• Title/Summary/Keyword: Valve body

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Repair of Complete Atrioventricular Septal Defect with Surgical Modification (변형술식에 의한 완전방실중격결손의 교정)

  • 김웅한;김수철;이택연;한미영;정철현;박영관;김종환
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.628-636
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    • 1999
  • Background: Recent advances in understanding the anatomy of the complete atrioventricular septal defect(including right-dominant unbalanced atrioventricular septal defect) have led to alternative methods of repairing these defects. Material and Method: From May 1997 to July 1998, 8 consecutive infants(age range, 2 to 28 months, mean body weight 6.0$\pm$2.2 kg) received a single-stage intracardiac repair of the complete atrioventricular septal defect with modified surgical methods. Depending on the specific anatomic structure, the procedure was simplified in 3 patients by a direct closure of the ventricular element of the defect(Group I). Two patients judged unsuitable for direct closure due to a potential left ventricular outflow tract obstruction had received a standard two-patch repair(Group II). The remaining 3 patients with right-dominant unbalanced complete atrioventricular septal defect underwent biventricular repair; to enlarge the orifice of the left atrioventricular valve, the ventricular septal patch was placed slightly more to the right of the ventricular crest, a left sided bridging leaflet was augmented with an autologous pericardial patch, and the leaflet was repaired with a double- orifice(Group III . Result: In all 8 patients, the postoperative echocardiography demonstrated good hemodynamics. Seven patients were weaned from the ventilators after a mean 3$\pm$1 days, and 1 patient was weaned after 24 days due to a reoperation and emphysematous lung problem. A reoperation was performed in 1 patient for progressive left atrioventricular valve regurgitation due to leaflet tearing. There were no early and late mortalities. At the time of the latest review, judging from the echocardiographic criteria, left atrioventricular valve stenosis was mild in 1 patient(mean pressure gradient 6.5 mmHg, 13.5%), left atrioventricular valve regurgitation was absent or grade I in 7 patients(87.5%). The right atrioventricular valve regurgitation was absent or grade I in all 8 patients(100%). Conclusion: Infants with complete atrioventricular septal defect were treated with either a simplified approach with direct closure of the ventricular element of the defect or a modified surgical technique for a right-dominant unbalanced atrioventricular septal defect, depending on the anatomic structure. The results were no operative mortalities and low morbidity.

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Experiment Study on Field Applicability of Siphon as a Intake Facility of Agricultural Reservoir for Disaster Prevention (재해대비 농업용저수지 취수시설로서 사이폰의 현장적용성에 관한 실험적 연구)

  • Yang, Young Jin;Lee, Tae Ho;Oh, Sue Hoon
    • Journal of The Korean Society of Agricultural Engineers
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    • v.60 no.2
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    • pp.103-110
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    • 2018
  • Most of the intake facilities of small agricultural reservoirs are conduits and they are regarded as serious defects due to the structural weakness that penetrates the body of the dam, and countermeasures are needed. This study suggests the application method of siphon type water intake facility by hydraulic model test and physical scale model test of siphon type water intake facility which has high safety and easy maintenance. Experimental results show that sufficient flow rate can be secured for the purpose of intaking water according to the differential head between the reservoir and the discharge part, and the flow rate can be controlled by the valve. The negative pressure was -31.5 kPa, and vibration and noise did not occur during the operation of the siphon. The maximum flow velocity in the discharge outlet was 1.11 m/s which meets the criterion for irrigation canals. Therefore, scour risk would be very low. As a result of the inflow distribution experiment, even if the inflow part is separated by only about 0.8 m, the flow velocity is remarkably decreased, so that the clogging by debris would not appear. When the pump was operated only once for the first time and the inside of the siphon was filled with water, continuous operation was possible by only valve operation. The results of this study are expected to be used for the design guidelines of the water intake facilities and improve safety and maintenance convenience of agricultural reservoirs.

Experience with Rastelli Procedure in the Repair of Congenital Heart Diseases (Rastelli 술식의 임상경험;72례)

  • 백희종
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1327-1336
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    • 1992
  • Between Jan. 1986 and Aug. 1992. 72 patients underwent Rastelli procedure. There were 43 male and 29 female, aged 46 days to 16 years [mean age, 5.2 years] with 18 patients less than 2 years of age. All patients had complex defect, 27 pulmonary atresia with ventricular septal defect, 18 corrected transposition of great arteries with pulmonary atresia or punmonary stenosis, 10 truncus arteriosus, 10 double outlet right ventricle with pulmonary atresia or stenosis, 7 complete transposition of great artersia with pulmonary atresia or pulmonary stenosis. The types of extracardiac valved conduit used were prosthetic valve[n=47, 24 car-bomedics, 19 Ionescu-Shiley, 4 Bjork-shiley] and hand-made trileaflet valve using pericardium. [n=23, 20 bovine pericardium, Z autologous pericardium, 1 equine pericardium] The mean size of valved cinduit was 5.25mm larger in diameter than the size of main pulmonary artery. [normalized to the patient`s body surface area] There were 17 hospital death[24%] and 4 late deaths[5.6%]. Postoperative complication rate was 38.9%a, none of which was conduit-related. All patients were followed pos-toperatively for 1 to 73 months. [mean 25.8 months] During follow-up period, reoperation was done in 6 patients due to stenosis of valved conduit. Mean interval between intial repair and reoperation was 20.3 months. In our experience, li recently extracardaic valved conduits between right ventricle [or pulmonary ventricle] and pulmonary artery were inserted with increasing frequency in infants less than 2 year, but hospital mortality was decreased, 2] Risk of reoperation due to conduit stenosis is low, so that the effect of graft failure on overall survival is minimized. 3] Nevertheless, because any type of extracardaic valved conduit is not ideal in children, we recommended that Lecompte should be done if cardiac anatomy is permitted.

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DEVELOPMENT OF A REVERSE CONTINUOUS VARIABLE DAMPER FOR SEMI-ACTIVE SUSPENSION

  • Yoon, Young-Hwan;Choi, Myung-Jin;Kim, Kyung-Hoon
    • International Journal of Automotive Technology
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    • v.3 no.1
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    • pp.27-32
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    • 2002
  • Semi-active suspension systems are greatly expected to be in the mainstream of future controlled suspensions fur passenger cars. In this study, a continuous variable damper for a passenger car suspension is developed. It is controlled actively and exhibits high performance with light weight, low cost, and low energy consumption. To get fast response of the damper, reverse damping mechanism is adapted, and to get small pressure change rate after blow-off, a pilot controlled proportional valve is designed and analyzed. The reverse continuous variable damper is designed as a HS-SH damper which offers good body control with reduced transferred input force from tire, compared with any other type of suspension system. The damper structure is designed, so that rebound and compression damping force can be tuned independently, of which variable valve is placed externally. The rate of pressure change with respect to the flow rate after blow-offbecomes smooth when the fixed orifice size increases. Damping forces are measured with the change of the solenoid current at the different piston velocities to confirm the maximum hysteresis of 20N, linearity, and variance of damping farce. The damping farce variance is wide and continuous, and is controlled by the spoof opening, of which scheme is usually adapted in proportional valves. The reverse continuous variable damper developed in this study is expected to be utilized in the semi-active suspension systems in passenger cars after its performance and simplicity of the design is confirmed through real car test.

Complete Repair of Tetralogy of Fallot in Neonate or Infancy (신생아및 영아기 활로씨 사징증의 완전 교정술)

  • 이정렬
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.32-41
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    • 1992
  • From August 1982 to December 1991, 58 consecutive infants with tetralogy of Fallot underwent primary repair. Age ranged from 22 days to twelve months [n=58, 8.7$\pm$2.7 months] and body weight from 3.1 to 13 kilograms [n=58, 7.8$\pm$1.7 kilograms]. Qne infant had absence of the pulmonary valve; one had Ebstein`s anomaly and one had supramitral ring. Thirty-two patients [56%] experienced anoxic spell. Preoperative pulmonary artery indices were measured in 38 cases, ranging 126-552mm2/M2BSA[n=38, 251$\pm$79mm2/M2BSA]. All infants required a right ventricular outflow tract patch; in 41, the patch extended across the pulmonary valve annulus, in 13 of them, monocusps were constructed. All had patch closure of ventricular septal defect. Two infants had REV operation for avoiding injury to the canal branch of the right coronary artery which cross the right ventricular out flow tract. Post repair PRV/LV were measured at operating room in 40 cases, which revealed mean value of 0.49$\pm$0.12 [range: 0.25-0.74]. The hospital mortality was 10.3% [6 patients], and causes of deaths were right heart failure due to sustained right ventricular hypertension[4] and right ventricular outflow tract obstruction, intractablesuraventricular tachyarrhythmia[1], hypoxia[1] due to residual right to left shunt across the atrial septal defect in patient associated with Ebstein`s anomaly. All infants were doing well at follow-up from 1 to 101 months[20.6 months /patient, 1, 072 patient-month] Serial postoperative echocardiograms revealed no residual ventricular septal defects and estimated RVOT gradients between 0 and 40 mmHg except 3 cases [50, 50, 60 mmHg]. There were no late deaths and late ventricular arrhythmias or congestive heart failure. Redo operations were done in 2 cases because of residual right ventricular outflow tract obstruction. This experience with infants with tetralogy of Fallot suggests that, if mortality is tolerable, eletive repair of tetralogy of Fallot could be reasonably undertaken during the first year of life, and even better results could be anticipated along with improvement of methods of myocardial protection and postoperative care.

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Complicatons and Residual Defects After Correction of Noncomplicated Ventricular Septal Defect (단순 심실중격결손증 수술 후 합병증 및 잔존 결손)

  • Jun, Tae-Gook;Hwang, Kyung-Hwan;Lee, Ho-Seok;Huh, Jung-Hee;Park, Kay-Hyun;Park, Pyo-Won;Chae, Hurn
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.139-145
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    • 2000
  • Background: The purpose of this study is to review the clinical course after the correction of noncomplicated ventricular septal defect and to analyze the morbidity and risk factors of postoperative complications and evaluate residual defect during the follow-up period. Material and Method: From September 1994 to June 1998 24 patients(median age 10 months) underwent surgery under the diagnosis of ventricular septal defect. We made a retrospective review of the clinical records including the operation notes critical care unit records echocardiography results and the follow-up records. Result: There was no early mortality nd late mortality. There was no postoperative complete conduction block. Respiratory complication was the most common complication. The body weight age type of ventricular septal defect associated anomalies and operative procedure were not related to the incidence of complications. residual ventricular septal defects aortic valve regurgitation and tricuspid valve regurgitation were insignificant in postoperative hemodynamics, Conclusions: Correction of the noncomplicated ventricular septal defect was done without mortality and complete heart block. Aggressive preoperative medical treatment and early surgical treatment may decrease postoperative complications. Postoperative residual shunt and tricuspid regurgitation were not problematic during the follow-up

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Serum Concentration of Nitrotyrosine as Indicator of Disease Progress in Dogs with Myxomatous Mitral Valve Disease

  • Bang, Ju-Hwan;Park, Jun-Seok;Seo, Kyoung-Won;Song, Kun-Ho
    • Journal of Veterinary Clinics
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    • v.36 no.2
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    • pp.102-105
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    • 2019
  • Nitrotyrosine was found to be dependent on the severity of myxomatous mitral valve disease (MMVD). However, a correlation of serum nitrotyrosine concentration in dogs with MMVD and the progression of the disease has not been investigated. This study compared changes in serum nitrotyrosine concentration with the progression of MMVD. Nine client-owned dogs were recruited for the study. Dogs were classified by measuring the amount of regurgitation using echocardiography into mild, moderate, or severe MMVD groups. Serum nitrotyrosine concentration was measured by an enzyme-linked immunosorbent assay test. Serum nitrotyrosine concentration was significantly higher at 180 days than at 0 day (P < 0.05). However, serum nitrotyrosine concentration at 360 days was lower than that at 180 days (P < 0.05). Serum nitrotyrosine concentration at 540 days was lower than at 180 days (P < 0.05). There was no correlation between serum nitrotyrosine and left atrial to aortic root diameter ratio (LA/Ao ratio) (n = 33, $R^2=0.003$, P = 0.759). Also, there was no correlation between serum nitrotyrosine and vertebral heart score (VHS) (n = 33, $R^2=0.026$, P = 0.368) and left ventricular end-diastolic diameter, normalized for body weight by the formula (LVEDDN) (n = 33, $R^2=0.053$, P = 0.196). The results of the study suggest that the progression of MMVD is correlated with changes in serum nitrotyrosine concentration, which shows potential for use as a cardiac biomarker which can be used to analyze the progression of disease in MMVD.

Change of coronary artery indices according to coronary dominance pattern in early childhood

  • Lee, Yoon Jin;Park, Kyoung Soo;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.62 no.6
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    • pp.240-243
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    • 2019
  • Purpose: Coronary arterial lesion assessment in children can be difficult, depending on the coronary dominance pattern. Although it is easier to determine coronary dominance with echocardiography in children than in adults, it is still difficult. This study aimed to examine the coronary dominance pattern according to the objective coronary artery (CA) indices. Methods: The CA diameter, aortic valve annulus, and abdominal aorta of 69 children without any cardiovascular disease were measured with cross-sectional echocardiography at Chungnam National University Hospital. To evaluate the coronary dominance pattern, echocardiography was primarily used; additionally, coronary computed tomographic angiography or coronary angiography (CAG). Coronary dominance was determined according to the status of the CA that gives rise to the posterior descending artery. Results: The mean age was $4.02{\pm}2.78years$, and the mean body surface area (BSA) was $0.70{\pm}0.22m^2$. Right dominance was present in 78% and left in 22% of the subjects. In those with left dominance, the CA to aortic valve annulus diameter ratio was $0.125{\pm}0.021$ in the right coronary artery (RCA) and $0.255{\pm}0.032$ in the left coronary artery (LCA). In those with right dominance, the corresponding ratio was $0.168{\pm}0.028$ in the RCA and $0.216{\pm}0.030$ in the LCA (P<0.05). Significant differences were also found in the diametric ratios of the CA to BSA and abdominal aorta (P<0.05). Conclusion: The CA indices showed significant difference according to the coronary dominance pattern in early childhood. It is possible to indirectly determine the coronary dominance pattern with the CA indices in children using echocardiography. The accuracy of coronary artery lesion diagnosis can be improved by taking coronary dominance into account.

Study of Fire and Explosion Prevention of an Internal Floating Roof Tank (내부 부상형저장탱크(IFRT) 화재·폭발 예방대책에 관한 연구)

  • Koo, Chae-Chil;Choi, Jae-Wook
    • Fire Science and Engineering
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    • v.33 no.1
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    • pp.45-49
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    • 2019
  • This study examined the safety of storage tanks by analyzing the causes of fire on outdoor storage tanks. The outdoor storage tank is a fixed device for the long-term storage of dangerous goods and consists of a tank body and accessories; the accessories consist of a vent system, breather valve, flame arrestor, etc. The flame arrestor is a necessary safety measure to prevent fire explosions on outdoor storage tanks. On the other hand, it has been suggested that the installation of a flame arrester is necessary to compare the domestic and international standards. In addition, the flame arrester should be installed in the existing outdoor storage tanks, to complement foreign standards because there are not enough domestic standards to verify the performance of the flame arrester.

Mitral Valve Repair for Mitral Regurgitation in Pediatric Patients (승모판폐쇄부전증를 가진 소아 환자에서 승모판성형술의 임상적 고찰)

  • Sim, Hyung-Tae;Yun, Tae-Jin;Park, Jeong-Jun;Jung, Sung-Ho;Uhm, Ju-Yeon;Jhang, Won-Kyoung;Kim, Young-Hwue;Ko, Jae-Kon;Park, In-Sook;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.536-545
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    • 2007
  • Background: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. Material and Method: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years, The mean age was $5.3{\pm}5.3$ years and the mean body weight was $20,0{\pm}16.3\;kg$. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). Result: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were $93.3{\pm}4.6%$ and $76.1{\pm}8.2%$, respectively. The 5-year freedom from mitral valve replacement rate was $83.6{\pm}6.7%$. There was no significant risk factor for reoperation. Conclusion: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.