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Minimal Invasive Surgery: A National Survey of Its Members by the Korean Association of Pediatric Surgeons (최소 침습 수술: 대한소아외과학회 회원을 대상으로 한 전국조사)

  • Kim, Dae Yeon;Kim, I.S.;Kim, H.Y.;Nam, S.H.;Park, K.W.;Park, W.H.;Park, Y.J.;Park, J.H.;Park, J.Y.;Park, J.S.;Park, J.Y.;Boo, Y.J.;Seo, J.M.;Seol, J.Y.;Oh, J.T.;Lee, N.H.;Lee, M.D.;Jang, J.H.;Jung, K.H.;Jung, S.Y.;Jung, S.E.;Jung, S.M.;Jung, E.Y.;Jung, J.H.;Cho, M.J.;Choi, K.J.;Choi, S.J.N.;Choi, S.O.;Choi, S.H.;Choi, Y.M.;Hong, J.
    • Advances in pediatric surgery
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    • v.20 no.1
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    • pp.1-6
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    • 2014
  • Minimal invasive surgery (MIS) has rapidly gained acceptance for the management of a wide variety of pediatric diseases. A questionnaire was sent to all members of the Korean Association of Pediatric Surgeons. Thirty one members (25.4%) took part in the survey that included data for the year 2012: demographic details, opinion regarding minimal invasive surgery and robotic surgery, spectrum of minimally invasive operations, and quantity of procedures. 48.4% of the respondents had more than 10 years experience, 35.5% less than 10 years experience, and 16.1 % had no experience. The respondents of the recommend MIS and perform MIS for surgical procedures are as follow; inguinal hernia (61.3%), simple appendicitis (87.1%), complicated appendicitis (80.6%), reduction of intussusceptions (83.9%), pyloromyotomy (90.3%), fundoplication (96.8%), biopsy and corrective surgery of Hirschsprung's disease (93.5%/90.3%), imperforate anus (77.4%), congenital diaphragmatic hernia (80.6%), and esophageal atresia (74.2%). The MIS procedures with more than 70% were lung resection (100%), cholecystectomy (100%), appendectomy (96.2%), ovarian torsion (86.7%), fundoplication (86.8%), hiatal hernia repair (82.6%), and splenectomy (71.4%). The MIS procedures with less than 30% were congenial diaphragmatic hernia reapir (29.6%), esophageal atresia (26.2%), correction of malroatation (24.4%), inguinal hernia repair (11.4%), anorectal malformation (6.8%), Kasai operation (3.6%).

Advanced Hybrid EER Transmitter for WCDMA Application Using Efficiency Optimized Power Amplifier and Modified Bias Modulator (효율이 특화된 전력 증폭기와 개선된 바이어스 모듈레이터로 구성되는 진보된 WCDMA용 하이브리드 포락선 제거 및 복원 전력 송신기)

  • Kim, Il-Du;Woo, Young-Yun;Hong, Sung-Chul;Kim, Jang-Heon;Moon, Jung-Hwan;Jun, Myoung-Su;Kim, Jung-Joon;Kim, Bum-Man
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.18 no.8
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    • pp.880-886
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    • 2007
  • We have proposed a new "hybrid" envelope elimination and restoration(EER) transmitter architecture using an efficiency optimized power amplifier(PA) and modified bias modulator. The efficiency of the PA at the average drain voltage is very important for the overall transmitter efficiency because the PA operates mostly at the average power region of the modulation signal. Accordingly, the efficiency of the PA has been optimized at the region. Besides, the bias modulator has been accompanied with the emitter follower for the minimization of memory effect. A saturation amplifier, class $F^{-1}$ is built using a 5-W PEP LDMOSFET for forward-link single-carrier wideband code-division multiple-access(WCDMA) at 1-GHz. For the interlock experiment, the bias modulator has been built with the efficiency of 64.16% and peak output voltage of 31.8 V. The transmitter with the proposed PA and bias modulator has been achieved an efficiency of 44.19%, an improvement of 8.11%. Besides, the output power is enhanced to 32.33 dBm due to the class F operation and the PAE is 38.28% with ACLRs of -35.9 dBc at 5-MHz offset. These results show that the proposed architecture is a very good candidate for the linear and efficient high power transmitter.

The Role of Intra-Aortic Balloon Pump in Coronary Artery Bypass Surgery (관상동맥 우회술에서의 대동맥내 풍선 펌프의 역할)

  • 박성식;김기봉
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.282-286
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    • 1997
  • In the era of coronary artery bypass grafting, the intraaortic balloon pump (IABP) is more widely used and its indication has been ex anded. We perf'orbed retrospective clinical analysis on the patients who have received IABP pre andfor postoperatively during the course of CABG. From January 1981 to June 1995, total 322 patients have received CABG at the Seoul National University Hospital and among them 50 patients (15.5%) were supported by IABP during the course of the operation. The mean age at the time. of the operation was 57.2 years (39∼ 75 years) and the male to female ratio was 33 : 17. The preoperative diagnosis was unstable angina in 33 (66%), stable angina in 7 (14%) and postinfarct angina in 8 patients(16%). As for the indications of the IABP, there were 13 cases(26%) with left main disease, 13 (26%) with class IV angina, 12 (24%) with difficulty in CPB weaning, 6 (12%) with postinfarct angina and 3 (6%) with severe LV dysfunction. In the remaining 3 cases, one patient was operated on after PTCA failure in emergency basis, another was a patient with AMI, and the other was one who had postoperative low c rdiac output syndrome. All IABPS were introduced via femoral artery and among them 45 cases (90%) percutaneously. The mean postoperative assist time was 22.3 hours (0.5 ∼ 168 hours) and IABP could be removed within 48 hours in most of them (44150). The operative mortality was 6.1% (3 cases) and postoperative morbidity was only one with lower extremity ischemia. The more general application of the IABP during the course of the CABG ,especially in patients with high preoperative risk factors or difficulty in CPB weaning is a good measure of protecting and recovering myocardial function with minimal risk.

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Evaluation on Thermal Performance Along with Constructability and Economic Feasibility of Large-diameter Cast-in-place Energy Pile (대구경 현장타설 에너지파일의 열교환 성능과 시공성 및 경제성 분석)

  • Park, Sangwoo;Sung, Chihun;Lee, Dongseop;Jung, Kyoungsik;Choi, Hangseok
    • Journal of the Korean Geotechnical Society
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    • v.31 no.5
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    • pp.5-21
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    • 2015
  • An energy pile is a novel type of ground heat exchangers (GHEX's) which sets up heat exchange pipes inside a pile foundation, and allows to circulate a working fluid through the pipe for exchanging thermal energy with the surrounding ground stratum. Using existing foundation structure, the energy pile can function not only as a structural foundation but also as a GHEX. In this paper, six full-scale energy piles were constructed in a test bed with various configurations of the heat exchange pipe inside large-diameter cast-in-place piles, that is, three parallel U-type heat exchangers (5, 8 and 10 pairs), two coil type heat exchangers (with a 500 mm and 200 mm pitch), and one S-type heat exchanger. During constructing the energy piles, the constructability of each energy pile was evaluated with consideration of the installation time, the number of workers and any difficulty for installing. In order to evaluate the thermal performance of energy piles, the thermal performance tests were carried out by applying intermittent (8 hours operating-16 hours pause) artificial cooling operation to simulate a cooling load for commercial buildings. Through the thermal performance tests, the heat exchange rates of the six energy piles were evaluated in terms of the heat exchange amount normalized with the length of energy pile and/or the length of heat exchange pipe. Finally, the economic feasibility of energy pile was evaluated according to the various types of heat exchange pipe by calculating demanded expenses per 1 W/m based on the thermal performance test results along with the market value of heat exchange pipes and labor cost.

Investigation on Diesel Injection Characteristics of Natural Gas-Diesel Dual Fuel Engine for Stable Combustion and Efficiency Improvement Under 50% Load Condition (천연가스-디젤 혼소 엔진의 50% 부하 조건에서 제동효율 및 연소안정성 개선을 위한 디젤 분무 특성 평가)

  • Oh, Sechul;Oh, Junho;Jang, Hyungjun;Lee, Jeongwoo;Lee, Seokhwan;Lee, Sunyoup;Kim, Changgi
    • Journal of the Korean Institute of Gas
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    • v.26 no.3
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    • pp.45-53
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    • 2022
  • In order to improve the emission of diesel engines, natural gas-diesel dual fuel combustion compression ignition engines are in the spotlight. In particular, a reactivity controlled compression ignition (RCCI) combustion strategy is investigated comprehensively due to its possibility to improve both efficiency and emissions. With advanced diesel direct injection timing earlier than TDC, it achieves spontaneous reaction with overall lean mixture from a homogeneous mixture in the entire cylinder area, reducing nitrogen oxides (NOx) and particulate matter (PM) and improving braking heat efficiency at the same time. However, there is a disadvantage in that the amount of incomplete combustion increases in a low load region with a relatively small amount of fuel-air. To solve this, sensitive control according to the diesel injection timing and fuel ratio is required. In this study, experiments were conducted to improve efficiency and exhaust emissions of the natural gas-diesel dual fuel engine at low load, and evaluate combustion stability according to the diesel injection timing at the operation point for power generation. A 6 L-class commercial diesel engine was used for the experiment which was conducted under a 50% load range (~50 kW) at 1,800 rpm. Two injectors with different spray patterns were applied to the experiment, and the fraction of natural gas and diesel injection timing were selected as main parameters. Based on the experimental results, it was confirmed that the brake thermal efficiency increased by up to 1.3%p in the modified injector with the narrow-angle injection added. In addition, the spray pattern of the modified injector was suitable for premixed combustion, increasing operable range in consideration of combustion instability, torque reduction, and emissions level under Tier-V level (0.4 g/kWh for NOx).

Investigation of the Condition of the Operation of the Livestock Liquid Manure Bin and Assessment of Malodorant Emissions (축분뇨 액비 저장조의 운영실태 및 악취 물질 발생량 조사)

  • Kim T. I.;Song J. I.;Joung S.;Jeong J. W.;Chung E. S.;Barroga A. J.;Yoo Y. H.;Yang C. B.;Kim M. K.
    • Journal of Animal Environmental Science
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    • v.11 no.3
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    • pp.189-196
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    • 2005
  • This study was carried out to determine the acceptability of liquid manure bin among livestock farmers and agricultural farmers, and quantify its malodorous compounds. The results were as follows; 1. The size of the manure bins owned by $93\%$ of 60 farmers surveyed was 200 M/T and were all in normal operation. Around $57\%$ of the normally operated bins were processed under aerobic condition. 2. Filly percent of the respondents utilized their liquid manure bin twice a year while $64\%$ used commercial microbial products to enhance maturity of their liquid manure and abatement of malodorous emissions. On the other hand, $43\%$ mentioned problems on the labor requirement, mechanical maintenance and lending cost of liquid manure processing and utilization, and the price of the commercial microbial products. 3. Malodorants emitted from livestock liquid manure bins and their boundary bin depended upon the livestock liquid manure processing condition. Within bin under the aerobic processing condition, Iso-valeric and propionic acid were ranged 0.012 to 0.07ppm and 0.17 to 2.85ppm, respectively. Within bin under the anoxic processing condition, n-butyric, n-valeric acid, and acetaldehyde were ranged 1.5 to 2.3ppm, 1.3 to 1.8ppm, and 0.8 to 2.1ppm, respectively. Malodorants emitted from the boundary of livestock liquid manure bins under the anoxic processing condition were detected the range of 0.4 to 0.9 ppm, more than the concentration of law regulation, as an acetaldehyde, but under the aerobic processing condition, they did not any detection.

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Case Report of Radiotherapy to a Breast Cancer Patient with a Pacemaker (인공심장박동기가 이식된 유방암환자의 방사선 치료에 대한 사례 보고)

  • Chae, Seung-Hoon;Park, Jang-Pil;Lee, Yang-Hoon;Yoo, Suk-Hyun;Seong, Won-Mo;Kim, Kyu-Bo
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.197-203
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    • 2012
  • Purpose: In this study, we considerate our radiation therapy process for the breast cancer patient implanted a pacemaker applying the machine movement surgery, shielding, beam selection. Materials and Methods: We perform radiation therapy to a 54 years old, breast cancer patient implanted a pacemaker. The patient underwent a surgery to move the position of a pacemaker to right side breast after consultation with cardiology department. Prescribed dose was 5,040 cGy and daily dose 180 cGy for 28 fractions. The 10 MV photon energy, field size 0/$9.5{\times}20$ cm, half beam and opposing portal irradiation are used. To find out appropriate thickness of shielding board, we carried out an experiment using a solid water phantom ($30{\times}30{\times}7$ cm), a Farmer-type chamber (TN30013, PTW, Germany) and a shielding board (Pb $28{\times}27{\times}0.1$ cm). We calculated expected absorbed dose to te pacemaker with absorb ratio and shielding ratio. In the PTP system (Eclipse, Varian, USA), we figured out how much radiation would be absorbed to the machine with and without shielding. First day of the radiation therapy, we measured head scatter to the pacemaker with MOSFET Dose Verification System (TN-RD-70-W, Medical Canada Ltd., Canada). Results: In the phantom measurement, we found out appropriate thickness was 2 mm of shielding board. In the RTP, when using 2 mm shielding the pacemaker will be absorbed 11.5~38.2 cGy and DVH is 77.3 cGy. In the first day of the therapy, 4.3 cGy was measured so 120.4 cGy was calculated during total therapy. The patient was free from any side effects, and the machine also normally functioned. Conclusion: As the report of association which have public confidence became superannuated, there is lack of data about new machine. We believe that radiation therapy to thiese kind of patients could be done successfully with co-operation, patient-suitable planning, accurate QA, frequent in-vivo dosimetry and monitoring.

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A Design of PLL and Spread Spectrum Clock Generator for 2.7Gbps/1.62Gbps DisplayPort Transmitter (2.7Gbps/1.62Gbps DisplayPort 송신기용 PLL 및 확산대역 클록 발생기의 설계)

  • Kim, Young-Shin;Kim, Seong-Geun;Pu, Young-Gun;Hur, Jeong;Lee, Kang-Yoon
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.47 no.2
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    • pp.21-31
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    • 2010
  • This paper presents a design of PLL and SSCG for reducing the EMI effect at the electronic machinery and tools for DisplayPort application. This system is composed of the essential element of PLL and Charge-Pump2 and Reference Clock Divider to implement the SSCG operation. In this paper, 270MHz/162MHz dual-mode PLL that can provide 10-phase and 1.35GHz/810MHz PLL that can reduce the jitter are designed for 2.7Gbps/162Gbps DisplayPort application. The jitter can be reduced drastically by combining 270MHz/162MHz PLL with 2-stage 5 to 1 serializer and 1.35GHz PLL with 2 to 1 serializer. This paper propose the frequency divider topology which can share the divider between modes and guarantee the 50% duty ratio. And, the output current mismatch can be reduced by using the proposed charge-pump topology. It is implemented using 0.13 um CMOS process and die areas of 270MHz/162MHz PLL and 1.35GHz/810MHz PLL are $650um\;{\times}\;500um$ and $600um\;{\times}\;500um$, respectively. The VCO tuning range of 270 MHz/162 MHz PLL is 330 MHz and the phase noise is -114 dBc/Hz at 1 MHz offset. The measured SSCG down spread amplitude is 0.5% and modulation frequency is 31kHz. The total power consumption is 48mW.

The Effects of Estrogen on Experimental Tooth Movement in Ovariectomized Rats (난소적출 백서에서 estrogen투여가 실험적 치아이동에 미치는 영향)

  • Jin, Keun-Ho;Kim, Jong-Ghee;Park, Byung-Keon;Kim, Oh-Hwan
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.585-597
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    • 1997
  • The purpose of this study was to evaluate the effect of estrogen on the periodontium and alveolar bone tissue response during experimental tooth movement in ovariectomized rats. Eighty female rats, 250gm in body weight, were classified into four groups ; sham operated group(NN), ovariectomized group(ON), ovariectomized & estrogen injected group(OE), sham operated & estrogen injected group(NE). flats were ovariectomized before 3 weeks to begin the experiment, which resulted in estrogen-deficient osteoporosis. In OE group & NE group, estrogen was injected $50{\mu}g/kg\;B.W.$ every other days. The left maxillary 1st molar was moved mesially with 60g force. Each foot rats were sacrificed after 1, 3, 7, 15 days from application of orthodontic appliance and alter additional 7 days from removal of orthodontic appliance. Histological findings on mesial roots of upper 1st molar in pressure and tension side are observed. The results were summarized as follows ; 1. In pressure side of alveolar bone, the number of osteoclasts and Howship's lacuna of ON group was significantly more than that of NN group from 1 day to 15 days(P<0.05). Especially the number of Howship's lacuna of ON group was significantly more than that of OE group during all experimental period(P<0.05). 2. In tension side of alveolar tune, the number of osteoclasts of ON group was significantly increased from 1 day to 3 days and decreased after 7 days. But the number of osteoclast of ON group was significantly mote than that of NN group during all experimental period(P<0.05). Also the number of Howship's lacuna of all groups was abruptly increased at 1 day, but slowly decreased till experimental 15 days. And the number of Howship's lacuna of of group was significantly more than that of NN group from 0 hr to 7 days(P<0.05). 3. The speed of tooth movement of OE group & NE group was similar to that of NN group(P>0.05). The amount of tooth movement of ON group between 7 days and 15 days was significantly greater than those of other groups(P<0.05). 4. The degree of relapse of ON group after 7 days from removal of orthodontic appliance was similar to those of other groups(P>0.05).

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A 13b 100MS/s 0.70㎟ 45nm CMOS ADC for IF-Domain Signal Processing Systems (IF 대역 신호처리 시스템 응용을 위한 13비트 100MS/s 0.70㎟ 45nm CMOS ADC)

  • Park, Jun-Sang;An, Tai-Ji;Ahn, Gil-Cho;Lee, Mun-Kyo;Go, Min-Ho;Lee, Seung-Hoon
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.3
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    • pp.46-55
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    • 2016
  • This work proposes a 13b 100MS/s 45nm CMOS ADC with a high dynamic performance for IF-domain high-speed signal processing systems based on a four-step pipeline architecture to optimize operating specifications. The SHA employs a wideband high-speed sampling network properly to process high-frequency input signals exceeding a sampling frequency. The SHA and MDACs adopt a two-stage amplifier with a gain-boosting technique to obtain the required high DC gain and the wide signal-swing range, while the amplifier and bias circuits use the same unit-size devices repeatedly to minimize device mismatch. Furthermore, a separate analog power supply voltage for on-chip current and voltage references minimizes performance degradation caused by the undesired noise and interference from adjacent functional blocks during high-speed operation. The proposed ADC occupies an active die area of $0.70mm^2$, based on various process-insensitive layout techniques to minimize the physical process imperfection effects. The prototype ADC in a 45nm CMOS demonstrates a measured DNL and INL within 0.77LSB and 1.57LSB, with a maximum SNDR and SFDR of 64.2dB and 78.4dB at 100MS/s, respectively. The ADC is implemented with long-channel devices rather than minimum channel-length devices available in this CMOS technology to process a wide input range of $2.0V_{PP}$ for the required system and to obtain a high dynamic performance at IF-domain input signal bands. The ADC consumes 425.0mW with a single analog voltage of 2.5V and two digital voltages of 2.5V and 1.1V.