• Journal of Chest Surgery
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• v.17 no.1
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• pp.48-52
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• 1984

Total anomalous pulmonary venous connection [TAPVC] defines a group of congenital heart disease which have in common the entire pulmonary venous drainage returning directly or indirectly to the right atrium instead of to the left atrium. Although this disorder represents only 1.3% of cases of congenital heart disease, if untreated the resultant mortality is greater than 80% in the 1st year of life. And since there is no satisfactory palliative treatment, correction of TAPVC Is high on the list of indications for open heart surgery in the 1st year of life. This paper describes 10 patients who underwent surgical correction of this disorder at SNUH between 1978 and 1983. 1. 7 were males and 3 females, with ages ranging from 5 months to 24 years. 2. 7 were supracardiac type, 2 cardiac type, and 1 mixed type TAPVC. We didnt experience infracardiac type. 3. All showed some degree of pulmonary hypertension preoperatively. 4. In 4 cases of supracardiac type, total circulatory arrest was used in brief period during anastomosis between common pulmonary venous trunk and left atrium. In the other cases, usual cardiopulmonary bypass with moderate to deep hyperthermia was used. 5. There were 2 cases of mortality; 1 died at operation, and the other at 4 months due to congestive heart failure. 6. Mortality seemed not closely related to age, body weight, or severity of pulmonary hypertension.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.206-211
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• 1991

Interruption of the aortic arch may be defined as discontinuity of the aortic arch in which either an aortic vessel or a patent ductus arteriosus supplies the descending aorta. This anomaly is a rare congenital malformation that usually occurs with severe associated intracardiac congenital anomalies, such as ventricular septal defect, patent foramen ovale and abnormal arrangement of the brachiocephalic arteries. Rarely, transposition of the great vessel, truncus arteriosus are coexistent. We experienced a case of the interrupted aortic arch [Type A] associated with VSD, PDA and patent foramen ovale in a 16 years old female. One stage total correction was done under profound hypothermia with total circulatory arrest. Aortic continuity was established using patent ductus arteriosus with anterior wall of main pulmonary artery, which was anastomosed obliquely to anteromedial side of the ascending aorta. Ventricular septal defect was closed using Dacron patch and patent foramen ovale was closed directly. Postoperative course was uneventful, except mild hoarseness.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.588-593
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• 1988

We experienced a case of interrupted aortic arch[Type A] associated with PDA, VSD, mitral regurgitation and single coronary artery. The patient was 7 years old boy, who showed congestive heart failure[NYHA functional class III]. One stage total correction was performed under profound hypothermia with total circulatory arrest. Aortic continuity was established using PDA with anterior wall of main pulmonary artery flap. VSD was closed with Dacron patch and mitral regurgitation repaired by Reed`s annuloplasty method. The postoperative cardiac catheterization revealed no pressure gradient between ascending aorta and descending aorta, decreased pulmonary artery pressure and trivial residual shunt[Qp/Qs: 1.28]. The aortogram showed good continuity of the aorta without narrowing of the anastomotic site. During the period of 1 year follow up, heart failure symptoms were nearly subsided.

• Journal of Chest Surgery
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• v.27 no.10
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• pp.862-867
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• 1994

We experienced two cases of dissecting aneurysm[DeBakey type III] of the thoracic aorta treated using intraluminal sutureless graft. Controversy still exists about the exact timing of surgical intervention for dissection of the descending thoracic aorta. The surgical indication of dissecting aneurysm[DeBakey type III] is continuous flow in the false lumen, continuous chest pain, compromise of arterial supply to a specific organ or limb, or extension of the dissection while the patient is receiving satisfactory medical treatment. Surgical therapy for dissection of the aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. Recently, a new method of treatment with a intraluminal sutureless graft that requires no end-to-end anastomosis has been developed. In our cases, cardiopulmonary bypass and circulatory arrest was utilized in repairing dissecting aneurysm of descending aorta[DeBakey type III] in order to avoid the aortic cross clamping because of friable aortic intima. The basic technique consists of vertical incision of descending aorta in the area of intimal tear and inserting the whole ringed graft into the true lumen of the dissected aorta and circumferentially ligating the aorta against the groove in the rings. Postoperative course was uneventful.

• The KSFM Journal of Fluid Machinery
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• v.15 no.4
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• pp.67-71
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• 2012

This study analyzed performance changes by an inner flow path of impeller groove for side channel type ring blower using CFD. Two models have the same side channel and clearance while one has an inner flow path and the other doesn't. To analyze the performance change of a ring blower, overall performance and local flow field were analyzed. For the overall performance, pressure increase and impeller torque were checked under the design flow condition. Under the design flow condition, pressure increase was greater for the model with the inner flow path. The model with the inner flow path showed improved efficiency because the area subject to torque decreased due to the creation of inner flow path. To analyze local flow field, a section was created from the representative location of each impeller groove toward the direction of radius. Inner channel pressure distribution depending on the rotation direction shows that the model with the inner flow path has pressure equilibrium of working fluid through the inner flow path. Velocity distribution of inside impeller groove shows that flow field was coupled and appeared to form an inner wall where the flow field was stabilized.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.599-604
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• 2002

Acute or chronic aortic dissection may lead to the rupture, which is the major cause of death. A dissecting aneurysm of ascending aorta(Stanford type A dissection) can rupture into the superior vena cava producing a aortocaval fistula, which is rare, but has been reported mostly in the cases of abdominal aortic aneurysm. We report a case of 67-year-old man with type A chronic dissection and aortocaval fistula, presenting symptoms of superior vena syndrome. The preoperative diagnosis was composed of radiologic examinations, including computed tomography, magnetic resonance imaging angiography and aortography. The dissecting aneurysm was resected and replaced, and the aortocaval fistula was repaired under deep hypothermic circulatory arrest. The details are described here.

• International Journal of Highway Engineering
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• v.18 no.6
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• pp.153-160
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• 2016

OBJECTIVES : The objective of this study is to develop a traffic accident model of a roundabout based on the type of land use. METHODS : The traffic accident data from 2010 to 2014 were collected from the "traffic accident analysis system (TAAS)" data set of the Road Traffic Authority. A multiple linear regression model was utilized in this study to analyze the accidents based on the type of land use. Variables such as geometry and traffic volume were used to develop the accident models based on the type of land use. RESULTS : The main results are as follows. First, the null hypothesis that the type of land use does not affect the number of accidents is rejected. Second, four accident models based on the type of land use have been developed, which are statistically significant (high $R^2$ values). Finally, the total entering and circulating volumes, area of the central island, number of speed breakers, mean number of entry lanes, diameter of the inscribed circle, mean width of the entry lane, area of the roundabout, bus stops, and number of circulatory roadways are analyzed to see how they affect the accident for each type of land use. CONCLUSIONS : The development of the accident models based on the type of land use has revealed that the accident factors at a roundabout are different for each case. Thus, more speed breakers in commercial areas and an inscribed circle of proper diameter in commercial and residential areas are determined to be important for reducing the number of accidents. Additionally, expanding the width of the entry lanes, decreasing the area of the roundabouts in residential areas, and reducing the conflict factors such as bus stops in green spaces are determined to be important.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1254-1260
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• 1992

Rupture of the posterior left ventricular wall following mitral valve replacement is a rare but fatal complication. Over a 10 year period from August 25 1980 to November 27 1990, we have experienced 6 such patients among 884 cases of mitral valve replacement with 4 deaths and 2 survivors. One patient had a type I rupture and another a type II rapture with the remaining four patients having suffered type III ruptures. All of the ruptures were dis covered intraoperatively enabling prompt reinstitution of the cardiopulmonary bypass and subsequent cardioplegic arrest prior to repair. Overzealous removal of calcified valve leaflets seemed to be responsible for the single type I rupture, and untethering of the so called ventricular loop appeared to be the main mechanism responsible for the type III ruptures. The single type II rupture that had occurred seemed to have been caused by inadvertent laceration of the papillary muscle with resultant rupture of the posterior LV wall at the base of the papillary muscle. Among the type III ruptures, 2 patients required intraaortic balloon pump[IABP] support only for mechanical assistance and 1 patient required both the IABP and the Biomedicus LV assist device for successfull weaning following repair of the LV rupture Another patient with a type II rupture also required the circulatory assistance of both the IABP and the bio-medicus LV assist device for weaning from the bypass. Attention to meticulous technical considerations such as avoiding over aggressive removal of heavily calcified valvular tissue, preservation of as much mural leaflet tissue and chordal stuctures as possible seemed helpful in preventing this catastrophic complication from occurring. Fusion and fibrous stricture of the chordal structures appeared particularly conducive to the type II ruptures as a result of the increased susceptibility to papillary injury during operation.

• Journal of Nutrition and Health
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• v.29 no.10
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• pp.1087-1095
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• 1996

The study was carried out to investigate a new type of functional foods with hypotensive effect which is critical in the prevention and treatment of hypertension and related circulatory diseases. The experimental diets(A, B, C) were prepared from plant based ingredients such as buckwheat, potato, perilla seed with different ratios formulated as an edible form appropriate for human consumption according to AIN-77 standard. Control group(D) was fed commercial rat chow. Twety-four 15-week-old SDR(Sprague Dawley rats) and twenty-four 20-week-old SHR(spontaneously hypertensive rats), weighing 200g respectively, were assigned to 4 treatments of 6 rats each in a completely randomized design. Blood pressure was measured at 7 day interval by tail-cuff sphygmomanometer using an IITC cuff pump and amplifier. The growth rates of both SHR and SDR were not statistically different in comparions with the control except those of diet B and C in SDR and SHR, respectively(p<0.05). When exprimental diets were fed, systolic blood pressure of SDR and SHR at day 28 had been lowered by 17-20 mmHg(ave. of 19.6mmHg for both strains) compared with the reference pressure at day 0. The levels of HDL-cholesterol were increased, while the levels of LDL-cholesterol consistently decreased in both strains when experimental diets were fed(p<.05). Plasma total cholesterol levels were not different among treatments. Plasma triglyceride levels were higher in control diet(commercial rat chow) due to two times higher fat content of control diet itself(p<.05). Atherogenic indices were lower compared to those of control when the experimental diets were fed in both strains (p,.05). The results suggest that the antihypertensive diets mainly consisting of plant-based ingredients may possibly effective in relieving hypertension as well as circulatory diseases.

• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.15-22
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• 2000

One hundred & seventy four consecutive free-flap transfers were reviewed to analyze distribution of the type of reconstructions, kinds of donor flaps as well incidence of complications. The role of emergent exploration and the effect of preoperative wound conditions in flap survival were evaluated. Free flap transfer for head and neck reconstruction was most common as 93 cases, followed by for upper extremity of 30 cases, for lower extremity 30 cases, 18 penile reconstructions and for trunk & breast 3 cases. Nine flaps exhibited signs of ciruclatory insufficiency between 5 hours and 7 days. Three were managed conservatively with ultimate partial necrosis of the flaps. Eight flaps required return to the operating room. On exploration, early arterial occlusion was revealed in 1 flap, late arterial occlusion in 2 flaps, early venous occlusion in 1 flap, late venous thrombosis in 2 flaps, prolonged venous spasm in 1 and hematoma in 1 flap. The average time from the first abnormal examination to exploration was 2.6 hours. There were no false-positive explorations. Four free flaps failed in spite of the correction of the cause of circulatory compromise. The remaining 4 flaps were salvaged following the correction the casuse. Recipient vessel problems such as irradiation and infection were the most common cause of circulatory crisis. Among the eight flaps requiring return to the operating room, single vein was anastomosed in three flaps and two veins in the remaining five. In the totally failed four flaps only single vein was anastomosed in three cases. The results of this study demonstrate the efficacy of clinical monitoring and the role of early exploration. Precautious selection of recipient vessels and two vein anastomosis are recommended for safe and better prognosis.