Background: The surgical technique for biventricular assist device(BVAD) implantation has mainly consisted of cannulation procedures. A median sternotomy has been the technique of choice as it gives a surgeon an excellent exposure of the heart. However, considering that most patients require a future sternotomy or already have a previous sternotomy, sternotomy-related complication remains a major concern in BVAD implantation. Based on this consideration as well as the clinical experiences of conventional heart surgery, the authors have hypothesized that the cardiac chambers for BVAD cannulation can be approached from the right side of the heart. The purpose of this studs to develop a novel surgical technique of right thoracotomy for BVAD implantation in an animals study. Material and Method: For last two years, 16 (11 calves, 3 canines, and 2 sheep) out of 30 experimental animals with AnyHeart implantation underwent a right thoracotomy. The device was used as an implantable BVAD in 14 animals, a wearable BVAD in 1, and an implantable LVAD in 1. The chest cavity was entered through the 4th intercostal space or the 5th periosteal bed. As for the BVAD use, a right inflow cannula was inserted into the right atrial free wall and a right outflow cannula was grafted onto the main pulmonary artery. A left inflow cannula was inserted into the interatrial groove and a left outflow cannula was grafted on the innominate artery of the ascending aorta. The connecting tubes were brought out through the thoracotomy wound and connected to the pump located in the subcutaneous pocket at the right flank. Result: Except for the 5 animals for a lilting test or during the early learning curve, all recovered smoothly from the procedures. The inflow drainage allowed the pump output 6.5 L/min at the maximum with 3-3.5 L/min in an average. Of the survivors, there noted no procedure-related mortality or morbidity. Necropsy findings demonstrated the well-positioned cannula tips in the each cardiac chamber
Journal of the Korean Institute of Traditional Landscape Architecture
/
v.32
no.3
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pp.46-57
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2014
This study contemplated the gardening culture from the pictures, which the scholars of late Joseon Dynasty, the aspects of garden landscapes and garden use behaviors are drawn as follows. 1. The yard by the detached house for men and guest in front of the premises(Sarang Madang) and backyard were the major places for Ahoi(social gatherings of the scholars). The mansions had interests in the management of the outer garden beyond the house wall with building structures like the pavilions on the high walls and side gates. This management and the selection of location anticipating in advance of the management are noteworthy. 2. Only house gardens had plant pots with flowers and the small flower bed(Hwa-O) at Sarang Madang occasionally had plant pots without flowers and oddly shaped stone pots and equipped pine branch eaves and traditional awnings made of plant material like a trellis. 3. The oddly shaped stones were significant landscape elements in the gardens of houses and villas. Some of them were depicted as the Taihu stone and this draws attention to the question of whether the Taihu stone was actually used in the garden of late Joseon Dynasty. 4. The gardens in villas accommodated the borrowed scenery with various materials like wooden fences, bamboo or reed fences, mud walls. They also had the artificial gardens with some odd shaped stones, old pines, bamboos, Japanese apricots, willows, paulownia trees, lotuses and plantains in the secured Madangs. 5. Gyeong Hwa Sa Jog(The scholars of the ruling class adapted to the 18th century's new historical aspect) of late Joseon Dynasty built the villas at the beautiful scenery closed to the their houses. 6. The Gardens around pavilions were located high closed to the mountain streams with nature like beautiful forests, oddly formed rocks, precipitous cliffs and viewing stones. The back side of the pavilion was enclosed by bamboo forests and the front had pines, ginkgoes and willows as shade trees. 7. The beautiful scenery which was preferred as the place for Ahoi was basically with fantastic peaks and precipitous cliffs which forms the distant view harmonized with a waterfall. Broad and flat rocks at the summit of a mountain which commands a bird's-eye view or on a mountain streamside with pine forest, willows and plum trees were chosen as the optimal places for Ahoi. 8. Pine trees were presumed to be more preferable than other species in the garden, especially an single planted old pine tree accented symbolism. 9. Portable tea braziers for boiling tea were adopted in all four types of the gardens. 10. The gardens mixed with auspicious landscape elements were the places of the arts for an unworldliness Ahoi through GeumGiSeoHwa(enjoying strings, go, writing and painting) and boiling tea.
Background: Reoperation is usually required for a right ventricle to pulmonary artery conduit obstruction caused by valve degeneration, conduit peel formation or somatic growth of the patient. An autologous tissue reconstruction (peel operation), where a prosthetic roof is placed over the fibrotic tissue bed of the explanted conduit, has been used to manage conduit obstructions at our institute since May 2002. Herein, the early and midterm results are evaluated. Material and Method: Between May 2002 and July 2006, 9 patients underwent obstructed extracardiac conduit replacement with an autologous tissue reconstruction, at a mean of 5.1 years after a Rastelli operation. The mean age at reoperation was $7.5{\pm}2.4$ years, ranging from 2.9 to 10.1 years. The diagnoses included 6 pulmonary atresia with VSD, 2 truncus arteriosus and 1 transposition of the great arteries. The preoperative mean systolic gradient was $88.3{\pm}22.2mmHg$, ranging from 58 to 125 mmHg. The explanted conduits were all Polystan valved pulmonary conduit (Polystan, Denmark). A bioprosthetic valve was inserted in 8 patients, and a monocusp ventricular outflow patch (MVOP) was used in 1 patient. The anterior wall was constructed with a Gore-Tex patch (n=7), MVOP (n=1) and bovine pericardium (n=1). Pulmonary artery angioplasty was required in 5 patients and anterior aortopexy in 2. The mean cardiopulmonary bypass time . was 154 minutes, ranging from 133 to 181 minutes; an aortic crossclamp was not performed in all patients. The mean follow-up duration was 20 months, ranging from 1 to 51 months. All patients were evaluated for their right ventricular outflow pathway using a 3-D CT scan. Resuit: There was no operative mortality or late death. The mean pressure gradient, assessed by echocardiography through the right ventricular outflow tract, was 20.4 mmHg, ranging from 0 to 29.6 mmMg, at discharge and 26 mmHg, ranging from 13 to 36 mmHg, at the latest follow-up (n=7, follow-up duration >1 year). There were no pseudoaneurysms, strictures or thrombotic occlusions. Conclusion: A peel operation was concluded to be a safe and effective re-operative option for an obstructed extracardiac conduit following a Rastelli operation.
Journal of Korean Society of Coastal and Ocean Engineers
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v.29
no.5
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pp.269-277
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2017
Recently, a submerged breakwater has been installing to prevent the erosion of shoreline everywhere. Artificially submerged breakwater is made to minimize the loss of nourishment sand beach erosion. For this reason, it has been indiscriminately constructed submerged breakwater that is planned in the country throughout. However, maintenance purposes to keep the shoreline of the beach is a method that is quite a few problems. There are also disadvantages such as expensive construction costs, ocean space utilization, water pollution and shoreline modification. In addition, person of utilizing the space of the ocean leisure does not like that because of the disconnection of ocean space. The beaches such as Gwanganri are artificially supplying nourishment sand to maintain the beach. The flexible construction method refers to a structure that is installed as a flexible material instead of submerged breakwater to prevent the loss of nourishment sand. In order to develop a new method to mitigate shoreline erosion, this study was carried out a hydraulic model experiment by installing a cell group as an example of the flexible method. Namely, in order to prevent the loss of nourishment sand, we decided to develop a new method that can mitigate the degree of beaches erosion by using cell group instead of submerged breakwater. In the two dimensional fixed hydraulic experiment, was carried out the effect reducing of wave height and the rate of low reflection due to the installation of the cell group. In movable bed experiment, the capture rate of the nourishment sand and the erosion prevention rate of the nourishment sand was performed for stability of shoreline. Therefore, according to the results of the hydraulic tests, it was possible to maintain the stable beaches due to installing the cell group on the erosion beaches, due to the effect of reducing wave height, the low reflection, the erosion prevention rate of nourishment sand, the high capture rate of nourishment sand.
Verfondern, Karl;Nabielek, Heinz;Kendall, James M.
Nuclear Engineering and Technology
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v.39
no.5
/
pp.603-616
/
2007
Roy Huddle, having invented the coated particle in Harwell 1957, stated in the early 1970s that we know now everything about particles and coatings and should be going over to deal with other problems. This was on the occasion of the Dragon fuel performance information meeting London 1973: How wrong a genius be! It took until 1978 that really good particles were made in Germany, then during the Japanese HTTR production in the 1990s and finally the Chinese 2000-2001 campaign for HTR-10. Here, we present a review of history and present status. Today, good fuel is measured by different standards from the seventies: where $9*10^{-4}$ initial free heavy metal fraction was typical for early AVR carbide fuel and $3*10^{-4}$ initial free heavy metal fraction was acceptable for oxide fuel in THTR, we insist on values more than an order of magnitude below this value today. Half a percent of particle failure at the end-of-irradiation, another ancient standard, is not even acceptable today, even for the most severe accidents. While legislation and licensing has not changed, one of the reasons we insist on these improvements is the preference for passive systems rather than active controls of earlier times. After renewed HTGR interest, we are reporting about the start of new or reactivated coated particle work in several parts of the world, considering the aspects of designs/ traditional and new materials, manufacturing technologies/ quality control quality assurance, irradiation and accident performance, modeling and performance predictions, and fuel cycle aspects and spent fuel treatment. In very general terms, the coated particle should be strong, reliable, retentive, and affordable. These properties have to be quantified and will be eventually optimized for a specific application system. Results obtained so far indicate that the same particle can be used for steam cycle applications with $700-750^{\circ}C$ helium coolant gas exit, for gas turbine applications at $850-900^{\circ}C$ and for process heat/hydrogen generation applications with $950^{\circ}C$ outlet temperatures. There is a clear set of standards for modem high quality fuel in terms of low levels of heavy metal contamination, manufacture-induced particle defects during fuel body and fuel element making, irradiation/accident induced particle failures and limits on fission product release from intact particles. While gas-cooled reactor design is still open-ended with blocks for the prismatic and spherical fuel elements for the pebble-bed design, there is near worldwide agreement on high quality fuel: a $500{\mu}m$ diameter $UO_2$ kernel of 10% enrichment is surrounded by a $100{\mu}m$ thick sacrificial buffer layer to be followed by a dense inner pyrocarbon layer, a high quality silicon carbide layer of $35{\mu}m$ thickness and theoretical density and another outer pyrocarbon layer. Good performance has been demonstrated both under operational and under accident conditions, i.e. to 10% FIMA and maximum $1600^{\circ}C$ afterwards. And it is the wide-ranging demonstration experience that makes this particle superior. Recommendations are made for further work: 1. Generation of data for presently manufactured materials, e.g. SiC strength and strength distribution, PyC creep and shrinkage and many more material data sets. 2. Renewed start of irradiation and accident testing of modem coated particle fuel. 3. Analysis of existing and newly created data with a view to demonstrate satisfactory performance at burnups beyond 10% FIMA and complete fission product retention even in accidents that go beyond $1600^{\circ}C$ for a short period of time. This work should proceed at both national and international level.
Purpose: To determine the role of radiotherapy for the treatment of portal vein thrombosis (PVT) from hepatocellular carcinoma (HCC). Material and Methods: A retrospective analysis was performed on 70 patients that had been diagnosed with HCC and were treated with three-dimensional conformal radiotherapy (3D-CRT) for the PVT. The radiation dose ranged from 40 Gy to 60 Gy (median dose: 48 Gy) and the biological effective dose (BED) ranged from 31.3 Gy to 78.0 $Gy_{10}$ (median dose: 61.6 $Gy_{10}$). Response was determined by measuring the extent of the PVT on a CT image at 0, 1 and 3 months after completion of the radiotherapy. The median follow-up period was 9 months. Results: The response rate was 47.1% (33 patients), with two patients (2.9%) showing a complete response, 31 patients (44.3%) showing a partial response, and 35 patients (50%) showing stable disease or no response. The 1-year progression-free survival rate was 60%, and the median progression-free survival time was 17 months. The median overall survival time was 11 months, the median survival time in the responders was 15 months and in the nonresponders was 8 months (p=0.032). Four patients (5.7%) had transient liver function impairment during treatment. Radiation induced liver disease (RILD) was observed in only one patient (1.4%). Conclusion: Three-dimensional conformal radiotherapy for the treatment of PVT from advanced HCC was a relatively effective and safe method.
The purpose of this study is to construct ecological pond using LID technique in order to create naturally comfortable community space in urban idle space. The specification of the ecological pond is $110m^2$ of surface area, $0.45{\pm}0.02m$ of average depth, and bed material is composed of gravel (diameter ${\leq}60mm$), sand (diameter ${\leq}2mm$) and bentonite. Rainfall and water depth monitoring were conducted to determine the annual characteristics of inflow of the water for the ecological pond, result of total rainfall was 1,287 mm and showed a seasonal imbalance that accounted for 71.3% (918 mm) during July to August, but the annual mean water depth was kept constant at $0.45{\pm}0.02m$ due to the secondary water source. Annual trends of basic water quality showed a significant changes according to the season, such as water temperature ($5.2{\sim}28.8^{\circ}C$), DO (5.0 ~ 13.8 mg/L), EC ($113{\sim}265{\mu}S/cm$). BOD, COD, TN, and TP in physicochemical water quality tended to increase after October, but the ion parameters such as $NH_3$ and $PO_4{^{3-}}$ were generally low. Phytoplankton indicators Chl-a and BGA (blue green algae) showed a sharp increase from July to August, and green algae (Selenastrum bibraianum, Pediastrum boryanum etc.) and filamentous blue green algae (Phormidium sp.) emerged as a dominant species. The ion parameters ($F^-$, $Na^+$, $K^+$, $Mg^{2+}$, $Ca^{2+}$) were strongly correlated with the $Cl^-$ as a conservative substance (R=0.70~0.97, p<0.05). Water quality was influenced by the ambient environment such as seasonal changes or rainfall, and it was closely related to fluctuation of the inflow of the water. In the future, it is necessary to consider ecological connections by referring to the characteristics surveyed in this study in order to effectively manage the water quality and biodiversity of the ecological pond in idle space.
Journal of the Korean Institute of Traditional Landscape Architecture
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v.39
no.4
/
pp.24-37
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2021
This study was conducted to newly examine the original landscape of Buyongjeong(芙蓉亭) and Juhamnu(宙合樓) areas in Changdeokgung Palace(昌德宮), focusing on the modern period including the Korean Empire, and to derive useful research results for restoration and maintenance in the future. The study results can be summarized as follows. First, the artificial island in Buyongji(芙蓉池) was originally made up of a straight layer using well-trimmed processed stone. However, during the maintenance work in the 1960s and 1970s, the artificial island in Buyongji was transformed into a mixture of natural and processed stones. The handrail installed on the upper part of the artificial island in Buyongji is a unique facility that is hard to find similar cases. The handrail existed even during the Korean Empire, but was completely destroyed during the Japanese colonial period. Second, Chwibyeong(翠屛), which is currently located on the left and right of Eosumun(魚水門), is the result of a reproduction based on Northern bamboo in 2008. Although there is a view that sees the plant material of Eosumun Chwibyeong as Rigid-branch yew, the specific species is still vague. Looking at the related data and circumstances from various angles, at least in the modern era, it is highly probable that the Eosumun Chwibyeong was made of Chinese juniper like Donggwanwangmyo Shrine(東關王廟) and Guncheongung(乾淸宮) in Gyeongbokgung Palace(景福宮). Third, the backyard of Juhamnu was a space with no dense trees on top of a stone staircase-shaped structure. The stone stairway in the backyard of Juhamnu was maintained in a relatively open form, and it also functioned as a space to pass through the surrounding buildings. However, as large-scale planting work was carried out in the late 1980s, the backyard of Juhamnu was maintained in the same shape as a Terraced Flower Bed, and it was transformed into a closed space where many flowering plants were planted. Fourth, Yeonghwadang Namhaenggak(暎花堂 南行閣), which had a library function like Gyujanggak(奎章閣) and Gaeyuwa(皆有窩), was destroyed in the late 1900s and was difficult to understand in its original form. Based on modern photographs and sketch materials, this study confirmed the arrangement axis of Yeonghwadang Namhaenggak, and confirmed the shape and design features of the building. In addition, an estimated restoration map referring to 「Donggwoldo(東闕圖)」 and 「Donggwoldohyung(東闕圓形)」 was presented for the construction of basic data.
Journal of the Korean Institute of Traditional Landscape Architecture
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v.41
no.4
/
pp.8-20
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2023
Although the landscape architectural facilities need to be repaired according to historical and authentic techniques, the repair criteria of the standard specification for repairing cultural heritages still remain at a theoretical level, and there are little research analyzing detailed techniques from specific cases. This study discussed the repair techniques based on historical facts, around terraced flower beds, ponds, waterways and pavement in the government-managed spaces in the Joseon Dynasty. It analyzed the materials and finish of stone wall elements, the structural reinforcement and backfill materials, and topsoil surface protection measures, and drew out stones for foundation reinforcement, plastering material for agglutination, and stone processing techniques for the terraced flower beds. It examined the materials and structures of the rock revetment, foundation reinforcement and waterproofing techniques and drew out the outstanding characteristics of the foundation work, the recycle of used elements and the management of water quality, for the ponds. It primarily investigated the materials, foundation reinforcement and waterproofing techniques and discovered the repair techniques such as cover stone finishing methods, foundation and backfill materials, and flow reduction methods, for the waterways. Finally, it provided actual cases of the foundation composition, auxiliary materials and tools, and the use of cyperaceae and highlighted the existence of professional craftsmen called Bangjeonjang(方磚匠), for the pavement. This study is expected to be a staring point for discovering the repair techniques for landscape architectural facilities and used as basic data for revising specifications in the future.
Background: No general consensus has been available regarding the necessity of postoperative radiation therapy (PORT) and its optimal techniques in the patients with chest wall invasion (pT3cw) and node negative (N0) non-small cell lung cancer (NSCLC). We did retrospective analyses on the pT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. And we compared them with the pT3cwN0 NSCLC patients who did not received PORT during the same period. Material and Method: From Aug. of 1994 till June of 2002, 22 pT3cwN0 NSCLC patients received PORT-PORT (+) group- and 16 pT3cwN0 NSCLC patients had no PORT-PORT (-) group. The radiation target volume for PORT (+) group was confined to the tumor bed plus the immediate adjacent tissue only, and no regional lymphatics were included. The prognostic factors for all patients were analyzed and survival rates, failure patterns were compared with two groups. Result: Age, tumor size, depth of chest wall invasion, postoperative mobidities were greater in PORT (-) group than PORT (+) group. In PORT (-) group, four patients who were consulted for PORT did not receive the PORT because of self refusal (3 patients) and delay in the wound repair (1 patient). For all patients, overall survival (OS), disease-free survival (DFS), loco-regional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS) rates at 5 years were 35.3%, 30.3%, 80.9%, 36.3%. In univariate and multivariate analysis, only PORT significantly affect the survival. The 5 year as rates were 43.3% in the PORT (+) group and 25.0% in PORT (-) group (p=0.03). DFS, LRFS, DMFS rates were 36.9%, 84.9%, 43.1 % in PORT (+) group and 18.8%, 79.4%, 21.9% in PORT(-) group respectively. Three patients in PORT (-) group died of intercurrent disease without the evidence of recurrence. Few suffered from acute and late radiation side effects, all of which were RTOG grade 2 or lower. Conclusion: The strategy of adding PORT to surgery to improve the probability not only of local control but also of survival could be justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. Authors were successful in the marked reduction of the incidence as well as the severity of the acute and late side effects of PORT, without taking too high risk of the regional failures by eliminating the regional lymphatics from the radiation target volume.
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