Mid-term results of IntracardiacLateral Tunnel Fontan Procedure in the Treatment of Patients with a Functional Single Ventricle (기능적 단심실 환자에 대한 심장내 외측통로 폰탄술식의 중기 수술성적)
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- Journal of Chest Surgery
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- v.31 no.5
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- pp.472-480
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- 1998
We reviewed the surgical results of intracardiac lateral tunnel Fontan procedure for the repair of functional single ventricles. Between 1990 and 1996, 104 patients underwent total cavopulmonary anastomosis. Patients' age and body weight averaged 35.9(range 10 to 173) months and 12.8(range 6.5 to 37.8) kg. Preoperative diagnoses included 18 tricuspid atresias and 53 double inlet ventricles with univentricular atrioventricular connection and 33 other complex lesions. Previous palliative operations were performed in 50 of these patients, including 37 systemic to pulmonary artery shunts, 13 pulmonary artery bandings, 15 surgical atrial septectomies, 2 arterial switch procedures, 2 resections of subaortic conus, 2 repairs of total anomalous pulmonary venous connection and 1 Damus-Stansel-Kaye procedure. In 19 patients bidirectional cavopulmonary shunt operation was performed before the Fontan procedure and in 1 patient a Kawashima procedure was required. Preoperative hemodynamics revealed a mean pulmonary artery pressure of 14.6(range 5 to 28) mmHg, a mean pulmonary vascular resistance of 2.2(range 0.4 to 6.9) wood-unit, a mean pulmonary to systemic flow ratio of 0.9(range 0.3 to 3.0), a mean ventricular end-diastolic pressure of 9.0 (range 3.0 to 21.0) mmHg, and a mean arterial oxygen saturation of 76.0(range 45.6 to 88.0)%. The operative procedure consisted of a longitudinal right atriotomy 2cm lateral to the terminal crest up to the right atrial auricle, followed by the creation of a lateral tunnel connecting the orifices of either the superior caval vein or the right atrial auricle to the inferior caval vein, using a Gore-Tex vascular graft with or without a fenestration. Concomitant procedures at the time of Fontan procedure included 22 pulmonary artery angioplasties, 21 atrial septectomies, 4 atrioventricular valve replacements or repairs, 4 corrections of anomalous pulmonary venous connection, and 3 permanent pacemaker implantations. In 31, a fenestration was created, and in 1 an adjustable communication was made in the lateral tunnel pathway. One lateral tunnel conversion was performed in a patient with recurrent intractable tachyarrhythmia 4 years after the initial atriopulmonary connection. Post-extubation hemodynamic data revealed a mean pulmonary artery pressure of 12.7(range 8 to 21) mmHg, a mean ventricular end-diastolic pressure of 7.6(range 4 to 12) mmHg, and a mean room-air arterial oxygen saturation of 89.9(range 68 to 100) %. The follow-up duration was, on average, 27(range 1 to 85) months. Post-Fontan complications included 11 prolonged pleural effusions, 8 arrhythmias, 9 chylothoraces, 5 of damage to the central nervous system, 5 infectious complications, and 4 of acute renal failure. Seven early(6.7%) and 5 late(4.8%) deaths occured. These results proved that the lateral tunnel Fontan procedure provided excellent hemodynamic improvements with acceptable mortality and morbidity for hearts with various types of functional single ventricle.
In the field of makeup cosmetics, especially, powder-based foundations such as two-way cake, pact and face powder, the quality of which is known to be strongly influenced by the properties of powder, surface treatment technology is widely used as a method to improve the various characteristics of powder texture, wear properties, dispersion ability and so on. The two-way cake or pressed-powder foundation is one of the familiar makeup products in Asian market for deep covering and finishing purpose. In spite of the relent progress in surface modification method such as composition of powders with different characteristics and application of a diversity of coating ingredient (metal soap, amino acid, silicone and fluorine), this product possess a technical difficulty to enhance both of the adhesion power and spreadability on the skin in addition to potential claim of consumer about heavy or thick feeling. This article is covering the preparation and coating method of nano-vesicle that mimic the double-layered lipid lamellar structure existing between the corneocytes of the stratum corneum in the skin for the purpose of improving both of two important physical characteristic of two-way cake, spreadability and adhering force to skin, and obtining better affinity to skin. Nano-vesicle was prepared using the high-pressure emulsifying process of lecithin, pseudo ceramide, butylene glycol and tocopheryl acetate. This nano-sized emulsion was added to powder-dispersed aqueous phase together with bivalent metal salt solution and then the filtering and drying procedure was followed to yield the nano-vesicle coated powder. The amount of nano-vesicle coated on the powder was able to regulated by the concentration of metal salt and this novel powder showed the lower friction coefficient, more uniform condition of application and higher adhesive powder comparing with the alkyl silane treated powder from the test result of spreadability and wear properties using friction meter and air jet method. Two-wav cake containing newly developed coated powder with nano-vesicle showed the similar advantages in the frictional and adhesive characteristics.
Background: Experimental studies of vascular remodeling in the pulmonary arteries have been performed actively. These models required a persistent vascular insult for intimal injury induced by chronic hypoxia, monocrotaline intoxication or chronic air embolism and characterized medial hypertrophy and neointimal formation by active synthesis of the extracellular matrix protein. The purpose of this study was to determine the pattern of pulmonary vascular remodeling after obstruction of the pulmonary vein. Material and Method: Obstruction of the right pulmonary vein with a metal clip was performed in Sprague-Dawley rats
Outlier detection research in ocean data has traditionally been performed using statistical and distance-based machine learning algorithms. Recently, AI-based methods have received a lot of attention and so-called supervised learning methods that require classification information for data are mainly used. This supervised learning method requires a lot of time and costs because classification information (label) must be manually designated for all data required for learning. In this study, an autoencoder based on unsupervised learning was applied as an outlier detection to overcome this problem. For the experiment, two experiments were designed: one is univariate learning, in which only SST data was used among the observation data of Deokjeok Island and the other is multivariate learning, in which SST, air temperature, wind direction, wind speed, air pressure, and humidity were used. Period of data is 25 years from 1996 to 2020, and a pre-processing considering the characteristics of ocean data was applied to the data. An outlier detection of actual SST data was tried with a learned univariate and multivariate autoencoder. We tried to detect outliers in real SST data using trained univariate and multivariate autoencoders. To compare model performance, various outlier detection methods were applied to synthetic data with artificially inserted errors. As a result of quantitatively evaluating the performance of these methods, the multivariate/univariate accuracy was about 96%/91%, respectively, indicating that the multivariate autoencoder had better outlier detection performance. Outlier detection using an unsupervised learning-based autoencoder is expected to be used in various ways in that it can reduce subjective classification errors and cost and time required for data labeling.
In combustion facilities, the nitrogen and sulfur in fossil fuels react with oxygen to generate air pollutants such as nitrogen oxides (NOX) and sulfur oxides (SOX), which are harmful to the human body and cause environmental pollution. There are regulations worldwide to reduce NOX and SOX, and various technologies are being applied to meet these regulations. There are commercialized methods to reduce NOX and SOX emissions such as selective catalytic reduction (SCR), selective non-catalytic reduction (SNCR) and wet flue gas desulfurization (WFGD), but due to the disadvantages of these methods, many studies have been conducted to simultaneously remove NOX and SOX. However, even in the NOX and SOX simultaneous removal methods, there are problems with wastewater generation due to oxidants and absorbents, costs incurred due to the use of catalysts and electrolysis to activate specific oxidants, and the harmfulness of gas oxidants themselves. Therefore, in this research, microbubbles generated in a high-pressure disperser and reducing agents were used to reduce costs and facilitate wastewater treatment in order to compensate for the shortcomings of the NOX, SOX simultaneous treatment method. It was confirmed through image processing and ESR (electron spin resonance) analysis that the disperser generates real microbubbles. NOX and SOX removal tests according to temperature were also conducted using only microbubbles. In addition, the removal efficiencies of NOX and SOX are about 75% and 99% using a reducing agent and microbubbles to reduce wastewater. When a small amount of oxidizing agent was added to this microbubble system, both NOX and SOX removal rates achieved 99% or more. Based on these findings, it is expected that this suggested method will contribute to solving the cost and environmental problems associated with the wet oxidation removal method.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The processing management forms of our country's filature factories in 1969 are summarized as follows. (1) About 80% of total cocoon collection is made within 5 days involving peak day, and 10% of cocoon collection is finished until 3 days before and after the peak day, (2) About 92% of alive cocoons transported on unpaved road, and about 40% of the cocoons purchased by all factories are loaded on trucks from common selling station which is far beyond 40km, therefore a new packing system of alive cocoons to drop the damage of cocoon qualities, should be taken. (3) 22% of all factories in our. country have only low-temperature cocoon drying machine. Therefore the installment of hot-air cocoon drying machine is required urgently. (4) In view of cocoon qualities in our country, the grouping method of cocoon for reeling. taken by about 50% of the factories at percent, which classify cocoons for reeling as high group (1,2,3,4 grades) and low group(5,6 grades), will have to be replaced by the method tat classify them high group (1,2 grades) middle group (3,4 grades), low group (5,6 grades). (5) The .ratio of cocoon assorting stood about 10% in multi-ends reeling, about 15% in automatic reeling, conclusively, the ratio of cocoon assorting for automatic reeling was higher tan that for multi-ends reeling. One person's ability for a day in cocoon assorting reaches to about 80-100kg. (6) Cocoon cooking condition requires the increase of the cooking time, the pressure and temperature used to be prolonged as much as the qualities of cocoons are material cocoon ior automatic and double cocoon machines are treated uncompletely. (7) Automatic silk reeling is being performed at 1-2
This study was conducted to standardize the manufacturing process of doenjang. The preparation methods, kinds and levels of the ingredients were determined by the statistical surveys of literatures obtained from cooking books, scientific papers and doenjang manufacturing factories. The standardized preparation of fermentation methods of doenjang were classified into two large groups, that were traditional and modified (commercialized) methods. Most soybeans used in doenjang preparation were the large size. To prepare traditional doenjang, soybeans were cleaned, scaled and cooked for 2 hrs at atmospheric pressure. These cooked soybeans were crushed in water and molded as brick shape. The molded soybean was dried for 2 days in the air, hung up by rice straw and fermented for 30~60 days under natural environmental condition (called meju). Recently soybean grain meju that inoculated with Asp. oryzae also frequently used to make traditional doenjang. The fermented meju was brined with a ratio of meju : salt : water = 18.4 : 14.6 : 67.0 and the meju-brine mixtures were ripened for 2 months. When the meju-brine mixture was fully fermented, it was separated into liquid and solid parts. The crushed solid part was further ripened in a separated pottery for 60 days and become doenjang. The liquid part was filtered, boiled and used as soy sauce. In modified commercial doenjang preparation, soybeans were cocked by autoclaving and then cooled about to 3
Cleaning of foreign matter and corrosion products on surface among conservation treatment of iron artifacts is an important part for looking up a original form. The sand blaster is the most popular equipment when it removes the foreign matter and corrosion products on iron artifacts surface. Current foreign matter and corrosion products equipment, which mostly uses, is sand blaster. Glass dust which sprayed from sand blaster is harmful and causing environmental pollution. In order to solve these problems, we investigated the