• Journal of Chest Surgery
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• 제22권6호
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• pp.990-995
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• 1989

Since 1984, 24 patients underwent repair of atrioventricular septal defect. Nineteen had a partial defect and 5 had a complete atrioventricular septal defect. There were 9 men and 15 women, ranging in age from 1 to 50 years [mean age, 13.3 years]. Four patients had a Downs syndrome. Additional congenital heart defects were present in 11 patients. One patient had palliative operation prior to total correction. In partial defects, the primum atrial septal defect was closed with Xenomedica patch and the mitral valve was repaired with simple closure of the septal commissure. Central incompetence from annular dilatation was repaired by a local annuloplasty. In complete defect, the septal defects were closed with two patches except one. Operative mortality was 5% in partial defects and 60% in complete defects and low cardiac output was the commonest etiology. In a mean follow-up period of 27.9 months [range, 4 to 63 months] there were no late death and no instances of late-onset complete heart block. One patient required reoperation [MVR] for residual mitral regurgitation. The majority of patients were asymptomatic and mean postop. NYHA functional class was 1.2.

• Journal of Chest Surgery
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• 제16권3호
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• pp.337-341
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• 1983

The experience with operative treatment for total correction of Tetralogy of Fallot at the department of Thoracic and Cardiovascular Surgery, Korea University Hospital from January, 1977, through April, 1983 was reviewed. Of the 29 patients reviewed, male to female occurrence ratio was 22:7 Type of V.S.D. was type II in 26 cases[90%] and total conus defect in 3 cases[10%]. Average size of V.S.D. was 19 mm. Type of Right ventricular outflow tract stenosis was highest frequency with pulmonary valvular and infundibular stenosis combined type in 21 cases[72%], and there were 8 deaths In this group. Type of R.V.O.T. reconstruction contains 2 cases of infundibulectomy only, 1 case of infundibulectomy with valvular commissurotomy, 2 cases of pericardial patch, 23 Cases of pericardial patch with Teflon or Dacron felt reinforced and 1 case of pulmonary valved conduit reconstruction. Operative mortality was higher in outflow patch through pulmonary valve ring. Overall mortality was 31%. Major causes of death and postoperative complications were low output syndrome, complete A-V block acute renal failure, ventricular fibrillation, bleeding brain abscess, and sudden cardiac arrest.

• Journal of Chest Surgery
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• 제18권4호
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• pp.598-604
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• 1985

One hundred consecutive patients with the Tetralogy of Fallot underwent total correction at National Medical Center during the period 1977 to 1984, Oct. During this study period, we adopted more active policy towards reconstruction of right ventricular outflow tract across pulmonary valve. The mortality was 48% for patients less than 15 kg and 19% in patients above 15kg. Initially Bretschneider`s solution was used as cardioplegia, which was replaced by St. Thomas` solution since 1983, Jan. After then overall mortality dropped to 9% compared to 45% of initial learning period. Heart block occurred In 11 patients, 10 of whom died of combined low cardiac output syndrome. Pure low cardiac output syndrome was noted in 18 patients, most of whom responded to medical measures well except 4 patients. Recently sepsis of Serratia marcescence, which occurred explosively during several months to open heart surgery patients, attacked 3 tetralogy patients resulting in 2 hospital deaths. Our experience has shown that body weight, choice of cardioplegia and accumulation of experience as well as advance of operative and postoperative techniques are still important factors affecting survival rate at initial learning period.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2013년도 제45회 하계 정기학술대회 초록집
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• pp.104.2-104.2
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• 2013

A residual gas analyzer (RGA) system has been developed in this laboratory. Characteristics of the RGA system parts such as ion source, quadrupole mass filter and sensitivity are introduced. Some efforts have been made to improve performance of the two types of ion sources, open ion source (OIS) and closed ion source (CIS). A metal mesh was placed onto the electron beam entrance of the CIS anode tube to block the filament field penetration. Sensitivity of the CIS ion sources with and without the mesh was compared by mass spectra of SF6 gas (97% He base) introduced into the CIS anode through a needle valve. About ten-times improvement in the RGA sensitivity was observed for the CIS with the mesh in the electron entrance. Computer simulation showed an axi-symmetric anode potential distribution and improved focusing of the electron beam inside the anode tube with the mesh.

• Journal of Chest Surgery
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• 제14권1호
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• pp.49-59
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• 1981

This is one case report of surgically treated partial atrioventricular canal. The 22 year-old male patient had no definitive history of frequent respiratory infection and cyanosis in his early childhood. Since his age of 7 years, dyspnea was manifested on exertion. First appearance of congestive heart failure was at his age of 16 years old. The physical examination revealed that the neck veins were distended and heaving of precordium. A thrill was palpable on the left 3rd-4th intercostal space extending from the sternal border toward the apex and Grade IV/VI systolic ejection murmur was audible on it. Neither cyanosis nor clubbing was noted. Liver was palpable about 5 finger breadths. Chest X-ray revealed increased pulmonary vascularity and severe cardiomegaly (C-T ratio = 74%). EKG revealed LAD, clockwise rotation, LVH and trifascicular block. Echocardiogram showed paradoxical ventricular septal movement, narrowed left ventricular outflow tract and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted in large left to right shunt (Qp : Qs = 5.7: 1), ASD and moderate pulfllonary hypertension. Finally, left ventriculogram revealed typical goose neck appearance of left ventrlcalar outflow tract. On Oct. 10, 1980, open heart surgery was performed. Operative findings were: 1. Large primum defect ($6{\times}5$ Cm in diameter) 2. Cleft on the anterior leaflet of mitral valve. 3. The upper portion of ventricular septum was descent but no interventricular communication. 4. Downward attachment of the atrioventricular valves on the ventricular muscular septum. 5. Medium sized secumdum defect ($2{\times}1$ Cm in diameter). The cleft was repaired with 4 interrupted sutures. The primum defect was closed with Teflon patch and the secundum defect was closed with direct suture closure. Postoperatively atrial flutter-fibrillation in EKG and Grade U/VI apical systolic murmur were found. The postoperative course was uneventful and discharged on 29th postoperative day in good general conditions.

• Journal of Chest Surgery
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• 제50권3호
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• pp.163-170
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• 2017

Background: The absence of atrial contraction (AC) after the maze procedure has been reported to cause subsequent annular dilatation and to increase the risk of embolic stroke. We hypothesized that the lack of AC could increase the risk of permanent pacemaker (PPM) implantation in patients undergoing the maze procedure. Methods: In 376 consecutive patients who had undergone a cryo-maze procedure and combined valve operation, recovery of AC was assessed at baseline and at immediate (${\leq}2$ weeks), early (${\leq}1$ year, $4.6{\pm}3.8$ months), and late (>1 year, $3.5{\pm}1.1$ years) postoperative stages. Results: With a median follow-up of 53 months, 10 patients underwent PPM implantation. Seven PPM implants were for sinus node dysfunction (pauses of $9.6{\pm}2.4$ seconds), one was for marked sinus bradycardia, and two were for advanced/complete atrioventricular block. The median (interquartile range) time to PPM implantation was 13.8 (0.5-68.2) months. Our time-varying covariate Cox models showed that the absence of AC was a risk factor for PPM implantation (hazard ratio, 11.92; 95% confidence interval, 2.52 to 56.45; p=0.002). Conclusion: The absence of AC may be associated with a subsequent risk of PPM implantation.

• 한국항해항만학회지
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• 제33권6호
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• pp.375-380
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• 2009

1년 전까지만 해도 조선시황은 한없는 호항을 누릴 것으로 보였다. 그러나 2008년 후반에 찾아든 글로벌 경제의 불황은 바로 해운시장을 뒤흔들었고 그 여파는 바로 조선 사장에도 한없는 추락을 가져오고 있다. 저자들은 이러한 사태를 예견하여 이미 드라이 도크의 건조에 신중을 기할 것을 주장한 바 있다. 여기에 비하여 Floating Dock는 건조 비용도 덜 들고, 건조 기간도 짧고, 이동성마저 갖추고 있기 때문에 훨씬 더 유연한 도크 건설 방법이 될 수 있다. 그러나 Floating Dock는 대형의 블록을 탑재할 때 갑작스런 중량의 이동으로 인한 중심의 큰 변화로 안정성이 크게 위협 받게 된다. 따라서 안전하게 블록을 탑재하기 위하여서는 아주 고도의 정밀한 발라스트 작업이 수행되어야 한다. 본 연구에서는 육상에서 만들어진 거대 블록을 플로팅도크에 밀어 넣는 Skid Launching System을 위한 플로팅도크 제어 시스템을 완성하여 안정적인 SLS를 구현하고자 한다. 이를 위하여 저자들은 우선 가상의 진수 절차를 만들어 모의 조정하는 시뮬레이터를 개발(Kim et al. 2008)한 바 있다. 본 논문에서는 이시뮬레이션을 바탕으로 실시간 모니터링하면서 실시간 제어하는 시스템을 만들고 실제 진수에 적용하고자 한다.

• 상하수도학회지
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• 제31권5호
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• pp.459-469
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• 2017

A real scale leakage test facility was developed to study the leak signal characteristics of water supply pipelines, and then leak tests were carried out. The facility was designed to overcome the limited experimental circumstances of domestic water supply pipeline experimental facilities. The length of the pipeline, which was installed as a straight line, is 280m. Six pipes were installed on a 70m interval with different pipe material and diameters that are DCIP(D200, D150, D100, D80), PE(D75) and PVC(D75).The intensity of the leakage is adjusted by changing the size of the leak hole and the opening rate of ball valve. Various pressure conditions were simulated using a pressure reducing valve.To minimize external noise sources which, deteriorate the quality of measured leak signal, the facility was built at a quiet area, where traffic and water consumption by customers is relatively rare. In addition, the usage of electric equipment was minimized to block out noise and the facility was operated using manual mode. From the experimental results of measured leakage signal at the facility, it was found that the signal intensity weakened and the signal of high frequency band attenuated as the distance from the water leakage point increased.

• 한국가스학회지
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• 제22권6호
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• pp.28-33
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• 2018

최근 들어 정부는 도시가스 미공급지역 해소 및 소규모 공급지역의 경제성 확보를 위해 준저압 공급을 확대하고 있다. 주로 중앙 저장 탱크에서 매설 배관으로 각 세대에 공급하고 있는데 타공사에 의한 매설 배관의 파손 시 가스의 누출을 차단할 방법으로 배관 파손에 의한 과류를 차단할 수 있는 밸브의 필요성이 대두되고 있다. 이 연구를 위해 System CFD Code인 Flownex를 이용하였으며 실제 과류차단밸브에 해당되는 Component를 개발 완료하였다. 본 연구를 진행하면서 Flownex의 정확도를 검증하기 위해 실험값과 비교 하였으며 2% 내외의 오차율을 확인하였고 본 연구를 위해 사용이 가능한 것으로 판단되었다. 본 연구에서는 마을 단위의 LPG 공급 배관망을 선정하여 Modeling을 하였으며 주배관에서 세대로 인입되는 가지관의 이음 부위에 임으로 과류차단밸브 Component를 설치하였다. 주 배관에서 세대까지 가장 긴 배관을 선택하여 세대 인입 직전에 배관을 임으로 파손시켜 과류가 발생하도록 시나리오를 정하였다. 배관이 파손됨에 따라 과류가 발생하게 되고 과류차단밸브가 작동하게 되는데 이 때 과류차단 밸브의 작동이 타 배관에 미치는 영향 및 오작동 유무를 분석하였다.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.