• Journal of Chest Surgery
• /
• v.28 no.6
• /
• pp.571-578
• /
• 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.

• Journal of Korean Neurosurgical Society
• /
• v.58 no.6
• /
• pp.539-546
• /
• 2015

Objective : To report the learning curve of percutaneous endoscopic lumbar discectomy (PELD) for a surgeon who had not been previously exposed to this procedure based on the period and detailed technique with a retrospective matched comparative design. Methods : Of 213 patients with lumbar disc herniation encountered during the reference period, 35 patients who were followed up for 1 year after PELD were enrolled in this study. The patients were categorized by the period and technique of operation : group A, the first 15 cases, who underwent by the 'in-and-out' technique; group B, the next 20 cases, who underwent by the 'in-and-out-and-in' technique. The operation time, failure rate, blood loss, complication rate, re-herniation rate, the Visual Analogue Scale (VAS) for back and leg were checked. The alteration of dural sac cross-sectional area (DSCSA) between the preoperative and the postoperative MRI was checked. Results : Operative time was rapidly reduced in the early phase, and then tapered to a steady state for the 35 cases receiving the PELD. After surgery, VAS scores for the back and leg were decreased significantly in both groups. Complications occurred in 2 patients in group A and 2 patients in group B. Between the two groups, there were significant differences in operative time, improvement of leg VAS, and expansion of DSCSA. Conclusion : PELD learning curve seems to be acceptable with sufficient preparation. However, because of their high tendency to delayed operation time, operation failure, and re-herniation, caution should be exercised at the early phase of the procedure.

• Transactions of the Korean Society of Automotive Engineers
• /
• v.14 no.6
• /
• pp.50-56
• /
• 2006

Residual gas fraction in a combustion process is very crucial to improve combustion and cyclic variations. Especially, the residual gas fraction is strongly affected by backflow of the residual gas during the valve overlap period in an idle operation. Therefore, it is one of the most interesting that valve timings can affect flow characteristics of gas exchange process, especially during idle operation. This analysis investigates residual gas fraction with respect to valve timing changes which is critical for combustion efficiency and engine performance. Flow characteristics of residual gas by changing intake and exhaust valve timing are calculated by CFD methodology during an idle operation in an SI engine. It is analyzed that retarded EVO and advanced IVO results in the increase of valve overlap period and consequently, residual gas fraction. Futhermore, changes in IVO have stronger effects on variation of residual gas fraction.

• Journal of the Korean Society of Hazard Mitigation
• /
• v.4 no.1 s.12
• /
• pp.33-40
• /
• 2004

The objective of this study is to develop single dam operation models for flood control using Fuzzy control technique, which can improve flood controllability. We set control rules by water level and inflow, and developed three models Fuzzy I, II, III according to rule to decide outflow. Fuzzy I model consists of six rules considering only flood control and Fuzzy II model considers the effect of water use by increasing water level at the end of flood control period as well as flood control during the same period. Finally, Fuzzy m is an adaptive model designed to perform multipurpose dam operation for both flood control and water use simultaneously based on a control rules.

• Journal of Korean Elementary Science Education
• /
• v.23 no.4
• /
• pp.273-278
• /
• 2004

According to Piaget, children aged 11 are in the middle of concrete operation period and formal operation period. So, it is necessary to adopt the Learning Cycle Model (LCM) which helps students improve their cognitive development. After determining the test for the Science Concept of Matter (SCOM), the experimental group showed higher average than the comparative group in the post-test. In the sound understanding, the experimental group showed higher ratio than the comparative group. And in the ratio of imperfect, wrong understanding and no response, the experimental group was lower than the comparative group. On the questions that were needed the complicated inquiry, many students of both groups still couldn't find the fundamental cause. In forming the scientific conceptualization, there was a meaningful difference (p < .001) after post-test Analysis of Covariance (ANCOVA) with pre-test result. After determining the test for the Test Inquiry Science Process (TISP), the experimental group showed higher average than the comparative group in the post-test. In the category of basic inquiry process which is needed in concrete operation, there was a meaningful difference (p < .05). In the category of unified inquiry process which is needed in formal operation, they showed no meaningful difference (p > .05). Therefore, applying the LCM to the chapter of 'Solution and Dissolving' is more effective on improving the scientific conceptualization and on helping the concrete operation abilities than the teacher centered learning.

• IE interfaces
• /
• v.11 no.3
• /
• pp.115-128
• /
• 1998

This paper presents a development of operation scheduling and reactive operation scheduling system for hull fabrication. The methodology for implementing operation scheduling system is HHGA(Hierarchical Hybrid Genetic Algorithm) which exploits both the global perspective of the genetic algorithm and the rapid convergence of the heuristic search for operation scheduling. The methodology for the reactive operation scheduling is the revised HHGA which consists of manual schedule editor for occurrence of exceptional events and the revised scheduling method used in operation scheduling. As the results of experiment, it has been confirmed that HHGA is able to search good operation scheduling within reasonable time, and the revised HHGA is able to search load-balanced reactive operation scheduling with minimum changes of initial operation schedule within short period of time.

• Journal of Korea Water Resources Association
• /
• v.31 no.1
• /
• pp.105-113
• /
• 1998

Reservoir operation during flood period can be divided into two parts: One is for an operating policy during flood period to consider water conservation and flood control, and the other is for flood time on a random water level at flood forecasting, This study is concerned with reservoir operation and discusses general reservoir operation at flood time. Flood control has problems such as the uncertainty of hydrologic models. technical limitations and some constraints. Therefore, we may prepare the quantitative flood control methods based on the assured flood control storage for reservoir operation. Transformed Reservoir Flood(TRF) Reservoir Operation Method(ROM) is a procedure which determines the adequate releases with considering dam safety for flood inflows over non-damaging discharge. Based on the TRF ROM which was explained in our published paper. the study discusses the TRF ROM with additional investigations and the general reservoir operation rules at flood time.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.35 no.1
• /
• pp.13-20
• /
• 2009

Background In contrast to defects of the mandible and mouth floor region, in the defect of maxilla, the availability of firmly attached oral and nasal mucosal linings is needed. In addition to it, in consider of operation field, operating convenience, and esthetics, reconstruction using prelaminated flap is strongly recommended. Therefore we consider the prelaminated flap through the cases that is reconstructed using prelaminated forearm flap and prelaminated scapular flap. Patients and Methods From 2001 to 2008, in OMFS SNUDH, there were 6 cases that had reconstruction using prelaminated forearm free flap and other 3 cases that had reconstruction using prelaminated scapular flap of maxilla. The average age of patients that were reconstructed using prelaminated forearm free flap was 47.5 years, the average prelaminated period (after $1^{st}$ operation ${\sim}$ until $2^{nd}$ operation) was 51.8 days and the average follow-up period after $2^{nd}$ operation was 35.3 months. As well, the average age of patients that were reconstructed using prelaminated scapular free flap was 37 years, the average prelaminated period (after $1^{st}$ operation ${\sim}$ until $2^{nd}$ operation) was 57 days and the average follow-up period after $2^{nd}$ operation was 42.3 months. Results Except 1 case that were reconstructed using prelaminated scapular flap, we could get firmly attached oral and nasal stable skin(mucosal like) lining, more adequate thickness flap than any other flap and improved esthetic and functional results in the other 8 cases that were reconstructed using prelaminated flap. The complications of the prelaminated forearm flap cases were inconvenient swallowing, sputum, limitation of mouth opening and difficult mastication. It came from flap shrinkage of the flap in some aspect, as well as other combined operations such as mass resection or RND. The difficult point of the reconstruction of prelaminated scapular flap was the possibility of vascular damage at preparation of flap in $2^{nd}$ surgery. The damage could cause the failure of the prelaminated scapular flap. And the skin-lining of the prelaminated flap had limitations, so it is needed to study about the cultured oral epithelium-lining flap instead of the skin-lining flap. Conclusion We considered about advantages, complications and notable things of prelaminated flap through maxillary reconstruction cases using prelaminated forearm flap and prelaminated scapular flap so far. Furthermore, we should go on studying for functional reconstruction of prelaminated fasciomucosal flap using cultured oral epithelium.

• Korean Journal of Adult Nursing
• /
• v.12 no.4
• /
• pp.666-677
• /
• 2000

The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.

• Journal of Korean Medicine Rehabilitation
• /
• v.30 no.4
• /
• pp.105-117
• /
• 2020

Objectives The objective of this study is to assess the effectiveness of electroacupuncture for patients with hip arthroplasty. Methods According to participants, intervention, comparison, outcome, study design, we searched for clinical studies that conducted electroacupuncture for patients with hip arthroplasty. Results Finally 11 randomized controlled trials were chosen for systemic review and meta-analysis. The frequently used evaluation tools were Incidence of postoperative cognitive dysfunction (POCD), heart rate, blood pressure. Almost studies showed electroacupuncture has effects for patients with hip arthroplasty. Through meta analysis, Electoacupuncture showed statistically significant effect of reducing the anesthetic dosage and incidence of postoperative psychonosema and adverse reactions in intra-operation period, reducing the incidence of POCD in peri-operation period, incidence of deep venous thrombosis in post-operation period. Conclusion 11 studies reported that electroacupuncture has significant effects on hip arthroplasty. But, many studies were assessed in a probable high risk of bias. And all studies published in one overseas country. So, it requires attention to comprehend this study. To make up for this limitaion, more well designed clinical research are needed.