• Proceedings of the Korean Vacuum Society Conference
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• 2014.02a
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• pp.452-452
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• 2014

블랑켓 일차벽이나 디버터와 같은 핵융합로 플라즈마 대향부품은 플라즈마로부터 입사되는 중성자 및 입자들을 차폐하여 구조물을 보호하고, 발생열을 에너지로 변환하기 위해 냉각재를 활용한 열제거 기능을 담당한다. 특히, 고속중성자와 입사 열부하 및 여러 입자들로부터 블랑켓 및 내부 구조물을 보호하기 위해 차폐체와 구조물로 구성된다. 세계적으로 차폐체로서는 텅스텐 혹은 텅스텐 합금, 구조물용 재료로는 저방사화 Ferritic Martensitic (FM) 강이 유력한 후보재료로 개발, 연구 중에 있다. 국내에서는 국제핵융합로(ITER) 사업을 통해 고온등방가압(HIP, Hot Isostatic Pressing)을 이용한 이종금속간 접합기술과 한국형 저방사화 고온구조재료인 ARAA (Advanced Reduced Activation Alloy)가 개발되고 있으며, 이를 활용한 설계, 접합법 개발, 제작목업의 건전성 평가 등이 수행되고 있다. 한국원자력연구원에서는 핵융합 기초사업의 일환으로 전북대와 공동으로 수행 중인 건전성 평가체계 개발을 위해, 기 개발된 접합법을 활용한 $45mm(H){\times}45mm(W){\times}2mm(T)$의 W/FM강 목업을 제작한 바 있으며, 이를 국내 구축된 고열부하 시험 장비인 KoHLT-EB (Electron Beam)를 활용한 고열부하 인가 건전성 평가시험을 준비 중에 있다. 이종금속간 접합 특성은 기계적 평가를 위한 파괴시험을 통해 검증, 이를 활용한 목업이 제작되었으며, 제작된 목업에 대한 초음파를 이용한 접합면의 비파괴 검사를 통해 결함이 없음을 확인하였다. 최종적으로 실제 사용되는 핵융합 운전조건과 유사 혹은 가혹한 조건에서 고열부하를 인가하여, 그 건전성을 평가가 이루어질 것이다. 고열부하 시험을 위해서는 냉각조건, 인가 열부하, 수명평가를 통한 반복 고열부하 인가 횟수 등이 사전에 결정되어야 한다. 이를 위해 상업용 열수력, 구조해석 코드인 ANSYS-CFX와 -mechanical을 이용한 시험조건 모의 및 수명 평가가 수행되었다. 구축 장비의 냉각계통을 고려하여 냉각수의 온도 및 속도는 $25^{\circ}C$, 0.15 kg/sec로, 열부하는 0.5 및 $1.0MW/m^2$에 대해 모의를 수행하였다. 정상상태 시 텅스텐의 최대 온도는 각 열부하 조건에 따라 $285.3^{\circ}C$와 $546.8^{\circ}C$였으며, 이에 도달하는 시간을 구하기 위해 천이해석을 수행하였고, 이를 통해 30초에 최대온도 95 %이상의 정상상태 온도에 도달함을 확인하였다. 또한, 목업의 초기 온도에 도달하는 냉각시간도 동일한 천이해석을 통해 30초로 가능함을 확인하였고, 최종 시험 조건을 30초 가열, 30초 냉각으로 결정하였다. 결정된 반복 열부하 인가 조건에서 이종금속 접합체가 받는 다른 열팽창 정도에 따른 응력을 계산하여 목업의 수명을 도출하였고, 이를 시험해야 할 반복 횟수로 결정하였다. 각 열부하 조건에 따른 온도조건을 ANSYS-mechanical 코드를 활용하여 열팽창과 이에 따른 접합면의 응력분포로 계산하였다. 0.5 및 $1.0MW/m^2$에 대해, 목업이 받는 최대 응력은 334.3 MPa와 588.0 MPa 였으며, 이 때 텅스텐과 FM강이 받는 strain을 도출하여 물성치로 알려진 cycle to failure 값을 도출하였다. 열부하에서 예상되는 수명은 0.5 및 $1.0MW/m^2$에 대해, 100,000 사이클 이상과 2,655 사이클로 계산되었으며, 시간적 제약을 고려 최종 평가는 $1.0MW/m^2$에 대해, 3,000사이클 정도의 실험을 통해 그 수명까지 접합건전성이 유지되는 지 실험을 통해 평가할 예정이다.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1326-1331
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• 1997

Background : Weaning is the process of switching a patient from mechanical ventilator to spontaneous breathing. A number of different weaning techniques can be employed. At recent study, conventional spontaneous breathing trial was superior to other techniques, such as intermittent mandatory ventilation(IMV) or pressure support ventilation(PSV). But adequate observation time of the spontaneous breathing trial was not determined. We reported the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotrachial tube. In this study, we tried to shorten the spontaneous breathing time from 60 minutes to 30 minutes. If weaning success was predicted after 30 minutes spontaneous breathing, extubation was done without reconnection with ventilator. Methodes : Subjects consisted of 42 mechanically ventilated patients from August 1994 to July 1995. The weaning trial was done when the patients recovered sufficiently from respiratory failure that originally required ventilatory assistance, the patients became alert and showed stable vital sign, and arterial $O_2$ tension was adequated($PaO_2$ > 55 mmHg) with less than 40% of inspired oxygen fraction. We conducted a careful physical examination when the patients was breathing spontaneously through the endobronchial tube for 30 minutes. We terminated the trial if a patients was any of following signs of distress; cyanosis, diaphoresis, tachypnea(above 30 breaths per minute), and extreme tachycardia. Patients who had none of this features during spontaneous breathing for 30 minutes were extubated promptly. Result : 17 weaning trials of 15 patients were done in 42 mechanically ventilated patients. Successful weaning and extubation was possible in 14 trials of total 17 trials. In this 14 patients, 8 patients were extubated after 30 minutes spontaneous breathing, 3 patients were extubated after 60 minutes spontaneous breathing, and 3 patients needed over 3 hours for extubation from weaning. We found similar overall success rate compared with weaning following a 60 minutes spontaneous breathing trial. Conclusion : From the result of present study, we believe that weaning and extubation from mechanical ventilation following a 30 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.71-79
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• 2003

Background : A bronchoalveolar lavage(BAL) is useful in diagnosing the etiology of bilateral pulmonary infiltrations, but may worsen the oxygenation and clinical status in severely hypoxemic patients. This study assessed the safety and efficacy of the continuous positive airway pressure(CPAP) using a conventional mechanical ventilator via a face mask as a tool for maintaining the oxygenation level during BAL. Methods : Seven consecutive patients with the bilateral pulmonary infiltrates and severe hypoxemia ($PaO_2/FIO_2$ ratio ${\leq}200$ on oxygen 10 L/min via mask with reservoir bag) were enrolled. The CPAP 5-6 $cmH_2O(F_IO_2\;1.0)$ was delivered through an inflatable face mask using a conventional mechanical ventilator. The CPAP began 10 min before starting the BAL and continued for 30 min after the procedure was completed. A bronchoscope was passed through a T-adapter and advanced through the mouth. BAL was performed using the conventional method. The vital signs, pulse oxymetry values, and arterial blood gases were monitored during the study. Results : (1) Median age was 56 years(male:female=4:3). (2) The baseline $PaO_2$ was $78{\pm}16mmHg$, which increased significantly to $269{\pm}116mmHg$(p=0.018) with CPAP. After the BAL, the $PaO_2$ did not decrease significantly but returned to the baseline level after the CPAP was discontinued. The $SpO_2$ showed a similar trend with the $PaO_2$ and did not decrease to below 90 % during the duration of the study. (3) The $PaCO_2$ increased and the pH decreased significantly after the BAL but returned to the baseline level within 30 min after the BAL. (5) No complications directly related to the BAL procedure were encountered. However, intubation was necessary in 3 patients(43 %) due to the progression of the underlying diseases. Conclusion : In severe hypoxemic patients, CPAP using a face mask and conventional mechanical ventilator during a BAL might allow minimal alterations in oxygenation and prevent subsequent respiratory failure.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.354-358
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• 2006

Background: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of $T-PLS^{TM}$ through the comparison of clinical effects of $T-PLS^{TM}$ (pulsatile pump) and $Bio-pump^{TM}$ (non-pulsatile pump) used for coronary bypass surgery. Material and Method: The comparison was made on 40 patients who had coronary bypass using $T-PLS^{TM}\;and\;Bio-pump^{TM}$ (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. Result: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with $T-PLS^{TM}\;(46{\pm}15\;mmHg\;in\;T-PLS^{TM}\;vs\;35{\pm}13\;mmHg\;in\;Bio-pump^{TM},\;p<0.05)$. The $T-PLS^{TM}$-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant $(9.7{\pm}3.9\;cc/min\;in\;T-PLS^{TM}\;vs\;8.9{\pm}3.6\;cc/min\;in\;Bio-pump^{TM},\;p=0.20)$. There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with $T-PLS^{TM}\;(24.5{\pm}21.7\;mg/dL\;in\;T-PLS^{TM}\;versus\;46.8{\pm}23.0mg/dL\;in\;Bio-pump^{TM},\;p<0.05)$. There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with $T-PLS^{TM}$, but the death rate was not statistically significant. Conclusion: Coronary bypass was operated with $T-PLS^{TM}$ (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which $Bio-pump^{TM}$ was used. In addition, $T-PLS^{TM}$ used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of $T-PLS^{TM}$.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.27-34
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• 2004

Background: Infective endocarditis shows higher operative morbidity and mortality rates than other cardiac diseases. The vast majority of studies on infective endocarditis have been made on aortic endocarditis, with little attention having been paid to infective endocarditis on the mitral valve. This study attempts to investigate the clinical aspects and operative results of infective endocarditis on the mitral valve. Meterial and Method: The subjects of this study consist of 23 patients who underwent operations for infective endocariditis on the mitral valve from June 1995 to May 2003. Among them, 2 patients suffered from prosthetic valvular endocarditis and the other 21 from native valvular endocarditis. The subjects were evenly distributed age-wise with an average age of 44.8$\pm$15.7 (11∼66) years. Emergency operations were performed on seventeen patients (73.9%) due to large vegetation or instable hemodynamic status. In preoperative examinations, twelve patients exhibited congestive heart failure, four patients renal failure, two patients spleen and renal infarction, and two patients temporary neurological defects, while one patient had a brain abscess. Based on the NYHA functional classification, seven patients were determined to be at Grade II, 9 patients at Grade III, and 6 patients at Grade IV. Vegetations were detected in 20 patients while mitral regurgitation was dominant in 19 patients with 4 patients showing up as mitral stenosis dominant on the preoperative echocardiogram. Blood cultures for causative organisms were performed on all patients, and positive results were obtained from ten patients, with five cases of Streptococcus viridance, two cases of methicillin-sensitive Staphylococcus aureus, and one case each of Corynebacteriurn, Haemophillis, and Gernella. Operations were decided according to the AA/AHA guidelines (1988). The mean follow-up period was 27.6 $\pm$23.3 (1 ∼ 97) months. Result: Mitral valve replacements were performed on 43 patients, with mechanical valves being used on 9 patients and tissue valves on the other 4. Several kinds of mitral valve repair or mitral valvuloplasty were carried out on the remaining 10 patients. Associated procedures included six aortic valve replacements, two tricuspid annuloplasty, one modified Maze operation, and one direct closure of a ventricular septal defect. Postoperative complications included two cases of bleeding and one case each of mediastinitis, low cardiac output syndrome, and pneumonia. There were no cases of early deaths, or death within 30 days following the operation. No patient died in the hospital or experienced valve related complications. One patient, however, underwent mitral valvuloplasty 3 months after the operation. Another patient died from intra-cranial hemorrhage in the 31st month after the operation. Therefore, the valve-related death rate was 4.3%, and the valve-related complication rate 8.6% on mid-term follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, 3-, and 5-year survival rates were 100%, 88.8%, and 88.8%, respectively. Conclusion: The findings suggest that a complete removal of infected tissues is essential in the operative treatment of infectious endocarditis of the mitral valve. It is also suggested that when infected tissues are completely removed, neither type of material nor method of operation has a significant effect on the operation result. The postoperative results also suggest the need for a close follow-up observation of the patients suspected of having brain damage, which is caused by preoperative blood contamination or emboli from vegetation, for a possible cerebral vascular injury such as mycotic aneurysm.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.201-209
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• 1996

Background : Auto-PEEP which develops when expiratory lung emptying is not finished until the beginning of next inspiration is frequently found in patients on mechanical ventilation. Its presence imposes increased risk of barotrauma and hypotension, as well as increased work of breathing (WOB) by adding inspiratory threshold load and/or adversely affecting to inspiratory trigger sensitivity. The aim of this study is to evaluate the relationship of auto-PEEP with WOB and to evaluate the effect of PEEP applied by ventilator (external PEEP) on WOB in patients with auto-PEEP. Method : 15 patients, who required mechanical ventilation for management of acute respiratory failure, were studied. First, the differences in WOB and other indices of respiratory mechanics were examined between 7 patients with auto-PEEP and 8 patients without auto-PEEP. Then, we applied the 3 cm $H_2O$ of external PEEP to patients with auto-PEEP and evaluated its effects on lung mechanics as well as WOB. Indices of respiratory mechanics including tidal volume ($V_T$), repiratory rate, minute ventilation ($V_E$), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), peak inspiratory pressure (PIP), $T_I/T_{TOT}$, auto-PEEP, dynamic compliance of lung (Cdyn), expiratory airway resistance (RAWe), mean airway resistance (RAWm), $p_{0.1}$, work of breathing performed by patient (WOB), and pressure-time product (PTP) were obtained by CP-100 Pulmonary Monitor (Bicore, USA). The values were expressed as mean $\pm$ SEM (standard error of mean). Results : 1) Comparison of WOB and other indices of respiratory mechanics in patients with and without auto-PEEP : There was significant increase in WOB ($l.71{\pm}0.24$ vs $0.50{\pm}0.19\;J/L$, p=0.007), PTP ($317{\pm}70$ vs $98{\pm}36\;cm$ $H_2O{\cdot}sec/min$, p=0.023), RAWe ($35.6{\pm}5.7$ vs $18.2{\pm}2.3\;cm$ H2O/L/sec, p=0.023), RAWm ($28.8{\pm}2.5$ vs $11.9{\pm}2.0cm$ H2O/L/sec, p=0.001) and $P_{0.1}$ ($6.2{\pm}1.0$ vs 2.9+0.6 cm H2O, p=0.021) in patients with auto-PEEP compared to patients without auto-PEEP. The differences of other indices including $V_T$, PEFR, $V_E$ and $T_I/T_{TOT}$ showed no significance. 2) Effect of 3 cm $H_2O$ external PEEP on respiratory mechanics in patients with auto-PEEP : When 3 cm $H_2O$ of external PEEP was applied, there were significant decrease in WOB ($1.71{\pm}0.24$ vs $1.20{\pm}0.21\;J/L$, p=0.021) and PTP ($317{\pm}70$ vs $231{\pm}55\;cm$ $H_2O{\cdot}sec/min$, p=0.038). RAWm showed a tendency to decrease ($28.8{\pm}2.5$ vs $23.9{\pm}2.1\;cm$ $H_2O$, p=0.051). But PIP was increased with application of 3 cm $H_2O$ of external PEEP ($16{\pm}2$ vs $22{\pm}3\;cm$ $H_2O$, p=0.008). $V_T$, $V_E$, PEFR, $T_I/T_{TOT}$ and Cdyn did not change significantly. Conclusion : The presence of auto-PEEP in mechanically ventilated patients was accompanied with increased WOB performed by patient, and this WOB was decreased by 3 cm $H_2O$ of externally applied PEEP. But, with 3 cm $H_2O$ of external PEEP, increased PIP was noted, implying the importance of close monitoring of the airway pressure during application of external PEEP.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.383-390
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• 2008

Purpose : This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis. Methods : The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records. Results : The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%. Conclusion : The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.695-702
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• 2008

Background: The choice between a bioprosthetic and a mechanical valve is an important decision in cardiac valve surgery, and the durability of the tissue valve is a major decision factor. We retrospectively evaluated the midterm results of bioprosthetic valve replacement in the mitral position. Material and Method: The subjects were all patients who had undergone mitral bioprosthesis replacement between July 1989 and August 200.7. Among the 216 patients, there were 236 surgical cases. The mean age was $63{\pm}15$ years, and the male to female ratio was 1 : 3. We retrospectively analyzed hospital and outpatient records such that the total follow-up duration amounted to 760.2 patient-years, and the mean follow-up duration was $41.9{\pm}40.7$ months (range $0{\sim}212$ months). Result: Early death occurred in 18 patients (8.3%), and 13 of these underwent concomitant cardiac procedures. The survival rate after 5 years was $79.9{\pm}3.5%$, and the survival rate after 8 years was $65.5{\pm}5.5%$, while freedom from structural valve deterioration (SVD) was $96.2{\pm}2.2%$ at 5 years and $85.9{\pm}5.3%$ at 8 years. Freedom from reoperation was $90.6{\pm}1.7%$ at 5 years and $90.4{\pm}4.2%$ at 8 years, while freedom from reoperation for SVD was $98.1{\pm}1.2%$ at 5 years and $92.3{\pm}4.1%$ at 8 years. On multivariate analysis of preoperative risk factors, small valve size (between 25mm and 27mm) was a significant risk factor for reoperation, and low LV ejection fraction (<40%) was a significant risk factor for SVD and mortality. Conclusion: Survival and freedom from reoperation for SVD in mitral bioprosthesis replacement had acceptable midterm results, but freedom from SVD Was relatively low. In particular, since SVD increased sharply at the eighth postoperative year, frequent follow-up and echocardiograms around that time will be helpful for the early detection of SVD. It will be necessary to conduct further studies involving long-term follow-up and more patients.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.1
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• pp.29-38
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• 2009

Statement of problem: A casting connection technique is widely used for repair, correction and addition to base metal framework. However, a casting connection technique may increase the risk of failure in clinical situations when high stresses exist. Purpose: The purpose of this study was to investigate the mechanical retentive groove design comparatively to increase the joint strength by using the three-dimensional finite element analysis model of a 3-unit fixed partial denture. Material and methods: Ten finite element models were constructed. (Model A: One retentive groove, Model B: Two retentive grooves, Model C: Three retentive grooves, Model D: Four retentive grooves, Model E: One horizontal groove and two vertical grooves, Model F: Two horizontal grooves and one vertical groove, Model G: One groove with the enlarged dimension, Model H: Two grooves with the enlarged dimension, Model I: One groove with the increased height, Model J: One groove with the increased width of base). The vertical force was applied to the mesial and the distal fossa to the casting connection of mandibular first molar. Results: The main factors, affecting joint strength of casting connection were both the retention between the primary cast and the secondary cast and the thickness of the primary cast remaining after preparing retentive groove. The increase of retentive force, according to the numbers and the dimension of retentive groove had an effect on distributing stress. However, in some cases, the increase of retentive force resulted in the increase of stress by reducing thickness of the primary cast in the connection area. Conclusion: The design of retentive groove that limits number of retentive groove for metal thickness and increases the depth of retentive groove for retention is highly recommended.

• Journal of Korea Soil Environment Society
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• v.2 no.2
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• pp.81-94
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• 1997

In many solute transport studies, either flux or resident concentration has been used. Choice of the concentration mode was dependent on the monitoring device in solute displacement experiments. It has been accepted that no priority exists in the selection of concentration mode in the study of solute transport. It would be questionable, however, to accept the equivalency in the solute transport parameters between flux and resident concentrations in structured soils exhibiting preferential movement of solute. In this study, we investigate how they differ in the monitored breakthrough curves (BTCs) and transport parameters for a given boundary and flow condition by performing solute displacement experiments on a number of undisturbed soil columns. Both flux and resident concentrations have been simultaneously obtained by monitoring the effluent and resistance of the horizontally-positioned TDR probes. Two different solute transport models namely, convection-dispersion equation (CDE) and convective lognormal transfer function (CLT) models, were fitted to the observed breakthrough data in order to quantify the difference between two concentration modes. The study reveals that soil columns having relatively high flux densities exhibited great differences in the degree of peak concentration and travel time of peak between flux and resident concentrations. The peak concentration in flux mode was several times higher than that in resident one. Accordingly, the estimated parameters of flux mode differed greatly from those of resident mode and the difference was more pronounced in CDE than CLT model. Especially in CDE model, the parameters of flux mode were much higher than those of resident mode. This was mainly due to the bypassing of solute through soil macropores and failure of the equilibrium CDE model to adequate description of solute transport in studied soils. In the domain of the relationship between the ratio of hydrodynamic dispersion to molecular diffusion and the peclet number, both concentrations fall on a zone of predominant mechanical dispersion. However, it appears that more molecular diffusion contributes to the solute spreading in the matrix region than the macropore region due to the nonliearity present in the pore water velocity and dispersion coefficient relationship.