• Journal of Chest Surgery
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• v.40 no.12
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• pp.805-810
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• 2007

Background: This paper reviews our experience retrospectively to examine the clinical results and effectiveness of lateral tunnel (LT) and extracardiac conduit (ECC) Fontan procedures at a single institution. Material and Method: One hundred and sixty five Fontan procedures were performed (67 LT and 98 ECC) between January 1996 and December 2006. Preoperative and postoperative hemodynamic values, arrhythmia, hospital and intensive care unit stay, chest tube drain, morbidity and mortality were reviewed. Result: The overall operative mortality in the LT and ECC groups was 4.5% (3) and 2.0% (2), respectively. There was a significant difference in the immediate postoperative transpulmonary gradient (LT $8.5{\pm}2.5$ vs ECC $6.6{\pm}2.4$, p-value<0.001) and central venous pressure (LT $18.3{\pm}3.8$ vs ECC $15.6{\pm}2.4$, p-value=0.001) between the two groups. The mean follow-up in the LT and ECC groups was $74.1{\pm}31.5$ and $38.1{\pm}29.1$ months, respectively. There was one late death. The actuarial survival at 10 years in the LT and ECC groups was 92% and 89%, respectively. In arrhythmia, the ECC patients showed a slightly low incidence but the difference was not statistically significant. Conclusion: Both the LT and ECC Fontan procedures showed comparable early and mid-term outcomes in terms of the surgical morbidity and mortality, postoperative hemodynamics, and mid-term survival. The ECC Fontan procedure reduces the risk of arrhythmia in the follow up period.

• Journal of Korean Society of Coastal and Ocean Engineers
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• v.31 no.3
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• pp.158-169
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• 2019

A probabilistic model that can predict the residual useful lifetime of structure is formulated by using the gamma process which is one of the stochastic processes. The formulated stochastic model can take into account both the sampling uncertainty associated with damages measured up to now and the temporal uncertainty of cumulative damage over time. A method estimating several parameters of stochastic model is additionally proposed by introducing of the least square method and the method of moments, so that the age of a structure, the operational environment, and the evolution of damage with time can be considered. Some features related to the residual useful lifetime are firstly investigated into through the sensitivity analysis on parameters under a simple setting of single damage data measured at the current age. The stochastic model are then applied to the rubble-mound breakwater straightforwardly. The parameters of gamma process can be estimated for several experimental data on the damage processes of armor rocks of rubble-mound breakwater. The expected damage levels over time, which are numerically simulated with the estimated parameters, are in very good agreement with those from the flume testing. It has been found from various numerical calculations that the probabilities exceeding the failure limit are converged to the constraint that the model must be satisfied after lasting for a long time from now. Meanwhile, the expected residual useful lifetimes evaluated from the failure probabilities are seen to be different with respect to the behavior of damage history. As the coefficient of variation of cumulative damage is becoming large, in particular, it has been shown that the expected residual useful lifetimes have significant discrepancies from those of the deterministic regression model. This is mainly due to the effect of sampling and temporal uncertainties associated with damage, by which the first time to failure tends to be widely distributed. Therefore, the stochastic model presented in this paper for predicting the residual useful lifetime of structure can properly implement the probabilistic assessment on current damage state of structure as well as take account of the temporal uncertainty of future cumulative damage.