• Annals of Coloproctology
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• 제34권6호
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• pp.306-311
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• 2018

Purpose: Hartmann operation is widely recognized as a useful procedure, especially in emergencies involving the rectosigmoid colon. One of the surgeon's foremost concerns after Hartmann operation is future colostomy reversal, as colostomy reversal after a Hartmann procedure is associated with relatively high morbidity and mortality. Laparoscopic surgical techniques continue to prove useful for an ever-increasing variety of indications. We analyzed the outcomes of laparoscopic Hartmann colostomy reversals at our center. Methods: We retrospectively analyzed the hospital records of 170 patients who had undergone Hartmann operation between January 2010 and June 2017 at Wonkwang University Hospital. Among 68 Hartmann colostomy reversals, we evaluated and compared the outcomes of 3 groups of patients: 29 patients in the open colostomy reversal group (OG) who had undergone laparotomies for Hartmann reversals, 19 patients in the conversion group (CG) whose laparoscopic procedures had required conversion to a laparotomy, and 20 patients in the laparoscopy group (LG). Results: The overall reversal rate for Hartmann colostomies was 40.5% during this time period. The duration of hospital stay was significantly shorter among LG patients ($10.15{\pm}2.94days$) than among OG patients ($16{\pm}9.5days$). The overall complication rate among OG patients was higher than that among LG patients (adjusted odds ratio, 8.78; P = 0.01). The most common complication was postoperative ileus (19.1%). Conclusion: If no contraindications to laparoscopy exist, surgeons should favor a laparoscopic reversal of Hartmann operation over an open reversal.

• 한국광학회지
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• 제19권1호
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• pp.1-8
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• 2008

샥-하트만(Shack-Hartmann) 파면 측정 센서는 여러 분야에서 다양하게 사용되고 있다. 특히 적응광학은 주요 응용분야 중 하나이다. 적응광학 시스템은 실시간으로 빠르게 동작되어야 하므로 고속 파면 측정이 필수적이다. 고속 파면 측정에서는 카메라의 노출시간이 매우 작기 때문에 파면 측정시에 광자 잡음(photon noise)와 판독 잡음(readout noise)등의 잡음의 영향을 크게 받는다. 따라서 잡음에 둔감한 고속 중심점 탐색 알고리즘이 요구된다. 본 논문에서는 잡음에 둔감한 고속 중심점 탐색 알고리즘으로 다중 해상도 상관관계법이 제안되었다. 이 방법은 고속 푸리에 변환(fast Fourier transform)을 이용한 상관관계법과 비교하여 다중 해상도 이미지를 이용함으로써 계산시간을 향상시켰다. 본 논문에서는 무게중심법(center of mass method)과 상관관계법(correlation method)과 다중해상도 상관관계법(multi-resolution correlation method)의 계산시간과 측정 정확도를 비교하기 위해 전산모사 방법이 사용되었다. 제안된 방법의 정확도는 기존의 상관관계법과 유사한 것을 확인하였다.

• Journal of Chest Surgery
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• 제11권4호
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• pp.422-427
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• 1978

Alterations in the serum and urine potassium were studied in twenty patients who underwent open heart surgery in National Medical Center during the period from Jan.1978 to June 1978. There were twelve cases congenital heart disease and eight acquired heart disease. Rigg-Kyvsgaad mark IV roller pump and Polystan bubble oxygenator were used in all patients. Hemodilution was carried out by priming the oxygenator with Hartmann`s solution. Measurements were made of the serum electrolyte, gas analysis and twenty four hour urine electrolytes. During the bypass, the serum potassium decreased Significantly from 4.2?.47 to 3.6?. 72 mEq. per liter. [p<0.05] Fifty seven miliequivalant of potassium chloride were added during operation-urine potassium was higher in the diuretic group than in the non diuretic group. Plasma potassium level in the diuretic group was more significantly reduced than nondiuretic group. In this series large amount of urine potassium loss was noted on the day of operation, the first and second post operative day.

• Journal of Yeungnam Medical Science
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• 제1권1호
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• pp.89-93
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• 1984

선택수술이 계획된 4세이하, 체중 18kg이하 소아 환자 38명을 대상으로 하여 수술전 병실에서 측정된 혈당치를 대조치로하고, 8시간 정도의 금식후 수술실로 오기 1시간 전부터 비포도당액인 Hartmonn's solution을 공급한 I군과 포도당이 함유된 Hartmann's dextrose solution을 공급한 II군으로 나누어 각각 혈당치를 측정하고 또 수술 1시간후의 혈당치를 측정하여 혈당치변화를 관찰하였던 바 다음과 같은 결론을 얻었다. 1) I군에서는 대조치 $95.4{\pm}13.3mg%$에 비해 8시간 금식후의 혈당치는 $85.6{\pm}12.2mg%$로 감소했으며, 수술후 1시간에 있어서의 혈당치는 $119.2{\pm}33.0mg%$로 대조치에 비해 유의한 증가를 보였다. 2) II군의 경우에는 대조치 $94.6{\pm}28.5mg%$에 비해 8시간 금식후의 혈당치는 $99.8{\pm}21.8mg%$)로 약간 증가되었고, 수술후 1시간의 혈당치는 $122.3{\pm}27.3mg%$로 유의한 증가를 보였다. 이상의 결과로 보아 신아에서 약 8시간정도의 금식으로는 저혈당이 초래되지 않으며, 또한 수술중에 혈당이 증가되므로 소아수술시 수술중 혈당유지를 위한 포도당액의 투에는 필요치 않은 것으로 사료된다.

• Smart Structures and Systems
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• 제12권2호
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• pp.209-233
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• 2013

With an annual growth rate of about 30%, wind energy systems, such as wind turbines, represent one of the fastest growing renewable energy technologies. Continuous structural health monitoring of wind turbines can help improving structural reliability and facilitating optimal decisions with respect to maintenance and operation at minimum associated life-cycle costs. This paper presents an integrated monitoring system that is designed to support structural assessment and life-cycle management of wind turbines. The monitoring system systematically integrates a wide variety of hardware and software modules, including sensors and computer systems for automated data acquisition, data analysis and data archival, a multiagent-based system for self-diagnosis of sensor malfunctions, a model updating and damage detection framework for structural assessment, and a management module for monitoring the structural condition and the operational efficiency of the wind turbine. The monitoring system has been installed on a 500 kW wind turbine located in Germany. Since its initial deployment in 2009, the system automatically collects and processes structural, environmental, and operational wind turbine data. The results demonstrate the potential of the proposed approach not only to ensure continuous safety of the structures, but also to enable cost-efficient maintenance and operation of wind turbines.

• Journal of Chest Surgery
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• 제3권2호
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• pp.73-90
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• 1970

Clinical perfusion data on 16 cases of cardiopulmonary bypass using Sigmamotor pump and RyggKyvsgaard Oxygenator which performed at Seoul National University Hospital during the period of Aug. 1968 to Aug. 1970 was analized. AIl cases were hemodiluted and the perfusion was carried out under the normothermic condition. The age of the patients ranged between 6 and 43 years. The b:dy weight varied between 18.3 and 54.0 kg and the body surface area between 0.78 and 1. 59$M^2$. The priming solution was consiste:I with fresh ACD blood. Hartmann solution and Mannitol. The average amount of priming was approximately 2242 ml. The average hemodilution rate was 17%. The flow rate ranged from 1.7L to 3.5L/Min/$M^2$ and averaged 2.4L/Min/$M^2$ or 78mI/Min/kg. The duration of perfusion varied from 22 to 110 min with average of 56.9 minutes. Some hemodynamic responses were observed. The arterial pressure dropped immediately after the initiation of partial perfusion and was more marked after the total perfusion foIlowed by gradual increase to the safety level. The central venous pressure reflected the reduced blood volume especially in the cases of prolonged perfusion which lasted over 60 min. In most of the cases, red blood cell count decreased and white blood ceIl count increased after the perfusion. Hemoglobin level was decreased, averaging of 12.5mg%, Hct 3.3% and platelets count of 18% postoperatively. Plasma hemoglobin increased mildly, from pre-perfusion average value of 4. 06mg% to postperfusion value of 22.5mg%. Serum potassium was 4.4mEq/L pre-operatively and was decreased to 3.7mEq/L postoperatively. Five cases showed definite hypopotassemia immediately after the operation. Sodium and chloride decreased mildly. These electrolyte changes are thought to be related with hemodilution. diuretics and reduced blood volume during and after the perfusion. Arterial blood pH value revealed minimal to moderate elevation from preperfusion average value of 7.376 to 7.461 during perfusion and then 7.365 after perfusion. The pC02 and hicarbonate showed minimal to moderately lowered values. The total CO2 was decreased. Buffer base decreased during perfusion (Av. 42.6mEq/L) and further decreased after the perfusion (Av. 40.8mEq/L). These arterial blood acid base changes suggested that the metabolic acidosis was accompanied by respiratory alkalosis during and immediately after the perfusion. Authors belived that the acidosis could more effectively be corrected with the more additional dose of bicarbonate than we used by this study. The chest tune drainage during the first 24 hours following operation was 1158 ml in average. One case (Case No. 15) showd definite bleeding tendency and it was believed that the cause might be due to the defect of heparin and protamine titration. The average urinary out put during 24 hours post-perfusion was 1291ml. One case (Case No. ]) showed definite post perfusion oliguria. As conclusion hemodilution using fresh ACD blood. Hartmann and Mannitol solution added with Bivon and high flow rate unler normothermia. was thought to amelioratc the severity of mctabolic acidosis during and after perfusion with relatively satisfactory effect on the diuresis and bleeding tendency.

• Advances in pediatric surgery
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• 제10권2호
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• pp.145-149
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• 2004

A 12-year-old boy with severe periumbilical pain visited the emergency room. Physical examination, abdominal ultrasonography, colonoscopy and CT, identified a lesion of sigmoid colon. Endoscopic biopsy showed a signet ring cell carcinoma of the sigmoid colon. On explorative laparotomy, cancer invasions of the adjacent structures and metastases on peritoneal wall were noticed. We performed palliative loop-ileostomy. He underwent chemotherapy and radiotherapy for 3 months. The second case was a 16-year-old boy with abdominal pain and hematochezia, transferred to our hospital with the diagnosis of acute appendicitis with periappendiceal abscess. Although he underwent appendectomy, the abdominal pain persisted. Digital rectal examination revealed a lumen-obstructing fungating mass in the rectum. Endoscopic biopsy revealed a adenocarcinoma. Cancer invasion of the adjacent structures and metastases involving the mesentery of the small intestine were found at laparotomy. A palliative procedure, a Hartmann's operation and end-colostomy at the sigmoid colon were performed. The patient died 8 month later due to pneumonia and sepsis. Chemotherapy was not applied.

• Journal of Chest Surgery
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• 제21권1호
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• pp.36-47
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• 1988

610 cases of open heart surgery was performed in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July 1981 to September 1987. The clinical data was summarized as follows: 1. The age distribution of congenital heart surgery patients was 2 to 41 years old [mean; 13.2 years] and surgery for acquired heart disease was 10 to 57 years old [mean: 32.8 years]. 2. There were 389 cases [63.8%] of acyanotic congenital heart anomalies, 63 cases [10.3%] of cyanotic congenital anomalies and 158 cases [25.9%] of acquired heart disease. 3. For myocardial protection, Bretschneider and potassium glucose solution had been used as cardioplegic solution and then since 1983, GIK solution has been used with repeated infusion method once for every 20 to 30 minutes of time interval after starting initial cardioplegia during operation with excellent results. 4. The ingredient of the priming solution is Hartmann`s solution, sodium bicarbonate, mannitol, potassium chloride, fresh ACD whole blood, calcium chloride, heparin and dexamethasone. 5. There were 96 cases [15.7%] of mild hypothermia, 333 cases [54.6%] of moderate hypothermia and 181 cases [29.7%] of intermediate hypothermia. 6. The mortality rate was 2.3% [9 out of 389 cases] in acyanotic congenital heart disease, 36.5% [23 out of 63 cases] in cyanotic congenital heart disease and 10.8% [17 out of 158 cases] in acquired heart disease, with overall mortality rate of 8.0% [49 out of 610 cases].

• Nuclear Engineering and Technology
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• 제45권5호
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• pp.581-588
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• 2013

This paper deals with the Safety Analysis for $CANDU^{(R)}$ 6 nuclear reactors as affected by main Heat Transport System (HTS) aging. Operational and aging related changes of the HTS throughout its lifetime may lead to restrictions in certain safety system settings and hence some restriction in performance under certain conditions. A step in confirming safe reactor operation is the tracking of relevant data and their corresponding interpretation by the use of appropriate thermal-hydraulic analytic models. Safety analyses ranging from the assessment of safety limits associated with the prevention of intermittent fuel sheath dryout for a slow Loss of Regulation (LOR) analysis and fission gas release after a fuel failure are summarized. Specifically for fission gas release, the thermal-hydraulic analysis for a fresh core and an 11 Effective Full Power Years (EFPY) aged core was summarized, leading to the most severe stagnation break sizes for the inlet feeder break and the channel failure time. Associated coolant conditions provide the input data for fuel analyses. Based on the thermal-hydraulic data, the fission product inventory under normal operating conditions may be calculated for both fresh and aged cores, and the fission gas release may be evaluated during the transient. This analysis plays a major role in determining possible radiation doses to the public after postulated accidents have occurred.

• 방사성폐기물학회지
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• 제20권1호
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• pp.43-63
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• 2022

The aim of this review is to communicate some essential knowledge of the underlying mechanism of the corrosion of structural containment alloys during molten salt reactor operation in the context of prospective online monitoring in future MSR installations. The formation of metal halide species and the progression of their concentration in the molten salt do reflect containment corrosion, tracing the depletion of alloying metals at the alloy salt interface will assure safe conditions during reactor operation. Even though the progress of alloying metal halides concentrations in the molten salt do strongly understate actual corrosion rates, their prospective 1^st order kinetics followed by near-linearly increase is attributed to homogeneous matrix corrosion. The service life of the structural containment alloy is derived from homogeneous matrix corrosion and near-surface void formation but less so from intergranular cracking (IGC) and pitting corrosion. Online monitoring of corrosion species is of particular interest for molten chloride systems since besides the expected formation of chromium chloride species CrCl₂ and CrCl₃, other metal chloride species such as FeCl₂, FeCl₃, MoCl₂, MnCl₂ and NiCl₂ will form, depending on the selected structural alloy. The metal chloride concentrations should follow, after an incubation period of about 10,000 hours, a linear projection with a positive slope and a steady increase of < 1 ppm per day. During the incubation period, metal concentration show 1^st order kinetics and increasing linearly with time^1/2. Ideally, a linear increase reflects homogeneous matrix corrosion, while a sharp increase in the metal chloride concentration could set a warning flag for potential material failure within the projected service life, e.g. as result of intergranular cracking or pitting corrosion. Continuous monitoring of metal chloride concentrations can therefore provide direct information about the mechanism of the ongoing corrosion scenario and offer valuable information for a timely warning of prospective material failure.