Background: Refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with arrhythmia surgery in patients who had Fontan operation. Material and Method: Between July 1986 and December 2003, 275 early survivors after Fontan operation were reviewed. Fourteen patients underwent. arrhythmia surgery at reoperation after Fontan operation, and mean age at reoperation was 16.8$\pm$7.1 (range: 4.5 ∼ 30.6) years. Mechanisms of arrhythmia included atrial flutter in 8 patients, and atrial fibrillation in 2. Arrhythmia surgery has evolved from isthmus cryoablation in 12 patients to right-sided maze in 2 patients. Thirty-two patients. underwent prophylactic isthmus cryoablation concomitantly at initial Fontan operation. Result: Postoperative arrhythmias occurred in 68 patients (24.7%) among 275. There was no early and late mortality after the arrhythmia surgery. After redo Fontan operation, all patients maintained normal sinus rhythm. Atrial flutter recurred in 3 patients who had sinus conversion with medication and 7 required permanent pacemakers with a mean follow-up of 26.5$\pm$29.1 (range: 2 ∼ 73) months. All patients have improved to NYHA class I or II. After prophylactic cryoablation at initial Fontan operation, 29 patients (90.6%) had sinus rhythm, 1 patient had junctional tachycardia, 1 patient had sinus nodal dysfunction, and 1 patient had AV block with a mean follow-up of 51.3$\pm$19.8 (range: 4∼80) months. Conclusion: Redo Fontan operation, and concomitant arrhythmia surgery reduced atrial arrhythmias and improved NYHA functional classification.
Kim, Hyun-Hwan;Yoo, Min-Yong;Kim, Jin-Chul;Kim, Kwang-Woo
International Journal of Highway Engineering
/
v.12
no.2
/
pp.17-23
/
2010
Since the relatively stiff binder shows a higher tensile strength as well as higher rutting resistance, it is believed that the binder stiffness is an important factor for rutting and tensile strength of asphalt mixtures. The typical tensile property is measured by indirect tensile strength (ITS) test at $25^{\circ}C$ and the rutting resistance is most widely measured by wheel tracking (WT) test at $60^{\circ}C$. The deformation strength ($S_D$) is newly developed property to estimate rut resistance of asphalt concretes at $60^{\circ}C$. The ITS and $S_D$ are very simple to measure by static test techniques, but the WT is measured by repeated loading procedure which requires relatively longer time and more efforts. Since these three properties are highly dependent upon the binder stiffness, it may be possible to estimate one property from another. Therefore, this study investigate the possibility of estimating the rutting characteristics (measured by WT test) by ITS or $S_D$ test, and the ITS by $S_D$. Because of binder stiffness effect, in the WT estimation by ITS, a tendency was observed for the higher ITS mixture to have the lower rut depth, giving $R^2{\fallingdotseq}$0.6, on the average. The ITS estimation by $S_D$ showed $R^2{\fallingdotseq}$0.64, and the WT estimation by SD showed $R^2{\fallingdotseq}$0.84, which is highest correlation among the three. Therefore, it was concluded that there is relatively good possibility of estimating WT result by $S_D$, and even though $R^2$ is somewhat low, there is some correlation between WT and ITS.
[ $\underline{Purpose}$ ]: This study was to design and fabricate a phantom for prostate cancer brachytherapy to validate a developed program applying a 3-film technique, and to compare it with the conventional 2-film technique for determining the location of an implanted seed. $\underline{Materials\;and\;Methods}$: The images were obtained from overlapped seeds by randomly placing a maximum of 63 seeds in the anterior-posterior (AP) position and at $-30^{\circ} to $30^{\circ} at $15^{\circ} intervals. Images obtained by use of the phantom were applied to the image processing procedure, and were then processed into the development program for seed localization. In this study, cases were set where one seed overlapped, where two seeds overlapped and where none of the three views resolved all seeds. The distance between the centers of each seed to the reference seed was calculated in a prescribed region. This distance determined the location of each seed in a given band. The location of the overlapped seeds was compared with that of the 2-film technique. $\underline{Results}$: With this program, the detection rate was 92.2% (at ${\pm}15^{\circ}), 94.1% (at ${\pm}30^{\circ}) and 70.6% (compared to the use of the 2-film technique). The overlaps were caused by one or more than two seeds that overlapped; the developed program can identify the location of each seed perfectly. However, for the third case the program was not able to resolve the overlap of the seeds. $\underline{Conclusion}$: This program can be used to improve treatment outcome for the brachytherapy of prostate cancer by reducing the number of errors in the process of reconstructing the locations of perfectly overlapped seeds.
Background: The femoral artery is the most common site of canuulation for cardiopulmonary bypass in surgery for type A aortic dissection. Recently, many surgeons prefer the axillary artery to the femoral artery as the arterial cannulation site for several benefits. We evaluated the safety and usefulness of axillary artery cannulation in surgery for acute type A aortic dissection. Material and Method: Between Oct. 1995 and Sep. 2001, 71 patients underwent operations for acute type A aortic dissection. The arterial cannula was inserted into the axillary artery in 31 patients (AXILLARY group, mean age=56), and into the femoral artery in 40 patients (FEMORAL group, mean age=57). We retrospectively compared the incidence of mortality, morbidities, and hospital course. Result: The mean duration of cardiopulmonary bypass and circulatory arrest were significantly shorier in the AXILLARY group (207 min and 39min, respectively) than in the FEMORAL group (263min and 49 min, respectively; P<0.05). Postoperative hospital stay was significantly shorter in the AXILLARY group than in the FEMORAL group (mean 15 days vs. 35 days, p<0.05). Although there was no difference in the incidence of new-onset permanent neurological dysfunction (3.2%, in the AXILLARY group, 2.5% in the FEMORAL group), the incidence of transient neurological dysfunction was significantly lower in the AXILLARY group (12.9% vs. 25%, p<0.05). In the FEMORAL group, two patients needed urgent conversion to cannulation site due to arch vessel malperfusion. In the AXILLARY group, there was only one patient who had a complication related to the cannulation, i.e., median nerve injury. Conclusion: Axillary artery cannulation was safe and helpful in decreasing the cerebral ischemic time and incidence of transient neuroligcal dysfunction in surgery for acute type A aortic dissection, It enabled us to approach the patients with aortic arch pathology more aggressively.
Cardiac transplantation has been the treatment of patients with end-stage heart disease since it was first performed in 1967. In Korea the first case was performed in 1992 and 42 patients underwent heart trans- plantation so far. The purpose of this article is to report short-term result of cardiac transplantation at our center. Between April 1994 and September 1995, 14 patients had undergone orthotopic heart transplantations. There was 12 male and 2 female patients. Mea recipient age was 34 years(range 11 to 54 years) and mean donor age was 28.4 years(16 to 50 years). Mean graft ischemic time was 120.7minutes(80 to 280 minutes). The follow-up period after transplantation was 11 months(3 to 17 months). Recipient diagnosis included dilated cardiomyopathy in 10, ischemic cardiomyopathy in 2, valvular cardiomyopathy in 1, congenital complex heart disease in 1 patient. The preoperative status of the recipients were state I (50%) and ll (50%) by UNOS classification and class 111 (5 patients) and class IV (9) by NYHA functional class. All patients were treated with triple-drug immunosuppression (cyclosporine, azathioprine, steroid) and induction with RATG. The rejection episodes were 5 times in 3 patients during the follow-up. Causes of infection were aspergillosis (2), and hepes zoster (1), CMV pneumonitis (1). Permanent pace- maker was inserted in 1 patient. Currently 9 patients are alive with seven patients in WYHA functional class I and two in class l . The ejection fraction increased from preoperative value of 19.9 $\pm$ 3.4% to postoperative value of 69.0 $\pm$ 5.6%. The causes of death were cellular rejection (1),chronic graft failure due to size-mismatching (1),respirat- oxy insufficiency due to asthma attack (1), subarachnoid hemorrhage (1), and RIO humoral rejection (1).
Proceedings of the Korean Vacuum Society Conference
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2012.02a
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pp.100-101
/
2012
The plasma damage free and room temperature processedthin film deposition technology is essential for realization of various next generation organic microelectronic devices such as flexible AMOLED display, flexible OLED lighting, and organic photovoltaic cells because characteristics of fragile organic materials in the plasma process and low glass transition temperatures (Tg) of polymer substrate. In case of directly deposition of metal oxide thin films (including transparent conductive oxide (TCO) and amorphous oxide semiconductor (AOS)) on the organic layers, plasma damages against to the organic materials is fatal. This damage is believed to be originated mainly from high energy energetic particles during the sputtering process such as negative oxygen ions, reflected neutrals by reflection of plasma background gas at the target surface, sputtered atoms, bulk plasma ions, and secondary electrons. To solve this problem, we developed the NBAS (Neutral Beam Assisted Sputtering) process as a plasma damage free and room temperature processed sputtering technology. As a result, electro-optical properties of NBAS processed ITO thin film showed resistivity of $4.0{\times}10^{-4}{\Omega}{\cdot}m$ and high transmittance (>90% at 550 nm) with nano- crystalline structure at room temperature process. Furthermore, in the experiment result of directly deposition of TCO top anode on the inverted structure OLED cell, it is verified that NBAS TCO deposition process does not damages to the underlying organic layers. In case of deposition of transparent conductive oxide (TCO) thin film on the plastic polymer substrate, the room temperature processed sputtering coating of high quality TCO thin film is required. During the sputtering process with higher density plasma, the energetic particles contribute self supplying of activation & crystallization energy without any additional heating and post-annealing and forminga high quality TCO thin film. However, negative oxygen ions which generated from sputteringtarget surface by electron attachment are accelerated to high energy by induced cathode self-bias. Thus the high energy negative oxygen ions can lead to critical physical bombardment damages to forming oxide thin film and this effect does not recover in room temperature process without post thermal annealing. To salve the inherent limitation of plasma sputtering, we have been developed the Magnetic Field Shielded Sputtering (MFSS) process as the high quality oxide thin film deposition process at room temperature. The MFSS process is effectively eliminate or suppress the negative oxygen ions bombardment damage by the plasma limiter which composed permanent magnet array. As a result, electro-optical properties of MFSS processed ITO thin film (resistivity $3.9{\times}10^{-4}{\Omega}{\cdot}cm$, transmittance 95% at 550 nm) have approachedthose of a high temperature DC magnetron sputtering (DMS) ITO thin film were. Also, AOS (a-IGZO) TFTs fabricated by MFSS process without higher temperature post annealing showed very comparable electrical performance with those by DMS process with $400^{\circ}C$ post annealing. They are important to note that the bombardment of a negative oxygen ion which is accelerated by dc self-bias during rf sputtering could degrade the electrical performance of ITO electrodes and a-IGZO TFTs. Finally, we found that reduction of damage from the high energy negative oxygen ions bombardment drives improvement of crystalline structure in the ITO thin film and suppression of the sub-gab states in a-IGZO semiconductor thin film. For realization of organic flexible electronic devices based on plastic substrates, gas barrier coatings are required to prevent the permeation of water and oxygen because organic materials are highly susceptible to water and oxygen. In particular, high efficiency flexible AMOLEDs needs an extremely low water vapor transition rate (WVTR) of $1{\times}10^{-6}gm^{-2}day^{-1}$. The key factor in high quality inorganic gas barrier formation for achieving the very low WVTR required (under ${\sim}10^{-6}gm^{-2}day^{-1}$) is the suppression of nano-sized defect sites and gas diffusion pathways among the grain boundaries. For formation of high quality single inorganic gas barrier layer, we developed high density nano-structured Al2O3 single gas barrier layer usinga NBAS process. The NBAS process can continuously change crystalline structures from an amorphous phase to a nano- crystalline phase with various grain sizes in a single inorganic thin film. As a result, the water vapor transmission rates (WVTR) of the NBAS processed $Al_2O_3$ gas barrier film have improved order of magnitude compared with that of conventional $Al_2O_3$ layers made by the RF magnetron sputteringprocess under the same sputtering conditions; the WVTR of the NBAS processed $Al_2O_3$ gas barrier film was about $5{\times}10^{-6}g/m^2/day$ by just single layer.
Proceedings of the Korean Radioactive Waste Society Conference
/
2005.06a
/
pp.311-318
/
2005
Transparency on the Total System Performance Assessment (TSPA) is the key issue to enhance the public acceptance for a permanent high level radioactive repository. To approve it, all performances on TSPA through Quality Assurance is necessary. The integrated Cyber R&D Platform is developed by KAERI using the T2R3 principles applicable for five major steps in R&D's. The proposed system is implemented in the web-based system so that all participants in TSPA are able to access the system. It is composed of FEAS (FEp to Assessment through Scenario development) showing systematic approach from the FEPs to Assessment methods flow chart, PAID (Performance Assessment Input Databases) showing PA(Performance Assessment) input data set in web based system and QA system receding those data. All information is integrated into Cyber R&D Platform so that every data in the system can be checked whenever necessary. For more user-friendly system, system upgrade included input data & documentation package is under development. Throughout the next phase R&D, Cyber R&D Platform will be connected with the assessment tool for TSPA so that it will be expected to search the whole information in one unified system.
Disused Sealed Radioactive Sources (DSRSs) are stored temporally in the centralized storage facility of Korea Radioactive Waste Agency (KORAD) and planned to be disposed in the low- and intermediate-level radioactive waste (LILW) disposal facility in Gyeongju city. In this study, preliminary post-closure safety assessment was performed for DSRSs in order to draw up an optimum disposal plan. Two types of disposal options were considered, i.e. engineered vault type disposal and rock cavern type disposal which were planned to be constructed and operated respectively in LILW disposal facility in Gyeongju city. Assessment end-point was individual effective dose of critical group and calculated by using GoldSim code. In normal scenario, the maximum dose was estimated to be approximately $1{\times}10^{-7}mSv/yr$ for both disposal options. It meant that both options had sufficient safety margin when compared with regulatory limit (0.1 mSv/yr). Otherwise, in well scenario, the maximum dose exceeded regulatory limit of 1 mSv/yr in engineered vault type disposal and the exposure dose was mainly contributed by $^{226}Ra$, $^{210}Pb$ (daughter nuclide of $^{226}Ra$) and $^{237}Np$ (daughter nuclide of $^{241}Am$). For rock cavern type disposal, even though the peak dose satisfied regulatory limit, the exposure doses by $^{14}C$ and $^{237}Np$ were relatively high above 10% of regulatory limit. Therefore, it is necessary to exclude $^{14}C$, $^{226}Ra$ and $^{241}Am$ for two type of disposal options and additional management such as long-term storage and development of disposal container for those radionuclides should be performed before permanent disposal for conservative safety and security.
Woo, Yang Won;Lee, Chang Hyun;Rajaraman, Bharanidharan;Yeo, Joon Mo;Lee, Won Young;Kim, Do Hyung;Jang, Seon-Sik;Kim, Kyoung Hoon
Journal of The Korean Society of Grassland and Forage Science
/
v.37
no.4
/
pp.315-321
/
2017
The present experiment was designed to investigate the effects of extruded linseed supplementation on methane production in Holstein steers. Four Holstein steers fitted with permanent cannulas were assigned to two dietary treatments in a duplicated $2{\times}2$ Latin square design: a control diet consisting of tall fescue straw (65%) and concentrate (35%), and a treatment diet supplemented with 3.8% extruded linseed by replacing a part of ingredients in the concentrate of the control diet. The concentrates of the control and the treatment diet were isoenergetic and isonitrogenous. Extruded linseed supplementation did not affect dry matter intake but significantly (P<0.05) increased the intake of lipid. Rumen pH was significantly (P<0.05) lower for control than for treatment. Although there was no significant difference between treatments, the concentration of total VFA in control was 21% higher than in treatment. The concentrations of acetic acid, propionic acid and butyric acid were not different between treatments. Extruded linseed supplementation significantly (P<0.05) reduced methane output(g/d) and emission factor. Methane conversion rate was lower for treatment than for control but no significant difference was found. The results of the present study showed that extruded linseed supplementation in the diet of Holstein steers could reduce methane output.
Objectives: This in vitro study investigated whether short-term application of calcium hydroxide in the root canal system for 1 and 4 wk affects the fracture strength of human permanent teeth. Materials and Methods: Thirty two mature human single rooted mandibular premolars in similar size and dentin thickness without decay or restorations were hand and rotary instrumented and 16 teeth vertically packed with calcium hydroxide paste and sealed coronally with caviton to imitate the endodontic procedure and the other 16 teeth was left empty as a control group. The apicies of all the samples were sealed with resin, submerged in normal saline and put in a storage box at $37^{\circ}C$ to mimic the oral environment. After 1 and 4 wk, 8 samples out of 16 samples from each group were removed from the storage box and fracture strength test was performed. The maximum load required to fracture the samples was recorded and data were analysed statistically by the two way ANOVA test at 5% significance level. Results: The mean fracture strengths of two groups after 1 wk and 4 wk were similar. The intracanal placement of calcium hydroxide weakened the fracture strength of teeth by 8.2% after 4 wk: an average of 39.23 MPa for no treatment group and 36.01 MPa for CH group. However there was no statistically significant difference between experimental groups and between time intervals. Conclusions: These results suggest that short term calcium hydroxide application is available during endodontic treatment.
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