• Title/Summary/Keyword: functional failure

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Plasma Etching and Polymerization of Carbon Fiber (플라즈마 에칭과 중합에 의한 탄소섬유의 표면 개질)

  • H. M. Kang;Kim, N. I.;T. H. Yoon
    • Proceedings of the Korean Society For Composite Materials Conference
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    • 2002.05a
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    • pp.143-146
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    • 2002
  • Unsized AS-4 carbon fibers were etched by RF plasma and then coated via plasma polymerization in order to enhance adhesion to vinyl ester resin. The gases utilized for the plasma etching were Ar, $N_2 and O_2$, while the monomers used for the plasma polymerization coating were acetylene, butadiene and acrylonitrile. The conditions for the plasma etching and the plasma polymerization were optimized by measuring interfacial adhesion with vinyl ester resin via micro-droplet tests. Among the treatment conditions, the combination of Ar plasma etching and acetylene plasma polymerization provided greatly improved interfacial shear strength (IFSS) of 69MPa compared to 43MPa with as-received carbon fiber. Based on the SEM analysis of failure surface and load-displacement curve, it was assume that the failure might be occurred at the carbon fiber and plasma polymer coating. The plasma etched and plasma polymer coated carbon fibers were subjected to analysis with SEM, XPS, FT-IR or Alpha-Step, and dynamic contact angles and tensile strengths were also evaluated. Plasma polymer coatings did not change tensile strength and surface roughness of fibers, but decreased water contact angle except butadiene plasma polymer coating, possibly owing to the functional groups introduced, as evidenced by FT-IR and XPS.

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Rehabilitative goals for patients undergoing lung retransplantation

  • Massimiliano Polastri;Robert M. Reed
    • Journal of Yeungnam Medical Science
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    • v.41 no.2
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    • pp.134-138
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    • 2024
  • Lung retransplantation (LRT) involves a second or subsequent lung transplant (LT) in a patient whose first transplanted graft has failed. LRT is the only treatment option for irreversible lung allograft failure caused by acute graft failure, chronic lung allograft dysfunction, or postoperative complications of bronchial anastomosis. Prehabilitation (rehabilitation before LT), while patients are on the waiting list, is recognized as an essential component of the therapeutic regimen and should be offered throughout the waiting period from the moment of listing until transplantation. LRT is particularly fraught with challenges, and prehabilitation to reduce frailty is one of the few opportunities to address modifiable risk factors (such as functional and motor impairments) in a patient population in which there is clearly room to improve outcomes. Although rehabilitative outcomes and quality of life in patients receiving or awaiting LT have gained increased interest, there is a paucity of data on rehabilitation in patients undergoing LRT. Frailty is one of the few modifiable risk factors of retransplantation that is potentially preventable. As such, it is imperative that professionals involved in the field of retransplantation conduct research specifically exploring rehabilitative techniques and outcomes of value for patients receiving LRT, because this area remains unexplored.

Total Anatomic Correction of Complex Heart Anomalies Associated with Complete Atrioventricular Septal Defect (완전방실중격결손증을 동반한 복잡심장기형의 해부학적 교정술에 관한 연구)

  • 김현조;김기출
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.263-270
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    • 1996
  • Twenty two patients underwent total anatomic correction of complete atrioventricular septal defect associated with other cardiac anomalies between July 1986 and December 1994. Age ranged from 6 months to 11 years(mean 49.6 $\pm$ 35.8 months), and they were composed of 7 males and 15 females. Combined major cardiac anomalies were tetralogy of Fallot(TOF) in 11 cases, double outlet of right ventricle (DORV) in 6 ca es, and transposition of great arteries (TGA) in 5 cases. Down's syndrome was associated in 5 patients with TOF and 1 patient with DORV. They were classified as Rastelli type A in 3 patients, B in 2 patients, and C in 17 patients. Modified Blalock-Taussig shunt was performed.in 5 patients and Waterston shunt in 1 patient as a palliative procedure. There were 7 perioperative deaths(31.8%) and the causes were pump weaning failure, low cardiac output, acute renal failure, persistant pulmonary hypertension and hypertensive crisis, and sepsis. Reoperations were performed in 4 cases to repair atrioventricular valvular regurgitation or to relieve the right ventricular outflow tract (RVOT) or pulmonary arterial stenosis. One late death was due to aspiration pneumonia. Second reoperation was necessary for progressive worsening of left atrioventricular regurgitation and RVOT stenosis in one patient. Fourteen survived patients were followed up for a mean of 66.0 $\pm$ 26.7months and all of them w re NYHA functional class I or II.

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Pseudonormal or Restrictive Filling Pattern of Left Ventricle Predicts Poor Prognosis in Patients with Ischemic Heart Disease Presenting as Acute Heart Failure

  • Lee, Jae-Geun;Beom, Jong Wook;Choi, Joon Hyouk;Kim, Song-Yi;Kim, Ki-Seok;Joo, Seung-Jae
    • Journal of Cardiovascular Imaging
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    • v.26 no.4
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    • pp.217-225
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    • 2018
  • BACKGROUND: In patients with acute heart failure (AHF), diastolic dysfunction, especially pseudonormal (PN) or restrictive filling pattern (RFP) of left ventricle (LV), is considered to be implicated in a poor prognosis. However, prognostic significance of diastolic dysfunction in patients with ischemic heart disease (IHD) has been rarely investigated in Korea. METHODS: We enrolled 138 patients with IHD presenting as AHF and sinus rhythm during echocardiographic study. Diastolic dysfunction of LV was graded as ${\geq}2$ (group 1) or 1 (group 2) according to usual algorithm using E/A ratio and deceleration time of mitral inflow, E'/A' ratio of tissue Doppler echocardiography and left atrial size. RESULTS: Patients in group 1 showed higher 2-year mortality rate ($36.2%{\pm}6.7%$) than those in group 2 ($13.6%{\pm}4.5%$; p = 0.008). Two-year mortality rate of patient with LV ejection fraction (LVEF) < 40% ($26.8%{\pm}6.0%$) was not different from those with LVEF 40%-49% ($28.0%{\pm}8.0%$) or ${\geq}50%$ ($13.7%{\pm}7.4%$; p = 0.442). On univariate analysis, PN or RFP of LV, higher stage of chronic kidney disease (CKD) and higher New York Heart Association (NYHA) functional class were poor prognostic factors, but LVEF or older age ${\geq}75$ years did not predict 2-year mortality. On multivariate analysis, PN or RFP of LV (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.09-5.84; p = 0.031), higher stage of CKD (HR, 1.57; 95% CI, 1.14-2.17; p = 0.006) and higher NYHA functional class (HR, 1.81; 95% CI, 1.11-2.94; p = 0.017) were still significant prognostic factors for 2-year mortality. CONCLUSIONS: PN or RFP of LV was a more useful prognostic factor for long-term mortality than LVEF in patients with IHD presenting as AHF.

Klebsiella pneumoniae necrotizing fasciitis on the upper lip in a patient with uncontrolled diabetes

  • Kim, Hyeong Seop;Chang, Yong Joon;Chung, Chul Hoon
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.127-131
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    • 2020
  • A 60-year-old woman with a history of diabetes mellitus and chronic renal failure was admitted to the hospital with severe pain in the upper lip, which began 4 days prior to admission, accompanied by a bullous lesion and suspected cellulitis in the upper lip. Immediately after admission, as the patient's general condition worsened, tests revealed a non-ST elevated myocardial infarction, septic embolism of the lung, as well as septic shock. Her upper lip suddenly presented a gangrenous and necrotic change, which the tissue and blood culture confirmed to be a Klebsiella pneumoniae infection. After a quick response, the patient's general condition improved. Subsequently, serial debridement was performed to effectively clear away the purulent discharge. While under general anesthesia, the process confirmed full-layer necrosis of the upper lip including the orbicularis oris muscle. Almost half of the entire upper lip sustained a full-layer skin and soft tissue defect, with scar contracture. Six months later, to correct the drooling and lip sealing following the defects, a scar release and an Abbe flap coverage were performed considering both functional and aesthetic aspects. The follow-up revealed a favorable corrective result of the upper lip drooling, and the patient was satisfied from a functional perspective.

Free Flap Coverage of the Finger Defect Caused by Digital Replantation Failure

  • Shim, Jung-Hwan;Jeong, Seong-Ho
    • Archives of Reconstructive Microsurgery
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    • v.22 no.2
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    • pp.63-68
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    • 2013
  • Purpose: In case of the failed replantation, if the patients want to preserve the length of amputated stump, toe transfer is the ideal choice. However, reconstruction of these amputated stump with a free flap can be a useful method when the patients refuse sacrificing their toe. Our purpose of this study is to evaluate availability of functional results and patient satisfaction after this procedure. Materials and Methods: From March 2008 to February 2012, we reconstructed the amputated stump with free flap by patients demand. Eleven patients were included, medial plantar artery perforator flap in seven cases and great toe pulp flap in five cases. Follow-up range 12 to 24 months and we evaluate patient satisfaction by using a visual analogue scale (VAS; 1=unsatisfied, 5=excellent) and functional recovery by measuring the range of motion of remaining joint at 12 months after operation. Results: During follow-up period, all transferred free flaps survived and no major complications were noted. Range of motion of remaining joint appeared satisfactory result ($15^{\circ}$ to $100^{\circ}$). The VAS patient satisfaction score for aesthetic were five in six patients, four in four patients, and three in one patient. Conclusion: In case of the failed digital replantation, if patient refuse toe transfer, it could be useful method to reconstruction with the free flap to preserving maximal length of amputated stump.

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A Basic Study on Functional Friction Surface of Artificial Joints (내마모성이 향상된 기능성 표면구조를 갖는 인공관절에 관한 기초적인 연구)

  • ;T. Yuhta
    • Journal of Biomedical Engineering Research
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    • v.22 no.6
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    • pp.519-526
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    • 2001
  • At present. about 0.3 million and more THRs (Total Hip Replacement) in a rear are being done worldwide. The increase in mechanical failure with the increase in THR, required more revisions. Revisions compensate mainly the wear of the artificial joint frictional surface and the loosening of the cup and stem. According to recent researches, loosening is mainly due to wear debris UHMWPE (Ultra High Molecular Weight Polyethylene) from frictional surfaces . To overcome the wear problems associated with artificial joint materials , new surface structures with regular Patterns were designed and fabricated The lubrication Properties were examined to evaluate the wear of the frictional surfaces. The surface structure manifested a Pattern of "dents" with a 0.2-1.0 mm of diameter and 0.6-2.0 mm of Pitch. From the friction test of the SUS316L vs UHMWPE using the frictional tester, we found that the lubrication Performance was improved due to of drastically reduced amount of abrasion. There were optimum sizes for the diameter and the pitch of the Pattern. The results demonstrated that the lubrication properties could be improved by Patterning of the frictional surfaces. The surface Patterning was effective in preventing wear of the frictional surfaces, and the life of an artificial joint could be extended with such Patterning.

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Cardiac Transplantation; 1 Case Report (심장이식 1례보고)

  • 송명근
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.224-227
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    • 1993
  • We experienced one case of orthotopic cardiac transplantation in a patient with end stage dilated cardiomyopathy. This 50 year-old female recipient was suffered from NYHA functional class IV cardiac failure and dependent upon intravenous inotropic support for 2 months [recipient category 1]. Her preoperative condition was grave with left ventricular ejection fraction of 20% and estimated systolic pulmonary arterial pressure [from Doppler study] was 50mmHg. The brain-dead donor was 31 year-old male with head trauma. The body sizes [weight, height] of the donor/recipient were 70 Kg, 165 cm / 43 Kg, 160 cm and appropriately overmatched. Preoperatively, identical ABO/Rh blood group [A+] and nonreacting HLA crossmatching were confirmed. On November 11 1992 cardiac transplantation was performed without complication. Multiple organ procurement team and heart transplantation team were organized the operation schedule appropriately to minimize the ischemic time. The pump time was 126 minutes and aortic crossclamping time of recipient heart was 73 minutes and, as a result, total ischemic time of the transplanted heart was 75 minutes. Postoperatively, the vital signs were stable with minimal inotropic support. The immunosuppressive therapy was commenced from preoperatively and cyclosporine, azathioprine, and corticosteroid were used as a combination therapy as scheduled and monitored with blood drug concentration, WBC count, renal function and most importantly regular endomyocardial biopsy.Now, 5 months after transplantation, the patient is in NYHA functional class II with minimal cardiac drug support.

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Hemodynamic Evaluation of St. Jude Medical Prosthesis (센 쥬드 판막의 혈류 역학적 고찰)

  • 문광덕
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1122-1131
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    • 1995
  • One hundred eighty-eight patients[August.23,1988,through July.30,1994 underwent aortic[AVR , mitral[MVR , or double [DVR valve replacement with the St.Jude Medical prosthesis. The author analyzed 100 patients with valvular heart disease,who underwent valve replacement with the St.Jude Medical prothesis from 1990 to 1994, at Hanyang University hospital Cardiovascular department. Information on volume and functional change of the heart chamber can be obtained by cardiac echocardiography and cartheterization. Out of 100 patients, 40 patients were male[40% and 60 patients were female [60% . Age ranged from 13 years to 68 years, with mean age of 42.6 years. Mean height was 160.3cm and mean body weight was 54.9Kg. According to NYHA functional classification, class III is most frequent and 60 patients could be classfied under it. MVR [involved Redo MVR was performed in 40 patients, AVR [involved Redo AVR was performed in 18 patients, and DVR [involved Redo DVR was performed in 42 patients. Warfarin [Coumadin anticoagulation was recommended for all patients. Life long warfarin anticoagulation was necessary to all patients who underwent valve replacement with St.Jude Medical prosthesis. Ideal prothrombin time was maintained about 30% during warfarinization. There were no case of mechanical failure. It followed a comparison of echocardiography before and after valve replacement at Hanyang University hospital [30 patients and a preoperative evaluation of cardiac catheterization and angiography [64 patients . The St.Jude Medical cardiac valve is a viable alternative in the surgical therapy of valvular heart disease.

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Laryngeal Transplantation in the Canine by End-to-end Anastomosis of the Recurrent Laryngeal Nerve Branches (반회신경분지의 단단문합에 의한 개의 후두이식)

  • 최홍식;김영호;조정일;김세헌;김상균;김광문;홍원표
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.9 no.1
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    • pp.59-65
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    • 1998
  • Instead of brilliant advancement of the organ transplantation in the medical fields, laryngeal transplantation still has couple of problems to be solved before trial on human. Among them functional restoration of the implanted larynx is the most important point. Recent advancement in animal model studies showed possibility of solving the main problem. Eighteen cases of canine laryngeal transplantation in mongrel dogs were done in this department. One cranial artery and two external jugular veins were connected. External and internal branches of the superior layngeal nerve and anterior and posterior branches of the recurrent laryngeal nerve were connected individually. Only two dogs have lived longer than 4 weeks(4weeks, and 10 1/2weeks) and they died unfortunately due to asphixia caused by obstruction of the cannula. Thirteen dogs only lived five days through 15 days. The main causes of the failure were obstruction of the connecting vein, pharyngocutaneous fistula and the wound infection. Although the result was not good enough to evaluate the functional restoration of the implanted larynx, the implanted larynges from the two dogs lived longer than minimum criteria of long term survival(4 weeks) were relatively good in shape at the time of autopsy. This program will be continued after renovation of the animal lab. facilities.

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