonitis may have been caused by contamination of the Set Plus, a component of the automated peritoneal dialysis device. Although Set Plus is disposable, the patient reused the product by cleansing with tap water. He was successfully treated with intraperitoneally-administered ceftazidime and has been well without recurrence for more than 2 years.

Reoperation for Mitral valvular disease - Clinical analysis of 21 cases - (승모판막질환에 대한 재수술: 21례 보고)

  • 유병하
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.649-654
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    • 1985
  • After first successful mitral valvotomy by Harken and Bailey in 1948, improvement of surgical technique and cardiac device may last rapidly for several years, but there after many patients deteriorate because of various causes, so incidence of reoperation for cardiac valvular disease has increased time by time. This paper is concerned with 21 patients in whom a second operation has been carried out from Jan. 1963 to Aug. 1984 at the department of Thoracic and Cardiovascular department, National Medical Center. Of 21 patients, 7 were male and 14 were female, and ages ranged from 14 to 37 years The second operation are classified into groups of secondary closed mitral commissurotomy [3 cases], open commissurotomy following closed mitral commissurotomy [1 case], Valve replacement following closed mitral commissurotomy [14 cases] or bioprosthetic valve replacement [3 cases]. Main cause of reoperation was restenosis or steno insufficiency, and that of bioprosthetic valve failure was bacterial endocarditis [1 case], fibrous tissue overgrowth on the Xenograft [1 case] and technical failure [1 case]. Early operative mortality was absent, but during follow-up, 4 patients died, so late mortality was 19.0%, and main cause of death was congestive heart failure.

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Application of Cardiac Electromechanical FE Model for Predicting Pumping Efficacy of LVAD According to Heart Failure Severity (심부전 정도에 따른 좌심실보조장치의 박동효율예측을 위한 심장의 전기역학적 유한요소 모델의 응용)

  • Jung, Dae Hyun;Lim, Ki Moo
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.38 no.8
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    • pp.715-720
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    • 2014
  • In order to maximize the effect of left ventricular assist device (LVAD) on ventricular unloading, the therapy should be begun at appropriate level of heart failure severity. We predicted pumping efficacy of LVAD according to the severity of heart failure theoretically. We used 3 dimensional finite element model of ventricle coupled with 6 Wind-kessel compartmental model of vascular system. Using the computational model, we predicted cardiac responses such as contractile ATP consumption of ventricle, left ventricular pressure, cardiac output, ejection fraction, and stroke work according to the severity of ventricular systolic dysfunction under the treatments of continuous LVAD. Contractile ATP consumption, which indicates the ventricular energetic loading condition decreased maximally at the $5^{th}$ level heart-failure under LVAD therapy. We conclude that optimal timing for LVAD treatment is $5^{th}$ level heart-failure when considering LVAD treatment as "bridge to recovery".

The Effects of Training on the Proper Use of Respiratory Rate Measurement Devices for Providing High-Quality Artificial Ventilation

  • Jae-Ran Lim;Sung-Hwan Bang;Hyo-Suk Song;Gyu-Sik Shim;Ho-Jin Park
    • Journal of the Korea Society of Computer and Information
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    • v.29 no.3
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    • pp.165-171
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    • 2024
  • This study aims to investigate the appropriate volume of artificial ventilation and success rate when Basic - emergency medical Technician administer bag valve mask(BVM) artificial ventilation to patients experiencing respiratory failure or respiratory arrest using a respiratory rate measurement device. The research was conducted from December 11th to 12th, 2023, targeting 20 Basic - emergency medical Technicians enrolled at D University. Ten participants were selected for the experimental group, receiving BVM ventilation training with the use of a respiratory rate measurement device, while the other ten were assigned to the control group, receiving BVM ventilation training without the use of a respiratory rate measurement device. The experiment involved providing artificial ventilation for 2 minutes. The results of the study indicated that the control group did not provide accurate tidal volume (p=.025). The experimental group demonstrated a higher success rate of ventilation over the 2-minute period, while the control group showed a significant difference (p=.001). Subjective perception of tidal volume and objectively measured tidal volume also exhibited a significant difference in the control group (p=.010). Therefore, training with a respiratory rate measurement device can align the subjective perception of tidal volume with objective measurements, increase the success rate of ventilation, and potentially contribute to improving survival rates in patients experiencing respiratory failure or respiratory arrest during cardiopulmonary resuscitation.

Study on 3D Printer Production of Auxiliary Device for Upper Limb for Medical Imaging Test (의료영상 검사를 위한 상지 보조기구의 3D 프린터 제작 연구)

  • Kim, Hyeong-Gyun;Yoon, Jae-Ho;Choi, Seong-Dae
    • Journal of radiological science and technology
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    • v.38 no.4
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    • pp.389-394
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    • 2015
  • There is a progressive development in the medical imaging technology, especially of descriptive capability for anatomical structure of human body thanks to advancement of information technology and medical devices. But however maintenance of correct posture is essential for the medical imaging checkup on the shoulder joint requiring rotation of the upper limb due to the complexity of human body. In the cases of MRI examination, long duration and fixed posture are critical, as failure to comply with them leads to minimal possibility of reproducibility only with the efforts of the examiner and will of the patient. Thus, this study aimed to develop an auxiliary device that enables rotation of the upper limb as well as fixing it at quantitative angles for medical imaging examination capable of providing diagnostic values. An auxiliary device has been developed based on the results of precedent studies, by designing a 3D model with the CATIA software, an engineering application, and producing it with the 3D printer. The printer is Objet350 Connex from Stratasys, and acrylonitrile- butadiene-styrene(ABS) is used as the material of the device. Dimensions are $120{\times}150{\times}190mm$, with the inner diameter of the handle being 125.9 mm. The auxiliary device has 4 components including the body (outside), handle (inside), fixture terminal and the connection part. The body and handle have the gap of 2.1 mm for smooth rotation, while the 360 degree of scales have been etched on the handle so that the angle required for observation may be recorded per patient for traceability and dual examination.

Life Prediction of Elastomeric U Seals in Hydraulic/Pneumatic Actuators Using NSWC Handbook (NSWC를 활용한 유공압 액추에이터 U 형 씰의 수명예측)

  • Shin, Jung Hun;Chang, Mu Seong;Kim, Sung Hyun;Jung, Dong Soo
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.38 no.12
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    • pp.1379-1385
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    • 2014
  • Even the rough prediction of the product test time before the lifetime test of mechanical component begins would be of use in estimating cost and deciding how to keep up with the test. The reliability predictions of mechanical components are difficult because failure or degradation mechanisms are complicated, and few plausible databases are available for lifetime prediction. Therefore, this study conducted lifetime predictions of elastomeric U seals that were respectively installed in a hydraulic actuator and a pneumatic actuator using lifetime models and a field database based on failure physics and an actual test database obtained from the NSWC handbook. To validate the results, the predicted failure rates were compared with the actual lifetime test results acquired in the lab durability tests. Finally, this study discussed an engineering procedure to determine the coefficients in the failure rate models and analyzed the sensitivity of each influential parameter on the seal lifetime.

A Study on the Life Characteristic of an Automotive Water-pump Bearing Using the Accelerated Test Method (가속시험법을 활용한 자동차용 워터펌프 베어링의 수명특성에 관한 연구)

  • Yang, Hui Sun;Shin, Jung Hun;Park, Jong Won;Sung, Baek Ju
    • Tribology and Lubricants
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    • v.31 no.2
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    • pp.35-41
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    • 2015
  • A water-pump located in the cooling area of a car circulates cooling water. A particular bearing element, known as a water-pump bearing, installed in the rotating part carries the entire load. The failure of this water-pump bearing has a direct impact on the failure of the automobile engine, and so securing its reliability is crucial. Several researchers have examined the design principles of the water-pump bearing, but there are no reports on the life characteristic of the bearing yet. Herein, we report the construction of test equipment to reproduce the spalling of the roller contact, which is the main failure mode of the chosen water-pump bearing. We chose the radial load as an accelerated stress factor and validated the failure mode by monitoring the surface defects. We conducted the accelerated life test after determining the accelerated stress level through a combination of finite element analysis and a preliminary test. In the life tests, we used an accelerometer to perform failure diagnosis. In the last stage of this study, we present a statistical reliability analysis. Thus, we fully estimated the shape parameter of the water-pump bearing, accelerating level on the load , and the lifetime (MTTF and B10 life) under real use conditions, and finally proposed an interval estimation value considering the uncertainty of the estimated value.

Animal Experiment of the Pneumatic Ventrivular Assist Device (공압식 심실 보조기의 동물실험)

  • Park, Seong-Sik;Kim, Sam-hyun;Seo, Pil-won;Choi, Chang-hyu;Lee, Sang-hoon;Lee, Hyuk-soo;Hwang, Seung-ok;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1065-1077
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    • 1999
  • Background : Ventricular assist devices(VADs) are being used for patients in postcvardiotomy cardiogenic shock status bridge to cardiac transplant settings and in post-myocardial infarction cardiogenic shock. The VAD which was developed at the Deparment of medical engineering in Dankook University College of Medicine was a pneumatically driven device and can maintain pulsatile flow. The goal of this study is to develop animal experimental models using the VAD and to clarify the reliability and hemodynamic property adequacy of end organ perfusion durability and severity of thrombotic-hemolytic tendency of the device. Material and Method : The pneumatic VAD was applied to 8 adult female lambs, We examined some hemodynamic parameters such as arterial blood pressure pulmonary capillary wedge pressure(pcwp) pulmonary artery pressure(PAP) left atrial pressure hour urine output cardiac index VAD flow EKG to determine the reliability of the VAD and hemodynamic compatibility of the experimental animals within 24 hours of experiment. We also observed the end organ perfusion durability of the VAD and thrombotic-hemolytic property of the VAD after 24 hours of VAD insertion. Result: We could monitor all hemodynamic parameters including pcwp PAP cardiac index EKG, adn hour urine as true clinical settings. We observed that the reliability of the VAD was excellent and the hemodynamic property of the experimental animal and end organ perfusion were adequate within 24 hours of experiment. In four lambs surviving 24 hours after insertion the reliability of the VAD and end organ perfusion were excellent and no thrombotic-hemolytic tendency was noted. However after 15 days of experiment the diaphragm of the VAD was torn and it was recommende that the durability of the VAD should be extended. Conclusion : e conclude that the pneumatic VAD developed at Dankook University Biomedical Engineering has good hemodynamic property and low thromboembolic tendency and presents adequate end organ perfusion but we noted that the durability of the device should be expanded further. It will be possible to do more reliable experiment in the future according to the animal experimental method developed in this study especially with the heart failure models.

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Clinical Characteristics of Poor Responders to Acupotomy and Safety Pretreatment Management (침도 침술시 부작용과 예방법에 관한 연구)

  • Kim, Sung-Chul
    • Journal of Acupuncture Research
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    • v.25 no.4
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    • pp.117-125
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    • 2008
  • Objectives : Analyze according to types of event causing the adverse outcome due to acupotomy, and discuss problems and safety reqirements to using this therapy in Korea. Methods : Based upon the indication, contraindication, treatment procedures, clinical obsevations, acupotomy-related adverse outcome case reports, the factors of damaging event were classified. Results : The main factors of adverse outcome by acupotomy were anatomical ignorance, contamination of device or hospital staff, failure to notice preexisting disease(cardiovascular disease, hypertension, renal failure, hemophilia, chronic Liver Disease, etc.), unskilled treatment procedures(massive bleeding) and techniques(nerve injury, hepatic and splenic injury, Pneumothorax). Conclusions : It is mandatory to prepare adequate sterilie aseptic technique. The clinician should ensure understand genernal health state of patient and anatomical direction.

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Single-pigtail plastic stent made from endoscopic nasobiliary drainage tubes in endoscopic ultrasound-guided gallbladder drainage: a retrospective case series

  • Koichi Soga
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.263-267
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    • 2024
  • Technical failure of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is often attributed to device failure. To rectify this problem, we developed a single-pigtail plastic stent (SPPS) for EUS-GBD. We retrospectively reviewed the cases of four patients who underwent EUS-GBD for acute cholecystitis. To prepare the SPPS, a 7.5-Fr endoscopic nasobiliary drainage tube was cut to an appropriate length. The use of SPPS during EUS-GBD was successful from both technical and clinical standpoints. The SPPS spontaneously detached 57 days after the procedure in patient 4 and 412 days after the procedure in patient 1. Patient 1 developed cholecystitis after 426 days and was managed with antibiotics. The other three patients did not develop any complications after surgery. In conclusion, we designed a new SPPS dedicated to EUS-GBD and established its technical feasibility and clinical effectiveness.