Journal of the military operations research society of Korea
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v.37
no.1
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pp.27-38
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2011
Purpose that studies the war history is to prevent the war in the advance through instruction that is gotten by understanding the past war and in case of emergency, it is to win victory in the war from the enemy by doing not commit a same mistake like the past war. For these reasons, many studies about the war history have proceeded continuously in domestic and outside the country, and those are being carried out in present. However, most of studies of the war history have been analyzed only on qualitative analysis. In this study, we want to suggest quantitative analysis method using simulation with qualitative analysis. As an example of study, we quantitatively analyzed the importance of logistics support on the Moscow expedition of Napoleon. Also, on the basis of this, we found failure factor of logistics support of Napoleon force and through this, deduced instruction. There is meaning that this paper suggested quantitative analytical method in terms of study of the war history with qualitative analytical method.
The occurrence of progressive collapse induced by the removal of the vertical load-bearing element in the structure, because of fire or earthquake, has been a significant challenge between structural engineers. Progressive collapse is defined as the complete failure or failure of a part of the structure, initiating with a local rupture in a part of the building and can threaten the stability of the structure. In the current study, the behavior of the structures equipped with a cylindrical friction damper, when the vertical load-bearing elements are eliminated, is considered in two cases: 1-The load-bearing element is removed under the gravity load, and 2-The load-bearing element is removed due to the earthquake lateral forces. In order to obtain a generalized result in the seismic case, 22 pair motions presented in FEMA p 695 are applied to the structures. The study has been conducted using the vertical push down analysis for the case (1), and the nonlinear time-history analysis for the second case using OpenSEES software for 5,10, and 15-story steel frames. Results indicate that, in the first case, the load coefficient, and accordingly the strength of the structure equipped with cylindrical friction dampers are increased considerably. Furthermore, the results from the second case demonstrate that the displacements, and consequently the forces imposed to the structure in the buildings equipped with the cylindrical friction damper substantially was reduced. An optimum slip load is defined in the friction dampers, which permits the damper to start its frictional damping from this threshold load. Therefore, the optimum slip load of the damper is calculated and discussed for both cases.
Two cases of the discrete membranous subaortic stenosis were experienced at the Department of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. Case I was 31 years old male with a history of aortic valve replacement[Ionescu-Shiley, 19mm] at the other hospital in 1980. Heart failure was noticed 6 years later. On cardiac catheterization, pressure gradient between left ventricle 4 aorta was 104 mmHg, but subvalvular aortic stenosis was not detected by preoperative 2-D echo <% left ventriculogram. Above case revealed stenoinsufficiency of the prosthetic valve. Under the diagnosis of the prosthetic valve failure, re-do aortic valve replacement[Bjork-Shiley, 23 mm] was done. During operation, the discrete membranous subaortic stenosis was incidentally found, and it was completely resected. So we thought that above discrete membranous subaortic stenosis was not detected at first operation, and it was progressed during 6 years, and accelerated the degeneration of the prosthetic valve. Case II was 20 years old female. Her complaints were exertional dyspnea, angina, syncope, which were aggravated since 5 years ago. 2-D echo <% left ventriculogram revealed the discrete membranous subaortic stenosis. Pressure gradient was 20 mmHg, but her symptoms were serious. Associated cardiac anomaly was the persistent left superior vena cava without connection with right superior vena cava. Complete excision of the membranous tissue was done. Post-operative pressure gradient between left ventricle & aorta was absent, and her complaints were nearly subsided. Both cases were type I according to the Newfeld classification of the discrete subvalvular aortic stenosis, and complete excision of the membranous tissue was done without myotomy or mymectomy. And short-term follow-up results[Case I:2 years, Case II: 1 ~ years] were good except soft systolic murmur[grade II/VI] at the aortic area in both cases.
Kim, Hyeun Sung;Ju, Chang Il;Kim, Seok Won;Kim, Sung Hoon
Journal of Korean Neurosurgical Society
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v.58
no.6
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pp.563-565
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2015
Juxtafacet cysts are implicated in neural compression. Thus far, it is known that surgical removal is the definitive treatment for symptomatic juxtafacet cyst because spontaneous regression is rare, and the failure rate of conservative treatment is high. We have reported a rare case of right-sided juxtafacet cyst development after the spontaneous resolution of contralateral left-sided facet cyst. The left-sided facet cyst resolved spontaneously without surgical treatment, but a juxtacyst developed on the contralateral facet on the right side, as illustrated on 4-year follow-up magnetic resonance images. To the best of our knowledge, this is the first report of newly developed contralateral juxtafacet cyst after spontaneous regression. Herein, we have discussed the natural history and the management of this rare case.
Laryngeal foreign bodies are not common among the foreign bodies of aerodigestive tract. It is relatively easy to diagnose in acute phase of entry because of a readily\ulcorner available history of intake, and signs or symptoms referable to the foreign body in the highly sensitive air passage. However, on occasion, sudden death by respiratory failure occurs due to complete obstruction of airway. Therefore, it is common and safe to remove the laryngeal foreign bodies by suspension laryngoscope under general anesthesia after tracheostomy. Recently, the authors experienced a case of metallic foreign body in larynx penetrating neck, which was removed by suspension laryngoscope under general anesthesia without any life threatening complication.
During the period from September 1989 through December 1992, 118 cases of coronary arterial bypass graft were performed at Department of Cardiothoracic Surgery, Asan Medical Center. Twenty-one of these had history of recent or remote percutaneous transluminal coronary angioplasty. They consisted of 13 males[age,58.7 + 5.4 years] and 8 females[age, 63.6 + 2.8years] with the mean age of 60.6. History of old myocardial infarction was noted in 24%[5/21] of the patients and congestive heart failure in 2 cases. The angina by type of presentation is unstable in all of the patients. The patterns of involvement of coronary arterial disease were left main disease[1], single vessel disease[5], double vessel involvement[10], and triple vessel involvement[5]. We performed 4 cases of single bypasses, 7 cases of double, 8 cases of triple, and 2 cases of quadruple bypasses. Total of 51 grafts[LIMA:12, RSVG:39] were inserted in 21 cases with average of 2.4 grafts per patient. The methods of myocardial protection were cold blood cardioplegia[8 cases], intermittent aortic occlusion[11], and continuous coronary perfusion with local coronary sharing[2]. There were no operative or late death. The only cardiac complication was 1 case of low cardiac output required IABP. The other complications were 1 case of sternal wound infection and 1 case of postoperative bleeding required reoperation. And there was no case of perioperative myocardial infarction. Postoperatively, 3 cases of recurrent angina were detected at 5, 7, and 18months after surgery. One of them was managed successfully with repeat PTCA[who was recurred 18 months postoperatively], and the other two with medication. I conclude that we can approach the patients more aggressively with PTCA, because of our acceptable operative risks.
During 42 month period 91 consecutive patient underwent coronary artery bypass surgery. The mean age of these patient was 57 years [range from 28 to 78 years . There were 57 men and 34 women. The preoperative risk factors that include beyond the 50 % of total patients were male sex, obesity, hypo-high-density lipoproteinemia, smoking, hypercholesterolemia, hyper-low-density lipoproteinemia, hypertriglyceridemia and hypertension. Preoperatively 27 patients had stable angina pectoris and 39 patients of unstable angina pectoris. Twenty five patients had previous myocardial infarction history. The patterns of disease were 8 patients of single vessel involvement, 18 patients of double vessel involvement, 54 patients of triple vessel involvement and 11 patients of left main coronary artery disease. Fifty five patients were in Canadian Cardiovascular Society functional class III. Myocardial revascularization was performed under emergency conditions in 5 patients. Nine percent of patients had previous PTCA history. We performed 16 cases of sequential anastomosis, internal mammary artery harvest in 86 percent of total patients and total 284 distal anastomoses[mean 3.1 anastomosis per patient . The mean ACC time was 60.5 minutes and ECC time was mean 110 minutes. The combined surgeries were 16 cases of endarterectomy, 2 cases of LV aneurysmectomy, 1 case of Bentall operation, 1 case of repair of sinus of Valsalva, 1 case of ligation of coronary AV fistula and 1 case of excision of breast mass. The most common complication was wound infection[12 cases, 13 % . There was one hospital death due to postoperative respiratory failure and low output syndrome in patient with postinfarction VSD, LV aneurysm. Postoperative 88 patients were in Functional class I or II. The 99mTc-MIBI myocardial perfusion scan that used as evaluation of postoperative state was well correlated with patient`s symptoms instead of some disadvantages.
Kim, Sunghwan;Choi, Jeongmin;Kim, Tae Han;Kong, Seong-Ho;Suh, Yun-Suhk;Im, Jong Pil;Lee, Hyuk-Joon;Kim, Sang Gyun;Jeong, Seung-Yong;Kim, Joo Sung;Yang, Han-Kwang
Journal of Gastric Cancer
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v.16
no.3
/
pp.167-176
/
2016
Purpose: The purpose of this study was to determine the effect of a prior gastrectomy on the difficulty of subsequent colonoscopy, and to identify the surgical factors related to difficult colonoscopies. Materials and Methods: Patients with a prior gastrectomy who had undergone a colonoscopy between 2011 and 2014 (n=482) were matched (1:6) to patients with no history of gastrectomy (n=2,892). Cecal insertion time, intubation failure, and bowel clearance score were compared between the gastrectomy and control groups, as was a newly generated comprehensive parameter for a difficult/incomplete colonoscopy (cecal intubation failure, cecal insertion time >12.9 minutes, or very poor bowel preparation scale). Surgical factors including surgical approach, extent of gastrectomy, extent of lymph node dissection, and reconstruction type, were analyzed to identify risk factors for colonoscopy performance. Results: A history of gastrectomy was associated with prolonged cecal insertion time ($8.7{\pm}6.4$ vs. $9.7{\pm}6.5$ minutes; P=0.002), an increased intubation failure rate (0.1% vs. 1.9%; P<0.001), and a poor bowel preparation rate (24.7 vs. 29.0; P=0.047). Age and total gastrectomy (vs. partial gastrectomy) were found to be independent risk factors for increased insertion time, which slowly increased throughout the postoperative duration (0.35 min/yr). Total gastrectomy was the only independent risk factor for the comprehensive parameter of difficult/incomplete colonoscopy. Conclusions: History of gastrectomy is related to difficult/incomplete colonoscopy performance, especially in cases of total gastrectomy. In any case, it may be that a pre-operative colonoscopy is desirable in selected patients scheduled for gastrectomy; however, it should be performed by an expert endoscopist each time.
El-Borgi, S.;Choura, S.;Neifar, M.;Smaoui, H.;Majdoub, M.S.;Cherif, D.
Smart Structures and Systems
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v.4
no.2
/
pp.209-220
/
2008
A methodology for the seismic vulnerability assessment of historical monuments is presented in this paper. The ongoing work has been conducted in Tunisia within the framework of the FP6 European Union project (WIND-CHIME) on the use of appropriate modern seismic protective systems in the conservation of Mediterranean historical buildings in earthquake-prone areas. The case study is the five-century-old Zaouia of Sidi Kassem Djilizi, located downtown Tunis, the capital of Tunisia. Ambient vibration tests were conducted on the case study using a number of force-balance accelerometers placed at selected locations. The Enhanced Frequency Domain Decomposition (EFDD) technique was applied to extract the dynamic characteristics of the monument. A 3-D finite element model was developed and updated to obtain reasonable correlation between experimental and numerical modal properties. The set of parameters selected for the updating consists of the modulus of elasticity in each wall element of the finite element model. Seismic vulnerability assessment of the case study was carried out via three-dimensional time-history dynamic analyses of the structure. Dynamic stresses were computed and damage was evaluated according to a masonry specific plane failure criterion. Statistics on the occurrence, location and type of failure provide a general view for the probable damage level and mode. Results indicate a high vulnerability that confirms the need for intervention and retrofit.
This paper reports 15 native valve endocarditis cases had surgical operation in the past 10 years at the department of Cardiovascular and Thoracic Surgery, Chonbuk National University Hospital. In this study, 10 cases out of 15 were in class I or II by the New York Heart Association functional classification. None of the cases had a history of taking addictive drugs. Five cases were congenital heart disease, three cases were rheumatic heart disease and two cases were degenerative heart disease. Thus 10 cases had the underlying disease. All cases had antibiotics treatment for 3 to 6 weeks before operation. In the culture test, only four cases were positive in the blood culture and one case was positive in the excised valve culture. Organisms on blood and valve culture were Streptococcus epidermis, Streptococcus viridans, Staphylococcus aureus and Staphylococcus epidermidis. In the 10 cases without ventricular septal defect, the aortic valve was involved in four, mitral in four, both in two and involved valves in the 5 cases with ventricular septal defect were tricuspid in three, pulmonic in two. Eight cases had operation because they showed moderate congestive heart failure due to valvular insufficiency and vegetation with or without embolism. Seven cases had operation because they showed persistent or progressive congestive heart failure and/or uncontrolled infection. Five cases with ventricular septal defect underwent the closure of ventricular septal defect, vegetectomy and leaflet excision of the affected valves without valve replacement. In the cases without ventricular septal defect, the affected valves were replaced with St. Jude mechanical prosthesis. Postoperative complications were recurrent endocarditis in two, embolism in one, allergic vasculitis in two, spleen rupture in one and postpericardiotomy syndrome in one. At the first postoperative day, one case died of cerebral embolism. At the 11th postoperative month, one case died of recurrent endocarditis and paravalvular leakage in spite of a couple of aortic valve replacement. In the survived cases[13 cases in this study , all cases but one became class I or II by the New York Heart Association functional classification.
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