• Journal of Biomedical Engineering Research
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• v.31 no.3
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• pp.199-209
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• 2010

The locking compression plates-distal femur(LCP-DF) are being widely used for surgical management of the extra-articular complex fractures of the distal femur. They feature locking mechanism between the screws and the screw holes of the plate to provide stronger fixation force with less number of screws than conventional compression bone plate. However, their biomechanical efficacies are not fully understood, especially regarding the number of the screws inserted and their optimal configurations. In this study, we investigated effects of various screw configurations in the shaft and the condylar regions of the femur in relation to structural stability of LCP-DF system. For this purpose, a baseline 3-D finite element (FE) model of the femur was constructed from CT-scan images of a normal healthy male and was validated. The extra-articular complex fracture of the distal femur was made with a 4-cm defect. Surgical reduction with LCP-DF and bone screws were added laterally. To simulate various cases of post-op screw configurations, screws were inserted in the shaft (3~5 screws) and the condylar (4~6 screws) regions. Particular attention was paid at the shaft region where screws were inserted either in clustered or evenly-spaced fashion. Tied-contact conditions were assigned at the bone screws-plate whereas general contact condition was assumed at the interfaces between LCP-DF and bone screws. Axial compressive load of 1,610N(2.3 BW) was applied on the femoral head to reflect joint reaction force. An average of 5% increase in stiffness was found with increase in screw numbers (from 4 to 6) in the condylar region, as compared to negligible increase (less than 1%) at the shaft regardless of the number of screws inserted or its distribution, whether clustered or evenly-spaced. At the condylar region, screw insertion at the holes near the fracture interface and posterior locations contributed greater increase in stiffness (9~13%) than any other locations. Our results suggested that the screw insertion at the condylar region can be more effective than at the shaft during surgical treatment of fracture of the distal femur with LCP-DF. In addition, screw insertion at the holes close to the fracture interface should be accompanied to ensure better fracture healing.

• Journal of Chest Surgery
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• v.51 no.4
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• pp.247-253
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• 2018

Background: Early extubation after cardiovascular surgery has some clinical advantages, including reduced hospitalization costs. Herein, we review the results of ultra-fast-track (UFT) extubation, which refers to extubation performed on the operating table just after the operation, or within 1-2 hours after surgery, in patients with congenital cardiac disease. Methods: We performed UFT extubation in patients (n=72) with a relatively simple congenital cardiac defect or who underwent a simple operation starting in September 2016. To evaluate the feasibility and effectiveness of our recently introduced UFT extubation strategy, we retrospectively reviewed 195 patients who underwent similar operations for similar diseases from September 2015 to September 2017, including the 1-year periods immediately before and after the introduction of the UFT extubation protocol. Propensity scores were used to assess the effects of UFT extubation on length of stay (LOS) in the intensive care unit (ICU), hospital LOS, and medical costs. Results: After propensity-score matching using logistic regression analysis, 47 patients were matched in each group. The mean ICU LOS ($16.3{\pm}28.6$ [UFT] vs. $28.0{\pm}16.8$ [non-UFT] hours, p=0.018) was significantly shorter in the UFT group. The total medical costs ($182.6{\pm}3.5$ [UFT] vs. $187.1{\pm}55.6$ [non-UFT] ${\times}100,000$ Korean won [KRW], p=0.639) and hospital stay expenses ($48.3{\pm}13.6$ [UFT] vs. $54.8{\pm}29.0$ [non-UFT] ${\times}100,000KRW$, p=0.164) did not significantly differ between the groups. Conclusion: UFT extubation decreased the ICU LOS and mechanical ventilation time, but was not associated with postoperative hospital LOS or medical expenses in patients with simple congenital cardiac disease.

• Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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• 2010.06a
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• pp.11-11
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• 2010

Thin-film-transistors (TFTs) that can be deposited at low temperature have recently attracted lots of applications such as sensors, solar cell and displays, because of the great flexible electronics and transparent. Transparent and flexible transistors are being required that high mobility and large-area uniformity at low temperature [1]. But, unfortunately most of TFT structures are used to be $SiO_2$ as gate dielectric layer. The $SiO_2$ has disadvantaged that it is required to high driving voltage to achieve the same operating efficiency compared with other high-k materials and its thickness is thicker than high-k materials [2]. To solve this problem, we find lots of high-k materials as $HfO_2$, $ZrO_2$, $SiN_x$, $TiO_2$, $Al_2O_3$. Among the High-k materials, $Al_2O_3$ is one of the outstanding materials due to its properties are high dielectric constant ( ~9 ), relatively low leakage current, wide bandgap ( 8.7 eV ) and good device stability. For the realization of flexible displays, all processes should be performed at very low temperatures, but low temperature $Al_2O_3$ grown by sputtering showed deteriorated electrical performance. Further decrease in growth temperature induces a high density of charge traps in the gate oxide/channel. This study investigated the effect of growth temperatures of ALD grown $Al_2O_3$ layers on the TFT device performance. The ALD deposition showed high conformal and defect-free dielectric layers at low temperature compared with other deposition equipments [2]. After ITO was wet-chemically etched with HCl : $HNO_3$ = 3:1, $Al_2O_3$ layer was deposited by ALD at various growth temperatures or lift-off process. Amorphous InGaZnO channel layers were deposited by rf magnetron sputtering at a working pressure of 3 mTorr and $O_2$/Ar (1/29 sccm). The electrodes were formed with electron-beam evaporated Ti (30 nm) and Au (70 nm) bilayer. The TFT devices were heat-treated in a furnace at $300^{\circ}C$ and nitrogen atmosphere for 1 hour by rapid thermal treatment. The electrical properties of the oxide TFTs were measured using semiconductor parameter analyzer (4145B), and LCR meter.

• Neonatal Medicine
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• v.17 no.2
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• pp.254-261
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• 2010

Little is known about neonatal mitochondrial disease, though mitochondrial metabolic disorders may often present in the neonatal period because of the high energy requirement of neonate. In newborn period, common presentations are not specific and the disease course may be rapid and fatal. In this study, we report three cases of neonatal mitochondrial disease. The first case was strongly suspected because of sudden seizure and mental change with severe lactic acidosis, and multiorgan failure. Plasma lactate/pyruvate (L/P) ratio was increased to 55.6 with marked lactic aciduria and increased plasma alanin up to 2,237 nmol/mL. In the second patient, a peritoneal dialysis was performed for acute adrenal and renal failure, but metabolic acidosis persisted. Plasma L/P ratio was increased to 23.9, and MRC I (mitochondrial respiratory chain defect) was diagnosed through the enzymatic analysis of the muscles. The third case showed repetitive episode of lactic acidosis during the first two months of life, hypotonia, failure to thrive and feeding difficulties. We found markedly increased cerebrospinal fluid L/P ratio up to 57 though plasma L/P ratio(19.4) was borderline with increased plasma lactate. The lactate peak was prominent in brain magnetic resonance spectroscopy (MRS). MRC II was confirmed through muscle biopsy. Plasma lactate level and lactate peak of brain MRS were normalized after conservative treatment.

• Journal of Gastric Cancer
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• v.3 no.4
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• pp.186-190
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• 2003

Purpose: The balance between cell proliferation and apoptosis is crucial for homeostatic maintenance in a cell population. Decreased apoptosis or uncontrolled proliferation can lead to cancer. The Fas receptor signal through a cytoplasmic death domain is very important in the apoptotic pathway. To identify the effect of the death domain of the Fas gene in the development and/or progression of gastric cancer, we examined the apoptotic potential of five known Fas mutants detected in gastric cancers. Materials and Methods: A wild-type Fas gene was cloned with cDNA from normal liver tissue and full length Fas was sequenced. Mutants of the gene were generated with sitedirected mutagenesis by using the wild-type gene and specific primers. Wild- and mutant-type genes were transfected to HEK293 cells. Forty-eight hours after transfection the cells were stained with DAPI and cell death was counted under fluorescent microscopy. Results: In wild-type Fas-transfected cells, the percentage of apoptotic cells was $85.9\pm3.6\%$, and significant cell death and classic morphologic signs of apoptosis were observed. However, the percentages of apoptotic cells transfected with N239D, E240G, D244V, and R263H of tumor-derived mutant Fas were $29.5\pm2.08\%,\;28.5\pm3.34\%,\;25.225\pm2.06\%,\;and\;36.625\pm4.49\%$, respectively. Conclusion: These results suggest that inactivation of Fas caused by mutations in the death domain of the Fas gene may be one of the possible escape mechanisms against Fas-mediated apoptosis and that inactivating mutation of the Fas may contribute to the development or progression of gastric cancers.

• Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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• 2003.07a
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• pp.352-356
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• 2003

A stoichiometric mixture of evaporating materials for $CuGaSe_2$ single crystal am films was prepared from horizontal electric furnace. Using extrapolation method of X-ray diffraction patterns for the polycrystal $CuGaSe_2$, it was found tetragonal structure whose lattice constant $a_0$ and $c_0$ were $5.615\;{\AA}\;and\;11.025\;{\AA}$, respectively. To obtain the single crystal thin films, $CuGaSe_2$ mixed crystal was deposited on thoroughly etched semi-insulating GaAs(100) substrate by the hot wall epitaxy (HWE) system. The source and substrate temperatures were $610^{\circ}C$ and $450^{\circ}C$, respectively, The crystalline structure of the single crystal thin films was investigated by the photoluminescence and double crystal X-ray diffraction (DCXD). The carrier density and mobility of $CuGaSe_2$ single crystal thin films measured with Hall effect by van der Pauw method are $9.24{\times}10^{16}\;cm^{-3}$ and $295\;cm^2/V{\cdot}s$ at 293 K, respectively. The temperature dependence of the energy band gap of the $CuGaSe_2$ obtained from the absorption spectra was well described by the Varshni's relation, $E_g(T)\;:\;1.7998\;eV\;-\;(8.7489\;{\times}\;10^{-4}\;eV/K)T^2(T\;+\;335\;K)$. After the as-grown $CuGaSe_2$ single crystal thin films was annealed in Cu-, Se-, and Ga-atmospheres, the origin of point defects of $CuGaSe_2$ single crystal thin films has been investigated by the photoluminescence(PL) at 10 K. The native defects of $V_{CU}$, $V_{Se}$, $CU_{int}$, and $Se_{int}$, obtained by PL measurements were classified as a donors or accepters type. And we concluded that the heat-treatment in the Cu-atmosphere converted $CuGaSe_2$ single crystal thin films to an optical n-type. Also, we confirmed that Ga in $CuGaSe_2/GaAs$ did not form the native defects because Ga in $CuGaSe_2$ single crystal thin films existed in the form of stable bonds.

• Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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• 2005.11a
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• pp.111-112
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• 2005

To obtain the single crystal thin films, $CuInSe_2$, mixed crystal was deposited on thoroughly etched semi-insulating GaAs(100) substrate by the hot wail epitaxy (HWE) system. The source and substrate temperatures were 620$^{\circ}C$ and 410$^{\circ}C$, respectively. The crystalline structure of the single crystal thin films was investigated by the photoluminescence and double crystal X-ray diffraction (DCXD). The carrier density and mobilily of $CuInSe_2$ single crystal thin films measured with Hall effect by van der Pauw method are $9.62\times10^{16}$ $cm^{-3}$ and $296cm^2/V{\cdot}s$ at 293 K, respectively. The temperature dependence of the energy band gap of the CulnSe$_2$ obtained from the absorption spectra was well described by the Varshni's relation E$_g$(T) = 1.1851 eV - ($8.99\times10^{-4}$ ev/K)T$_2$/(T + 153K). After the as-grown $CuInSe_2$ single crystal thin films was annealed in Cu-, Se-, and In-atmospheres the origin of point defects of $CuInSe_2$ single crystal thin films has been investigated by the photoluminescence(PL) at 10 K. The nat ive defects of V$_{Cu}$, $V_{Se}$, Cu$_{int}$, and $Se_{int}$ obtained by PL measurements were classified as a donors or accepters type. And we concluded that the heat-treatment in the Cu-atmosphere converted $CuInSe_2$ single crystal thin films to an optical n-type. Also, we confirmed that In in $CuInSe_2$/GaAs did not form the native defects because In in $CuInSe_2$ single crystal thin films existed in the form of stable bonds.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.220-224
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• 1989

In candidates for aortic valve replacement [AVR]it is our primary intention to implant the largest possible vale prosthesis of at least 23 mm in diameter in patients with severe valvular aortic stenosis. However, in many patients there is an additional subvalvular asymmetric septal hypertrophy which in some cases may cause an postextrasystolic increase of the LV-aortic gradient. Another component of the aortic stenosis syndrome is a narrow valvular ring, or a combination of both. After complete removal of the diseased valve and decalcification the narrow aortic ring [< 23 mm] can be widened firstly by transaortic subvalvular septal myectomy- [TSM] thus unfolding the left ventricular outflow tract[LVOT]and secondly by extending the oblique aortic incision into the aortic valve ring or further down into the anterior leaflet of the mitral valve. The sub-and supra-valvular defect will be closed by patch enlargement of the aortic root [PEAR] using autologous pericardium. These techniques allow a considerable enlargement of the valvular ring of about 4 to 10 mm in circumference. In a retrospective study using a computerized program, 847 patients with AVR [1980-1984]were reviewed to evaluate the intraoperative hemodynamic results mainly concerning relief of the transvalvular gradient. In 626 patients AVR was performed, 151 patients had double valve replacement [AVR+MVR], and 70 patients had AVR plus additional surgical procedures. Concentrating on the AVR-group [n=626] there were 103 patients with TSM, 24 patients with PEAR and 20 patients with TSM+PEAR which demonstrated that in a total, of 147 patients of this groups [23.5%] an additional procedure was necessary. The Statistical evaluation of the intraoperative pressure measurements before and after AVR in relation to the size of the implanted prostheses indicated the lowest preoperative mean gradient in patients with AVR alone, the highest in patients who afforded TSM plus PEAR. However, after AVR the mean gradients in all three groups were very low [mean 5 to 10 mmHg]. These data indicate that in patients with a narrow aortic ring and additional considerable ASH, TSM and PEAR are suitable techniques to enlarge the aortic root to enable the implantation of an adequate aortic valve prosthesis. Long-term controls have shown that autologous pericardium is a qualified graft material for the ascending aorta.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.25-32
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• 2010

Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

• Proceedings of the Korean Vacuum Society Conference
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• 2011.08a
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• pp.148-148
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• 2011

Recently, there have been many research activities to develop the large-area plasma source, which is able to generate the high-density plasma with relatively good uniformity, for the plasma processing in the thin-film solar cell and display panel industries. The large-area CCP sources have been applied to the PECVD process as well as the etching. Especially, the PECVD processes for the depositions of various films such as a-Si:H, ${\mu}c$-Si:H, Si3N4, and SiO2 take a significant portion of processes. In order to achieve higher deposition rate (DR), good uniformity in large-area reactor, and good film quality (low defect density, high film strength, etc.), the application of VHF (>40 MHz) CCP is indispensible. However, the electromagnetic wave effect in the VHF CCP becomes an issue to resolve for the achievement of good uniformity of plasma and film. Here, we propose a new electrode as part of a method to resolve the standing wave effect in the large-area VHF CCP. The electrode is split up a series of strip-type electrodes and the strip-type electrodes and the ground ones are arranged by turns. The standing wave effect in the longitudinal direction of the strip-type electrode is reduced by using the multi-feeding method of VHF power and the uniformity in the transverse direction of the electrodes is achieved by controlling the gas flow and the gap length between the powered electrodes and the substrate. Also, we provide the process results for the growths of the a-Si:H and the ${\mu}c$-Si:H films. The high DR (2.4 nm/s for a-Si:H film and 1.5 nm/s for the ${\mu}c$-Si:H film), the controllable crystallinity (~70%) for the ${\mu}c$-Si:H film, and the relatively good uniformity (1% for a-Si:H film and 7% for the ${\mu}c$-Si:H film) can be obtained at the high frequency of 40 MHz in the large-area discharge (280 mm${\times}$540 mm). Finally, we will discuss the issues in expanding the multi-electrode to the 8G class large-area plasma processing (2.2 m${\times}$2.4 m) and in improving the process efficiency.