• Title/Summary/Keyword: functional failure

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Combined Percutaneous and Minimal on Internal Fixation of Calcaneal Fractures Using Extensile Lateral Approach (광범위 외측 도달법을 이용한 종골 골절의 경피적 및 최소 내고정술)

  • Yu, Sun-O;Kim, Joo-Sung;Kim, Jong-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.201-207
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    • 2002
  • Purpose: To present the clinical analysis of the results obtained in 38 cases of displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation using extensile lateral approach. Materials and Methods: From March 2000 to February 2002, thirty-eight displaced intraarticular fractures of the calcaneus in 35 patients were fixed with 3.5mm cannulated screws and percutaneous 2.5mm K-wires. The extensile lateral approach was used in all cases. The average follow-up period was 16 months. Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The clinical results were graded as excellent in 8 cases(21%), good in 22 cases(58%), fair in 6 cases(16%), and poor in 2 cases(5%). Two cases of poor result were type IV of Sanders classification. The postoperative reduction status of the articular surface was analyzed by computed tomography in all cases and was found to be less 2mm of step off in 30 cases and between 2 and 4mm in 8 cases. Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. Using early functional postoperative care, all fractures healed without secondary displacement except 1 case on an average of ten weeks. Two cases had superficial necrosis of the wound margins, however, secondary wound healing was uneventful and skin grafting was not needed. Conclusion: Combined minimal internal fixation and percutaneous pin fixation using extensile lateral approach is useful operative method of intraarticular calcaneal fractures because providing enough stability to permit functional aftercare and allowing excellent anatomical reduction. In addition, this method diminishes the risk of lateral soft tissue problems.

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Effect of the Extracorporeal Circulation on Renal Function in Adult Open Heart Patients (개심술시 체외순환이 신장기능에 미치는 영향)

  • Lee, Jae-Won;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.718-731
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    • 1985
  • Renal dysfunction is a common complication of open-heart surgery: a form of controlled hemorrhagic shock, and successful perioperative management of renal dysfunction depends on recognition of the risk factors and optimal management of factors influencing renal function, including cardiopulmonary bypass, and early detection of renal failure. Changes in renal functional parameters including Ccr, Cosm, CH2O, FENa, and RFI were observed prospectively in forty five patients operated on at Dept. of Thoracic and Cardiovascular Surgery, S.N.U.H., from April to June, 1985. They were 23 males and 22 females with 35 acquired and 10 congenital heart diseases and the mean age and body surface area of them were 38.010.3 years [22-63] and 1.5518 M2[1.151.92] respectively. Followings are the conclusion. 1. The Ccr, representative of renal function, is significantly improved from 90.231.3 ml/min/M2 preoperatively to 101.536.4 ml/min/M2 postoperative and day [P<0.05], and all patients were classified as postoperative renal functional class I of Abel, which representing adequate renal protection during our cardiopulmonary bypass. 2. The Cosm is significantly elevated at immediate postperfusion time and remained high at postoperative one day representing osmotic diuresis at that time, but CH2O shows no significant changes at immediate postperfusion period and is decreased significantly at postoperative one day, representing recovery of renal concentrating ability at that time with decreasing urine flow. 3. The absolute value and changing tendency in FENa and RFI during perioperative period shows no diagnostic reliability on these parameters, but those of CH2O appear to reveal future renal function more accurately than Ccr 4. The depth of hypothermia may be protective upon renal function against the ill effects of prolonged nonpulsatile cardiopulmonary bypass. 5. The depth of the hypothermia, pump time of more than 150 minutes, poor cardiac function, and intraoperative events such as embolism appear to be related with immediate postperfusion renal function. 6. Hemoglobinuria and hemolysis, poor preoperative renal function, history of cardiac surgery, and massive transfusion associated with bleeding appear not to be related with renal dysfunction.

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Development of Functional Markers for Detection of Inactive DFR-A Alleles Responsible for Failure of Anthocyanin Production in Onions (Allium cepa L.)

  • Park, Jaehyuk;Cho, Dong Youn;Moon, Jin Seong;Yoon, Moo-Kyoung;Kim, Sunggil
    • Horticultural Science & Technology
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    • v.31 no.1
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    • pp.72-79
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    • 2013
  • Inactivation of the gene coding for dihydroflavonol 4-reductase (DFR) is responsible for the color difference between red and yellow onions (Allium cepa L.). Two inactive DFR-A alleles, DFR-$A^{PS}$ and DFR-$A^{DEL}$, were identified in our previous study. A functional marker was developed on the basis of the premature stop codon that inactivated the DFR-$A^{PS}$ allele. A derived cleaved amplified polymorphic sequences (dCAPS) primer was designed to detect the single nucleotide polymorphism, an A/T transition, which produced the premature stop codon. Digested PCR products clearly distinguished the homozygous and heterozygous red $F_2$ individuals. Meanwhile, to develop a molecular marker for detection of the DFR-$A^{DEL}$ allele in which entire DFR-A gene was deleted, genome walking was performed and approximately 3 kb 5' and 3' flanking sequences of the DFR-$A^R$ coding region were obtained. PCR amplification using multiple primers binding to the extended flanking regions showed that more of the extended region of the DFR-A gene was deleted in the DFR-$A^{DEL}$ allele. A dominant simple PCR marker was developed to identify the DFR-$A^{DEL}$ allele using the dissimilar 3' flanking sequences of the DFR-A gene and homologous DFR-B pseudogene. Distribution of the DFR-$A^{PS}$ and DFR-$A^{DEL}$ alleles in yellow onion cultivars bred in Korea and Japan was surveyed using molecular makers developed in this study. Results showed predominant existence of the DFR-$A^{PS}$ allele in yellow onion cultivars.

Implant-assisted removable partial denture for severely atrophied mandible (심한 하악 치조제 흡수를 가진 환자에서 임플란트를 이용한 가철성 국소의치로 수복한 증례)

  • Choi, Bada;Kim, Yeun Ju;Lee, Jae Hoon
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.2
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    • pp.171-175
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    • 2019
  • Mandible with severe alveolar bone atrophy poses a significant challenge in terms of reproducing clinically acceptable anatomy for a removable prosthesis. To overcome this potential complication, altered cast impression technique is often recommended to capture accurate and functional gingiva tissues. It becomes possible to get proper anchors functional impression by placing 2 implants crowns which were impossible in previous implant overdenture impression technique. In this case, an 80-year old female patient with severe mandibular ridge atrophy was treated with an implant-assisted removable partial denture with two implant crowns on the canine area. An altered cast impression was taken with an individual tray on a metal framework of removable partial denture on both posterior edentulous areas. The patient was satisfied with the final prosthesis after failure of 2 previous prostheses. Clinician had a difficult time to manage disabled patient and patient were suffered with ill-fitting denture due to inaccurate impression in conventional overdenture condition. The oral rehabilitation was completed with placing 2 implants as proper anchor.

Maxillary anterior prosthetic treatment concerning anterior guidance of a patient who lost stable holding contact (안정적인 교합접촉을 잃은 환자에서의 전방유도를 고려한 치료증례)

  • Park, Jong-Hoon;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.467-474
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    • 2019
  • Recently, many patients undergo anterior prosthetic treatment for esthetic reasons. In some patients complain about functional reasons such as inaccurate pronunciation and occlusal discomfort after the treatment. Anterior teeth are important esthetically but in the occlusal point of view, anterior guidance is the second most important factor in occlusion, next to centric relation. Failure to determine an appropriate anterior guidance might lead to posterior occlusal interference, which can highly affect the stability of the posterior teeth. Also, discomfort might occur if the customized interior guidance is not in harmony with the patient's envelope of function. The patient in this case complained of overall discomfort in the maxillary anterior area after prosthetic treatment. The expressed difficulty in pronunciation, unstable occlusion due to lack of stable holding contact and discomfort of the facial muscles. Maxillary anterior prostheses were refabricated through systematic diagnosis and treatment and thus, this case presents esthetical and functional satisfaction to both the patient and the dentist.

Study of Aging and Performance About Separation Devices Has Been Stored (장기 보관된 분리장치의 성능 및 노화에 관한 연구)

  • Kim, Dong-seong;Jin, Hong-Sik
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.49 no.7
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    • pp.565-572
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    • 2021
  • In this study, a study on the performance and aging of explosive bolts stored for a long time among pyrotechnic mechanical devices(PMD) used as separation devices in the defense field is conducted. For this, explosive bolts that had been installed in the weapon system for about 10 years are secured. Performance and life extension test procedures are established based on the AIAA Standard and MIL-STD. Before performance evaluation, non-functional tests are performed to check whether external changes or failures occurred. Next, circuit inspection and X-ray tests are conducted to check the failure in internal circuits and structures. After that, performance test is carried out to confirm the operation of the samples that passed the non-functional test. Through this test, separation of bolt and separation time are measured, and some samples are tested after a high temperature storage test to confirm the remaining life and the possibility of extension. Finally, the remaining life and reliability are predicted based on the results of the test and the Arrhenius model to identify remaining shelf life and reliability depend on time.

Midterm outcomes of suture anchor fixation for displaced olecranon fractures

  • Michael J. Gutman;Jacob M. Kirsch;Jonathan Koa;Mohamad Y. Fares;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.39-44
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    • 2024
  • Background: Displaced olecranon fractures constitute a challenging problem for elbow surgeons. The purpose of this study is to evaluate the role of suture anchor fixation for treating patients with displaced olecranon fractures. Methods: A retrospective review was performed for all consecutive patients with displaced olecranon fractures treated with suture anchor fixation with at least 2 years of clinical follow-up. Surgical repair was performed acutely in all cases with nonmetallic suture anchors in a double-row configuration utilizing suture augmentation via the triceps tendon. Osseous union and perioperative complications were uniformly assessed. Results: Suture anchor fixation was performed on 17 patients with displaced olecranon fractures. Functional outcome scores were collected from 12 patients (70.6%). The mean age at the time of surgery was 65.6 years, and the mean follow-up was 5.6 years. Sixteen of 17 patients (94%) achieved osseous union in an acceptable position. No hardware-related complications or fixation failure occurred. Mean postoperative shortened disabilities of the arm, shoulder, and hand (QuickDASH) score was 3.8±6.9, and mean Oxford Elbow Score was 47.5±1.0, with nine patients (75%) achieving a perfect score. Conclusions: Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes. Additionally, this technique resulted in high rates of osseous union without any hardware-related complications or fixation failures.

Pathophysiology of olive flounder Paralichthys olivaceus suffering from emaciation (여윔증 넙치, Paralichthys olivaceus의 증상에 대한 병태생리학적 고찰)

  • Kim, Yi-Kyung;Jeong, Joon-Bum;Lee, Mu-Kun;Park, Soo-Il;Park, Myeong-Ae;Choe, Mi-Kyung;Yeo, In-Kyu
    • Journal of fish pathology
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    • v.24 no.1
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    • pp.11-18
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    • 2011
  • This study was aimed to investigate the pathophysiological changes of olive flounder, Paralichthys olivaceus suffering from emaciation. A plasma osmolality was higher in the emaciated and control flounders than that of normal teleost, suggesting osmoregulatory failure in both of them. Also, the control in the same stock with emaciated flounder seem to be classified into a primary degree of emaciation. According to microscopic observations, the inflammatory responses were observed in the submucosal layer of anterior intestine, although the some of mucosal intestinal epithelium still remained. It was suggested that the pathological changes of the anterior part give rise to malabsorption of nutrients through the mucosa. In the posterior intestine and rectum, the mucosal epithelium were almostly sloughed off and severe inflammatory responses were observed in the submucosa. Immunoreaction for NKCC was not detected in the mucosal epithelial cells in intestine because of sloughing of epithelium. These changes would lead to functional disorder in the intestine, such as malabsorption of nutrients and osmoregulatory failure. Also important is to investigate the recovery phase.

Case about cardiogenic general edema of Soeumin apoplexy patient (소음인(少陰人) 전신부종(全身浮腫)에 대한 증례(證例))

  • Shin, Mi-ran;Kim, Sun-hyung;Kim, Dal-rae
    • Journal of Sasang Constitutional Medicine
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    • v.12 no.1
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    • pp.265-270
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    • 2000
  • Occasionally, apoplexy is caused by functional or physiologic cardiopulmonary abnormality. In addition, theses may become the factor of aggravating apoplexy and involve complication. If patient has cardiopulmonary disease, progressing of apoplexy is commonly used to be accelerate and prognosis is deteriorative. There by the patient who has cardiopulmonary disease, should be particularly treated for cardiopulmonary disease. We got good result, during treat Soeumin cerebral vascular infarction patient who has pulmonary edema leaded from congestive heart failure, with Sasang Constitutional treatment. Therefore I reported them here. She was 68 years old, female patient. She visited our hospital for apoplexy with right side hemiparesis, dysphagia, dysphasia. After her admission into our hospital, we knew that she has congestive heart failure. The diagnosis is established. She presented with severe general edema and pulmonary edema. Although Soeumin edema usually classified as Taiyin Disease, we classified this as Shaoyin Disease, through diet, discharge, sleep, tongue and symptoms. We has prescribed Gungguichongsoyijung-tang(芎歸蔥蘇理中湯) in accordance with the principle of invigorating the Spleen and lower Yin(建碑而降陰). And her symptoms has improved.

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MEDIAN CLEFT OF THE LOWER LIP AND MANDIBLE;A CASE REPORT (하순 및 하악골 정중열의 치험례)

  • Cha, Doo-Won;Kim, Hyun-Soo;Baek, Sang-Heum;Kim, Chin-Soo;Byeon, Ki-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.263-269
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    • 2001
  • Median cleft of the lower lip and/or mandible is a rare congenital anomaly, first mentioned by Couronne in 1819. Monroe(1966), Fujino(1970), Ranta(1984) and Oostrom(1996) conducted comprehensive reviews and list cases in literature. Median cleft varies greatly, from a simple vermilion notch to a complete cleft of the lip involving the tongue, the chin, the mandible, the supporting structures of the median of the neck, and the manubrium sterni. The associated anomalies include ankyloglossia, cleft tongue, neck contraction, heart lesion, absence of hyoid bone, and so on. The etiology of median cleft is unknown. Various possibilities, such as failure of mesodermal penetration into the midline, failure of fusion of mandibular processes, external factors apart from the embryogenic pattern such as pressure, position in utero, circulatory failure caused placental adhesion, diseases in pregnancy, and so on, have been discussed. A 8-year-old girl was referred to the Dept. of Oral & Maxillofacial Surgery, Kyungpook National University Hospital and had been aware of the fact that at birth "she had something wrong with her mouth." Shortly after birth she had been examined by a plastic surgeon and at that time surgical procedure had been performed to release the tongue from the lower jaw and lip at local hospital. On admission, she had a slight notching of lower lip and two fibrous frenum ran from the lip along the ventral surface of the tongue, diastema between her mandibular central incisors, and slightly constricted bifid mandible associated independent movement of the two halves of mandible. The patient had autogenous iliac bone graft to reconstruct the mandibular midline defect. The postoperative result was uneventful. In future, the correction of the soft tissue deformities such as notching of the lower lip and partial ankyloglossia will be required for the esthetic and functional improvement.

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