• Journal of Korean Society of Disaster and Security
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• v.14 no.4
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• pp.47-60
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• 2021

Recently, as the occurrence frequency of sudden floods due to climate variability increased, the damage of aging chuteway slabs of spillway are on the rise. Accordingly, a wide array of field survey, hydraulic experiment and numerical simulation have been conducted to find the cause of damage on chuteway slabs. However, these studies generally reviewed the flow characteristics and distribution of pressure on chuteway slabs. Therefore the derivation of damage on chuteway slabs was relatively insufficient in the literature. In this study, the cavitation erosion and hydraulic jacking were assumed to be the causes of damage on chuteway slabs, and the phenomena were reproduced using 3D numerical models, FLOW-3D and COMSOL Multiphysics. In addition, the cavitation index was calculated and the von Mises stress by uplift pressure distribution was compared with tensile and bending strength of concrete to evaluate the possibility of cavitation erosion and hydraulic jacking. As a result of numerical simulation on cavitation erosion and hydraulic jacking under various flow conditions with complete opening gate, the cavitation index in the downstream of spillway was less than 0.3, and the von Mises stress on concrete was 4.6 to 5.0 MPa. When von Mises stress was compared with tensile and bending strength of concrete, the fatigue failure caused by continuous pressure fluctuation occurred on chuteway slabs. Therefore, the cavitation erosion and hydraulic jacking caused by high speed flow were one of the main causes of damage to the chuteway slabs in spillway. However, this study has limitations in that the various shape conditions of damage(cavity and crack) and flow conditions were not considered and Fluid-Structure Interaction (FSI) was not simulated. If these limitations are supplemented and reviewed, it is expected to derive more efficient utilization of the maintenance plan on spillway in the future.

• Composites Research
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• v.35 no.4
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• pp.248-254
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• 2022

In this study, TiB₂-steel composite with high-fractional TiB₂ reinforcement was fabricated by gas pressure infiltration process and the microstructure analysis and compressive strength and hardness were evaluated. To elucidate the correlation between microstructure and mechanical properties for fabricated composite, after the compression test of TiB₂-steel composite, the fracture surface was analyzed and the fracture behavior on compression test was predicted. As a result of the compression fracture surface analysis, interfacial failure trace between the steel matrix and the reinforcement was observed, and the interface between the steel matrix and the reinforcement was analyzed using TEM. From the result of microstructure analysis on the fabricated composite, it was confirmed that, in addition to TiB₂ reinforcement and steel matrix, TiC phase and coarse (Fe,M)₂B (M=Cr,Mn) phase were formed. Throughout the thermodynamic calculation, it was confirmed that TiC and (Fe,M)₂B can be formed as a stable phase under the process condition. The fabricated TiB₂-steel composite had a significantly increased hardness, and the compressive strength and Young's modulus were improved by 3.07 times and 1.95 times, respectively, compared to steel matrix. It seems that the coarse (Fe,M)₂B (M=Cr,Mn) phase formed throughout the composite causes the deterioration of mechanical properties, and by controlling the formation of the (Fe,M)₂B (M=Cr,Mn) phase, it is judged that the mechanical properties of the TiB₂-steel composite can be further improved.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.71-79
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• 2003

Background : A bronchoalveolar lavage(BAL) is useful in diagnosing the etiology of bilateral pulmonary infiltrations, but may worsen the oxygenation and clinical status in severely hypoxemic patients. This study assessed the safety and efficacy of the continuous positive airway pressure(CPAP) using a conventional mechanical ventilator via a face mask as a tool for maintaining the oxygenation level during BAL. Methods : Seven consecutive patients with the bilateral pulmonary infiltrates and severe hypoxemia ($PaO_2/FIO_2$ ratio ${\leq}200$ on oxygen 10 L/min via mask with reservoir bag) were enrolled. The CPAP 5-6 $cmH_2O(F_IO_2\;1.0)$ was delivered through an inflatable face mask using a conventional mechanical ventilator. The CPAP began 10 min before starting the BAL and continued for 30 min after the procedure was completed. A bronchoscope was passed through a T-adapter and advanced through the mouth. BAL was performed using the conventional method. The vital signs, pulse oxymetry values, and arterial blood gases were monitored during the study. Results : (1) Median age was 56 years(male:female=4:3). (2) The baseline $PaO_2$ was $78{\pm}16mmHg$, which increased significantly to $269{\pm}116mmHg$(p=0.018) with CPAP. After the BAL, the $PaO_2$ did not decrease significantly but returned to the baseline level after the CPAP was discontinued. The $SpO_2$ showed a similar trend with the $PaO_2$ and did not decrease to below 90 % during the duration of the study. (3) The $PaCO_2$ increased and the pH decreased significantly after the BAL but returned to the baseline level within 30 min after the BAL. (5) No complications directly related to the BAL procedure were encountered. However, intubation was necessary in 3 patients(43 %) due to the progression of the underlying diseases. Conclusion : In severe hypoxemic patients, CPAP using a face mask and conventional mechanical ventilator during a BAL might allow minimal alterations in oxygenation and prevent subsequent respiratory failure.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1204-1212
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• 2002

Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$ $H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.472-480
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• 1998

We reviewed the surgical results of intracardiac lateral tunnel Fontan procedure for the repair of functional single ventricles. Between 1990 and 1996, 104 patients underwent total cavopulmonary anastomosis. Patients' age and body weight averaged 35.9(range 10 to 173) months and 12.8(range 6.5 to 37.8) kg. Preoperative diagnoses included 18 tricuspid atresias and 53 double inlet ventricles with univentricular atrioventricular connection and 33 other complex lesions. Previous palliative operations were performed in 50 of these patients, including 37 systemic to pulmonary artery shunts, 13 pulmonary artery bandings, 15 surgical atrial septectomies, 2 arterial switch procedures, 2 resections of subaortic conus, 2 repairs of total anomalous pulmonary venous connection and 1 Damus-Stansel-Kaye procedure. In 19 patients bidirectional cavopulmonary shunt operation was performed before the Fontan procedure and in 1 patient a Kawashima procedure was required. Preoperative hemodynamics revealed a mean pulmonary artery pressure of 14.6(range 5 to 28) mmHg, a mean pulmonary vascular resistance of 2.2(range 0.4 to 6.9) wood-unit, a mean pulmonary to systemic flow ratio of 0.9(range 0.3 to 3.0), a mean ventricular end-diastolic pressure of 9.0 (range 3.0 to 21.0) mmHg, and a mean arterial oxygen saturation of 76.0(range 45.6 to 88.0)%. The operative procedure consisted of a longitudinal right atriotomy 2cm lateral to the terminal crest up to the right atrial auricle, followed by the creation of a lateral tunnel connecting the orifices of either the superior caval vein or the right atrial auricle to the inferior caval vein, using a Gore-Tex vascular graft with or without a fenestration. Concomitant procedures at the time of Fontan procedure included 22 pulmonary artery angioplasties, 21 atrial septectomies, 4 atrioventricular valve replacements or repairs, 4 corrections of anomalous pulmonary venous connection, and 3 permanent pacemaker implantations. In 31, a fenestration was created, and in 1 an adjustable communication was made in the lateral tunnel pathway. One lateral tunnel conversion was performed in a patient with recurrent intractable tachyarrhythmia 4 years after the initial atriopulmonary connection. Post-extubation hemodynamic data revealed a mean pulmonary artery pressure of 12.7(range 8 to 21) mmHg, a mean ventricular end-diastolic pressure of 7.6(range 4 to 12) mmHg, and a mean room-air arterial oxygen saturation of 89.9(range 68 to 100) %. The follow-up duration was, on average, 27(range 1 to 85) months. Post-Fontan complications included 11 prolonged pleural effusions, 8 arrhythmias, 9 chylothoraces, 5 of damage to the central nervous system, 5 infectious complications, and 4 of acute renal failure. Seven early(6.7%) and 5 late(4.8%) deaths occured. These results proved that the lateral tunnel Fontan procedure provided excellent hemodynamic improvements with acceptable mortality and morbidity for hearts with various types of functional single ventricle.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.108-118
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• 1999

Background: To evaluate the risk factor and long-term result of arterial switch operation , a retrospective study was done. Material and Method: A retrospective analysis was done to evaluate the early and long-term results on 58 patients who underwent an arterial switch operation(ASO) for transposition of the great arteries(TGA) with intact ventricular septum, between January 1988 and December 1996. Beforesurgery, 36 patients(62.1%) underwent balloon atrial septostomy, 32 patients(51.7%) received PGE1 infusion, and preparatory banding of pulmonary artery was performed on 6 patients(mean LV/RV pressure ratio 0.53$\pm$0.11). Result: The age at operation ranged from 1 to 137 days(mean 24$\pm$26 days) and the weights ranged from 1.8 to 6.8 kg (mean 3.5$\pm$0.8 kg). There were 14 early deaths(24.1%), but of the last 24 patients operated on since 1994, there were only 2 early deaths(8.3%). In the risk factor analysis, the date of operation was the only risk factor for early death(p-value < 0.01). Eight of the 14 early deaths were due to acute myocardial failure(mainly inadequate coronary blood flow). The length of follow-up ranged from 2 months to 8 years, average of 36$\pm$27 months. The follow-up included sequential noninvasive evaluations and 21 catheterizations and angiographic studies performed 5 to 32 months postoperatively with particular attention to the great vessel and coronary anastomosis, ventricular function, valvular competence, and cardiac rhythm. There were 5 late deaths(11.4%), one of thesedeaths was related to the late coronary problems, two to aspiration, one to uncontrolled chronic mediastinitis, and one to progressive aortic insufficiency and heart failure. The most frequent postoperative hemodynamic abnormality was supravalvular stenosis and the degree of pulmonary or aortic obstruction had slowly progressed in some cases, however there were no children who had to undergo a reoperation for supravalvular pulmonary or aortic stenosis. Aortic regurgitation was identified in 9 patients, which was mild in 7 and moderate in 2 and had progressed in some cases. Two patients who had an unremarkable perioperative course were identified as having coronary artery obstructions. The other late survivors were in good condition, were in sinus rhythm, and had normal LV functions. Actuarial survival rate at 8 years was 68.8%. Conclusion: We concluded that anatomic correction will be established as the optimal approach to the TGA with intact ventricular septum, though further long-term evaluations are needed.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.1
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• pp.37-46
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• 1994

The purpose of this study was to evaluate the effect of various cements on the retention of casting crown and the cement film thickness. To evaluate the retention of crown, thirty maxillary premolars were used and prepared to largely same dimension. According to the routine method, Non-precious metal crowns were made. The teeth and the metal crowns were divided into three groups and cemented under 5kg static pressure. Group I was composed of 10 teeth and 10 metal crowns and was cemented with zinc phohsphste cement. Group II was composed of 10 teeth and 10 metal crowns and was cemented with Panavia-EX cement. Group III was composed of 10 teeth and 10 metal crowns and was cemented with All-Bond & composite resin cement. After 5 days, the cemented specimens were mounted and the failure loads were measured by an Instron Universal Testing Machine. To evaluate the cement film thickness. 5 metal teeth and 5metal crowns from a prepared maxillary premolar were made. Two marks were flawed on the margin part of each surface at 4-surfaces of each specimen(one mark : crown, the other : metal tooth) and were measured the width with SEM photograph(80 sheets) before and after cementation(Panavia-EX, All-Bond cement, & ZPC) was made. Differences of the widths of marks between before and after were measured, and differences from 4-surfaces of a specimen cemented with a cement were measured and calculated. The results were as follows ; 1. There was a statistically significant difference between the failure loads of group III and the others(p<0.05). 2. There was a statistically significant difference between the cement film thickness of group III and the others(p<0.05).

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.645-653
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• 1999

Introduction : Although myocardial ischemia tends to occur more frequently than can he documented in ventilated patients, it has not been well studied on the factors related to the occurrence of the ischemia. Methods : To investigate the related factors to ischemia development, a prospective study was done in 95 cases with consecutive 73 patients who had received mechanical ventilation(MV) in MICU. In addition to 24 h holter monitoring, echocardiogram, electrolytes, cardiac enzymes, hemodynamic, and gas exchange measurements were done within 24 h after initiation of MV in 69 cases. The measurements were repeated at weaning period in 26 cases. The ischemia was defined by the ST segment changes; up-sloping depression more than 1.5 mm or down-sloping or horizontal depression more than 1.0 mm from isoelectric baseline for 80 ms following J point. Results : Twelve patients(12.6% in 95 cases) developed ischemia in total. The incidence of ischemia development showed an increased tendency in the initial 24 hr after MV (15.9%) and in patients with left-sided heart failure found by echocardiogram (18.2%) compared with that of the weaning period (3.8%) and patients without heart failure (10.9%) (P=0.12, P=0.09, in each). There were no differences in APACHE III score, baseline ECG findings, electrolytes abnormalities, use of inotropics or bronchodilators, presence of sepsis or shock, mode of ventilation, and survival rate according to the development of ischemia. Maximal heart rates and mean arterial pressure also were not different between patients with ($137.2{\pm}30.9/min$, $82.5{\pm}15.9$ mm Hg) and without ischemia ($l29.5{\pm}29.7/min$, $83.8{\pm}17.6$ mm Hg). Conclusion : Although the incidence of myocardial ischemia was 12.6% in total, there were no clinically predictable factors to the development of ischemia during mechanical ventilation.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.254-259
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• 2010

Background: Diagnosing chronic pulmonary embolism at an early stage is difficult because of the patient’s nonspecific symptoms. This condition is not prevalent in Korea, and in fact, there have been only a few case reports on this in the Korean medical literature. We analyzed the surgical outcome of performing pulmonary thromboendarterectomy in patients with chronic pulmonary embolism. Material and Method: The study subjects included those patients who underwent surgery for chronic pulmonary embolism from 1996 to 2008. For making the diagnosis, echocardiography, chest CT and a pulmonary perfusion scan were performed on the patients who complained of chronic dyspnea. Result: Pulmonary endarterectomy was performed as follows: by incision via a mid-sternal approach (7 patients); by incision via a left posterolateral approach (1 patient); using the deep hypothermic circulatory arrest technique (4 patients); under ventricular fibrillation (3 patients); and under cardioplegic arrest (1 patient). The postoperative systolic pulmonary artery blood pressure significantly decreased from a preoperative value of $78.9{\pm}14.5\;mmHg$ to $45.6{\pm}17.6\;mmHg$ postoperatively (p=0.000). The degree of tricuspid regurgitation was less than grade II after surgery. Two patients died early on, including one patient who had persistent pulmonary hypertension without improvement and right heart failure. Conclusion: Patients who have chronic pulmonary embolism are known to have a poor prognosis. However, we think that early surgical treatment along with making the proper diagnosis before the aggravation of right heart failure can help improve the quality of a patient's life.

• International Journal of Highway Engineering
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• v.8 no.2 s.28
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• pp.63-74
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• 2006

During the construction of circular underground pipe, the non-proper compaction along the pipe and the decrease of compaction efficiency have been the main problems to induce the failure of underground pipe or facility. The use of CLSM (controlled low strength materials) should be one of the possible applications to overcome those problems. In this research, the full-scaled field test and the numeric analysis using PENTAGON-3D FEM program were carried out for three different cases on the change of backfill materials, including the common sand, the soil from construction site, and the CLSM. From the full-scaled test in field, the use of in-situ CLSM as backfill materials reduced the vertical and lateral deformation of the pipe, as well as the deformation of the ground surface. The main reason for reducing the deformation would be the characteristics of the CLSM, especially self-leveling and self-hardening properties. The measured earth pressure at the surround of the corrugated pipe using the CLSM backfills was the smaller than the other cases, and the absolute value was almost zero. Judging from the full-scaled field test and FEM analysis, the use of CLSM as backfill materials should be one of the best choices reducing the failure of the underground pipes.