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Posttransplantation Lymphoproliferative Disorder after Liver Transplantation in Pediatric Patients: Report from a Single-center Over 21 Years (간 이식 소아에서 발생한 이식 후 림프 증식 질환: 단일 기관에서의 21년 경험)

  • Lee, Jung-Hwa;Ko, Jae-Sung;Seo, Jeong-Kee;Yi, Nam-Joon;Suh, Kyung-Suk;Lee, Kuhn-Uk;Kang, Gyeong-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children. Methods: From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated. Results: The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4${\pm}$21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy. Conclusion: Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.

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Finite element analysis of peri-implant bone stress influenced by cervical module configuration of endosseous implant (임플란트 경부형상이 주위골 응력에 미치는 영향에 관한 유한요소법적 분석)

  • Chung, Jae-Min;Jo, Kwang-Heon;Lee, Cheong-Hee;Yu, Won-Jae;Lee, Kyu-Bok
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.394-405
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    • 2009
  • Statement of problem: Crestal bone loss, a common problem associated with dental implant, has been attributed to excessive bone stresses. Design of implant's transgingival (TG) part may affect the crestal bone stresses. Purpose: To investigate if concavely designed geometry at a dental implant's TG part reduces peri-implant bone stresses. Material and methods: A total of five differently configured TG parts were compared. Base model was the ITI one piece implant (Straumann, Waldenburg, Switzerland) characterized by straight TG part. Other 4 experimental models, i.e. Model-1 to Model-4, were designed to have concave TG part. Finite element analyses were carried out using an axisymmetric assumption. A vertical load of 50 N or an oblique load of 50 N acting at $30^{\circ}$ with the implant's long axis was applied. For a systematic stress comparison, a total of 19 reference points were defined on nodal points around the implant. The peak crestal bone stress acting at the intersection of implant and crestal bone was estimated using regression analysis from the stress results obtained at 5 reference points defined along the mid plane of the crestal bone. Results: Base Model with straight configuration at the transgingival part created highest stresses on the crestal bone. Stress level was reduced when concavity was imposed. The greater the concavity and the closer the concavity to the crestal bone level, the less the crestal stresses. Conclusion: The transgingival part of dental implant affect the crestal bone stress. And that concavely designed one may be used to reduce bone stress.

Reliability Based Stability Analysis and Design Criteria for Reinforced Concrete Retaining Wall (신뢰성(信賴性) 이론(理論)에 의한 R.C.옹벽(擁壁)의 안정해석(安定解析) 및 설계규준(設計規準))

  • Cho, Tae Song;Cho, Hyo Nam;Chun, Chai Myung
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.3 no.3
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    • pp.71-86
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    • 1983
  • Current R.C. retaining wall design is bared on WSD, but the reliability based design method is more rational than the WSD. For this reason, this study proposes a reliability based design criteria for the cantilever retaining wall, which is most common type of retaining wall, and also proposes the theoretical bases of nominal safety factors of stability analysis by introducing the reliability theory. The limit state equations of stability analysis and design of each part of cantilever retaining wall are derived and the uncertainty measuring algorithms of each equation are also derived by MFOSM using Coulomb's coefficient of the active earth pressure and Hansen's bearing capacity formula. The levels of uncertainties corresponding to these algorithms are proposed appropriate values considering our actuality. The target reliability indices (overturning: ${\beta}_0$=4.0, sliding: ${\beta}_0$=3.5, bearing capacity: [${\beta}_0$=3.0, design for flexure: [${\beta}_0$=3.0, design for shear: ${\beta}_0$=3.2) are selected as optimal values considering our practice based on the calibration with the current R.C. retaining wall design safety provisions. Load and resistance factors are measured by using the proposed uncertainties and the selected target reliability indices. Furthermore, a set of nominal safety factors, allowable stresses, and allowable shear stresses are proposed for the current WSD design provisions. It may be asserted that the proposed LRFD reliability based design criteria for the R.C. retaining wall may have to be incorporated into the current R.C. design codes as a design provision corresponding to the USD provisions of the current R.C. design code.

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A COMPARATIVE STUDY ON THE CHEMICAL COMPOSITION AND MECHANICAL PROPERTIES OF FOUR LOW-GOLD-CONTENT DENTAL CASTING ALLOYS MANUFACTURED IN KOREA (한국산(韓國産) 치과주조용(齒科鑄造用) 저금함유합금(低金含有合金)의 조성(組成) 및 기계적(機械的) 성질(性質)에 관(關)한 비교연구(比較硏究))

  • Chang, Ik-Tae;Yang, Jae-Ho;Kim, Chang-Whe;Kim, Kwang-Nam;Lee, Sun-Hyung;Kim, Yung-Soo;Chang, Wan-Shik
    • The Journal of Korean Academy of Prosthodontics
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    • v.19 no.1
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    • pp.17-27
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    • 1981
  • This study was conducted to determine the chemical composition and the mechanical properties of four commercially available low gold-based crown and bridge alloy produced in Korea. Four dental casting gold-silver-palladium alloys, i.e., A, B, C and D (code of alloys) were selected for the evaluation of chemical composition, ultimate tensile strength, elongation. values and Vickers hardness. The chemical composition of test specimens was analyzed by both emission spectrography and wet gravitation method with a 1.5gm of low gold ingot. The tensile properties and Vickers hardness was determined with cast specimens treated in following three conditions; as-cast, softening heat treatment and hardening heat treatment. The tensile testing bars were cast in accordance with the model designed by Gettleman and Harrison (1969) which was modified from the A. D. A. Specification No. 14 for dental chromium-cobalt casting alloy. Nine tensile test specimens were made from a split silicone mold for each of the test alloys to the size of 2.5mm in diameter and a gauge length of 10mm. All four alloys were handled in accordance with conventional methods used in Type III gold alloys. Ultimate tensile strength and elongation were measured on an Instron Universal Tensile Testing Machine (Model 1125, Japan) operated at a crosshead rate of 0.1cm/min. Elongation values were measured using Digital Measuring Microscope (MS-152, FUSOH, Japan). Vickers hardness was determined with a Vickers Hardness Tester (Model VKH-l, Japan) at a 1.0kg load on a mounted tensile test specimen. The following results were obtained from this study; 1. All tested alloys were composed of Au, Ag, Pd, Cu, Zn and Fe in common. The composition rate of gold for all four alloys was found in the range of $42{\sim}47$ weight % as shown below. Alloy A; Au 45%, Ag 40.2%, Pd 5.76%, others 9.04%. Alloy B; Au 47.1%, Ag 29.03%, Pd 6.98%, others 16.92%. Alloy C; Au 45%, .Ag 26.9%, Pd 6.83%, others 21.07%. Alloy D; Au 41.8%, Ag 34.4%, Pd 6.95%, others 16.85%. 3. The ultimate tensile strength of the four alloys was in the range of $31{\sim}82kg/mm^2$. The test results were shown in the below order from the highest value; As-cast condition; D, B, C, A. Softening heat treament; B, C, D, A. Hardening heat treatment; D, B, C, A. 4. The test :results of the elongation rate for each alloy were in the range of $0.5{\sim}18%$. The test results were shown in the below order from the highest value; As-cast condition; A, D, B, C. Softening heat treatment; A, C, D, B. Hardening heat treatment; C, D, B, A. 5. Vickers hardness for each of the four alloys was in the range of $120{\sim}230$. The test results were shown in the below order from the highest value; As-cast condition; C, B, D, A Softening heat treatment; D, B, C, A. Hardening heat treatment; D, A, C, B. 6. There were no differences in the physical properties between as-cast condition and softening heat treatment.

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Photoelastic stress analysis of the mandibular unilateral free-end removable partial dentures according to the design (하악 편측 유리단 가철성 국소의치의 설계에 따른 광탄성 응력 분석)

  • Park, Cheol-Woo;Kay, Kee-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.206-214
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    • 2009
  • Statement of problem: There are common clinical cases in which the mandibular first and second molars are missing unilaterally. Purpose: This study was designed to compare and evaluate the magnitude and distribution of stress produced by four kinds of mandibular unilateral free-end removable partial dentures that could be applied clinically in Kennedy class II cases. Material and methods: Four unilateral free-end removable partial dentures using clasp, Konus crown, resilient attachment, and flexible resin were fabricated on the photoelastic models of the Kennedy class II cases. The vertical load of 6㎏ was applied on the central fossa of the first molar of every removable partial denture in the stress freezing furnace and the photoelastic models were frozen according to the stress freezing cycle. After these models were sliced mesio-distally to a thickness of 6mm, the photoelastic isochromatic white and black lines of the sliced specimens were examined with the transparent photoelastic experiment device and photographs were taken with a digital camera. The fringe order numbers at eight measuring points in the photograph were measured with the naked eye. Results: The maximum fringe order number of each sliced specimen and the fringe order number at the residual ridge just below the loading point were in the decreasing order of the unilateral removable partial dentures using flexible resin followed by clasp, resilient attachment, and Konus crown. The fringe order number at the root apex of the second premolar was in the decreasing order of the unilateral removable partial dentures using clasp followed by flexible resin, Konus crown, and resilient attachment. Conclusion: The removable partial denture using Konus crown showed the most equalized stress distribution to the supporting alveolar bone of abutment teeth and residual ridge under the vertical loads. The removable partial denture using flexible resin can be applied to the case that has a better state of residual ridge than abutment teeth.

Analysis on Seismic Resistance Capacity of Hollow Concrete Block Reinforced Foundation Ground by Using Shaking Table Test (진동대 시험을 이용한 중공블록 보강 기초의 내진성능분석)

  • Shin, Eun-Chul;Lee, Yeun-Jeung;Yang, Tae Chul
    • Journal of the Korean Geosynthetics Society
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    • v.20 no.4
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    • pp.85-93
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    • 2021
  • The seventy percentage of Korean Peninsular is covered by the mountainous area, and the depth of west sea and south sea is relatively shallow. Therefore, a large scale land reclamation from the sea has been implemented for the construction of industrial complex, residental area, and port and airport facilities. The common problem of reclaimed land is consisted of soft ground, and hence it has low load bearing capacity as well as excessive settlement upon loading on the ground surface. The hollow concrete block has been used to reinforce the loose and soft foundation soil where the medium-high apartment or one-story industrial building is being planned to be built. Recently the earthquakes with the magnitude of 4.0~5.0 have been occurred in the west coastal and southeast coastal areas. Lee (2019) reported the advantages of hollow concrete block reinforced shallow foundation through the static laboratory bearing capacity tests. In this study, the dynamic behavior of hollow concrete block reinforced sandy ground with filling the crushed stone in the hollow space has been investigated by the means of shaking table test with the size of shaking table 1000 mm × 1000 mm. Three types of seismic wave, that is, Ofunato, Hachinohe, Artificial, and two different accelerations (0.154 g, 0.22 g) were applied in the shaking table tests. The horizontal displacement of structure which is situated right above the hollow concrete block reinforced ground was measured by using the LVDT. The relative density of soil ground are varied with 45%, 65%, and 85%, respectively, to investigate the effectiveness of reinforcement by hollow block and measured the magnitude of lateral movement, and compared with the limit value of 0.015h (Building Earthquake Code, 2019). Based on the results of shaking table test for hollow concrete block reinforced sandy ground, honeycell type hollow block gives a large interlocking force due to the filling of crushed stone in the hollow space as well as a great interface friction force by the confining pressure and punching resistance along the inside and outside of hollow concrete block. All these factors are contributed to reduce the great amount of horizontal displacement during the shaking table test. Finally, hollow concrete block reinforced sandy ground for shallow foundation is provided an outstanding reinforced method for medium-high building irrespective of seismic wave and moderate accelerations.

Numerical Analyses for Evaluating Factors which Influence the Behavioral Characteristics of Side of Rock Socketed Drilled Shafts (암반에 근입된 현장타설말뚝의 주면부 거동에 영향을 미치는 변수분석을 위한 수치해석)

  • Lee, Hyuk-Jin;Kim, Hong-Taek
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.26 no.6C
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    • pp.395-406
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    • 2006
  • Drilled shafts are a common foundation solution for large concentrated loads. Such piles are generally constructed by drilling through softer soils into rock and the section of the shaft which is drilled through rock contributes most of the load bearing capacity. Drilled shafts derive their bearing capacity from both shaft and base resistance components. The length and diameter of the rock socket must be sufficient to carry the loads imposed on the pile safely without excessive settlements. The base resistance component can contribute significantly to the ultimate capacity of the pile. However, the shaft resistance is typically mobilized at considerably smaller pile movements than that of the base. In addition, the base response can be adversely affected by any debris that is left in the bottom of the socket. The reliability of base response therefore depends on the use of a construction and inspection technique which leaves the socket free of debris. This may be difficult and costly to achieve, particularly in deep sockets, which are often drilled under water or drilling slurry. As a consequence of these factors, shaft resistance generally dominates pile performance at working loads. The efforts to improve the prediction of drilled shaft performance are therefore primarily concerned with the complex mechanisms of shaft resistance development. The shaft resistance only is concerned in this study. The nature of the interface between the concrete pile shaft and the surrounding rock is critically important to the performance of the pile, and is heavily influenced by the construction practices. In this study, the influences of asperity characteristics such as the heights and angles, the strength characteristics and elastic constants of surrounding rock masses and the depth and length of rock socket, et. al. on the shaft resistance of drilled shafts are investigated from elasto-plastic analyses( FLAC). Through the parametric studies, among the parameters, the vertical stress on the top layer of socket, the height of asperity and cohesion and poison's ratio of rock masses are major influence factors on the unit peak shaft resistance.

Removal Torque Values of Retaining Screws Tightened to Implant-Supported Prosthesis with Different Connection Systems by Various Tightening Technique (다른 연결 시스템을 갖는 임플랜트 상부 구조물에서 조임술식에 따른 지대주 나사의 풀림 토크값에 대한 연구)

  • Kim, Dong-Wook;Choi, Yu-Sung;Jo, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.4
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    • pp.343-358
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    • 2011
  • As implant treatment has become popular, lots of different shapes and materials of the implant upper component have been supplied. And there are also diverse reports about failures including loosening of the abutment screw which is one of the most common reason. Purpose : The purpose of this study is to find out how different screw tightening orders and methods influence on screw loosening according to the different connection systems. The upper component was fabricated by casting method. After fabricating master models that are precisely attached to the upper component, 5 experimental models each for the external connection system and internal connection system were fabricated using splinting impression technique. First, to find out the influence of the screw tightening order, screws were tightened in 3 orders; 1-2-3-4, 2-3-1-4, 2-4-3-1. After tightening, removal torque values (RTV) of each group was measured. And also to find out the influence of screw tightening method, a model with 2-3-1-4 screw tightening order was tightened with 30 Ncm at one time(1-step method) and the RTV was compared with the same order group (2-3-1-4) in the 2 step method. In the external connection system, RTV appeared significantly lower in group 2-3-1-4 than group 2-4-3-1 (p<0.05). And also in the internal connection system, the RTV of group 2-3-1-4 appeared significantly lower than that of group 2-4-3-1 and 1-2-3-4 (p<0.05). When comparing the tightening number of the screw without considering the screw tightening order, the first tightened screw appeared significantly higher RTV than the second one in the external connection system (p<0.05), however there was no significant difference from the first tightened screw to the last tightened screw in the internal connection system. And there was no statistically significant difference between the two screw tightening methods in both internal and external connection system. In the comparison of external and internal connection system, each RTV appeared 16.27 Ncm and 14.25 Ncm and appeared as a statistically significant difference (p<0.05). There was a significant difference in RTV measured according to the screw tightening order. The lowest RTV appeared in the groups started tightening from the middle. There was also a significant difference in RTV between the two connection system groups. A further study is needed to find out the influence factors in RTV and also a study is required related to the load condition.

Analysis of Greenhouse Thermal Environment by Model Simulation (시뮬레이션 모형에 의한 온실의 열환경 분석)

  • 서원명;윤용철
    • Journal of Bio-Environment Control
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    • v.5 no.2
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    • pp.215-235
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    • 1996
  • The thermal analysis by mathematical model simulation makes it possible to reasonably predict heating and/or cooling requirements of certain greenhouses located under various geographical and climatic environment. It is another advantages of model simulation technique to be able to make it possible to select appropriate heating system, to set up energy utilization strategy, to schedule seasonal crop pattern, as well as to determine new greenhouse ranges. In this study, the control pattern for greenhouse microclimate is categorized as cooling and heating. Dynamic model was adopted to simulate heating requirements and/or energy conservation effectiveness such as energy saving by night-time thermal curtain, estimation of Heating Degree-Hours(HDH), long time prediction of greenhouse thermal behavior, etc. On the other hand, the cooling effects of ventilation, shading, and pad ||||&|||| fan system were partly analyzed by static model. By the experimental work with small size model greenhouse of 1.2m$\times$2.4m, it was found that cooling the greenhouse by spraying cold water directly on greenhouse cover surface or by recirculating cold water through heat exchangers would be effective in greenhouse summer cooling. The mathematical model developed for greenhouse model simulation is highly applicable because it can reflects various climatic factors like temperature, humidity, beam and diffuse solar radiation, wind velocity, etc. This model was closely verified by various weather data obtained through long period greenhouse experiment. Most of the materials relating with greenhouse heating or cooling components were obtained from model greenhouse simulated mathematically by using typical year(1987) data of Jinju Gyeongnam. But some of the materials relating with greenhouse cooling was obtained by performing model experiments which include analyzing cooling effect of water sprayed directly on greenhouse roof surface. The results are summarized as follows : 1. The heating requirements of model greenhouse were highly related with the minimum temperature set for given greenhouse. The setting temperature at night-time is much more influential on heating energy requirement than that at day-time. Therefore It is highly recommended that night- time setting temperature should be carefully determined and controlled. 2. The HDH data obtained by conventional method were estimated on the basis of considerably long term average weather temperature together with the standard base temperature(usually 18.3$^{\circ}C$). This kind of data can merely be used as a relative comparison criteria about heating load, but is not applicable in the calculation of greenhouse heating requirements because of the limited consideration of climatic factors and inappropriate base temperature. By comparing the HDM data with the results of simulation, it is found that the heating system design by HDH data will probably overshoot the actual heating requirement. 3. The energy saving effect of night-time thermal curtain as well as estimated heating requirement is found to be sensitively related with weather condition: Thermal curtain adopted for simulation showed high effectiveness in energy saving which amounts to more than 50% of annual heating requirement. 4. The ventilation performances doting warm seasons are mainly influenced by air exchange rate even though there are some variations depending on greenhouse structural difference, weather and cropping conditions. For air exchanges above 1 volume per minute, the reduction rate of temperature rise on both types of considered greenhouse becomes modest with the additional increase of ventilation capacity. Therefore the desirable ventilation capacity is assumed to be 1 air change per minute, which is the recommended ventilation rate in common greenhouse. 5. In glass covered greenhouse with full production, under clear weather of 50% RH, and continuous 1 air change per minute, the temperature drop in 50% shaded greenhouse and pad & fan systemed greenhouse is 2.6$^{\circ}C$ and.6.1$^{\circ}C$ respectively. The temperature in control greenhouse under continuous air change at this time was 36.6$^{\circ}C$ which was 5.3$^{\circ}C$ above ambient temperature. As a result the greenhouse temperature can be maintained 3$^{\circ}C$ below ambient temperature. But when RH is 80%, it was impossible to drop greenhouse temperature below ambient temperature because possible temperature reduction by pad ||||&|||| fan system at this time is not more than 2.4$^{\circ}C$. 6. During 3 months of hot summer season if the greenhouse is assumed to be cooled only when greenhouse temperature rise above 27$^{\circ}C$, the relationship between RH of ambient air and greenhouse temperature drop($\Delta$T) was formulated as follows : $\Delta$T= -0.077RH+7.7 7. Time dependent cooling effects performed by operation of each or combination of ventilation, 50% shading, pad & fan of 80% efficiency, were continuously predicted for one typical summer day long. When the greenhouse was cooled only by 1 air change per minute, greenhouse air temperature was 5$^{\circ}C$ above outdoor temperature. Either method alone can not drop greenhouse air temperature below outdoor temperature even under the fully cropped situations. But when both systems were operated together, greenhouse air temperature can be controlled to about 2.0-2.3$^{\circ}C$ below ambient temperature. 8. When the cool water of 6.5-8.5$^{\circ}C$ was sprayed on greenhouse roof surface with the water flow rate of 1.3 liter/min per unit greenhouse floor area, greenhouse air temperature could be dropped down to 16.5-18.$0^{\circ}C$, whlch is about 1$0^{\circ}C$ below the ambient temperature of 26.5-28.$0^{\circ}C$ at that time. The most important thing in cooling greenhouse air effectively with water spray may be obtaining plenty of cool water source like ground water itself or cold water produced by heat-pump. Future work is focused on not only analyzing the feasibility of heat pump operation but also finding the relationships between greenhouse air temperature(T$_{g}$ ), spraying water temperature(T$_{w}$ ), water flow rate(Q), and ambient temperature(T$_{o}$).

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