• Journal of Chest Surgery
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• 제24권7호
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• pp.647-655
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• 1991

The efficacy of cold blood potassium cardioplegia during periods of ischemic arrest was assessed in 88 patients undergoing open heart surgical procedures at Chonnam National University Medical School from December, 1987 to January, 1989. The purpose of this study was to determine if the aortic cross clamping time[ACCT] over 120 minutes correlated with operative mortality, incidence of postoperative ventricular tachyarrhythmias, needs of postoperative inotropic support and serum enzyme levels. The patients were divided according to aortic cross clamping time[less than 120 minutes and 120 minutes or greater]. The results were as follows: 1. The operative mortality was 3.2% in ACCT<120min group and 7.7% in ACCT>120 min group. 2. The incidence of postoperative ventricular tachyarrhythmia was 1.6% in ACCT <120min group and 11.5% in ACCT>120min group[p<0.05]. 3. The incidence of postoperative inotropic support in congenital heart disease was 13.0Fo in ACCT<120min group and 45.0%o in ACCT>120min group[p<0.05]. The incidence in acquired heart disease was 26.0% in ACCT<120min group and 40.0% in ACCT> 120min group. 4. After cardiopulmonary bypass, serum GOT, LDH, CPK and CPK - MB were elevated prominently. Children showed higher value of the enzymes examined than adults did before and after cardiopulmonary bypass. In congenital heart diseases, postoperative serum GOT, LDH, CPK and CPK - MB levels of ACCT>120min group were significantly higher than those of ACCT<120min group. Postoperative serum GOT, LDH and CPK - MB levels of ACCT>=120min group were significantly higher than those of ACCT<120min group also in acquired heart diseases. The results suggest that the myocardial protective effect with cold blood potassium cardioplegic solutions was not sufficient when the aortic cross clamping time was over 120 minutes.

• Journal of Chest Surgery
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• 제22권2호
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• pp.225-233
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• 1989

Cardioplegia and myocardial protection were performed under cardiopulmonary bypass during open heart surgery with the use of St. Thomas Hospital cardioplegic solution [4 [C] for the coronary artery perfusion and normal saline solution [4[ c] for the topical cardiac cooling. To maintain the state of myocardial protection, coronary artery reperfusion was carried out using St. Thomas Hospital cardioplegic solution at the interval of 30 minutes. A total number of patients studied were 57 cases, including 37 cases of correction for congenital anomalies and 20 cases for acquired heart diseases. Cardiopulmonary bypass time during the surgery was observed to be average of 87.89*47.55 hours, aortic cross-clamping time [ACCT] to be average of 76.68*44.27 hours raging from 30 to 191 minutes. In order to evaluate the effects of myocardial protection in the surgery, serum enzyme levels were determined. To observe the relationship between ACCT and myocardial protection effects, patients studied were divided into the following 3 groups. I group: ACCT 60 minutes, II group: ACCT 90 minutes, III group: ACCT over 91 minutes [1] SGOT; The positive value [increased over 200 units] for ischemic myocardial injury during operation was observed in 11 cases [19.3% of the total] of the total patients studied, of which 4 cases [13.3%] in I group, 1 case [10.0%] in II group, and 6 cases [35.3%] in III group. [2] LDH; The positive value [increased over 900 units] for ischemic myocardial injury during operation was observed in 9 cases [15.7% of the total] of the total patients studied, of which 2 cases [6.6%] in I group, 1 case [10.0%] in II group and 6 cases [35.3%] in III group. [3] CPK; The positive value [increased over 800 units] for ischemic myocardial injury during operation was observed in 10 cases [17.5% of the total] of the total patients studied, including 4 cases [13.3%] in I group, 1 case [10.0%] in II group, and 5 cases [29.4%] in III group [4] The myocardial protection method used in the present study was demonstrated to be effective for the myocardial protection in the surgery with ACCT of up to 90 minutes. A few ischemic myocardial injury were observed in the surgery with ACCT over 91 minutes, but no significant cardiac dysfunction was noted. The surgery with ACCT of up to 191 minutes did not appear to give rise any significant interference with postoperative recovery.

• 핵의학기술
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• 제16권2호
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• pp.29-34
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• 2012

Siemens사의 CT 선량 감소 소프트웨어인 IRIS의 적용을 통하여 CT 선량 감소 시 노이즈 감소 효과와 해상력의 보존 그리고 ACCT에 IRIS 각 kernel의 적용 시 SUV 변화를 확인하는데 목적을 두었다. Biograph mCT 40 slice 스캐너를 이용하여 AAPM CT performance phantom, Anthropomorphic chest phantom을 관전압 120 kVp로 고정하고 100-10 mAs까지 15%감소하여 스캔 후 FBP, IRIS 각 kernel을 적용하여 재구성 하여 영상의 노이즈, 해상력, 영상 평가를 시행하였다. NEMA IEC body phantom을 이용하여 55.5 MBq를 background에 주입하고 열소와 배후 방사의 비를 8:1이 되도록 모형을 제작하였다. 120 kVp, 50 mAs 조건으로 1분, 2분, 3분, 4분 스캔하여 영상을 획득한 후 ACCT에 IRIS 각 kernel을 적용하여 기존 FBP 방식을 적용한 SUV와의 평가를 시행하였다. IRIS의 적용 시 기존 FBP 방식에 비하여 45% 선량을 감소하였음에도 불구하고 해상력 저하 없는 노이즈 감소 효과가 확인 되었으며 SUV 평가 실험에서 IRIS의 I70f kernel을 제외하고는 기존 FBP 방식을 통하여 획득된 SUV와 유의한 차이가 나타나지 않았다. 본 연구를 통하여 IRIS 적용 시 기존 FBP 방식에 비하여 CT 피폭선량 감소와 해상력 저하 없는 노이즈 감소 효과를 입증하였으며 IRIS kernel의 적절한 적용을 통하여 PET/CT 검사 시 환자 피폭선량 감소는 물론 FBP 방식에 비하여 우수한 영상의 획득이 가능할 것이라 사료된다.

• 조명전기설비학회논문지
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• 제18권4호
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• pp.97-103
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• 2004

단상 유도전동기의 기동전류는 정격전류의 3-6배로 전등의 명멸, TV 화면의 산란, 전동기의 절연 열화, 옥내배선의 순간적인 열화 등을 발생시켜 전력손실, 가전제품의 효율저하 및 수명을 단축시키고 있다. 이러한 문제점을 개선하기 위해 본 논문에서는 트라이액과 교류변류기를 사용하여 기동전류를 3.7(%) 감소시키는 방법을 제안하였으며, 또한 반도체 소자를 사용함으로써 수명은 반영구적임을 확인하였다.

• 한국안전학회지
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• 제34권2호
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• pp.15-21
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• 2019

Recently, the number of facilities and users of zipline which is the most popular among extreme leisure facilities has been increasing year by year. Zipline is a means of transporting durable wire between two timber or stay and moving the trolley connected to the passenger at high speed in the opposite direction. However, due to the nature of the zip line facility, the risk of accidents is always present and safety accidents are frequently occurring. Therefore, this study investigates the current state of safety management and extract the problem in terms of safety management through analyzing the installation state of zipline facilities in the case of accidents and reviewing of similar facility regulations. In order to solve this problem, we will contribute to establishment of comprehensive and systematic countermeasures and establishment of safety improvement system by suggesting measures to improve safety management through analyzing foreign regulations and safety management regulations for zipline and other extreme leisure facilities.

• Journal of Chest Surgery
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• 제23권5호
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• pp.854-863
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• 1990

Since the open heart surgery was performed, various kinds of problem concerning the extracorporeal circulation[EGG] have been known. The author investigated the changes of serum potassium ion before and after ECC among the 102 patients including 63 adults and 39 children who underwent open heart surgery from April 19S6 to February 1990 in Chung-Ang University Hospital. The mean values of potassium ion before and after ECC were analyzed according to the influencing factors such as priming solution, aortic cross clamping time, the underlying disease, the type of oxygenator and the amount of cardioplegic solution. The results were as follows: l. In the aspect of congenital and acquired heart disease groups, the mean values of serum potassium ion[Mean\ulcornerS.D.] before and after ECC revealed a significant change only in the acquired heart disease group[congenital; 3.87$\pm$0.48mEq /L vs. 4.05$\pm$0.73mEq /L, P>0.05, acquired: 4.40 $\pm$0.98mEq /L vs. 4.11$\pm$0.52mEq /L, P<0.05]. Between the two groups, the changes of the mean values of serum potassium ion before and after ECC were significant[P<0.05]. But all values were within normal limits. 2. In the aspect of the aortic cross clamping time[ACCT], in the groups of less or more than 120 minutes, the mean values of serum potassium ion before and after ECC revealed no significant change[less than 120 min; 3.97+-0.64mEq /L vs. 3.99+0.67mEq /L, P>0.05, more than 120 min; 4.34+0.82mEq /L vs. 4.27+0.62mEq /L, P>0.05], and The changes of mean values of serum potassium ion between the two groups were not significant[P>0.05]. 3. In both membrane and bubble oxygenator groups, the mean values of serum potassium ion before and after ECC did not reveal a significant difference respectively [membrane; 4.74 +1.40mEq /L vs. 4.28+0.3lmEq /L, P>0.05, bubble; 4.02 +0.60mEq /L vs. 4.05 L0.68mEq/L, P>0.05], and no differences between the membrane and bubble oxygenator groups[P >0.05]. 4. In the groups of membrane and bubble oxygenator in the cases of ACCT more than 120 minutes, the mean values of serum potassium ion before and after ECC did not reveal a significant difference respectively[membrane; 4.36$\pm$0.85mEq /L vs. 4.37$\pm$0.26mEq /L, P>0.05, bubble; 4.30 $\pm$0.80mEq/L vs. 4.23$\pm$0.67mEq/L, P>0.05], and no differences between the two groups[P>0.05]. 5. In spite of increased amount of cold potassium cardioplegic solution, the mean values of serum potassium ion before ECC were similar to those of serum potassium ion after ECC[less than 20ml /kg

• Journal of Chest Surgery
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• 제33권7호
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• pp.560-564
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• 2000

배경; 아프로티닌(Aprotinin)은 nonspecific serine protease inhibitor로 개심술에서 항염효과와 혈액 응고효과를 갖고 있다. 또한 아프로티닌은 심폐기 작동 중에는 항트롬빈(antithrombin) 효과가 있다. 본 연구는 아프로티닌이 헤파린(heparin)사용 양 및 ACT(activated clotting time) 에 어떠한 영향을 미치는 가를 알아보기 위하여 시행하였다. 대상 및 방법; 1998년 12월 1일부터 1999년 11월 30일 까지 본원에서 개심술을 받은 환자 중 연령이 18세 이상인 82명을 대상으로 연구하였다. 환자들은 아프로티닌을 사용한 군(Group A)과 사용하지 안흥ㄴ 군(Group C)으로 나누어 연구하였다. 모든 환자에서 수술 전 체중, 신장, 체표면적, pump time, ACC time 등을 조사하였다. ACT의 측정 시기는 헤파린 공급 전, 공급 후 20분, 40분, 60qs과 프로타민 공급 후 20분 등이었다. 또한 ACT 변화 정도를 알아보기 위하여 헤파린 공급 전과 공급 후 20분, 공급 후 40분과 20분 사이의 차이를 조사하였다. 결과; 연구 대상 환자들이 굴변 특징에서는 연령, 펌프시간 및 대동맥차단 사간에서 모두 A군에서 증가된 소견을 보였다. (p<0.05). 헤파린 공급 전과 프로타민 공급 후의 ACT는 두 군에서 차이가 없으며 헤파린 공급 후 20분(607$\pm$22.3, 525$\pm$169초), 40분(889$\pm$315, 546$\pm$103초), 60분 (748$\pm$310, 472$\pm$115 초)에 측정한 ACT는 모두 A군에서 증가된 소견을 보였다. (p<0.05), 헤파린 공급 전과 궁급 후 20분 사이의 ACT 차이는 A한 군에서 증가된 소견을 보였고(p<0.05), 헤파린 공급 후 40분과 20분 사이의 ACT의 차이 또한 A군에서 증가된 소견을 보였다. (p<0.05). 두 군간의 총 헤파린 및 프로타민 사용 양에는 차이가 없었다. (p>0.05). 결론; 결론적으로 아프로티닌은 본 연구에서 CPB time을 고려해 볼 때 헤파린사용 양을 의미있게 줄여 줄 수 있을 것으로 생각되며 또한 ACT를 증가시켜 주기 때문에 추가적인 헤파린 감량이 가능할 것으로 생각된다.