• Title/Summary/Keyword: Repair Method

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Teflon Felt Strip Mitral Valve Repair as an Alternative to Expensive Commercial Rings (테플론 펠트를 사용한 승모판막 성형술: 고가의 상업적 제품에 대한 대체물로 가능한가?)

  • Park, Kook-Yang;Jeon, Yang-Bin;Park, Chul-Hyun
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.216-222
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    • 2008
  • Background: Prosthetic annuloplasty rings are used for the reconstruction of the mitral valve annulus. However, there is controversy over the best ring to use for reconstruction. In this study, we evaluated the long term result of using a Teflon felt strip as an alternative to commercial rings. Material and Method: From 1996 to 2007, we enrolled 47 patients with pure mitral regurgitation greater than grade III. All patients had an ejection fraction of 40% or more. Patients with congenital heart disease or other valvular heart disease were excluded from this study. They were divided into two groups; the commercial ring group (Group CR) and the Teflon felt ring group (Group TF). Result: There was no mortality. The postoperative echocardiography showed no significant change in the overall ejection fraction (from $58.0{\pm}11.2%\;to\;42.8{\pm}8.4%$). There were no significant differences between the two groups with regard to morbidity, the reoperation rate and recurrence of mitral regurgitation greater than grade II. Conclusion: The long term results from this study showed that posterior mitral annuloplasty using Teflon felt had similar results compared to annuloplasty using commercial rings.

Midterm Results of Mitral Valve Repair by the New Chordae Formation Technique (승모판막 폐쇄부전증에서 신건삭 형성술을 이용한 판막 성형술의 임상분석)

  • Lee, Jae-Won;Lim, Han-Jung;Jung, Sung-Ho;Kim, Kun-Il;Choo, Suk-Jung;Song, Hyun;Song, Meung-Gun
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.329-337
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    • 2001
  • 배경: 승포판 전엽이나 교련 또는 여러 판엽에 걸쳐 광범위한 병변으로 인한 승모판 역류의 경우 수술수기에 대한 뚜렷한 정립이 되어 있지 않은 실정이다. 최근 이러한 병변의 승모판 역류의 경우 PTEE(Polytetrafluro-ethylene)을 이용한 신건삭 형성술의 시행이 점차 늘고 있다. 이에 저자들은 PTEE를 이용한 신건삭 형성술이 승모판 성형술에 어떠한 영향을 미치는지 알아보고자 하였다. 대상 및 방법: 1994년 1월부터 1999년 12월까지 승모판막 성형술을 시행 받은 322명의 환자 중에서 신건삭 형성술을 이용하여 승모판 성형술을 시행한 144례(I군)과 신건삭 형성술 이외의 방법으로 승모판 성형술을 시행한 178례(II군)를 대상으로 하였다. 두 군에서 수술 직후ㅘ 수술 후 6개월, 1년 및 1년 단위로 주기적인 심초음파를 시행하였고 이를 통계적 검정하였다. 결과: 같은 기간 승모판 성형술은 승모판막 폐쇄 부전증으로 내원한 환자의 95%(306)에서 추적 관찰이 가능하였다. 두 구난에 수술 전 혈류 역학적인 차이를 보이지 않았고, 수술 전 평균 승모판막 폐쇄 부전의 정도는 I군이 3.8$\pm$0.4, II군이 3.6$\pm$0.3였으나 수술 후 추적 관찰에서 각각 1.3$\pm$0.9와 1.1$\pm$0.7 정도의 양호한 판막 성형술의 결과를 보였고 승모판막 면적의변화나 승모판막에서의 평균 압력차이 등 혈류 역학적인 결과에도 차이를 보이고 있지 않았다. 술 후 3명(0.9%)의 조기 사망과 4명 (1.2%)의 후기 사망이 있었으나 두 군간의 차이는 보이지 않았다. 만기 생존율( 93.7$\pm$3.3 vs 88.0$\pm$1.95) 및 판막살패가 발생하기 않을 확률( 93.7$\pm$3.6 vs 93.3$\pm$3.4%) 과 재수술이 필요치 않을 활률(99.3$\pm$0.7 vs 96.0$\pm$1.9%), 색전증, 감염성 심내막염, 판막과 관련된 합병증 발생률 등에서 두 군간에 의미 있는 차이는 없었다. 전엽과 후엽에서 신건삭 형성술을 시행한 환자에서는 통계학적인 차이가 없었다(p=0.29) 결론: 신건삭 형성술을 이용한 승모판 성형술은 승모판 성형술의 증가(r=0.98, p<0.01)를 가져 왔을 뿐만 아니라 내구성과 안정성에 있어 기존의 안전화된 수술 수기와 견줄만하다. 특히 이러한 신건삭 형성술은 승모판 전엽에 병변이 있는 경우와 교련부 및 여러 엽에 광범위한 병변으로 인하여 재건술이 어려운 경우에도 승모판 재건을 가능하게 하는 우수한 수술 수리가 사료된다.

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Open Heart Surgery after Pulmonary Artery Banding in Children (소아에서 폐동맥밴딩술후의 개심술 치료)

  • 김근직;천종록;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.781-789
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    • 1999
  • Background: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. Material and Method: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6$\pm$9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). Result: The mean time interval from PAB to the second-stage operation was 15.5$\pm$8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. Conclusion: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.

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The Outcome of Cardiac Surgery in Low Birth Weight Infants (저체중 출생아의 심기형 수술의 성적)

  • 성시찬;김시호;이영석
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.430-438
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    • 2002
  • It is known that low birth weight is a risk factor for poor outcome in cardiac surgery for many cardiac defects. We reviewed our recent surgical experiences on congenital heart defect (other than patent ductus arteriosus) in low birth weight babies. Material and Method: From September 1994 to February 2001, 31 consecutive infants weighing 2500 g or less underwent cardiac surgery with (OHS group n=12) or without cardiopulmonary bypass (CHS group n=19). A retrospective study was carried out to evaluate short-and intermediate-term outcome. Mean gestational age and age at operation were 36.9 weeks(range, 32.3-42weeks) and 32.1days (range, 0-87days) respectively. Mean body weight at birth and operation were 1972g (range, 1100-2500g) and 2105g (range, 1450-2500 g) respectively. There was no difference between the two groups in age and body weight. Defects included ventricular septal defect (VSD) (n=3), VSD with arch anomaly (n=2), total anomalous pulmonary venous return (n=2), transposition of the great arteries (TGA) (n=2), truncus arteriosus (n=2), and univentricular heart with cor triatriatum (n=1) in OHS group, and coarctation of aorta (n=7), tetralogy of Fallot (TOF) (n=3), TOF with pulmonary atresia (n=3), multiple muscular VSDs (n=1), double outlet right ventricle (n=1), pulmonary atresia with intact ventricular septum (n=2), tricuspid atresia (n=1), and TGA with multiple VSD (n=1) in CHS group. 13 patients (41.9%) were intubated pre-operatively. Result: There were 4 early deaths(<30 days); 1 (8.3%) in OHS group and 3 (15.8%) in non-OHS group. All these early deaths were related to the pulmonary artery banding(PAB). There was no operative mortality in infants undergoing complete repair and palliative operations other than PAB. Delayed sternal closure was required in 3 patients. Prolonged postoperative mechanical ventilation (>7 days) was required in 7 patients(58.3%) in OHS and 7(38.8%) in CHS group. Late mortality occurred in 3 patients, two of which were non-cardiac. A patient in OHS group was documented to have neurologic sequelae. All the survivors except two are in NYHA class 1. Conclusion: Complete repair and palliative operations other than PAB can be performed in low birth weight infants with low operative mortality and an acceptable intermediate-term result. However, about a half of the patients required long-term postoperative mechanical ventilation.

Twelve Years of Experience with Vascular Ring Surgery (혈관륜 수술의 12년 경험 보고)

  • Kim, Yun-Seok;Goo, Hyun-Woo;Jhang, Won-Kyoung;Yun, Tae-Jin;Seo, Dong-Man;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.749-756
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    • 2009
  • Background: Vascular ring is a rare anomaly of the aortic arch. We did surgical repair procedures on 16 cases of vascular ring over the past 12 years. This article reviews our results. Material and Method: Between 1995 and 2007, 16 patients (5 with double aortic arch, 7 with right aortic arch-left ligamentum, 4 with pulmonary artery sling) underwent surgical repair. Mean age at the time of the operation were as follows: double aortic arch, $5.7{\pm}5.5$ years; right aortic arch-left ligamentum, $6.1{\pm}13.4$ years; pulmonary artery sling, $2.9{\pm}2.6$ years. Five patients (71%) with right aortic arch-left ligamentum had an associated Kommerell's diverticulum. Two patients (40%) with double aortic arch, 2 patients (28.6%) with right aortic arch-left ligament and 4 patients (100%) with pulmonary artery sling had associated airway stenosis. Cardiac anomalies were present in 8 of 16 patients. Result: There was no peri-operative or post-operative mortality. The mean hospital stay was $27.1{\pm}38.2$ days. None of our patients underwent reoperation. Conclusion: Vascular ring is rare, but, it needs surgical correction. It is important to suspect the diagnosis and to validate with echocardiography. Preoperative and postoperative computed tomography and bronchoscopy are useful to evaluate the airway and surrounding structures.

Mid to Long Term Outcomes of Surgical Treatment for Isolated Coarctation of Aorta (단순 대동맥 축착의 외과적 치료 후 중.장기 결과)

  • Lee, Seung-Cheol;Yoon, Tae-Jin;Park, Jeong-Jun;Song, Meong-Gun;Kim, Young-Hwee;Ko, Jae-Kon;Park, In-Sook;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.83-89
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    • 2007
  • Background: The surgical repair of an isolated coarctation of the aorta, without complex cardiac anomalies, has improved, with very good results. However, despite the success of surgical repair, many long-term complications, such as hypertension, re-coarctation and an aortic aneurysm, still exist. Material and Method: Between 1991 and 2006, 50 patients diagnosed with an isolated coarctation of the aorta were reviewed retrospectively. The incidence of re-coarctation and hypertension were compared with respect to age and surgical methods. Result: There were no early & late mortality, or post operative aortic aneurysms. Hypertension developed in 11 patients (22%). A greater number of patients in the child/adult group had hypertension (52.4%) than in the neonate/infant group (0%). With respect to the surgical methods, the patients in the graft interposition group suffered more hypertension (88.9%) than those in the EEEA (extended end to end anastomosis) group (5.3%). Post operative re-coarctation developed in 2 out of the 29 patients (6.9%) in the neonate/infant group and 2 out of the 21 patients (9.5%) in the child/adult group, but without any statistical difference. There were no statistical differences between the operative type-related groups. Conclusion: Even though the surgical outcomes have greatly improved, an isolated coarctation of the aorta still has many long-term problems, such as hypertension and re-coarctation. An isolated coarctation is accepted as a systemic vascular dysfunction, and often progresses to other cardiovascular diseases. Therefore, patients with a coarctation of the aorta have to be carefully followed-up, and aggressive management must be given when required.

Survey on the Regular Maintenance of Agricultural Machinery (농업기계 정기점검정비 실태조사)

  • Kang, J.W;Lee, W.Y.;Lee, S.B.;Lee, J.H.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.3 no.1
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    • pp.142-157
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    • 2001
  • This study was conducted to get the basic information for promoting farm machinery productivity by surveying the regular maintenance and repair status of major farm machinery such as power tiller, farm tractor, rice transplanter and combine harvester. The survey was carried out through 9 provinces including Cheju province by direct visiting farmers with prepared questionnaire. The results of this study can be summarized as follows : 1. The average farming carrier of the surveyed farmers was 25.3 years, and 21-30 years of farming carrier showed the highest portion as 40.7%. The average carrier of using farm machinery was 9.4 years, and that was 14.9 years for power tiller, 8.3 years for farm tractor, 9.0 years for rice transplanter, 7.9 years for combine harvester, 7.5 years for mini tiller, 9.7 years for power sprayer, and 8.2 years for binder etc. 2. The regular maintenance for farm machinery was conducted mainly at repair shop (49.5%) or dealer agency (12.0%) as 61.5%, and 34.9% of farmers conducted the regular maintenance by themselves at their house. 3. The reasons for not-fully recognizing operation manual and insufficient before-, during-, after-maintenance of farm machinery were insufficient time for them (45.8%), troublesome (22.9%), unknown maintenance method (16.3%), unknown the necessity for maintenance (12.4%), and others (2.6%) in order. 4. For the annual exchange of engine oil, 3.2 times is necessary but actually 1.7 times was exchanged for power tiller, 4.3 times is necessary but actually 1.9 times was exchanged for farm tractor, 2.7 times is necessary but actually 1.7 times was exchanged for rice transplanter, 2.2 times is necessary but actually 2.3 times was exchanged combine harvester. 5. For the annual cleanness or exchange of fuel filter, 3.2 times is necessary but actually 1.1 times was done for power tiller, 4.3 times is necessary but actually 1.6 times was done for farm tractor, 2.7 times is necessary but actually 1.7 times was done for rice transplanter, 1.9 times is necessary but actually 0.8 times was done for combine harvester. 6. For the annual cleanness or exchange of air filter, 3.2 times is necessary but actually 1.4 times was done for power tiller, 4.2 times is necessary but actually 2.4 times was done for farm tractor, 2.6 times is necessary but actually 1.6 times was done for rice transplanter, 3.9 times is necessary but actually 7.0 times was done for combine harvester. 7. For the experience of breakdown related to maintenance, 5.3% of farmers experienced breakdown due to the insufficient exchange of engine oil, 7.7% of farmers experienced breakdown due to the insufficient cleanness or exchange of fuel filter, and 2.9% of farmers experienced breakdown due to the insufficient cleanness or exchange of air filter. 8. Most farmers (76.1%) recognized the necessity for agricultural machinery training or education, and most farmers preferred about one week for the training period, simple or ease maintenance for the training level, agricultural technical center or agricultural machinery manufacturer for the training agency. 9. Complete recognition of operation manual and sufficient before-, during-, and after-maintenance for farm machinery can minimize the breakdown as well as conduct suitable period farming, enlarge the endurance, prevent the safety accidents, and promote productivity of farm machinery. Therefore, these can be accomplished by the thorough training or education for agricultural machinery.

A Study of Korean Costume in the Collection of Overseas Museums (해외 박물관 소장 한국 복식문화재에 관한 연구)

  • 윤은재;임영자
    • Journal of the Korean Society of Costume
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    • v.36
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    • pp.219-238
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    • 1998
  • For the purpose of this Study, the situation of Korean costume properties in the collection of overseas museums was investigated through correspondence, interviews with their curators and persons in charge and survey. As results were made about the situation of museum science (conservation) and practical utilization of costume properties. So, the study result were drawn as follows : Krean costume properties unexplaind of 'Korean cultural Properties' could be found in the Metropolitan Museum of Art of New York(135 pieces), the Brooklyn Museum of New York(20 pieces), the Newark Museum of New Jersey(15 pieces), and the Victoria Albert Museum of London(100 pieces). Korean costume properties in the collection of over-seas museums mostly fall under the rang of period between the 19th century and the early 20th century and are classified into everyday clothing, wedding costume and armors for the most part. In 1900s, museum in several countries began to collected Korean cultural properties through foreign missionaries or diplomats as well as merchants or travellers in who bought Korean objects. Recently, scholars, traditional Korean costume designerss and diplomatic and consular offices in overseas have donated our Korean costume to many foreign museums. Korean costume properties were largely on display in the dependent display of folklore museums or in a part of exhibition gallery for Asian culture and there were the separate exhibition rooms in museums in the United Kingdom, Germany, Denmark, Austria, Japan and the United States America. But the size and level of display room for Korean cultural properties is one third as large as that for chinese or Japanese cultual properties. It was found in this study that the traditional Korean costume in the collection of overseas museums was largely recorded only as general items rather than given their proper names. The typical example of misnaming included bridal's Kimono for Wonsam(원삼) in the Metropolitan Museum of Art, Yeonroksaek-bumunsajeokori for Dangeui(당의) and Jissan-gryongwonmunsadurumagi for Kongdali(동달이) in the Okura collection of the Tokyo National Museum, and so on. And the Victoria Albert Museum modified the way of wearing Daenim(대님) and the National Museum of Ethnology in Osaka seemed to misplace the ornament of Keanggi(댕기) on Mubok(무복) and Josunjuk(조선족: Chinese-Korean) Museum also misplace hansam(한삼). On the one hand, the Newark museum of New Jersey mixed Chinese armor with the Korean one and the Photohraph of King Kojong(고종) with Chinese one. It is corrected to publish and disseminate the book concering Korean costume in order to inform foreign museums of thed proper names and wearing method of our traditional costumed. The repair of costume before cleaning in the process of conservation treatment can prevent damage likely to occur as the properties of fiber itself are weakened in liquid. It is recommended that western 8-figure stitch and tacking stitch is added to Korean traditional stitching method. Museums in the U.S.A and the U.K are concerned about the aftermath of cleaning it-self, specially conservation treatment may exert on remains and predominantly use the vacuuming method to remove dust or bits of straw before the exhibition beings. But in case of Korea, the dry cleaning and wet cleaning method are used according to the nature and state of a sample costume. This comprehensive cleaning method is gradually developing scientifically but it is expected that those concerned will make a chemical analysis of the solvent to be used and also the more precise test of costume properties will be conducted before cleaning them. A partial study was made here because the scope of study was too broad and vast. It is expected that more studies will be conducted concerning our costume culture under the long-term plan and active support at the government level.

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Construction Techniques of Earthen Fortifications in the Hanseong Period of Baekje Kingdom (백제 한성기 토성의 축조기술)

  • LEE, Hyeokhee
    • Korean Journal of Heritage: History & Science
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    • v.55 no.2
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    • pp.168-184
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    • 2022
  • This paper examined the construction techniques of the earthen fortifications in the Hanseong Period of Baekje Kingdom, which has been researched most frequently among the Three Kingdoms. The construction processes of the Earthen Fortifications were reviewed and dividing into 'selection of location and construction of the base', 'construction of the wall', and 'finish, extension and repair'. The results show that various techniques were mobilized for building these earthen fortifications. Techniques which were adequate for the topography were utilized for reinforcing the base, and several other techniques were used for constructing the wall. In particular, techniques for wall construction may be clearly divided into those of the fill(盛土) and panchuk(版築) techniques. The fill method has been assumed since the 2000s to have been more efficient than the panchuk technique. This method never uses the structure of the panchuk technique and is characterized by a complex soil layer line, an alternate fill, use of 'earth mound(土堤)'/'clay clod(土塊)', and junctions of oval fill units. The fill method allows us to understand active technological sharing and application among the embankment structures in the period of the Three Kingdoms. The panchuk technique is used to construct a wall using a stamped earthen structure. This technique is divided into types B1 and B2 according to the height, scale, and extension method of the structure. Type B1 precedes B2, which was introduced in the late Hanseong Period. Staring with the Pungnap Earthen Fortification in Seoul, the panchuk technique seems to have spread throughout South Korea. The techniques of the fill and panchuk techniques coexisted at the time when they appeared, but panchuk earthen fortifications gradually dominated. Both techniques have completely different methods for the soil layers, and they have opposite orders of construction. Accordingly, it is assumed that both have different technical systems. The construction techniques of the earthen fortifications began from the Hanseong Period of Baekje Kingdom and were handed down and developed until the Woongjin-Sabi Periods. In the process, it seems that there existed active interactions with other nations. Recently, since studies of the earthen fortifications have been increasing mainly in the southern areas, it is expected that comparative analysis with neighboring countries will be done intensively.

Deterioration Evaluation Method of Noise Barriers for Managements of Highway (고속도로 방음벽 유지관리를 위한 방음벽 노후도 평가 방안)

  • Kim, Sangtae;Shin, Ilhyoung;Kim, Kyoungsu;Kim, Daae;Kim, Heungrae;Im, Jahae;Lee, Jajun
    • Journal of Environmental Impact Assessment
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    • v.28 no.4
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    • pp.387-399
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    • 2019
  • This research aimed to prepare the classification of the damage types and the damage rating system of noise barriers for expressway noise barriers and to develop deterioration evaluation method of noise barriers by reflecting them. The noise barrier consists of soundproof panels, foundations and posts and the soundproof panels with 10 different types of materials are used in a single or mixed form.In this paper, damage of soundproof panel shows a single or composite damage, and thus a evaluation model of deterioration has been developed for noise barriers that can reflect the characteristic of noise barriers. Materials used mainly for soundproof walls were divided into material types for metal, plastic, timber, transparent and concrete. And damage types for noise barrier were classified into corrosion, discoloration, deformation, spalling and dislocation and damage types were subdivided according to the noise barrier's components and materials. Damage rating was divided into good, minor, normal and severe for each major part of noise barrier to assess damage rating of soundproof panel, foundation and post. The deterioration degree of noise barrier was evaluated comprehensively by using the deterioration evaluation method of whole noise barrier using weighted average. Deterioration evaluation method that can be systematically assessed has been developed for noise barrier using single or mixed soundproof panel and noise barrier with single or complex damage types. Through such an evaluation system, it is deemed that the deterioration status of noise barrier installed can be systematically understood and utilized for efficient maintenance planning and implementation for repair and improvement of noise barriers.