• Journal of Chest Surgery
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• 제33권5호
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• pp.391-397
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• 2000

Background: Cardiac involvement of Behcets disease is very rate, however, the prognosis of Behcet disease depends on cardiovascular complications. In this article, we described surgical treatment of aortic insufficiency with Behcets disease. Material and Method: From March 1986 to February 1998, we operated on 10 patients of aortic insufficiency with Behcets disease. Male to female ratio was 8 to 2, and age ranged from 21 to 40 years(mean 32.8 years). There were 8 patients with evidence of Behcets disease and another 2 patients had some suspicious findings of Behcets disease(i.e., prosthetic value dehiscence, hypertrophied aortic wall). Adequate preoperative medical treatment for Behcets disease was done in 3 patients. Result: We performed 24 open heart surgeries in 10 patients. Redo value replacements using prosthetic valves were done in 4 patients. Among them, 2 patients were operated on for a second redo valve replacement and one of them operated on for a 4th and 5th operation because of recurrent paravalvular leakage. These 4 patients expired. 1 patient who had undergons tissue value replacement is alive. 1 patient who underwent Cabrol operation expired dut to rupture of graft anastomosis site. We used homografts in 3 patients. In 2 of them, we performed aortic root replacement and subcoronary valve replacement in another patient. The patient who underwent subcoronary valve insertion had remnant aortic insufficiency, so we are closely observing him. We also performed Ross operation in a 24 year old female who suffered severs aortic insufficiency and endocarditis after aortic valvuloplasty. 5 patients are alive and mean follow up duration is 49.0 months. Among them, we used homografts or sutografts in 4 patients. We could observe excellent clinical results in the patients who underwent aortic root replacement using homograft and they were treated medically for Behcets disease. Conclusion: We concluded that adequate preporative diagnosis, clinical suspicion, and periopertive medical treatment for Behcets disease are very important for the result of surgical management of aortic insufficiency with Behcets disease. The use of homograft or autograft was helpful for the healing of anastomosis site and we should carefully observe the long term follow up results.

• 한국가스학회지
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• 제22권6호
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• pp.16-27
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• 2018

대한민국 정부에서 2014년부터 LPG배관망과 LPG소형탱크를 도시가스 공급망 개설이 어려운 산간이나 도서지역에 보급하는 사업을 시작했다. 마을단위와 군단위로 LPG집단공급시설을 설치하면서 기존의 가스공급 압력이 아닌 10배 이상의 높은 준저압(25kPa~100kPa)으로 소비자에게 공급하게 되면서 가스사고의 위험성이 높아졌다. 기존의 가스공급압력보다 10배 이상 높은 압력이기 때문에 가스가 누출 되었을 때 빠른 속도로 많은 양이 누출하게 된다. 이에 준저압 가스배관의 안전성 확보를 위해 과류차단밸브가 필요하게 되었지만, 국내에서는 준저압 매몰배관용 과류차단밸브가 미개발되어 있으며 보급 또한 되어 있지 않는 상황이다. 이에 한국가스안전공사에서는 과류차단밸브의 국산화를 위해 과류차단밸브를 기개발한 해외의 성능기준과 제품을 조사 중에 있으며, 과류차단밸브의 성능평가를 위해 성능시험설비를 구축하여 준저압 연료가스 매몰배관용 과류차단밸브를 연구 개발 중에 있다.

• 상하수도학회지
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• 제21권5호
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• pp.609-619
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• 2007

The objective of this paper is to evaluate the feasibility of conjunctive Operation between Multi-regional water supply networks from multiple source as a effective way to meet two conditions: to minimize the electric cost for providing water demanded and meet the water flow rate for satisfying customers. EPAnet Model is used to calculate a hydraulic water distribution condition based on an integrated operation of water supply systems located in short distance. The modeling was conducted on several simulation cases including the individual operation by existing inter-regional water supply networks within short distance, the conjunctive operation of more than two existing networks with valve fully closed and full open constraint. As a study distribution system, water supplying systems of the Geojae-city in the Geongsang Namdo Province was selected and investigated. It was found that a well-allocated water supply scheme based on a conjunctive operation promises to save the electric cost and satisfy all operational goals such as stability and revenues during the period. The result such as unit district costs, pareto optimum pump combination sets will be applied to the optimization for a conjunctive operation of existing inter-regional water supply networks within short distance.

• 한국추진공학회지
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• 제6권3호
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• pp.19-27
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• 2002

액체로켓 엔진에서 작동초기인 연소기 내의 점화를 결정하는 추진제의 공급 순서는 엔진의 안정적인 운영에 필수적이다. 본 논문에서는 KSR-III 주엔진의 점화 순서에 대해 간략히 설명하였고, 점화순서를 결정하는 시험측정인자에 대한 종류 및 측정 신뢰성에 대해 살펴보았다. 점화 cyclogram에서 중요한 추진제의 공급시간을 정확히 결정하기 위해 엔진의 메니폴드 체적과 유량에 관련된 충전시간, 그리고 밸브 개폐시간에 대해 논의하였다. 또한, 점화에 있어 연료나 산화제 공급의 순서를 다르게 하는 경우 점화초기 엔진의 연소 특성에 대해 기술하였다. 측정변수에 의해 결정된 점화 cyclogram으로 연소시험을 수행한 결과에 대해 간략히 기술하였다.

• 대한기계학회논문집
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• 제18권10호
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• pp.2686-2697
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• 1994

When a railway train enters a tunnel at high speed, a compression wave is formed in front of the train and propagates along the tunnel. The compression wave subsequently emerges from the exit of the tunnel, which causes an impulsive noise. In order to estimate the magnitudes of the noises and to effectively minimize them, the characteristics of the compression wave propagating in a tunnel must be understood. In the present paper, the experimental and analytical investigations on the attenuation and distortion of the propagating compression waves were carried out using a model tunnel. This facility is a kind of open-ended shock tube with a fast-opening gate valve instead of a general diaphragm. One-dimensional flow model employed in the present study could appropriately predict the strength of the compression wave, Mach number and flow velocity induced by the compression wave. The experimental results show that the strength of a compression wave decreases with the distance from the tunnel entrance. The decreasing rate of the wave strength and pressure gradient in the wave is strongly dependent on the strength of the initial compression wave at the tunnel entrance.

• 한국물환경학회지
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• 제31권5호
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• pp.523-532
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• 2015

Hydrocyclone is widely used in industry, for its simple design, high capacity, low maintenance and low operational cost. The objective of this study is to develop hydrocyclone coagulation and filtration system. The system is made of hydrocyclone ballasted coagulation with polyaluminium chloride silicate (PACS) and upflow filter to treat micro particles in urban storm runoff. Roadside sediment particles (< $200{\mu}m$) was mixed with tap water to make various turbid suspensions to simulate urban storm runoff. The filter cartridge was filled with polyethylene media system and ran 1hr per everyday and total operation time were 8.19hrs and backwashing everyday after end of operation. The operation condition of flowrate was $8.2{\sim}11.9m^3/day$ (mean $10.1m^3/day$) and surface overflow rate (SOR) based on filter surface area was $45.5{\sim}65.9m^3/m^2/day$ (mean $55.7m^3/m^2/day$). The range of PACS dosage concentration was 14.0~31.5 mg/L. As the results of operation, the range of removal efficiency of turbidity, SS were 81.0~95.8% (mean 89.5%) 81.8~99.0% (mean 91.4%), respectively. An increase of filtration basin retention time brought on increased of removal efficiency of turbidity and SS, and increase of SOR brought on decreased of removal efficiency. During the first flush in urban area, storm runoff have an high concentration of SS (200~600 mg/L) and the filtration bed becomes clogged and decreased of removal efficiency. Backwashing begins when the drainage pipe valve at the filtration tank bottom is completely open (backwashing stage 1). Backwashing stage 2 was using air bubbles and water jet washing the media for 5 mins and open the drainage valve. After backwashing stage 1, 2, 61.83~64.04%, 18.53~27.51% of SS loading was discharged from filtration tank, respectively. Discharged SS loading from effluent was 7.12~14.79% and the range of residual SS loading in fliter was 2.26~5.00%. The backwashing effects for turbidity, SS were 89.5%, 91.4%, respectively. The hydrocyclone coagulation and filtration with backwashing system, which came out to solve the problems of the costly exchange filter media, and low efficiency of removing micro particles of filter type nonpoint treatment devices, is considered as an alternative system.

• Journal of Chest Surgery
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• 제48권1호
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• pp.25-32
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• 2015

Background: We evaluated operative outcomes after third or more cardiac operations for valvular heart disease, and analyzed whether pericardial coverage with artificial membrane is helpful for subsequent reoperation. Methods: From 2000 to 2012, 149 patients (male : female=70 : 79; mean age at operation, $57.0{\pm}11.3$ years) underwent their third to fifth operations for valvular heart disease. Early results were compared between patients who underwent their third operation (n=114) and those who underwent fourth or fifth operation (n=35). Outcomes were also compared between 71 patients who had their pericardium open during the previous operation and 27 patients who had artificial membrane coverage. Results: Intraoperative adverse events occurred in 22 patients (14.8%). Right atrium (n=6) and innominate vein (n=5) were most frequently injured. In-hospital mortality rate was 9.4%. Total cardiopulmonary bypass time ($225{\pm}77$ minutes vs. $287{\pm}134$ minutes, p=0.012) and the time required to prepare aortic cross clamp ($209{\pm}57$ minutes vs. $259{\pm}68$ minutes, p<0.001) increased as reoperations were repeated. However, intraoperative event rate (13.2% vs. 20.0%), in-hospital mortality (9.6% vs. 8.6%) and postoperative complications were not statistically different according to the number of previous operations. Pericardial closure using artificial membrane at previous operation was not beneficial in reducing intraoperative events (25.9% vs. 18.3%) and shortening operation time preparing aortic cross clamp ($248{\pm}64$ minutes vs. $225{\pm}59$ minutes) as compared to no-closure. Conclusion: Clinical outcomes of the third or more operations for valvular heart disease were acceptable in terms of intraoperative adverse events and in-hospital mortality rates. There were no differences in the incidence of intraoperative adverse events, early mortality and postoperative complications between third cardiac operation and fourth or more.

• Journal of Chest Surgery
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• 제25권3호
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• pp.232-239
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• 1992

Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

• 대한방사선기술학회지:방사선기술과학
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• 제34권1호
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• pp.35-41
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• 2011

항암 치료를 받는 환자들은 장기간의 안정적인 정맥확보를 위해 중심정맥 카테터 삽입이 점차 증가하는 추세로 장기간의 항암제 투여, 종합 비경구적 영양법, 반복적 혈액채취와 항생제 투여, 혈액 투석을 위해 시행되고 있다. 그중 주입구를 완전히 피하에 심는 피하매몰형 중심정맥포트(chemo-port)의 설치가 많이 시행되고 있다. 본 연구에서는 항암치료를 받은 환자 중 중재적 방사선과에서 전형적인 카테터 끝이 열려 있는(non-valved) 포트와 새로운 형태의 카테터 끝이 닫혀 있는(valved) 포트를 삽입했던 환자를 대상으로 발생한 합병증이나 문제점에 관한 후향적 조사를 바탕으로 올바른 피하매몰 중심정맥 포트의 선택 및 관리, 해결 방안을 모색하고자 함이다. 2006년 1월부터 2010년 5월까지 피하매몰 중심정맥포트를 삽입한 438명을 대상으로 하였다. 이중 valved 포트를 삽입한 경우는 109명이었고 non-valved 포트를 삽입한 경우는 329명이었다. 포트의 사용상의 문제점을 의뢰한 56명 중 실제로 발생된 30명의 합병증이나 문제점을 valved. non-valved 포트로 나누어 비교 평가하였다. 포트 시술 후 valved 포트에서 문제점과 합병증이 11.93%, non-valved 포트에서 문제점과 합병증이 5.17% 발생하여 상대적으로 valved 포트에서 문제가 더 많이 발생하였다. Valve사용 유무에 따른 포트 사용 시 두께가 얇은 포트의 사용을 권장하고 시술시 환자 감염이 유발하지 않게 가이드라인을 설정해야 하며 시술이후에도 포트를 사용 시 전용바늘을 사용하고 사용 후 생리식염수의 의한 관 세척 등 포트관리에 체계적인 관리가 필요하다. 추가적인 문제점이 발생 시 원인을 찾아내어 해결책을 제시하고 향후 반복적인 합병증이나 문제점이 발생하지 않게 하여 포트 삽입술의 유용성과 안전성을 증대해야 한다.

• Journal of Chest Surgery
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• 제12권3호
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• pp.281-288
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.