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Long Term Results of Valve Replacement with the St. Jude Medical Heart Valves: Thirteen Year Experience (St. Jude 기계판막을 이용한 판막 치환술의 장기 성적)

  • Kim, Chang-Gon;Gu, Ja-Hong;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.891-898
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    • 1997
  • Between May 1984 and January 1996, 130 patients were replaced cardiac valve using 150 St. Jude Medical prosthetic valves(42 aortic, 68 mitral, 20 aortic and mitral valve replycements). Follow-up was 97.6% complete. The early mortality rate was 5.4%, and late mortality rate was 4.9%. The valve-related late mortality rate was 3.3%. Of late complications, there were 6 anticoagulant related hemorrhages, 4 thromboembolisms and 1 paravalvular leakage. Linearized rates of late complication and valve-related late mortality were as follows: total late complications, .1.68o per patient-year: anticoagulant related hemorrhages, 0.92% per patient-year: thromboembolism, 0.61% per patient-year: paravalvular leakage, 0.15% per patient-year: reoperation, 0.15% per patient-year: and valve-related late mortalities, 0.61% per patient-year. Actuar al event free rate at 10 years was 87.4 $\pm$ 3.2%. The overall actuarial survival rate was 90.4$\pm$2.7% at 5 years, 87.5$\pm$3.3% at 10 years. Ninety eight percent of the survivors were in the New York Heart Association functional class I or II at the end of follow-up. There was significant improvement of cardiothoracic ratio. In conclusion, this study suggests the excellent durability of the St. Jude Medical Heart valve and remarkable functional benefit for the majority of the patients. However, prosthesisrelated complications are still common. Outcome is strongly related to the patient's preoperative cardiac condition and to the adequacy of anticoagulation control.

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Scapular Free Flap (유리 견갑 피판 이식술)

  • Chung, Duke-Whan;Han, Chung-Soo;Yim, Chang-Moo
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.24-34
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    • 1996
  • There are many kinds of free flaps for management of extensive soft tissue defect of extremities in orthopaedic field. Free vascularized scapular flap is one of the most useful and relatively easy to application. This flap has been utilize clinically from early eighties by many microsurgical pioneers. Authors performed 102 cases of this flap from 1984 to 1995. We have to consider about the surgical anatomy of the flap, technique of the donor harvesting procedures, vascular varieties and anatomical abnormalities and success rate and the weak points of the procedure. This flap nourished by cutaneous branches from circumflex scapular vessels emerges from the lateral aspect of the subscapular artery 2.5-5cm from its lateral origin passing through the triangular space(bounded by subscapularis, teres minor, teres major, long head of triceps). The terminal cutaneous branch runs posteriorly around the lateral border of the scapular and divided into two major branches, those transeverse horizontally and obliquely to the fascial plane of overlying skin of the scapular body. We can utilize these arteries for scapular and parascapular flap. The vascular pedicle ranged from 5 to 10 cm long depends on the dissection, usually two venae comitantes accompanied circumflex scapular artery and its major branches. The diameter of the circumflex scapular artery is more than 1mm in adult, rare vascular variation. Surgical techniques : The scapular flap can be dissected conveniently with prone or lateral decubitus position, prone position is more easier in my experience. There are two kinds of surgical approaches, most of the surgeon prefer elevation of the flap from its outer border towards its base which known easier and quicker, but I prefer elevation of the flap from its outer border because of the lowering the possibilities of damage to vasculature in the flap itself which runs just underneath the subcutaneous tissue of the flap and provide more quicker elevation of the flap with blunt finger dissection after secure pedicle dissection and confirmed the course from the base of the pedicle. There are minimal donor site morbidity with direct skin closure if the flap size is not so larger than 10cm width. This flap has versatility in the design of the flap shape and size, if we need more longer and larger one, we can use parascapular flap or both. Even more, the flap can be used with latissimus dorsi musculocutaneous flap and serratus anterior flap which have common vascular pedicle from subscapular artery, some instance can combined with osteocutaneous flap if we include the lateral border of the scapular bone or parts of the ribs with serratus anterior. The most important shortcoming of the scapular free flap is non sensating, there are no reasonable sensory nerves to the flap to anastomose with recipient site nerve. Results : Among our 102 cases, overall success rate was 89%, most of the causes of the failure was recipient site vascular problems such as damaged recipient arterial conditions, and there were two cases of vascular anomalies in our series. Patients ages from 3 years old to 62 years old. Six cases of combined flap with latissimus dorsi, 4 cases of osteocutaneous flap for bone reconstruction, 62 parascapular flap was performed - we prefer parascapular flap to scapular. Statistical analysis of the size of the flap has less meaningful because of the flap has great versatility in size. In the length of the pedicle depends on the recipient site condition, we can adjust the pedicle length. The longest vascular pedicle was 14 cm in length from the axillary artery to the enter point cutaneous tissue. In conclusion, scapular free flap is one of the most useful modalities to manage the large intractable soft tissue defect. It has almost constant vascular pedicle with rare anatomical variation, easy to dissect great versatility in size and shape, low donor morbidity, thin and hairless skin.

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Flow Resistance and Modeling Rule of Fishing Nets -2. Flow Resistance of Bag Nets- (그물어구의 유수저항과 모형수칙 -2. 자루형 그물의 유수저항-)

  • KIM Dae-An
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.28 no.2
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    • pp.194-201
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    • 1995
  • In order to make clear the resistance of bag nets, the resistance R of bag nets with wall area S designed in pyramid shape was measured in a circulating water tank with control of flow velocity v and the coefficient k in $R=kSv^2$ was investigated. The coefficient k showed no change In the nets designed in regular pyramid shape when their mouths were attached alternately to the circular and square frames, because their shape in water became a circular cone in the circular frame and equal to the cone with the exception of the vicinity of frame in the square one. On the other hand, a net designed in right pyramid shape and then attached to a rectangular frame showed an elliptic cone with the exception of the vicinity of frame in water, but produced no significant difference in value of k in comparison with that making a circular cone in water. In the nets making a circular cone in water, k was higher in nets with larger d/l, ratio of diameter d to length I of bars, and decreased as the ratio S/S_m$ of S to the area $S_m$ of net mouth was increased or as the attack angle 9 of net to the water flow was decreased. But the value of ks15m was almost constant in the region of S/S_m=1-4$ or $\theta=15-90^{\circ}$ and in creased linearly in S/S_m>4 or in $\theta<15^{\circ}$ However, these variation of k could be summarized by the equation obtained in the previous paper. That is, the coefficient $k(kg\;\cdot\;sec^2/m^4)$ of bag nets was expressed as $$k=160R_e\;^{-01}(\frac{S_n}{S_m})^{1.2}\;(\frac{S_m}{S})^{1.6}$$ for the condition of $R_e<100$ and $$k=100(\frac{S_n}{S_m})^{1.2}\;(\frac{S_m}{S})^{1.6}$$ for $R_e\geq100$, where $S_n$ is their total area projected to the plane perpendicular to the water flow and $R_e$ the Reynolds' number on which the representative size was taken by the value of $\lambda$ defined as $$\lambda={\frac{\pi d^2}{21\;sin\;2\varphi}$$ where If is the angle between two adjacent bars, d the diameter of bars, and 21 the mesh size. Conclusively, it is clarified that the coefficient k obtained in the previous paper agrees with the experimental results for bag nets.

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The 'Consequence Analysis' of Variables Affecting the Extent of Damage Caused by Butane Vapor Cloud Explosions (부탄가스 증기운폭발의 피해범위에 영향을 미치는 변수에 관한 고찰)

  • Char Soon-Chul;Choo Kwang-Ho
    • Journal of the Korean Institute of Gas
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    • v.5 no.4 s.16
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    • pp.1-7
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    • 2001
  • This paper presents a 'consequence analysis' for vapor cloud explosions caused by heavy gas leakages from commercially used storage tanks at petrochemical plants. Particularly, this paper emphasizes on evaluating the results of various vapor cloud explosion accidents from Butane storage tanks. Also this paper analyses the impact of variables on the accidents in order to acquire the optimum conditions for variables. $SuperChems^{TM}$ Professional Edition was applied to analyse the impact (If atmospheric and other variables in the situation where vapor cloud continuously disperses from the ground level. Under the assumption that practical operating conditions are selected as a standard condition, and Butane leaks from the storage tank for 15 minutes, the results show that the maximum distance of LFL (Lower Flammable Limit) was 52 meters and overpressure by the vapor cloud explosion was 1 psi at 128.2 meters. It is observed that the impact of the variables on accidental Butane storage tank leakage mainly varied upon atmospheric stability, wind velocity, pipe line size, visible length, etc., and changes in the simulation result occurred as the variables varied. The maximum distance of the LFL (Lower Flammable Limit) increased as the visible length became shorter, the size of the leak became larger, the wind velocity was decreased, and the climatic conditions became more stable. Thus, by analysing the variables that influence the simulation results of explosions of Butane storage tanks containing heavy gases, I am presenting the most appropriate method for 'consequence analysis' and the selection of standards for suitable values of variables, to obtain the most optimal conditions for the best results.

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A Study on the Method of Minimizing the Bit-Rate Overhead of H.264 Video when Encrypting the Region of Interest (관심영역 암호화 시 발생하는 H.264 영상의 비트레이트 오버헤드 최소화 방법 연구)

  • Son, Dongyeol;Kim, Jimin;Ji, Cheongmin;Kim, Kangseok;Kim, Kihyung;Hong, Manpyo
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.28 no.2
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    • pp.311-326
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    • 2018
  • This paper has experimented using News sample video with QCIF ($176{\times}144$) resolution in JM v10.2 code of H.264/AVC-MPEG. The region of interest (ROI) to be encrypted occurred the drift by unnecessarily referring to each frame continuously in accordance with the characteristics of the motion prediction and compensation of the H.264 standard. In order to mitigate the drift, the latest related research method of re-inserting encrypted I-picture into a certain period leads to an increase in the amount of additional computation that becomes the factor increasing the bit-rate overhead of the entire video. Therefore, the reference search range of the block and the frame in the ROI to be encrypted is restricted in the motion prediction and compensation for each frame, and the reference search range in the non-ROI not to be encrypted is not restricted to maintain the normal encoding efficiency. In this way, after encoding the video with restricted reference search range, this article proposes a method of RC4 bit-stream encryption for the ROI such as the face to be able to identify in order to protect personal information in the video. Also, it is compared and analyzed the experimental results after implementing the unencrypted original video, the latest related research method, and the proposed method in the condition of the same environment. In contrast to the latest related research method, the bit-rate overhead of the proposed method is 2.35% higher than that of the original video and 14.93% lower than that of the latest related method, while mitigating temporal drift through the proposed method. These improved results have verified by experiments of this study.

Growth Characteristics and Vegetation Structure of the Pinus densiflora Forest for Sugumagi of Unmun Temple, Cheongdo-gun, Korea (청도군 운문사 입구 수구막이 소나무림 식생구조 및 생육 특성)

  • Kang, Gi Won;Lee, Do-I;Han, Bong-Ho;Kwak, Jeong-In
    • Journal of the Korean Institute of Landscape Architecture
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    • v.48 no.5
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    • pp.1-15
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    • 2020
  • This study was designed to come up with a way of managing a cultural landscape forest by conducting research on the vegetation structure and growth characteristics. This study's target site, which was 45,201㎡ in size, was Pinus densiflora forest for Sugumagi placed at the entrance of Unmun Temple, Sinwon-ri, Unmun-myeon, and Cheongdo-gun in the southernmost part of Gyeongsangbuk-do, Korea. Sugumagi means the water of the valley flows far away, and where no downstream is visible according to feng shui. The historical sources of the Sugumagi Pinus densiflora forest at the entrance of Unmun Temple isn't clear. It waw only found at that location. The Pinus densiflora forest at the entrance of Unmun Temple is located in the waterway in terms of Feng Shui. The present condition of growth was investigated through a grid surveys of 98 trees and Pinus densiflora growth. As a result of the analysis of growth status, Pinus densiflora, Larix leptolepis, Zelkova serrata, Celtis sinensis, and Rhus javanica were distributed in the conopy layer, and 28 species including Ailanthus altissima were grown in the understroy layer, and 92 species, including Ampelopsis brevipedunculata, in the shrub layer. The plant community structure was divided into low, medium and high-density Pinus densiflora forests in the study area, based on the number in the conopy layer and the grade of and the trees analyzed. As a result of the analysis, the Pinus densiflora dominated the low, medium and high-density Pinus densiflora forests, and there were no competitive species. The relative dominance of the low-density Pinus densiflora forests was 46.9% on average, medium-density was 62.6% and 50.2% was found in high-density. The mean species diversity of Shannon in the low-density study was 0.7055, medium-density study was 0.8966 and the average species diversity of Shannon in the high-density study was 0.8317. The analysis of the age and growth of 25 sample trees in the Sugumagi Pinus densiflora forest shows that the distribution of the chest diameter (DBH) of the sample Pinus densiflora is 38 to 77cm with the average chest diameter being 61.1cm. The age was 84-161 years and the average was 114 years. In the Pinus densiflora forest, most(670,659, or 98.3%) of the tree trunk wound was collected for rosins during the Japanese colonia Era, Of the total 670, 659 were Pinus densiflora, 98.3% of the total. 394 were surgically repaired in 2005. For the preservation of the Sugumagi Pinus densiflora forest, dead trees should be replaced with substitute trees appropriate to the middle and south topography. It is demanded that foreign species such as Larix leptolepis in the research area should be removed and Pinus densiflora that underwent surgical operations should be regularly sterilized. It is also emphasized that the management of insecticide is important.

Springtime Distribution of Inorganic Nutrients in the Yellow Sea: Its Relation to Water Mass (수괴특성에 따른 춘계 황해의 영양염 분포 특성)

  • Kim, Kyeong-Hong;Lee, Jae-Hak;Shin, Kyung-Soon;Pae, Se-Jin;Yoo, Sin-Jae;Chung, Chang-Soo;Hyun, Jung-Ho
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.5 no.3
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    • pp.224-232
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    • 2000
  • Inorganic nutrient concentrations in relation to springtime physical parameters of the Yellow Sea were investigated during April 1996. Three major water masses, i.e., the Yellow Sea Warm Current Water (YSWC), Coastal Current Water (CCW) and Changjiang River Diluted Water (CRDW), prevailed in the study area. Water masses were vertically wel1 mixed throughout the study area, and nutrients were supplied adequately from bottom to surface layer. As result of ample nutrients supplied by vertical mixing together with progressed daylight condition, springtime phytoplankton blooms were observed, which was responsible for the depletion of inorganic nutrients in surface water column. Low nutrients concentration in bottom water of the central Yellow Sea (Stn. D9; nitrate: <2 ${\mu}$M, phosphate: <0.3 ${\mu}$) was associated with the entrance of YSWC which is characterized by high temperature and salinity. Influenced by runoff and vertical tidal mixing, CCW with high nutrient concentrations probably associated with China and Korea coastal waters with high nutrients concentration. For the local scale of inorganic nutrient distribution, nutrient transfers from coast to central areas were limited due to restriction imposed by tidal fronts (Stn. D6) and thus affected the horizontal nutrient profiles. Relatively high phytoplankton biomass was observed in the tidal front (Chl-${\alpha}$=12.38 ${\mu}$gL$^{-1}$) during the study period. Overall, the springtime nutrient distribution patterns in the Yellow Sea appeared to be affected by: (1) Large-scale influx of YSWC with low nutrient concentrations and CCW with high nutrient concentrations influenced by Korea and China coastal waters; (2) vertical mixing of water mass and phytoplankton distribution; and (3) local-scale tidal front as well as phytoplankton blooms alongthe tidal front.

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Characterization and Classification of Potential Acid Sulfate Soils on Flood-plains (하해혼성(河海混成) 잠재특이산성토양(潛在特異酸性土壤)의 분포(分布)와 분류(分類))

  • Jung, Yeun-Tae;No, Yeong-Pal;Baeg, Cheong-Oh
    • Korean Journal of Soil Science and Fertilizer
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    • v.22 no.3
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    • pp.173-179
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    • 1989
  • Characterization and classification of the potential acid sulfate soils found on flood-plains in Yeongnam area were summarized as follows: 1. The "Potential acid sulfate soil" layer(s) were appeared in the around 2-4m substrata of soil profiles and characterized by the fine texture, high reduction and physical unripened soft mud deposits or having higher contents of organic matter with dark color. 2. The contents of total sulfur (T-S) in those soils were ranged around 0.45-0.9% and the materials exhibited a strong acidity upon the oxidation with $H_2O_2$. Although the T-S contents was low as much as 0.15%, the sulfidic materials were also acidified strongly by the oxidation with $H_2O_2$ in the condition of lower content of carbonates. As defined in Soil Taxonomy of USDA, most of the sulfidic materials contained less than 3 times carbonate ($CaCO_3$ equivalent wt. %), but there were some which abundant in shell fragments, contained more than 3 times carbonate by weight percentage and that not much acidified by the oxidation with $H_2O_2$. 3. The contents of T-S correlated negatively with the pH oxidized by $H_2O_2$ and with the fizzing time (minutes) due to addition of $H_2O_2$. 4. The potential acid sulfate soils could be defined as soil materials that had sulfidic layer(s) more than 20cm thick within 4m of the soil profile and contained more than 0.15% of T-S with less than 3 times carbonate ($CaCO_3$ equiv. %). A tentative interpretative soil classification system was proposed, i.e., "Weak potential acid sulfate (T-S, 0.15-0.5%)", "Moderate potential acid sulfate (T-S, 0.5-0.75%)", and "Strong potential acid sulfate (T-S, more than 0.75%)". Finally, it was proposed that the "Detailed soil survey with high intensity" should be carried out in the areas of agricultural engineering works such as arableland readjustment works, in advance.

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Study of Oil Palm Biomass Resources (Part 5) - Torrefaction of Pellets Made from Oil Palm Biomass - (오일팜 바이오매스의 자원화 연구 V - 오일팜 바이오매스 펠릿의 반탄화 연구 -)

  • Lee, Ji-Young;Kim, Chul-Hwan;Sung, Yong Joo;Nam, Hye-Gyeong;Park, Hyeong-Hun;Kwon, Sol;Park, Dong-Hun;Joo, Su-Yeon;Yim, Hyun-Tek;Lee, Min-Seok;Kim, Se-Bin
    • Journal of Korea Technical Association of The Pulp and Paper Industry
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    • v.48 no.2
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    • pp.34-45
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    • 2016
  • Global warming and climate change have been caused by combustion of fossil fuels. The greenhouse gases contributed to the rise of temperature between $0.6^{\circ}C$ and $0.9^{\circ}C$ over the past century. Presently, fossil fuels account for about 88% of the commercial energy sources used. In developing countries, fossil fuels are a very attractive energy source because they are available and relatively inexpensive. The environmental problems with fossil fuels have been aggravating stress from already existing factors including acid deposition, urban air pollution, and climate change. In order to control greenhouse gas emissions, particularly CO2, fossil fuels must be replaced by eco-friendly fuels such as biomass. The use of renewable energy sources is becoming increasingly necessary. The biomass resources are the most common form of renewable energy. The conversion of biomass into energy can be achieved in a number of ways. The most common form of converted biomass is pellet fuels as biofuels made from compressed organic matter or biomass. Pellets from lignocellulosic biomass has compared to conventional fuels with a relatively low bulk and energy density and a low degree of homogeneity. Thermal pretreatment technology like torrefaction is applied to improve fuel efficiency of lignocellulosic biomass, i.e., less moisture and oxygen in the product, preferrable grinding properties, storage properties, etc.. During torrefacton, lignocelluosic biomass such as palm kernell shell (PKS) and empty fruit bunch (EFB) was roasted under an oxygen-depleted enviroment at temperature between 200 and $300^{\circ}C$. Low degree of thermal treatment led to the removal of moisture and low molecular volatile matters with low O/C and H/C elemental ratios. The mechanical characteristics of torrefied biomass have also been altered to a brittle and partly hydrophobic materials. Unfortunately, it was much harder to form pellets from torrefied PKS and EFB due to thermal degradation of lignin as a natural binder during torrefaction compared to non-torrefied ones. For easy pelletization of biomass with torrefaction, pellets from PKS and EFB were manufactured before torrefaction, and thereafter they were torrefied at different temperature. Even after torrefaction of pellets from PKS and EFB, their appearance was well preserved with better fuel efficiency than non-torrefied ones. The physical properties of the torrefied pellets largely depended on the torrefaction condition such as reaction time and reaction temperature. Temperature over $250^{\circ}C$ during torrefaction gave a significant impact on the fuel properties of the pellets. In particular, torrefied EFB pellets displayed much faster development of the fuel properties than did torrefied PKS pellets. During torrefaction, extensive carbonization with the increase of fixed carbons, the behavior of thermal degradation of torrefied biomass became significantly different according to the increase of torrefaction temperature. In conclusion, pelletization of PKS and EFB before torrefaction made it much easier to proceed with torrefaction of pellets from PKS and EFB, leading to excellent eco-friendly fuels.

Time-relationship between Deformation and Growth of Metamorphic Minerals around the Shinbo Mine, Korea: the Relative Mineralization Time of Uranium Mineralized Zone (신보광산 주변지역에서 변성광물의 성장과 변형작용 사이의 상대적인 시간관계: 우라늄 광화대의 상대적인 광화시기)

  • Kang, Ji-Hoon;Lee, Deok-Seon
    • Economic and Environmental Geology
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    • v.45 no.4
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    • pp.385-396
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    • 2012
  • The geochemical high-grade uranium anormal zone has been reported in the Shinbo mine and its eastern areas, Jinan-gun, Jeollabuk-do located in the southwestern part of Ogcheon metamorphic zone, Korea. In this paper is reported the time-relationship between deformation and growth of metamorphic minerals in the eastern area of Shinbo mine, which consists of the Precambrian metasedimentary rocks (quartzite, metapelite, metapsammite) and the age-unknown pegmatite and Cretaceous porphyry which intrude them, and is considered the relative mineralization time on the basis of the previous research's result. The D1 deformation formed the straight-type Si internal foliation which is defined mainly as the arrangement of elongate quartz, biotite, opaque mineral in andalusite porphyroblast. The D2 deformation, which is defined by the microfolding of Si foliation, formed S2 crenulation cleavage. It can be divided into two sub-phases, early crenulation and late crenulation. The former occurs as the curvetype Si foliation in the mantle part of andalusite. The latter occurs as S1-2 composite foliation which warps around the andalusite. The andalusite porphyroblast began to grow under non-deformation condition after the formation of S1 foliation which corresponds to the straight-type Si foliation. It continued to grow before the late crenulation phase. The age-unknown pegmatite intruded after the D2 deformation and grew the fibrous sillimanite which random masks the S1-2 composite foliation. The D3 deformation formed F3 fold which folded the S1-2 composite foliation, D2 crenulation, fibrous sillimanite. It means that the intrusion of pegmatite related to the growth of the fibrous sillimanite took place during the inter-tectonic phase of D2 and D3 deformations. The retrograde metamorphism is recognized by the chloritization of biotite and two-way cleavage lamellae which is parallel to the S1-2 composite foliation and the F3 fold axial surface in the andalusite porphyroblast. It occurred during the D2 late crenulation phase and D3 deformation. In considering of the previous research's result inferring the most likely candidate for the uranium source rock as pegamatite, it indicates that the age-unknown pegmatite intruded during the inter-tectonic phase of D2 and D3 deformations, i.e. during the retrograde metamorphism related to the uplifting of crust, and formed the uranium ore zone around the Shinbo mine.