• Journal of Advanced Marine Engineering and Technology
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• v.32 no.6
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• pp.877-885
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• 2008

Steam injection heater is the most widely used method for fresh water generator throughout industry. This method is often chosen because of its simplicity. The steam bubbles condense and give up their heat to the surrounding liquid. Experimental study on steam injection heater has been performed in order to find the effect of major parameter. And conservation equation and Bernoulli obstruction theory are used for numerical simulation model of vapor flow-rate. Qualitative comparisons between simulations and measurements show a good agreement and the simulation models are thereby verified.

• Journal of Gastric Cancer
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• v.8 no.3
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• pp.148-153
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• 2008

Purpose: Malignant bowel obstruction caused by recurrent gastric cancer must be treated appropriately to improve the effects of treatment and to prolong survival. We reviewed the surgical treatments for malignant bowel obstruction caused by recurrent gastric cancer. Materials and Methods: The subjects were patients with malignant bowel obstruction caused by recurrent gastric cancer and these patients were treated by surgical procedures at our hospital from 1998 to 2008. The patients were treated by resection, ostomy or bypass. The success of treatment was decided when the patients were able to tolerate more than a liquid diet. Results: 42 patients were treated 46 times by surgical procedures. Resection was done12 times, ostomy was done 24 times and bypass was done 10 times. The hospital stay and the period to liquid diet after the operation were shorter in the ostomy group. The post operative morbidity rate was 21.7% and the post operative death rate was 8.7%. There was no significant difference in survival according to the type of surgery. Conclusion: Ostomy is good choice for selected patients because it has a shorter hospital stay and period to liquid diet. There was no significant difference in survival according to the type of surgery because curative resection is difficult to perform in patients with malignant bowel obstruction.

• Investigative and Clinical Urology
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• v.59 no.6
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• pp.376-382
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• 2018

Purpose: The authors performed this study to investigate the risk factors for predicting stent failure and to evaluate its impact on prognosis. Materials and Methods: Between January 2002 and March 2017, we retrospectively reviewed 117 consecutive patients who underwent retrograde ureteral stenting and exchanging at least once every 3 months for malignant ureteral obstruction. The patients were classified according to their pre-stenting chronic kidney disease (CKD) stage. The factors affecting stent failure were analyzed using a logistic regression model. Overall survival (OS) was estimated, and the prognostic significance of each variable was estimated using Cox proportional-hazards regression modeling. Results: Before stenting, 91 patients were CKD stages 1-3 and 26 patients were CKD stages 4-5. These two groups differed significantly only in pre-stenting estimated glomerular filtration rate (eGFR), bilateral obstruction, and pre-stenting pyuria. Among the 117 patients, stent failure occurred in 30 patients (25.6%), and there were no differences between the groups. Pre-stenting pyuria and post-stenting complications were significant predictors of stent failure. There were 79 deaths in total, including 56 in the CKD stages 1-3 group and 23 in the CKD stages 4-5 group. In the multivariate analysis predicting patient OS, pre-stenting eGFR and post-stenting disease progression were significant factors. Conclusions: Internal ureteral stenting was effective for maintaining renal function in malignant ureteral obstruction. However, it did not restore renal function, which is related to the prognosis of the patients. Therefore, to improve patients' renal function and prognosis, patients who require stenting must be quickly recognized and treated.

• Journal of Chest Surgery
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• v.26 no.8
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• pp.595-603
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• 1993

We analysed 60 consecutive patients who got Senning operation for transposition of the great arteries [TGA] with or without ventricular septal defects [VSD]. There were 41 simple TGA [group I] and 19 TGA with VSD [Group II], the operative mortality was 20 % [in group I 4.9 %, group II 52.6 %]. Among the survivors [n=48], the mean follow-up period was 7 years [range, 1 year to 13.5 years] and the actuarial survival rate at 13 years were 95 % in group I and 42 % in group II. Preoperative high left ventricular pressure and high pulmonary arterial pressure affected the surviving [p<0.01]. There occurred various type of arrhythmia like junctional rhythm, first degree atrioventricular [AV] block, sick sinus syndrome and complete AV block, and we inserted 2 permanent pacemakers for these patients. The incidence of arrhythmia were 28.2 % [11/39] in group I and 55.6 % [5/9] in group II, and the actuarial freedom from arrhythmia at 13 years after operation was 66 % [71 % in group I, 44 % in group II]. Increased aortic cross clamping time had affected the development of arrhythmia [p<0.05] which meant the complexity of the operation. The total incidence of left ventricular outflow tract obstruction [LVOTO] was 31.3 % [15/48], but only 3 patients [6.25 %] showed the significant gradient requiring reoperation. The pulmonary venous pathway obstruction [PVO] were found in 3 patients, all in group I, and among them only one required the reoperation. The estimated freedom from PVO was 89 % at 13 years [87 % in group I, 100 % in group II], but we couldn`t find any significant systemic venous obstruction in our series. There occurred 27.1 % [13/48] mild degree tricuspid valve regurgitation without necessary surgical correction. We experienced 14.6 % [7/48] reoperation rate: 3 residual VSD, 3 LVOTO, 1 PVO, 3 atrial baffle leakage. For this high incidence of complication rate after Senning operation and high mortality in TGA with VSD, We do not use this kind of surgical modality any more and do the Jatene operation for all the TGA patients since several years ago.

• Advances in pediatric surgery
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• v.1 no.1
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• pp.27-32
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• 1995

Jejunal and ileal atresias are the most common cause of congenital intestinal obstruction and accounts for about 1/3 of all cases of intestinal obstruction in newborns. Despite the relative frequency of this anomaly, its survival rate was less than 10% up to 1950, more recently the survival rate has risen rapidly to 90% with the introduction of modern surgical techniques and the use of total parenteral nutrition. In 1969 Thomas described a tapering jejunoplasty to manage the discrepancy in the size of the proximal dilated lumen & contracted distal lumen, and to preserve absorptive surface when the dilated jejunum involved a long length, and Grosfeld et al.(1979) facilitated this method by using GIA staplers. Author have also used GIA stapler to resect the antimesenteric portion of the dilated proximal bowel in 8 cases of jejunoileal atresias with good results. The following results were obtained ; 1. There we 3 jejunal atresias & 5 ileal atresias, and male to female sex ratio was 5 : 3. 2. The type of atresia was as follows ; type IIIa was 3 cases, type IIIb was 4 cases, type IIIb+IV was 1 case. 3. In non-complication cases(5 cases), the mean hospital day was 16 days, and oral feeding was feasible from 6.2 days after operation. 4. The complications(anastomotic leakage, pneumonia) were frequently occurred in type IIIb cases and in low birth weight cases(75%). 5. Mortality rate was 25% including DAMA(discharge against medical advice) discharge case.

• Radiation Oncology Journal
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• v.14 no.2
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• pp.123-128
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• 1996

Purpose : This is a retrospective study to compare the Palliation rates, survival rates and complications of low dose rate and high dose rate endobronchial brachytherapy in the management of malignant airway obstruction. Materials and methods : Forty three consecutive patients with malignant airway compromise from primary or metastatic lung tumors were treated with low dose rate(LDR) endobronchial Iridium-192 insertion(21 patients) between October 1988 and June 1992, and high dose rate(HDR) endobronchial brachytherapy(22 patients) between August 1992 and April 1994 with palliative aim Flexible fiberoptic bronchoscopy under fluoroscopic control was utilized in all 91 procedures. Twenty seven LDR Procedures delivered a dose of 5-7.5 Gy to a 1.0 cm radius respectively. Results : Subjective and objective responses to treatments were evaluated on follow-up examinations by clinical examination, chest x-rays and CT scan of the chest on some patients. Fifteen of 21 LDR patients and 19 of 22 HDR Patients showed subjective improvement in terms of better breathing and less Productive cough as well as complete disappearance of hemoptysis. Objective improvement on chest x-rays and CT scan of the chest had been demonstrated on 8 LDR Patients and 10 HDR patients. Conclusion : The technique of LDR and HDR endobronchial brachytherapy is simple and well tolerated procedure with minimal morbidity It Provides excellent palliation by keeping airway Patent in these short life-spanned patients.

• Clinical and Experimental Reproductive Medicine
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• v.23 no.1
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• pp.61-66
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• 1996

Vasectomy has become a popular method for male sterilization and this, in tum, has been followed by an increase in the number of patients requiring vasectomy reversal. Recently, many authors have reported a high success rate of vasovasostomy using microsurgical techniques. However, a significant discrepancy exist between the anatomical patency rate and pregnancy rate despite improvements in surgical techniques. Number of 420 patients who underwent vasovasostomy by a modified one layer reanastomosis from January 1986 to December 1994 were reviewed. Of the total, Complete follow up were possible in 115 patients. Of the 115 patients, 74 patients were treated by macroscopic reanastomosis, and microscopic technique were applied in 41 patients. Duration of vasal obstruction, gross apperance of vasal fluid, operative method, presence or absence of sperm and sperm granuloma, and results of postoperative semen analysis were analyzed as factors influencing the pregnancy rate. Success rates for patency and for pregnancy were 81% and, 42% respectively. Rate of pregnancy were increased if there were shorter periods of obstruction(<10years), bilateral observation of watery vasal fluid, presence of sperm bilaterally, bilateral presence of sperm granuloma at the vasectomy site, and normal results on postoperative semenalysis. With these results, we can conclude that all factors mentioned may affect the success rate of pregnancy following vasovasostomy.

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.6-9
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• 2009

Gastric cancer with gastric outlet obstruction has a high incidence of direct invasion into neighboring organs, with a low resection rate and a poor prognosis. Traditionally, open gastrojejunostomy has been the standard palliative treatment in these patients. Recently, endoscopic self-expanding metal stents have been used increasingly for the palliative treatment of malignant gastric outlet obstruction, but the choice of modality to treat the obstruction caused by gastric cancer is still controversial. Many studies have shown that endoscopic stenting is less invasive and offers not only a shorter time to oral intake and length of hospital stay, but also less frequent complications compared to open gastrojejunostomy. However, recurrent obstruction by tumor overgrowth and ingrowth occur more frequently and re-intervention for recurrent obstructive symptoms are more frequently performed after stent placement than after gastrojejunostomy. Thus, stent placement may be associated with more favorable results in patients with a relatively short life expectancy, while gastrojejunostomy is preferable in patients with a more prolonged prognosis. Also, open surgery affords a greater chance for curative surgery. However, most underlying diseases analyzed in previous studies were pancreaticobiliary malignancies, and there have been few prospective studies specific for patients with gastric cancer. Additional randomized controlled trials with larger sample sizes are expected to decide the treatment modality for unresectable gastric cancer with gastric outlet obstruction.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.2
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• pp.278-283
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• 2004

Meckel's diverticulum is found in about 3% of the population, often incidentally during laparotomy or at autopsy. Over 50% of patients who develop symptoms from this anomaly are younger than 2 years of age. The most common symptom of this lesion is intestinal obstruction. Rarely Meckel's diverticulum is complicated by a mesodiverticular band, which is believed to be a remnant of a vitelline artery. We report a 11-year-old girl with small bowel obstruction because of an intestinal hernia beneath the mesodiverticular band. The causative factor was a stenotic area in the terminal ileum caused by a ringlike lipovascular mesenteric band encroaching externally on the lumen. Although the incidence of mesodiverticular bands complicating Meckel's diverticulum is quite low, the rapid clinical course and the associated high mortality rate make this an important disease.

• Journal of Chest Surgery
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• v.14 no.3
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• pp.254-259
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• 1981

This is a case of successfully surgically treated RVOT obstruction caused by projection of the herniated aortic cusp through subpulmonic supracristal VSD at Department of Thoracic and Cardiovascular Sugery, Hanyang University Hospital. The patient was a 17 year old boy. Congenital heart anomaly was suspected at 2 years of his age. He had palpitation, dyspnea on exertion and epistaxis for 2 years prior to admission to our hospital. On examination, the blood pressure was 170/0mmHg. And the pulse rate was 100/rain. Widening of pulse pressure, water hammer pulse [bounding pulse]. To and fro murmur and head nodding were noted. Cardiomegaly was seen in chest x-ray. EKG, Echocardiography, Cardiac catheterization and angiocardiography were performed. On April 27, 81. Open heart surgery was performed under the impression of VSD combined with AI. On Rt. ventriculotomy, we noticed RVOT obstruction caused by prolapsed rt coronary cusp through a VSD. The subpulmonic supracristal VSD measuring 2.5 x 3 Cm in diameter was closed with Teflon patch graft and then the prolapsed aortic leaflet was plicated by placing three 8-figure suture between the free edge and the base of the leaflet through transverse aortotomy. After operation, excellent result was obtained: B.P, was 110/50mmHg and any sign of AI or residual shunt was not found at discharge.