• Journal of Chest Surgery
• /
• v.35 no.8
• /
• pp.580-583
• /
• 2002

Background: Obtaining precise hemodynamic and morphological information in the early postoperative period after surgical correction of congenital heart disease is important in determining the need for future medical or surgical intervention. We investigated the residual shunting after surgical repair of simple ventricular septal defect in order to know the incidence of residual shunting in the postoperative period and the natural history of small residual shunts located in the peripatch area. Material and Method: Forty three consecutive patients under one year of age who underwent patch repair of a simple ventricular septal defect were evaluated for incidence of residual shunts by echocardiography. Result: Eleven patients had echocardiographic residual shunt in the peripatch area at immediate postoperative period, however, there were no patients who needed reoperation due to deteriorated hemodynamic effect of residual shunt. The incidence of residual shunts was not significantly different with type of ventricular septal defect and material used for closure. During follow up period, two patients were lost and remaining nine patients no longer showed evidence of residual shunt. The mean time of last evidence of shunt was $4.2{\pm}3.6$ months after operation. Conclusion: Residual peripatch shunt flow was frequently noted in the immediate postoperative period following surgical repair of ventricular septal defect, however, most of them were disappeared within six months.

• Journal of Chest Surgery
• /
• v.29 no.2
• /
• pp.147-152
• /
• 1996

his study was undertaken to assess the residual interventricular shunt following surgical closure of the isolated ventricular septal defect. From January 1989 through December 1993, 211 patients underwent surgical closure of the isolated ventricular septal defect. All patients had 2D-Echocardlo-graphic study after operation to rule out residual ventricular septal defect. There was a 9.5% incidence of a definite residual shunt. The type of ventricular septal defect, closure method of the defect and cardiopulmonary bypass time showed no significant differences between two groups. The sue of ventricular septal defect (6.3 $\pm$ 3.7mm versus 10.6 $\pm$ 5.8mm : p : 0.0034), aortic cross-clamping time(32.6 $\pm$ 15.0 minutes versus 48.5 $\pm$ 20.0 minutes, p : 0.0003), pulmonary-to-systemic pressure ratio(0.31 $\pm$ 0.22 versus 0.51 $\pm$ 0.33, p=0.019) and mean pulmonary artery pressure(20.3 $\pm$ 11.9 mmHg versus 29.1 $\pm$ 16.2 mmHg, p : 0.009) were meaningfully different between two groups. There were 9 insta ces of spontaneous closure of the residual shunts at mean 21 months of following up (ranged 1 ~43 months). In conclusion, we suggest that the size of ventricular septal defect, aortic cross-clamping time and mean pulmonary artery pressure may play an important role in occurance of residual ventricular septal defect.

• Journal of Chest Surgery
• /
• v.34 no.4
• /
• pp.351-355
• /
• 2001

개흉술에 의한 수술적 폐쇄방법 및 경도관 동맥관 폐쇄술은 동맥관 개존중의 치료방법으로 발전되어 왔으나, 이러한 술식은 개흉술에 의한 합병증, 지속적인 단락 및 용혈의 가능성, 기구의 이동이나 색전증의 발생, 지속적인 단락시 세균성 심내막염 방지를 위한 지속적인 항생제 사용등의 단점이 있어 저자들은 흉강경을 이용한 수술을 시행하였다. 총 6례의 환자에서 흉강경을 이용한 동맥관 개존증 수술을 시행하였으며. 이중 대동맥 외막(adventitia) 박리중 지형이 잘 되지 않았던 1례에서는 소개흉술(minithoracotomy)로 전환하였다. 술 후 이시행한 이학적 검사상에서 모든 환아에 심잡음이 소실되었음을 확인할 수 있었으며, 흉부 방사선 검사상 점진적인 폐혈관음영의 감소를 관찰할 수 있었으며 수술중 동맥관 파열이나 불완전한 동맥관 폐쇄, 기흉, 애성(hoarseness) 등의 합병증은 발생되지 않았다. 환아들은 술후 평균 3.4일째 퇴원하였으며, 퇴원후 외래추적 관찰검사시 시행한 심초음파 검사상 동맥관의 재개통이나, 잔류단락은 관찰되지 않았다. 본원에서는 개흉술 및 경도관 동맥관 폐쇄술의 단점을 방지할수 있으며, 성공적인 동맥관 폐쇄, 작은 피부절개 반흔에 의한 미용적 효과, 짧은 재원기간등의 장점을 가진 흉강경을 이용항 동맥관 결찰술을 시해앟여 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
• /
• v.48 no.2
• /
• pp.158-164
• /
• 2005

Purpose : We reviewed the therapeutic results of various Duct-Occlud coils(pfm AG, $K{\ddot{o}}ln$, Germany) to evaluate the efficacy of the most-recently modified Duct-Occlud coil(Nit-Occlud) in the transcatheter closure of patent ductus arteriosus(PDA), including large defects more than 4 mm in diameter. Methods : Two hundred and five patients who underwent percutaneous PDA occlusion using Duct-Occlud devices from March 1996 to December 2003 were enrolled and four types of Duct-Occlud [Standard(S), Reinforced(R), Reinforced reverse cone(RR) and Nit-Occlud(N)] were used in this study. The patients were followed up by echocardiogram and physical examination before discharge, one month, six months and 12 months after the procedure. Results : The rate of residual shunt according to the type of Duct-Occlud were as follows : S-54%, R-72%, RR-50%, N-14%(P<0.05 compared with other devices) at one month, S-25%, R-44%, RR-37%, N-0%(P<0.05 compared with other devices) at six months, S-8%, R-8%, RR-4%, N-0%(P<0.05 compared with S and R) at 12 months and later. Nit-Occlud coil showed the complete occlusion of PDA after six months of follow-up, even in 12 patients with relatively large PDA(>4 mm). Conclusion : The transcatheter closure of PDA using Duct-Occlud was an effective treatment and our study revealed that a Nit-Occlud coil which showed higher rate of occlusion even in PDA with large diameters over than 4 mm, was a more effective modality compared to previous devices.

• 전기의세계
• /
• v.28 no.11
• /
• pp.26-30
• /
• 1979

현재 산업용으로 많이 쓰이고 있는 연축전지나 Alkali 전지의 충전용 충전기가 반도체화 이후 Thyristor식 자동충전기로 전환되고 있는데 발맞추어 본 연구에서는 현재의 충전기로서의 장점을 충분히 가지고 있으면서 부하단자가 단락되거나 개방되거나 또는 전원이 잘못 접속될 경우에도 충전기 부하나 회로를 충분히 보호할 수 있는 충전기를 설계하고져 했다. 본 연구의 연구대상은 Battery의 잔류전압을 이용한 UJT 이장발진기로 구동되는 SCR식 충전기 회로이다. 아울러 Soft start 회로와 동기회로 그리고 Pulse 증폭회로를 첨가시켜 보다 충전특성을 향상시켰으며 엄밀한 특성시험, 즉 지연회로 시험, 출력단자 개방시험, 단락시험, 출력단자 오결선시험등을 통해 여러가지 장해가 없음을 확인했다. 그리고 가급적 휴대가 가능하도록 소형화 시키면서 누구나 손쉽게 조작할 수 있는 간편하고 실용적인 충전기를 설계하는데 힘썼다. 그래서 다음과 같은 장점을 본래의 장점에다 부가시킬 수 있었다. (가) Soft start 회로를 첨가시켜 평균 30-50sec의 지연시간을 얻을 수 있었다. (나) 동기회로를 별도로 첨가시켜 Pulse 신호의 동기를 확실하게 할 수 있었다. (다) Pulse 증폭회로를 사용하여 SCR의 제어능력을 확실하게 할 수 있었다. 결론적으로 본 충전기는 Trickle 충전을 제외한 초충전 균등충전 부동충전 보정충전 급속충전등을 자유로이 할 수 있었고 소형 경량이고 취급이 간편하여 실용적이라고 본다. 그러나 여러가지 조건하에서의 현장실험을 다해보지 못한 것이 약간 아쉽다.

• Proceedings of the KIEE Conference
• /
• 2006.11a
• /
• pp.237-239
• /
• 2006

The residual flux(${\psi}_r$) in transformer's iron cores cause the distortion of short-circuit current occasionally. And some considerable distortion effect on the validation of test results. To prevent this situation, there needs some suitable control of residual flux through the pretest. This paper deals with the how to control the residual flux in pretest and the comparison between the two test results which were obtained by different test method.

• Journal of Chest Surgery
• /
• v.31 no.8
• /
• pp.749-755
• /
• 1998

Background: Twelve patients with acyanotic tetralogy of Fallot(TOF), characterized by the combination of a malaligned ventricular septal defect(VSD) and infundibular pulmonic stenosis with the clinical finding of acyanosis at rest, underwent surgical correction between January 1988 and July 1997. Materials and methods: 9.92% of patients with the diagnosis of TOF were acyanotic TOF in the same period. Ages ranged from 12 to 42 months(mean 25.2 months). 2D-echocardiographic studies, cardiac catheterization, and angiocardiograms were performed in all patients before operation. The preoperative mean systemic arterial oxygen saturation was 93.5%. According to the 2D-echocardiographic analysis, there was Lt-to-Rt shunt through VSD in 4 patients, bidirectional shunt in 2 patients, and no shunt in 6 patients. Results: The preoperative mean right ventricle to pulmonary artery(RV-PA) pressure gradients were 52.3 mmHg on 2D- echocardiogram and 48.4 mmHg on cardiac catheterization. The repair of ventricular septal defect was performed through a right atrial approach and the hypertrophic infundibular muscle bundles were resected by the transatrial and transpulmonary approach. Six patients(50%) received a transannular patch. The mean cardiopulmonary bypass time was 135.0 minutes, and the aortic crossclamp time was 87.8 minutes. Postoperative complications included bleeding necessitating reentry in one and chylothorax in one. No patient died after operation and there were no late deaths. Postoperative 2D-echocardiograms revealed tiny patch dehiscence in 5 cases and a moderate RV-PA pressure gradients(mean 15.3 mmHg). All patients were in New York Heart Association functional class 1 after operation. Conclusions: acyanotic TOF is the uncommon form of TOF, and acyanotic TOF can be repaired with a good outcome.

• Clinical and Experimental Pediatrics
• /
• v.50 no.5
• /
• pp.469-475
• /
• 2007

Purpose : This study was performed to compare the safety, efficacy and clinical results of the Amplatzer septal occluder (ASO) for closure of secundum atrial septal defect (ASD) with surgery. Methods : One hundred fifteen patients diagnosed as isolated secundum ASD in Gil Medical Center, Gachon University of Medicine from January 2000 to July 2006 were included. Seventy patients underwent surgical repair of ostium secundum ASD. Forty-five consecutive patients were treated with percutaneous closure using ASO. We compared the mortality, morbidity, hospital stay, and efficacy between two groups. Results : Male to female ratio was 1:2.4. The mean age and the size of defects were not statistically different. No mortality occurred in either group. The success rate was 97.8% in the device group and 100% in the surgical group. The overall rate of complications was higher in the surgical group than in the device group (64.0 vs. 15.6%, P<0.05). Hospital stay was shorter in the device group than in the surgical group ($4.2{\pm}1.2$ vs. $12.4{\pm}4.7days$, P<0.0001). Residual shunt rates were more frequent in the device group (8.9%) than in the surgical group (4.3%) at discharge. All residual shunts disappeared at 3 months follow-up. Conclusion : Percutaneous closure of ASD using ASO is a safe and effective alternative to surgical repair. The indications of percutaneous ASD closure with ASO would be expanded by accumulation of experiences and evolutions of device.

• Journal of the Korean Vacuum Society
• /
• v.9 no.2
• /
• pp.162-166
• /
• 2000

High quality $Si_3N_4$ metal-insulator-metal (MIM) capacitors were realized by plasma enhanced chemical vapor deposition (PECVD). Titanium nitride (TiN) adapted as a diffusion barrier reduced the interfacial reaction between $Si_3N_4$ dielectric layer and aluminum metal electrode showing neither hillock nor observable precipitate along the interface. The capacitance and the current-voltage characteristics of the MIM capacitors showed that the minimum thickness of $Si_3N_4$ layer should be limited to 500 $\AA$ under the present process, below which most of the capacitors were electrically shorted resulting in the devastation of on-wafer yield. According to the transmission electron microscopy (TEM) on the cross-sectional microstructure of the capacitors, the dielectric breakdown was caused by slit-like voids formed at the interface between TiN and $Si_3N_4$ layers when the thickness of $Si_3N_4$ layer was less than 500 $\AA$. Based on the calculation of thermally-induced residual stress, the formation of voids was understood from the mechanistic point of view.

• Proceedings of the Korean Vacuum Society Conference
• /
• 1998.02a
• /
• pp.80-80
• /
• 1998

RU02 박막은 전이금속으로서 rutile 구조이며, 넓은 온도 영역에서 금속성의 를 나타내고, 700도 이상의 높은 온도에서 열적 안정성을 갖는 물질이다 이러한 특성 때문 에 RU02 박막은 실리콘 디바이스에서 배선 게이트 전극 확산 장벽 등에 응용가능성이 높 은 물질로 각광을 받고 있다- 특히 다결정 RU02 박막은 DRAM (dynamic random access m memory) 내의 강유전성 축전기의 전극으로서 유망한 물질이다. 지금까지 이러한 응용분야에 사용된 전극물질은 pt 금속이었다 그러나 이러한 금속전극은 SI 산소 그리고 강유전체의 구성물질 등과의 상호확산, pt 표면의 hillock의 존재로 생기는 전기적 단락, 기판과의 나쁜 점작성, 어려운 에칭 프로세스 등의 단점을 가지고 있다 더욱 더 심각한 문제는 P Pt'ferroelectric/Pt 구조에서 나타나는 aging과 fatigue인데, 이는 108 사이쿨 이후에 스위칭 가 능한 잔류 pOlarization 으$\mid$ 감소를 유발하게 된다- 최근 Berstein은 Pt 대신에 RU02를 사용함으로써 강유전체 축전기에서의 fatigue 현상을 크게 감소시켰다고 보고 한 바 있다 Burst川도 RU02 가 실리콘 표면과 유전체 물질 사이에 전기전도 어떠한 상호 확산도 일어나지 않음을 보였다. 그러나 이러한 연구 결과에도 증착조건과 RU02 박악의 특성에 관한 상호 관계가 충분히 더욱 더 중은 강유전성 박막올 만들기 위해서는 이러한 박막 전극에 않고 있다 연구되지 대한 상세한 연구가 반드시 필요하다고 본다. RU02 박막은 실리콘 기판 위에 고주파 마그네트론 스퍼터링 방법으로 증착하였다. 사용 한 타켓은 2 인치의 직경을 가지는 CERAC 사에서 제작한 Ruol다 초기 진공은 1O~6 Torr 이하였고, 고주파 전력은 20 - 80W 까지 변화시켰다 반응성 스퍼터링율 하기 위해 아르곤과 산소롤 주입하였고, 산소/(산소+아르곤)의 비를 변화시켰다 기판의 온도와 증착압력은 각각 상온에 서 500도까지 , 5mTorr에 서 100mTorr 까지 변 화시 켰 다 RU02 박막의 결정성을 조사하기 위해 XRD 표면 형상과 단면을 조사하기 위해 SEM을 사용하였다‘ 박악의 비저항을 조사하기 위해 4-단자법 van der Pauw 방법을 사용하였다. RU02 박막은 증착압력이 높을수록 비저항은 높아지고, 두께는 감소하였다. 특히 1 100mTorr에서는 작업가스와 스퍼터된 입자사이의 심각한 산란 때문에 아예 증착이 이루어 지지 않았다‘ RF 전력이 증가할수록 비저항이 낮아졌다. 이는 두께에 의존하는 결과이며 전형적인 금속박막에서 나타나는 현상과 유사함을 알 수 있었다- 기판온도와 작업가스의 산소 분압이 높을수록 비저항이 감소하였다‘ 이러한 사실은 성장한 박악의 결정구조와 밀접한 관련이 있음을 보여준다.