• Journal of Chest Surgery
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• v.33 no.6
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• pp.487-493
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• 2000

Background: Early patency of the coronary artery bypass grafting is determined mainly by surgical technique and status of coronary artery. We analyzed the early result, focusing on the relationship between postoperative angiographic findings and the patency rate. Material and method: During the period of July 1997- August 1999, 86 cases of CABG were performed and the postoperative coronary artery angiography was done in 76 cases on postoperative day 7 to assess the graft patency. Result: Overall graft patency was 90.2% on the angiographic finding. Factors influencing the early graft occlusion were the surgeon's experience, small coronary artery size less than 1.5mm in diameter, coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site(p<0.001). Operative mortailty was 2.3%. Early recurrence of the symptom was 19.8% during the follow up period. Conclusion: We examined the postoperative coronary angiography and found that the surgeon's experience, small coronary artery size less than 1.5mm in diameter, bypass surgery on the coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site were the factors for the graft occlusion.

• Quality Improvement in Health Care
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• v.7 no.2
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• pp.218-228
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• 2000

Background : Among 'structure', 'process' and 'outcome' approaches, outcome evaluation is considered as the most direct and best approach to assess the quality of health care providers. Risk-adjustment is an essential method to compare outcome across providers. This study has aims to judge performance of hospitals by severity adjusted mortality rates of coronary artery bypass graft (CABG) surgery. Methods : Medical records of 584 patients who got the CABG surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups was used to quantify severity of patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex. For evaluation of hospital performance, we calculated ratio of observed number to expected number of deaths and z score [(observed number of deaths - expected number of deaths)/square root of the variance in the number of deaths], and compared observed mortality rate with confidence interval of adjusted mortality rate for each hospital. Results : The overall in-hospital mortality was 7.0%, ranged from 2.7% to 15.7% by hospital. After severity adjustment the mortality by hospital was from 2.7% to 10.7%. One hospital with poor performance was distinctly divided from others with good performance. Conclusion : In conclusion, severity-adjusted mortality rate of CABG surgery might be applied as an indicator for hospital performance evaluation in Korea. But more pilot studies and improvement of methodologies has to be done to use it as quality indicator.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.40 no.7
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• pp.435-440
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• 2016

Effects of the increase rate of Reynold number on near-wall turbulent structures are investigated by performing direct numerical simulations of transient turbulent channel flows. The simulations were started with the fully-developed turbulent channel flow at $Re_{\tau}=180$, then temporal accelerations were applied. During the acceleration, the Reynolds number, based on the channel width and the bulk mean velocity, increased almost linearly from 5600 to 13600. To elucidate the effects of flow acceleration rates on near-wall turbulence, a wide range of durations for acceleration were selected. Various turbulent statistics and instantaneous flow fields revealed that the rapid increase of flow rate invoked bypass-transition like phenomena in the transient flow. By contrast, the flow evolved progressively and the bypass transition did not clearly occur during mild flow acceleration. The present study suggests that the transition to the new turbulent regime in transient channel flow is mainly affected by the flow acceleration rate, not by the ratio of the final and initial Reynolds numbers.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.7-12
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• 1998

The study in detection of perioperative myocardial infarction by serial ECGs and the analysis of risk factors involved was carried out from January 1994 to July 1996 on 87 consecutive patients undergoing coronary artery bypass grafting. There were significant differences in the mean CK-MB peaks and frequencies of flipping in LDH1/LDH2 among the 3 groups(group I: new Q-wave, group II: S-T change, group III: no ECG change). The ECG was considered positive for postoperative myocardial infarction if the new Q-waves appeared in the postoperative period or if S-T segment changes persisted for more than 48 hours. The hospital mortality rate was 3.3% and the perioperative infarction rate was 17.2%. The following risk factors of the perioperative MI were found: endarterectomy, decreased ejection fraction($\leq$40%) and prolonged aortic cross clamping time. Left main disease, triple vessel disease, 3 or more graft, unstable angina and hypertension did not correlate with myocardial infarction. This study suggests that serial ECGs could be used as means of detecting the perioperative myocardial infarction after coronary artery bypass grafting.

• Transactions of the Korean Society of Automotive Engineers
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• v.12 no.6
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• pp.38-45
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• 2004

This paper studies the effects of intake port configuration on the swirl that is key parameter in the flow field of direct injection diesel engines. In-cylinder flow characteristics is known to have significant effects on fuel air mixing, combustion and emissions. To investigate the swirl flow generated by various intake ports, steady state flow tests were conducted to evaluate the swirl. Helical port geometry, SCV shape and bypass were selected as the design parameters to increase the swirl flow and parametric study was performed to choose the optimal port shape that would generate a high swirl ratio efficiently. The results revealed that a key factor in generating a high swirl ratio was to suitably control the direction of the intake air flow passing through the valve seat. For these purposes, we changed the distance of helical and tangential port as well as installed bypass near the valve seat and the effects of intake port geometry on in-cylinder flow field were visualized by a laser sheet visualization method. From the experimental results, we found that the swirl ratio and mass flow rate had a trade off relation. In addition, the result indicates that the bypass is a effective method to increase the swirl ratio without sacrificing mass flow rate.

• Nuclear Engineering and Technology
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• v.49 no.1
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• pp.196-208
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• 2017

This study presents an experimental work in a petrochemical company for scanning a buried pipeline using $Tc^{99m}$ radiotracer based on the measured velocity changes, in order to determine the flow reduction along a pipeline. In this work, $Tc^{99m}$ radiotracer was injected into the pipeline and monitored by sodium iodide scintillation detectors located at several positions along the pipeline. The flow velocity has been calculated between every two consecutive detectors along the pipeline. Practically, six experiments have been carried out using two different data acquisition systems, each of them being connected to four detectors. During the fifth experiment, a bypass was discovered between the scanned pipeline and another buried parallel pipeline connected after the injection point. The results indicate that the bypass had a bad effect on the volumetric flow rate in the scanned pipeline.

• Journal of Korean Society on Water Environment
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• v.20 no.2
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• pp.132-144
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• 2004

The purpose of this study was to evaluate alternatives for stable operation of WWTP(Wastewater Treatment Plant) with a higher rate of inflows and a higher concentration of pollutants during wet weather to minimize the pollution loads being discharged into receiving waters. 3Q(Q: dry weather flow) of a base flow is normally intercepted and flows into WWTP as it was current practice. It is revealed by simulation that the bypassing alternative of 1Q through secondary treatment and 2Q into the stream after primary treatment was as good as it is expected. The bypass pollution loads were in the range of 23.9 ~ 38.5 % of the total loads flowing into the WWTP indicating that the bypassed flows need an extra treatment such as stormwater detention reservoir, high-rate coagulation with sedimentation, and step-feed. The high-rate coagulation with sedimentation was the most effective with respect to removal of the pollution loads.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.8-14
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• 2018

Background: Minimally invasive direct coronary artery bypass grafting (MIDCAB) has the advantage of allowing arterial grafting on the left anterior descending artery without a sternotomy incision. We present our single-center clinical experience of 66 consecutive patients. Methods: All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007 and July 2015. Preoperative, intraoperative, postoperative and follow-up data - including major adverse cardiovascular and cerebrovascular events (MACCE), graft patency, and the need for re-intervention - were collected. Results: The mean age of the patients was $69.4{\pm}11.1years$ and 73% were male. There was no conversion to an on-pump procedure or a sternotomy incision. The 30-day mortality rate was 1.5%. There were no cases of stroke, although 2 patients had to be re-explored for bleeding, and 81.8% were extubated in the operating room or on the day of surgery. The median stay in the intensive care u nit and in the hospital were 1.5 and 9.6 days, respectively. The median follow-up period was 11 months, with a 5-year overall survival rate of $85.3%{\pm}0.09%$ and a 5-year MACCE-free survival rate of $72.8%{\pm}0.1%$. Of the 66 patients, 32 patients with 36 grafts underwent a postoperative graft patency study with computed tomography angiography or coronary angiography, and 88.9% of the grafts were patent at $9.7{\pm}10.8months$ postoperatively. Conclusion: MIDCAB is a safe procedure with low postoperative morbidity and mortality and favorable mid-term MACCE-free survival.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.239-244
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• 1976

Alterations in the serum magnesium level were studied in twenty patients who had open-heart surgery during the period from August 1974 to May 1975. The patients were chosen at random. The operative procedures included repair for congenital heart diseases in fifteen patients and cardiac valve replacement for acquired valvular heart diseases in five patients. The age ranged from 8 to 46 years, with an average of 19 years. None of the patients had a history of gross neuromuscular abnormalities. Cardiopulmonary bypass was carried out using a roller pump and a disposable oxygenator. The prime solution consisted of 2 units of ACD banked blood and approximately an equal volume of non-blood additives in adults, while a relatively smaller volume was added in children. The average flow rate was 2,733 ml per minute. Blood samples for magnesium and arterial blood pH were obtained the day after admission 25 minutes after initiation of the bypass and on the morning the day after operation. Preoperative data were then compared with those obtained during the bypass and postoperatively by a paired test. During the bypass, the serum magnesium level decreased significantly from $1.425{\pm}0.029$ to $1.210{\pm}0.063mEq.$ liter (p<0.001). Also, there was a significant decrease in serum magnesium from $1.425{\pm}0.029$ preoperatively to $1.255{\pm}0.083mEq$. per liter (p<0.001). Also, there was a significant decrease in serum magnesium from $1.425{\pm}0.029$ preoperatively to $1.255{\pm}0.083mEq$. per liter postoperatively (p<0.01). The duration of bypass was less than 90 minutes in 10 patients (group A) and exceeded 90 minutes in the remaining 10 (group B). There was no statistical correlation between the groups A and B ($p{\gg}0.20$). Statistical analyses of the serum magnesium level and arterial blood pH showed no significant correlation with correlation coefficient; being -0.3485(pre-op), -0.2971(during bypass), and -0.1008(post-op), respectively. In all the patients, no gross neuromuscular abnormalities were found postoperatively. At present, the clinical significance of the serum magnesium level during and after bypass is controversial. In the near future, however, it is expected that improvements in prime solution and heart-lung machine will solve this problem.

• Resources Recycling
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• v.22 no.3
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• pp.65-72
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• 2013

A vertical column pneumatic separator was modified to improve its separation performance. A branch column was installed at the center of the main column, which created a bypass flow and changed the flow rate of the main column before and after the branch column. To separate a mixture comprising light and heavy materials, the airflow in main column after the branch column was set to lift the only light materials and the airflow in main column before the branch column was set to prevent the flow of the light materials from flowing downwards. Materials directed into the branch column were separated from the flow and returned to the feeder through the cyclone linked to the branch column. The performances of the straight-type separator and the modified separator were compared using glass and zirconia beads with a narrow size distribution.