• Journal of Chest Surgery
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• 제28권6호
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• pp.571-578
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• 1995

Rastelli operation in which right ventricle[RV and pulmonary artery[PA is connected with an artificial graft is effective in increasing the pulmonary blood flow in certain types of congenital heart disease but, in many, it requires a reoperation because of the relative stenosis of graft that develops as the patients become old. The purpose of this study is to evaluate the various factors which many influence the long term outcome of such patients following a Rastelli operation. A total of 47 patients underwent a Rastelli operation during a 15 year period between November, 1978 and October 1993. The mean follow-up period is 76.1 51.3 months.1 Among the 47 patients, a valved conduit was used in 30[63.8% , and non-valved conduit in 17[36.2% patients. In the 8 patients[17.0% who died postoperatively, a valved conduit was used in 5 [16.6% and a non-valved conduit in 3[17.6% . There was no statistical difference in mortality between the 2 groups. There was a good linear correlation between the body surface area[X and the conduit size[Y [Y=3.86X + 14.6, R=0.55, P=0.01 .2 Ten patients underwent replacement of the conduit during the follow-up period. The type of conduit used and the frequency of subsequent replacement were as follows: Ionescu-Shiley, valved-33.3%, Carpentier-Edwards, valved-30.8%, Hancock, valved-80% and non-valved conduit-9.1%. The median period free of reoperation was 110 months for the valved and 79 months for the non-valved group, there being no statistical difference between the 2 groups. 3 The patients who did not require reoperation are all doing well [New York Heart Association Functional Classification: Class I . Pressure gradient between the RV and the PA was 20 mmHg in 10 randomly selected patients who did not require reoperation and 92 9 mmHg in 10 patients who did require reoperation.4 In the 10 patients who underwent a conduit replacement procedure.5 Among patients undergoing reoperation, 2 died from endocarditis.The remaining 8 patients are doing well without limitation in physical activity at a mean follow-up period of 32.7 33.9 months [range 2 to 89 months . 6 At 5, 7, and 10 years, the reoperation-free rates among all patients were 96%, 91% and 29% and the survival rates were 82%, 82% and 71%. In conclusion, Rastelli operation is an effective procedure in ameliorating symptoms in a select group of patients with congenital heart disease. Because of the inherent nature of relative graft stenosis and degeneration, a long-term follow-up is required under the proper selection of the graft material.

• 콘크리트학회논문집
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• 제17권3호
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• pp.329-334
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• 2005

폴리머콘크리트는 시멘트 콘크리트에 비해 강도와 내구적 성능 등 여러면에 있어 우수하여 건설현장에서의 벽체용 패널, 통신용 맨흘, 기계설비의 기초, 지하연결박스 등 다양한 용도로 개발되고 사용되어지고 있다. 그러나 폴리머콘크리트는 그 결합재로 쓰이고 있는 수지의 비용이 높아 경제적인 면에서 불리하여 기존 수지를 대체할 수 있는 결합재에 관한 연구가 필요하다. 여기서, PET를 재활용한 폴리머콘크리트는 산업폐기물을 재활용한 것이므로 경제적인 건설 소재가 될 수 있으며, 친환경적인 효과를 가져올 수 있기 때문에 현재 연구가 활발하게 이루어지고, 사용 영역이 확대 될 것으로 전망된다. 하지만 아직까지 PET재활용 폴리머콘크리트의 응력-변형률 거동에 관해서는 기초적인 연구상태에 있다. 따라서, 본 연구에서는 폐 PET를 합성한 불포화 폴리에스터 수지를 폴리머콘크리트의 결합재로 이용하여 콘크리트를 제조하였으며, 수지량, 골재의 최대치수, 양생방법에 변화를 주었다. 그리고 변위제어가 가능한 M.T.S 장비를 사용하여 응력-변형률 곡선을 관찰하였다. 그 결과 PET 재활용 폴리머콘크리트의 압축강도는 수지의 함량, 굵은골재의 크기변화, 양생방법에 모두 영향을 받는 것으로 나타났다. 탄성계수의 변화는 수지의 함량이 크게 좌우하였으며, 굵은골재의 최대치수와 양생방법에서 크게 영향을 받지 않았다. 최대응력에서의 변형률은 수지의 함량과 굵은골재의 최대치수에 영향을 많이 받는 것으로 나타났다.

• Pediatric Infection and Vaccine
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• 제23권3호
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• pp.209-216
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• 2016

목적: 선천성 심장병을 가진 소아와 성인에서 발생한 감염성 심내막염의 차이점을 찾아보고자 하였다. 방법: 2000년 1월부터 2016년 5월까지 선천성 심장병이 있으면서 심내막염으로 입원 치료를 받은 소아 14예와 성인 11예를 대상으로 의무기록을 검토하였다. 결과: 소아는 모두 심내막염을 진단받기 전에 선천성 심장병을 진단받았고, 팔로사징이 가장 많았다. 성인은 4예만 선천성 심장병을 심내막염 전에 진단받았고, 심실중격결손이 가장 많았다. 심내막염 진단전 소아 6예, 성인 2예가 개심 교정 수술을 받았다. 원인균은 소아에서는 포도알균, 성인에서는 사슬알균이 가장 많았다. 증상 발현 후 심내막염이 진단되기까지 소아는 9일, 성인은 42일이 걸렸다. 결론: 소아 감염성 심내막염은 성인에 비해 진단과 경과에서 뚜렷한 차이를 보였다. 따라서, 감염성 심내막염의 진단과 치료에는 나이에 맞고, 체계적인 재평가가 필요할 것이다.

• 대한족부족관절학회지
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• 제20권1호
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• pp.12-18
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• 2016

Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.

• Journal of Chest Surgery
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• 제33권4호
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• pp.290-300
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• 2000

Background: To evaluate the diagnostic accuracy of EBT(Electron Beam Tomography) in the diagnosis of conotruncal anomaly and to determine whether it can be used as a substitute for cardiac angiography. Material and Method: 20 patients(11M & 9F) with TOF(n=7, pulmonary atresia 2), DORV(n=7), complete TGV(n=4), & corrected TGV(n=2) were included. The age ranged from 7 days to 26 years(median 60 days). We analyzed the sequential chamber localization, the main surgical concenrn in each disease category (PA size, LVED volume and coronary artery pattern for TOF & pulmonary atresia, the LV mass, LVOT obstruction, coronary artery pattern for complete TGV, and type of VSD and TV-PV distance for DORV, etc) and other associated anomalies(e.g., VSD, arch anomalies, tracheal stenosis, etc). Those were compared with the results of echocardiography(n=19), angiography (n=9), and surgery(n=11). The interval between EBT and echocardiography/angiography was within 20/11 days, respectively except for an angiography in a patient with corrected TGV (48 days). Result: EBT correctly diagnosed the basic components of conotruncal anomalies in all subjects, compared to echocardiography, angiography or surgery. These included the presence, type and size of VSD(n=20), pulmonic/LV outflow tract stenosis(n=15/2), relation of great arteries and the pattern of the proximal epicardial coronary arteries(16 out of 20). EBT proved to be accurate in quantitation of the intrapericardial and hilar pulmonary arterial dimension and showed high correlation and no difference compared with echocardiography, angiography, or surgery(p>0.05) except for left pulmonary arterial & ascending arterial dimension by echocardiography. LVED volume in seven TOF(no difference: p>0.05 & high correlation: r=0.996 with echocardiography), and LV mass in 4 complete TGV were obtained. Additionally, EBT enabled the cdiagnosis of subjlottic tracheal stenosis and tracheal bronchus in 1 respectively. Some peripheral PA stenosis were not detected by echocardiography, while echocardiography appeared to be slightly more accurate than EBT in detecing ASD or PDA. Conclusion: EBT can be a non-invasive and accurate modality of for the evaluation of most anatomical alteration including peripheral PS or interruption in patients with conotruncal anomalies. Combined with echocardiography, EBT study provides sufficient information for the palliative or total repair of anomalies.

• Journal of Chest Surgery
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• 제35권2호
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• pp.113-117
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• 2002

기계판막이나 조직판막을 이용한 인공판막 치환술의 한계가 인식되면서부터 대동맥판막 성형술은 판막치환술의 대안으로 관심을 끌어왔다. 대상 및 방법: 1999년 7월부터 2000년 7월까지 대동맥판막 폐쇄부전으로 설상절제술(triangular resection)을 시행 받은 8명의 환자를 대상으로 수술합병증 및 수술 전후의 심초음파 소견을 비교하였다. 8례 중 남자와 여자는 각자 4명이었으며, 평균 연령은 18.4$\pm$12.6세였다. 술전 시행한 심초음파검사에서 대동맥판막 폐쇄부전의 정도는 평균 3.570.5였다. 6례에서는 심실중격결손증을 동반한 삼첨판인 대동맥판막이었고, 2례에서는 이첨판이었다. 수술방법은 탈출된 판엽을 nodule of Arantius를 중심으로 다른 엽보다 길어진 만큼 설상절제하고 교련술을 시행하였다. 이첨판인 경우는 raphe를 제거하였다. 결과: 기사망이나 합병증은 발생하지 않았다. 평균 추적기간은 11.9$\pm$3.6개월이었으며, 술후 항응고제는 사용되지 않았다. 수술전, 퇴원전 그리고 마지막 추적 검사시 시행한 심초음파검사에 의한 대동맥판막 폐쇄부전의 정도는 각각 grade 3.5$\pm$0.6, grade 0.6$\pm$0.5 그리고 grade 0.8$\pm$0.6으로 통계적으로 유의하게 감소하였다(p value=0.01). 마지막 추적검사에서의 대동맥판막 폐쇄부전의 정도는 grade 2가 1명이였고, 나머지 환자들에서는 grade 1이거나 경도 미만한 정도였다. 결론: 설상절제술은 만족할만한 조기결과를 보여주지만,오랜 기간의 추적검사가 필요하리라 본다.

• Journal of Chest Surgery
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• 제24권7호
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• pp.674-684
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• 1991

The surgical treatment of tetralogy of Fallot [TOF] was initiated by Blalock and Taussig in 1945 with the establishment of the subclavian artery to pulmonary artery anastomosis. In an imaginative and daring effort, in 1954, Lillehei and collaborators [1955] using controlled cross-circulation, carried out the first intracardiac repair of TOF by closing the ventricular septal defect [VSD] and relieving the pulmonary stenosis under direct vision. Nowadays, total correction is the ideal operation for treatment of TOF and is accomplished with extracorporeal circulation. And the results of surgery for TOF have steadily improved over the years, thanks to important contributions of many surgeons. Nevertheless because of its protean physiologic and anatomic presentation, TOF continues to offer challenges to cardiologist and cardiac surgeons. Thirty two cases of TOF have undergone total corrective surgery using extracorporeal circulation in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, Inje University, from Oct. 1985 to Feb. 1990. Clinical considerations were applied to these cases and the results were obtained as follows. 1. The heart lung machine used for extracorporeal circulation was SarnsO 7000, 5-head roller pump, and the number and type of oxygenators were 10 of bubble type and 22 of membrane type. The mean bypass time was 148.9 minutes and the mean aortic cross clamp time was 123.8 minutes. The GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 2. 20 cases were male and 12 were female, the mean age was 8 years old and the mean body weight was 25Kg. 3. The preoperative symptoms were cyanosis [29 cases], squatting [27 cases] and etc. The mean values of preoperative Hb., Hct., and SaO2 were 16.5 gm /dl, 50.3%, and 78.5%. 4. Combined anomalies were noticed in 16 cases [50%]. Among them 10 cases were PFO and 6 cases were ASD. 5. The degree of aorta overriding were 25% in 5 cases, 25 ~ 50% in 22 cases and above 50% in 5 cases. The dPA/Ao [ratio of diameter of pulmonary artery trunk to ascending aorta] were below 25% in 5 cases, 25 ~ 50% in 10 cases, 50 ~ 70% in 6 cases and above 75% in 11 cases. 6. The types of RVOT [right ventricular outflow tract] stenosis were valvular and infundibular in 14 cases [43.6%], diffuse hypoplastic type in 12 cases [37.5%], infundibular in 5 cases, and valvular and supravalvular in 1 case. 7. One stage radical corrective surgery was applied to the all cases. In widening of the RVOT, 3 types of patches were used: MVOP [monocusp ventricular outflow patch, Polystan BioprosthesesO] in 3 cases, knitted Dacron vessel patches in 2 cases, and double layer with bovine pericardium and woven Dacron prosthesis in 26 cases. 8. Postoperative complications were occurred in 15 cases. Among them, low output syndrome were occurred in 10 cases [31.3%] and 2 of them were expired postoperatively.

• Journal of Periodontal and Implant Science
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• 제27권1호
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• pp.165-177
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• 1997

The purpose of this study was to perform on the biological activity of Magnolia and Zizyphi fructus extract mixtures on the wound healing of defected rat calvaria. For the determination of the mixture ratio of two extracts for oral administration, preliminary experiments were performed with the mixture combination of 2000 and $3000{\mu}g/ml$ of Magnolia extract, and also 20, 30, 200, 300, 2000 and $3000{\mu}g/ml$ of Zizyphi fructus extract, respectively and divided into 6 groups. The combination of extracts mixture were tested on the enhancing effect of cellular activity. The effect of the extracts mixture on the cellular activity was evaluated using MTT method and measured on the results with optical density by ELISA reader. The ability to tissue regeneration of the extracts mixture was performed by measuring new bone and new connective tissue regeneration on the 5mm defected rat calvaria for 1, 2 and 3 weeks after oral administration of 2 different dosages groups : 10:1(0.1g/kg) and 10:1(0.5g/kg). It was employed the same dosages of unsaponifiable fraction of Zea Mays L as positive controls. Each group of rat was sacrificed and en bloc section for histological examination. The effect on the cellular activity of each mixture ratio showed significantly higher in $2000{\mu}g/ml$ of Magnolia extract and $200{\mu}g/ml$ of Zizyphi fructus extract group to compare with other groups. These preliminary results showed that appropriate mixture ratio of two extracts was 10:1 of Magnolia and Zizyphi fructus extract. Histological examination on the activity of tissue regeneration of each group showed that 2weeks and 3weeks specimens of 0.5g/kg of 10:1 extract mixture of Magnolia and Ziziphi fructus administrated rat calvaria revealed significantly more osteoid and new bone formation of defected calvaria with unification of defected area than the specimens of any other negative and positive controls. Even though the specimen administrated the same dosages of unsaponifiable fraction of Zea Mays L, positive controls, showed the trend that they promote significantly the repair of calvarial defect, their bone reparative activities were less inductive than the same dosages of Magnolia and Ziziphi fructus extract mixture. These results implicated that the mixture of Magnolia and Zizyphi fructus extracts should be highly effective on the wound healing of bony defected site and might have potential possibilities as an useful drug to promote periodontal tissue regeneration.

• 문화기술의 융합
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• 제5권4호
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• pp.379-385
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• 2019

본 연구는 도시철도 콘크리트궤도 목침목 분기기의 손상현황 및 손상유형별 원인을 분석하고자 현장조사를 수행하였다. 또한 약 24년간의 분기기 유지관리이력을 열차 통과톤수와 연계하여 운영 호선별로 구분하여 손상발생빈도와 연계분석하고 현재까지 수행되어온 손상항목별 궤도보수내용의 적정성을 비교 분석하였다. 도시철도 콘크리트 도상에 적용된 목침목 분기기의 특성상 목침목 하부에 삽입되어 있는 침목방진패드의 성능유지가 중요하다. 현장조사결과 목침목 분기기 궤도구조의 적정탄성 수준 부족에 따른 손상 및 다양한 유형의 레일손상이 조사되었으며, 레일의 손상은 독립적인 손상이 아닌 다른 궤도구성품의 손상에서 기인되어 유발되는 경우도 다수 발견되었다. 분기기 궤도구성품별 손상빈도 분석결과, 손상발생빈도는 레일, 타이플레이트, 나사스파이크, 목침목 순으로 나타났으며 이를 바탕으로 목침목 분기기 궤도구조의 주요 손상유형은 목침목의 변형에 따른 나사스파이크와 타이플레이트의 고정상태불량에서 기인된 손상이 주요 손상유형으로 분석되었다. 연구결과, 분기기에 적용된 목침목의 변형은 레일체결장치구성품의 고정상태 불량을 초래하고 이로 인한 연계손상이 유발될 수 있음을 현장조사결과를 바탕으로 분석하였다. 또한 분기기의 중점 점검항목 및 현행 분기기 점검 시트의 보완점을 도출하여 개선 안을 제시하였다.

• 청정기술
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• 제27권4호
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• pp.297-305
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• 2021

국내 알루미늄 산업에서 압출공정은 생산량 기준 40% 이상의 비중을 차지하고 있는 주요 공정이다. 국내 알루미늄 압출업체 대부분이 30년 이상 된 노후 설비를 이용하여 생산하고 있기 때문에 제품 정밀도 및 품질 저하, 낮은 생산성 등의 문제를 격고 있다. 압출 설비는 한번 도입하면 주요 부품의 마모 또는 파손 발생 전에는 설비를 교체하지 않는 구조로 신규 설비에 비해 생산성 감소 및 불량률이 증가하기 때문에 설비의 유지 관리가 중요하다. 노후 압출기는 부품의 도면이 소실된 경우가 많아 현장에서 적절한 보수가 어렵고 유지 관리를 위한 기술력 부재로 인해 재제조에 어려움을 겪고 있기 때문에 해체 단계에서부터 체계적인 재제조 방안이 고안되어야 한다. 본 연구에서는 노후 압출설비의 재제조를 위해 재제조 고장모드 영향분석 방법을 고안하였다. 부품에 대한 재제조 대상 부품의 파손에 대한 심각도, 압출 공정 중 고장/파손에 따른 수명 그리고 재제조에 따른 자원순환의 가치를 고려하여 위험우선순위를 산정하고 재제조 대상을 선정하였다. 노후 압출기의 재제조 공정의 표준화 정립을 위해 노후 압출기의 구조에 따른 모듈 및 부품에 대한 분석 등을 통해 재제조 고장모드 영향분석을 수행하였으며 부품별 우선순위를 선정하여 자원순환의 효율성 및 제품 품질 안정화를 위한 재제조 연구를 수행하였다.