• 대한기계학회논문집
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• 제17권2호
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• pp.313-330
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• 1993

The propagating crack problems under dynamic plane mode in orthotropic material is studied in this paper. To analyze the dynamic fracture problems in orthortropic material, it is important to know the dynamic stress components and dynamic displacement components around the crack tip. Therefore the dynamic stress components of dynamic stress field and dynamic displacement components of dynamic displacement field in the crack tip of orthotropic material under the dynamic load and the steady state in crack propagation were derived. When the crack propagation speed approachs to zero, the dynamic stress component and dynamic displacement components derived in this study are identical to the those of static state. In addition, the relationships between dynamic stress intensity factor and dynamic energy release rate are determinded by using the concept of crack closure closure energy with the dynamic stresses and represented according to physical properties of the orthotrophic material and crack speeds. The faster the crack velocity, the greater the stress value of stress components in crack tip. The stress value of the stress component of crack tip is greater when fiber direction coincides with the crack propagation than when fider direction is normal to the crack propagation.

• Clinical and Experimental Pediatrics
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• 제56권2호
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• pp.90-93
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• 2013

Congenital coronary arteriovenous fistulas (CCAFs) are rare coronary artery abnormalities in which blood is shunted into a cardiac chamber or great vessel. If the fistula itself is large and tortuous, it is generally recommended to occlude the fistula to prevent several complications. In approaches of transcatheter occlusion, the transvenous approach is preferred over the transarterial approach. The transvenous approach would enable the cannulation of a relatively larger catheter or sheath without potential damage to the femoral vessels or normal coronary arteries, which can occur in the transarterial approach. The transvenous approach may also minimize the blind pouch after releasing the devices. Herein, we report the success of transvenous proximal closure of a CCAF using an Amplatzer vascular plug (AVP) in a 3-year-old patient with cardiomegaly. Complete occlusion was achieved by a single AVP and thrombus formation of the distal aneurysmal portion of the fistula. We suggest that this strategy of closing the proximal end with a dilated fistula using a single AVP by the transvenous approach may be a good option in treating CCAFs in a young child.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.570-574
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• 2013

Background The elliptical excision is the standard method of removing benign skin lesions, such as congenital melanocytic nevi. This technique allows for primary closure, with little to no dog-ear deformity, but may sacrifice normal tissue adjacent to the lesion, resulting in scars which are unnecessarily long. This study was designed to compare the predicted results of elliptical excision with those resulting from our excision technique. Methods Eighty-two patients with congenital melanocytic nevus on the face were prospectively studied. Each lesion was examined and an optimal ellipse was designed and marked on the skin. After an incision on one side of the nevus margin, subcutaneous undermining was performed in the appropriate direction. The skin flap was pulled up and approximated along several vectors to minimize the occurrence of dog-ear deformity. Results Overall, the final wound length was 21.1% shorter than that achieved by elliptical excision. Only 8.5% of the patients required dog-ear repair. There was no significant distortion of critical facial structures. All of the scars were deemed aesthetically acceptable based on their Patient and Observer Scar Assessment Scale scores. Conclusions When compared to elliptical excision, our technique appears to minimize dogear deformity and decrease the final wound length. This technique should be considered an alternative method for excision of facial nevi.

• Journal of Chest Surgery
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• 제16권4호
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• pp.476-484
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• 1983

Ventricular septal defect[VSD] associated with aortic regurgitation[AR] represents 2 to 7.5% of all VSD which is most common congenital heart disease. The aortic valve may by normal in infants with VSD, but the aortic regurgitation may be developed in these patients later. The aortic valve became fibrotic, thickened, deformed and prolapsed, so these late deformities require to be corrected with plication, valvuloplasty or aortic valve replacement [AVR]. There are some controversy between the early repair of VSD alone and the late repair of VSD and aortic valve till now. From December 1971 to August 1983, we had experienced 24 patients of VSD associated with AR which constitute 6.5% of our total patients with VSD. The VSD was subpulmoary [type I] in 14[58.3%], subcristal [type II] in 8[33.3%], atrioventricular canal type[type III] in 1, and combine of type I and II in 1. Patch repair of VSD was made in 15 patients and direct suture of small VSD in 9.14 patients had aortic plication of valvuloplasty and 9 had AVR accompanying VSD repair, and 1 patient had VSD closure alone. The postoperative courses of these patients were uneventful except in some cases. A patient who was undertaken AVR with Starr-Edwards ball valve and VSD closure, died due to left ventricular failure and low cardiac output syndrome. Follow up shows, in 14 patients with aortic plication or valvuloplasty, AR was developed in 9. In 9 AVR, there were two later complications which were paravalvular leakage in one and re-AVR due to subacute bacterial endocarditis in another.

• 한국추진공학회지
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• 제9권2호
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• pp.70-77
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• 2005

축소-팽창 디퓨저가 장착된 초음속 이젝터를 제작하여, 다양한 위치에서의 측정된 압력으로 부유동의 초음속 시동조건을 찾아내었다. 우선 부유동 흡입구의 크기의 영향을 알아내기 위하여 다양한 흡입구 직경으로 실험하였으며, 부유동의 초음속 시동은 흡입구 직경과 축소-팽창 디퓨저 직경의 비, d/D가 0.306 미만인 경우에만 일어났다. 이보다 큰 d/D에서는, 아음속 시동이 먼저 시작되고, 흡입구를 막으면서 주유동의 유입이 전 유동장을 채우게 되어 수직 충격파를 축소-팽창 디퓨저의 하류로 내려보내게 된다 이러한 상황에서 다시 흡입구를 열어도 히스테리시스의 영향으로 초음속 시동이 유지된다.

• 대한후두음성언어의학회지
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• 제23권2호
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• pp.129-132
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• 2012

Background and Objectives : MPT is directly related to degree of glottal closure. So it is widely used in the assessment of glottal closure with unilateral vocal fold paralysis. But MPT could be influenced not only by glottal closure but also by pulmonary function. So MPT might not reflect glottal closure in UVFP with decreased pulmonary function. The purpose of the study is to evaluate usefulness of MPT and ratio of /s/ time to /z/ time before and after injection laryngoplasty in UVCP with decreased pulmonary function. Materials and Methods : This study involved 34 patients with unilateral vocal fold paralysis : with decreased pulmonary function in group A (n=15) : with normal pulmonary function in group B (n=19). All patients underwent injection laryngoplasty. Paramters of perceptual analysis, acoustic analysis, aerodynamic analysis, videostroboscopy were compared between two groups. Results : Breathness and asthenic scale, G scale of perceptual analysis were significantly improved in both groups. Glottal gap index were significantly decreased after injection in both groups. In aerodynamic analysis, MPT was improved after injection laryngoplasty in both groups, but S/Z ratio was improved only in group B. In correlation analysis, /s/ time was not correlated with pulmonary function. Conclusion : S/Z ratio reflects neither the pulmonary function nor the glottal clousure properly. MPT is more useful indicator than S/Z ratio to evaluate vocal fold paralysis even with decreased pulmonary function.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.432-436
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• 2009

Purpose: Negative pressure therapy has been used in various conditions to promote wound healing. It has also been used to secure a skin graft by improving microcirculation and improving tight adhesion between the graft and the recipient bed. To reduce post burn scar contracture and improve aesthetical result, many types of dermal substitutes have been invented and used widely. The goal of this study was evaluate usefulness of the VAC (Kinetic concepts Inc., San Antonio, TX) in improving the take rate and time to incorporation of Integra$^{(R)}$ in reconstruction of burn scar contracture. Methods: A retrospective study was performed from October, 2006 to December, 2008. The VAC was utilized for 11 patients. The average patient's age was 19.7 years (range 5 - 27) and average surface area was $785cm^2$ (range 24 - 1600). The burn scars were excised deep into normal subcutaneous tissue to achieve complete release of the scar, Integra$^{(R)}$ was sutured in place with skin staple와 Steri - strip$^{(R)}$. Then slit incisions were made on silicone sheet only with No.11 blade for effective drainage. The VAC was used as a bolster dressing over Integra$^{(R)}$. Negative - Pressure ranging from 100 to 125 mm Hg was applied to black polyurethane foam sponge trimmed to the appropriate wound size. An occlusive seal over the black polyurethane foam sponge was maintained by a combination of the occlusive dressing, OP - site$^{(R)}$. The VAC dressing changes were performed every 3 or 4 days until adequate incorporation was obtained. The neodermis appeared slightly yellow to orange color. When the Integra$^{(R)}$ deemed clinically incorporated, The VAC was removed and take was estimated with visual inspection. Very thin STSG(0.006 ~ 0.008 inches) was performed after silicone sheet removal. Result: The mean time for clinically assessed incorporation of Integra$^{(R)}$ was 10.00 days (range 9 - 12). The mean dressing change was 3.5 times until take was obtained. In All patients, Integra$^{(R)}$ had successful incorporation in tissue without serious complications. Conclusion: Integra$^{(R)}$ in combination with Vacuum - Assisted Closure(VAC) may be incorporated earlier than conventional dressing method.

• 한국농공학회지
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• 제14권1호
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• pp.2503-2519
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• 1972

The studies were carried out to find the cause and the quantitative evaluation of sea dike materials loss which is occured during the period of construction works for the tideland reclamation projects on the west coast of Korea. Major subjects to studies were to establish the typical relationships between the tidal flow and the movement of dike materials, the tidal-flow and the erosion, the dike materials and the ratio of material movement(losses), construction methods and the ratio of materials movement (losses). Based on the above subjects, the studies were made for the purpose of obtain the following informations; (1) Collecting and evaluaing the data of dike material losses due to foundation settlement, from designed existing dikes on the west coast. (2) By the field investigation at A-San Sea Dike, Pyong Taek Project, the Comparison would be made by the relationships between the tide velocity and the movement of dike foundation under the natural conditions and the period of construction so that find out the relationship between the dike materials of foundation situation and settlements. With regard to the dike construction works, it is so difficult to calculate the exact quantity of material losses due to the foundation settlements. The major factors that affect the settlement losses of the dike materials are: (1) Topographical variation (2) Swepting the sectional area of dike by the tide velocity. (3) Dumping riprap to the outerside of dike during the period of construction works. (4) Sectional area losses by the cause of occurence of the new tide channels. (5) material losses by the heavy storms. (6) Consolidation settlement by the foundation weakness. (7) Material losses by the earth materials by tide flow. Most hi호 material losses were occured by the Consolidation settlement due to the foundation weakness, the maximum tide velocities due to decrease the cross sectional area of the gaps and erosion of foundation due to the range of tide, Inner and outerside of dike, or dike material loses due to the tide flow. Final conclusion would be obtained by the continuous measurement of consolidation settlement at the stage of final clusure of the dike. (It is scheduled to close on the end of 1972) However, intermediate conclusion can be introduced as follows: (1) The estimation of material(losses) during the period of construction works for the existing sea-dikes up to date were only empirical. The material losses at the general closure for design was estimated at 10% of the riprap, 20% of the earth materials, and 20% of the riprap, 40% of the earth materials at the final closure of the dike. The final closure estimated double quantity to the general closure, but it is still doubt. (2) The ratio of consolidation settlements was found smaller than the calculated quantity. It can be foreseen that settlement speeds is higher thom the calculated speeds. (3) The movement of dike foundation under the natural conditions were not so depends on the geological conditions of the foundation. (4) When the tide velocities was estimated 100 at the normal tide, it was estimated 125 at the high tide and 55 at the low tide. The tide velocities at the low tide shows apparently lower than the high tide and the higher velocities at the deep water depth.

• 대한후두음성언어의학회지
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• 제13권1호
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• pp.5-17
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• 2002

Objectives : Videostrobokymography(VSK) has been recently developed and reported by Sung et at. We aimed to analyze vibratory patterns and objective parameters in various benign vocal fold lesions using VSK, and examine the efficacy of VSK in clinical application. Materials and Methods : Using VSK, we analyzed the vibration pattern of normal vocal fold and various benign lesions, such as nodules, polyps, cysts, Reinke's edema and unilateral vocal fold paralysis. We also calculated objective parameters, open quotient and asymmetric index, and compared them with mean values of parameters in normal controls. Results : In nodules, polyps, and cysts, the open quotient on the site of the lesion was similar to the mean value in normal controls, however, on the other part of the vocal folds it was much larger than normal mean value. In Reinke's edema, irregular and asymmetric vibration was observed. The posterior portion of the vocal folds showed larger open quotients than the anterior portion. In the unilateral vocal fold paralysis, irregular vocal folds vibration and incomplete closure of the vocal folds were documented. Much larger asymmetric indices were calculated in the unilateral vocal fold paralysis than in normal controls and other lesions. The asymmetric index could be a good quantitative parameter of vibration from a patient with vocal fold paralysis. Conclusion : This study demonstrated that VSK could generate clear quantitative documentations of fine vibrations of vocal folds in many different benign lesions. VSK has a potential as an effective tool for quantitative analysis of vibratory patterns of the vocal folds iii clinical settings.

• Journal of Chest Surgery
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• 제40권12호
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• pp.837-842
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• 2007

배경: 미숙아는 흔히 동맥관의 폐쇄가 지연되어 혈역학적으로 의미 있는 좌우단락을 초래함으로 환아의 성장 및 정상 발육에 악영향을 미친다. 저자들은 액와 소개흉술을 통한 미숙아 동맥관 개존증 폐쇄의 효과에 대해 알아보고자 하였다. 대상 및 방법: 2002년 4월부터 2006년 10월까지 동맥관 개존증을 동반한 재태기간 37주 미만의 미숙아 중 인도메타신 부적응증 또는 치료 실패 등으로 수술적 교정을 받은 20명을 대상으로 하였다. 출생 당시 재태기간은 25+3에서 34+6주 사이로 평균 28.8+3.4주이었고, 출생 후 평균 $15.6{\pm}6.3$일째에 수술하였다. 수술 당시의 체중은 680에서 2,100 g 사이로 평균 $1,174{\pm}416\;g$이었는데 이 중 1,500 g 미만은 16명이었고 1,000 g 미만은 9명이었다. 수술은 모두 신생아 중환자실에서 이루어졌는데 측와위에서 왼팔을 현수시킨 자세로 길이 $2{\sim}3\;cm$의 액와 소개흉술을 통하여 접근하였다. 동맥관 크기는 평균 $3.8{\pm}0.3\;mm$로 동맥관의 폐쇄는 주로 클립을 사용하였는데, 2예에서 박리 중 동맥관 파열로 동맥관 분리술(division)을 시행하였다. 결과: 술 전부터 인공호흡기에 의존해 온 환아 12명 중 10명이 술 후 호흡기 증상의 호전과 함께 평균 9.7일 사이에 인공호흡기 이탈이 가능하였다. 수술과 직접적으로 연관된 사망이나 합병증은 없었으나 병원 내 만기 사망이 2예에서 있었는데 1예는 술 후 41일째 폐렴으로, 나머지 1예는 술 후 131일째 패혈증으로 사망하였다. 결론: 액와 소개흉술을 통한 미숙아 동맥관 개존증의 폐쇄는 혈역학적 불안정성을 개선하여 미숙아의 성공적인 성장 및 정상 발달에 도움이 되었다. 수술의 침습도 및 이에 따른 위험성은 매우 적어 조기에 적극적인 외과적 요법이 권장된다.