• Title/Summary/Keyword: Pressure Vessels

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Early and Midterm Results of Arterial Switch Operation for Double-Outlet Right Ventricle with Subpulmonary VSD (폐동맥하 심실증격결손을 동반한 양대혈관 우심실기시중에서 동맥전환술의 중단기 결과)

  • 양승인;이형두;김시호;조광조;우종수;이영석;성시찬
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.313-321
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    • 2004
  • Excellent clinical results of the arterial switch operation and the limited availablity of the intraventricular rerouting has recently made an arterial switch operation to become the therapeutic method of choice for the repair of double-outlet right ventricle (DORV) with subpulmonary ventricular septal defect (VSD). The early and midterm outcomes of arterial switch operation for this anomaly were evaluated. Material and Method: Between August 1994 and July 2002, 13 patients underwent an arterial switch operation for the correction of double-outlet right ventricle with subpulmonary VSD at Dong-A university hospital.. The 50% rule was used to define DORV. Median age and mean body weight were 27 days (range, 3-120 days) and 3.8$\pm$0.7kg (range, 2.92-5.3kg) respectively. Aortic arch anomalies were associated in 6 cases (46.2%), which were all repaired through one-stage operation. The relationship of the great arteries were side-by-side in 8 cases (61.5%) and anteroposterior in 5 (38.5%). Coronary artery patterns were 1 LCx-2R in 6 cases, retropulmonary left coronary artery (LCA) in 6, and intramural LCA in 1 respectively. The enlargement of VSD was required in 1 patient and the patch enlargement of right ventricular outflow tract was performed in another one patient. The Lecompte maneuver was used in all but 3 patients with a side by side relationship of the great arteries. Result: Overall postoperative hospital mortality was 23.1 % (3/13). All operative deaths were occurred in the patients with aortic arch anomalies. There was one late death related to the postoperative complication of the central nerve system during the mean follow-up of 41.3$\pm$30.7 months. Pulmonary valvar stenosis (>30mmHg of pressure gradient) developed in 1 patient (10%) and left pulmonary artery stenosis in 2 (20%), among them, one required reoperation 52 months after repair. There was an asymptomatic patient with moderate aortic regurgitation. 5-year survival rate including operative deaths was 68.3%. Conclusion: Although the operative mortality is high in the patients with aortic arch anomaly, the arterial switch operation for DORV with supbpulmonary VSD can be performed with low operative mortality and low reoperation rate in the patients Without arch anomaly. The arterial switch operation can be considered a good option for this complex anomaly.

Risk Factors Analysis and Results of the Arterial Switch Operation for Transposition of the Great Arteries with Intact Ventricular Septum (심실중격결손을 동반하지 않은 대혈관전위증 환자에서 동맥 전환술의 결과 및 위험인자 분석에 관한 연구)

  • 김용진;오삼세;이정렬;노준량;서경필
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.108-118
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    • 1999
  • Background: To evaluate the risk factor and long-term result of arterial switch operation , a retrospective study was done. Material and Method: A retrospective analysis was done to evaluate the early and long-term results on 58 patients who underwent an arterial switch operation(ASO) for transposition of the great arteries(TGA) with intact ventricular septum, between January 1988 and December 1996. Beforesurgery, 36 patients(62.1%) underwent balloon atrial septostomy, 32 patients(51.7%) received PGE1 infusion, and preparatory banding of pulmonary artery was performed on 6 patients(mean LV/RV pressure ratio 0.53$\pm$0.11). Result: The age at operation ranged from 1 to 137 days(mean 24$\pm$26 days) and the weights ranged from 1.8 to 6.8 kg (mean 3.5$\pm$0.8 kg). There were 14 early deaths(24.1%), but of the last 24 patients operated on since 1994, there were only 2 early deaths(8.3%). In the risk factor analysis, the date of operation was the only risk factor for early death(p-value < 0.01). Eight of the 14 early deaths were due to acute myocardial failure(mainly inadequate coronary blood flow). The length of follow-up ranged from 2 months to 8 years, average of 36$\pm$27 months. The follow-up included sequential noninvasive evaluations and 21 catheterizations and angiographic studies performed 5 to 32 months postoperatively with particular attention to the great vessel and coronary anastomosis, ventricular function, valvular competence, and cardiac rhythm. There were 5 late deaths(11.4%), one of thesedeaths was related to the late coronary problems, two to aspiration, one to uncontrolled chronic mediastinitis, and one to progressive aortic insufficiency and heart failure. The most frequent postoperative hemodynamic abnormality was supravalvular stenosis and the degree of pulmonary or aortic obstruction had slowly progressed in some cases, however there were no children who had to undergo a reoperation for supravalvular pulmonary or aortic stenosis. Aortic regurgitation was identified in 9 patients, which was mild in 7 and moderate in 2 and had progressed in some cases. Two patients who had an unremarkable perioperative course were identified as having coronary artery obstructions. The other late survivors were in good condition, were in sinus rhythm, and had normal LV functions. Actuarial survival rate at 8 years was 68.8%. Conclusion: We concluded that anatomic correction will be established as the optimal approach to the TGA with intact ventricular septum, though further long-term evaluations are needed.

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A Study on Responses of the Korean kidnapping Terror in overseas (한국인 해외인질납치테러 대응방안)

  • Jeong, Joon-Sik;Kim, Won-Ki
    • Korean Security Journal
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    • no.20
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    • pp.339-363
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    • 2009
  • The 9.11 demonstrated that terrorist attack could be more serious problem than the war in our modern life. No countries in the world have evaded being a target for terrorists today. As well as South Korea, the whole world must share attentions and responsibilities for fighting against the terrorism. Since the international terrorist groups have expanded their targets from Western countries to Koreans, civilian hostages are no longer other's affair; it became a serious threat to public. Increased Korean investment, trade, missionary, and travel overseas also expanded activity regions worldwide. It also result increased terrorist threats and possible abduction. The number of kidnapping crisis has increased since the terrorists use it as an effective method of sending a message. Piracy refers to a broad range of violent acts at sea, and has traditionally been regarded as common enemies. Piracy constitutes a great threat to the security of navigation as well as to the safety of vessels and crews. Lessons from hostage issues such as Korean hostage crisis in Somalia and Afghanistan show that it can cause criticism on moral issues if armed rescue missions fail or hostages are killed, so the governments and related corporations try to solve it by paying ransom. Terrorists and use these advantages in order to put a huge pressure on the governments. In this study we will look at essential characteristics and types of hostage abductions and recognition of national safety, lessons and solutions to previous Korean hostage cases in overseas. At the same time, it provides a guidelines of the direction in the fighting against terrorist groups and Piracy.

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Tissue changes of pulp and periodontium on rapid tooth movement with osteotomy in dogs (골절단을 이용한 급속 치아이동 후 치수 및 치주조직 변화)

  • Kang, Kyung-Hwa;Kim, Eun-Cheol;Lee, Sun-Kyung;Lim, Chae-Woong;Matduda, Kiku;Tae, Ki-Chul;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.34 no.2 s.103
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    • pp.131-142
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    • 2004
  • The movement of tooth-bone segments by osteotomy can simultaneously shift tooth and surrounding alveolar bone in a relatively short period. The purpose of this study was to evaluate the tissue changes in pulp, periodontal ligament, and alveolar bone in rapid tooth-bone movement with osteotomy. The mandibular 3rd premolar of a dog was extracted and cortical bones of the buccal and lingual area were eliminated, and then cortical bones around the mesial and distal area of root, and below the root apex of the mandibular 4th premolar were osteotomized. After a one-week latency period, a tooth-borne distraction device was activated for 6 days. And pulp, periodontal ligament and alveolar bone were evaluated clinically, radiologically, histologically and immunohistochemically at 0, 1, 2, 4, 6, 8 weeks of the consolidation Period and conclusions were roached as follows. 1. Latency period didn't affect total amount or tooth movement and healing process of tissue during consolidation period. 2. Bone formation continued through 8 weeks of consolidation in distracted side, with a high peak at 1-2 weeks, and the lowest at 6-8 weeks or consolidation. 3. At 1 week of consolidation, alveolar bone resorption, osteoclast appearance and inflammatory cell infiltration were the most active, and dentinoclasts characteristically appeared on the pulp and pressure side of the periodontal ligament. 4. The expression of $TGF-\beta$ was area-specific, as it was strong-positive at bone matrix, osteoblast osteoclast of alveolar bone, and dentinoclast inside pulp, but weak in pulp, cementoblast and acellular cementum. 5. The expression of $TGF-\beta$ was generally observed at the initial 1-2 weeks of consolidation at vessels, periodontal ligament cells, and osteoblast near alveolar bone on the distraction side of the periodontal ligament, and was significantly decreased after 6 weeks of consolidation.

Echocardiographic Follow-up after Arterial Switch Operation for Transposition of the Great Arteries (동맥전환술을 시행한 대혈관전위 환자에서 심초음파를 이용한 술후 추적)

  • 한승세;정태은;이동협;오정훈;이정철
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.754-762
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    • 2001
  • Background: To evaluate the efficacy of arterial switch operation for transposition of great arteries, serial echocardiographic studies were performed in 8 patients who underwent the surgery between 1989 and 1998 at Dept. of Thoracic & Cardiovascular Surgery, Yeungnam University Hospital in Daegu City, Korea. Material and Method: Follow-up period ranged from 6 months to 11 years(average of 4.1 years). Body weight ranged from 2.6kg to 4.8kg, with average of 3.6kg. 5 of 8 patients were preoperatively diagnosed as TGA+VSD, and 3 as TGA+IVS. LV function was evaluated by the measurement of LV shortening fraction, LVSTI, and LVEF. RVSTI was also measured. Postoperative function of valve and growth of great vessels were analyzed by the measurement of PSPGV, valvular regurgitation, LA/AO ratio, root dimension of aorta and pulmonary artery, comparing with the age matched controls, respectively. Result: LVEF had an average of 65.0+9.03% which is tended to increase serially. LVAOPG had an average of 15.9mmHg. RVPAPG, 27.5mmHg. From the measurement of aortic root dimension of 6 patients at end-systole, aortic root growth was assumed to increase more than the mean value of normal growth. PA root dimension at end-systole showed a similar growth progress when compared with age matched normal controls. Postoperative pulmonic valve regurgitation was noted in 5 of total 8 patients, in which 1 patient who showed grade 2 and 4 showed below grade 1. AR, in 6 patients and all grade 1 Except 1 patient, all the valvular regurgitations were below grade 1, which was presumed to be clinically insignificant.

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A Study for Mechanical Property for A516-60, A283-C, A285-C and SB410 materials under Low Temperature (저온영역에서의 A516-60, A283-C, A285-C, SB410 소재 특성 평가)

  • Oh, Jung-Soo;Lee, Hee-Bum;Lee, Bong-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.9
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    • pp.405-411
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    • 2019
  • In this study, tensile tests were carried out on materials (A516-60, A283-C, A285-C, and SB410) for structural and pressure vessels at temperatures of $20^{\circ}C$, $-20^{\circ}C$, and $-40^{\circ}C$, and the changes in the mechanical properties were analyzed. Compared to the results at $20^{\circ}C$, the average yield stress increased by 6.4% and 7.5% at $-20^{\circ}C$ and $-40^{\circ}C$ for A516-60, while the average tensile stress increased by 1.3% and 4.1%, respectively. The average elongation decreased by 4.7% and 20.4% at these temperatures. In the case of A283-C, the average yield stress increased 8.8% and 9.8%, the average tensile stress increased by 4.1% and 5.9%, and the average elongation rate decreased by 7.4% and 9.9% at $-20^{\circ}C$ and $-40^{\circ}C$, respectively. For A285-C, the average yield stress increased by 1.8% and 8.6%, and the average tensile stress increased by 2.6% and 5.3%, respectively, but there was little change in the average elongation. Finally, for SB410, the average yield stress increased by 7.1% and 11.8%, the average tensile stress increased by 4.3% and 5.5%, but the average elongation rate decreased by 8.7% and 13.5%, respectively.