The Fontan principle of redirecting systemic venous blood into the pulmonary arteries via a conduit was initially proposed for Tricuspid Atresia, but it and its modifications have now gained a much wider application than initially intended. From September 1978 to July 1983, Atriopulmonary anastomosis has been performed in 23 patients, 2 months to 19 years of age, Seoul National University Hospital. The diagnoses were Tricuspid Atresia [TA] in 13, Univentricular Heart [UVH] in 9 and one case of Double Outlet of Right Ventricle [DORV]. Previous procedures included two Glenn shunts and one Blalock-Taussl8 shunt. Among these 23 patients, 10 patients had Right Atrial to Pulmonary Artery conduit, with a valve in 7 and without in 3. The remaining 13 patients had direct anastomosis between RA to PA. There were 14 early deaths, 7 of 13 TA patients, 6 of 9 UVH patients and one DORV, and the total hospital mortality was 60%. But there were no later deaths, 9 of these 23 patients survived operation and are presently alive. The Fontan procedure can be done with an acceptable low mortality with good functional results for Tricuspid Atresia and other complex lesion in foreign hospital, but till now our results revealed much higher risks. For our good operative results and effective patients selection, we must clarify the exact condition of pulmonary arterial system and accumulate much more experiences and technique.
Glutaraldehyde have been used as the most effective cross-linking agent for stabilizing collagen fibers and preventing biodegradation. We processed bovine pericardium in a solution containing 0.625% glutaraldehyde,0.05M HEPES buffer and 0.26% magnesium chloride in saline. The glutaraldehyde-preserved bovine pericardium was implanted in 36 patients at Seoul National University Hospital during a 11-month period between May 1989 and March 1990. 24 were males and 12 females, with ages ranging from 6 months to 168 months [mean age of 43 months]. In 12 patients, the glutaraldehyde-preserved bovine pericardium was used for orthotopic reconstruction of the pericardial sac. In 24 patients. the glutaraldehyde-preserved bovine pericardium was heterotopically implanted.; pulmonary monocusp implant and RVQT [right ventricular outflow tract] patch widening were performed in 10 patients, pulmonary monocusp implant in 6, RVOT patch widening in 4, valved conduit in 2, conduit and pulmonary angioplasty in 1, and ventricular septation in l. With vascular suture techniques, the anastomoses were immediately tight. There was no bleeding from the needle holes and no oozing through bovine pericardium itself. During the follow-up period of up to 10 months, no infections of the glutaraldehyde-preserved bovine pericardium occurred and no bovine pericardium-related complications were observed in this series.
In a patient with single ventricle associated with complex systemic and/or pulmonary venous drainage, intraatrial Fontan procedure is sometimes technically difficult due to the complex spatial relationship between their orifices in the atrium. We report a case of the modified extracardiac conduit Fontan procedure in a patient with a single ventricle in which the inferior vena cava and the hepatic vein drained separately into the atrium and the intraatrial orifice of the hepatic vein was abut to the orifice of the left lower pulmonary vein.
Journal of The Korean Society of Agricultural Engineers
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v.64
no.5
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pp.17-26
/
2022
In this study, in order to establish the criteria for evaluation of importance by the type of facility specialized for agricultural reservoirs, an expert group consisting of a total of 167 members who were in management, or specialized in the fields of design, research, and diagnosis were organized, and the importance for facilities was set with application of the AHP technique. The importance of dam body, spillway, and intake structure composing a reservoir were set at 59%, 24%, and 17%, and the importance of dam crest, upstream slope, and downstream slope constituting a dam body was set at 32%, 31%, and 37%, respectively. In addition, the importance of approach channel, regulated channel, chute channel, and stilling basin consisting a spillway was set at 15%, 44%, 26%, and 15%, and the importance of inclined conduit and outlet conduit consisting an intake structure was set at 35% and 65%, respectively. The safety grade of the reservoirs evaluated by applying the newly presented importance values in this study showed the rearrangement of the grades with a change of 11% compared to the previous grades. In this way, the newly established criteria are expected to be utilized as basic data with strategic importance in reservoir safety management and disaster prevention as well as the operation of systems in the future.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.30
no.6
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pp.465-473
/
2004
Purpose : The essential triad for nerve regeneration is nerve conduit, supporting cell and neurotrophic factor. In order to improve the peripheral nerve regeneration, we used polyglycolic acid(PGA) tube and brain-derived neurotrophic factor(BDNF) gene transfected Schwann cells in sciatic nerve defects of SD rat. Materials and methods : Nerve conduits were made with PGA sheet and outer surface was coated with poly(lactic-co-glycolic acid) for mechanical strength and control the resorption rate. The diameter of conduit was 1.8mm and the length was 17mm Schwann cells were harvested from dorsal root ganglion(DRG) of SD rat aged 1 day. Schwann cells were cultured on the PGA sheet to test the biocompatibility adhesion of Schwann cell. Human BDNF gene was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into E1 deleted region of adenovirus shuttle vector, pAACCMVpARS. BDNF-adenovirus was multiplied in 293 cells and purified. The BDNF-Adenovirus was then infected to the cultured Schwann cells. Left sciatic nerve of SD rat (250g weighing) was exposed and 14mm defects were made. After bridging the defect with PGA conduit, culture medium(MEM), Schwann cells or BDNF-Adenovirus infected Schwann cells were injected into the lumen of conduit, respectively. 12 weeks after operation, gait analysis for sciatic function index, electrophysiology and histomorphometry was performed. Results : Cultured Schwann cells were well adhered to PGA sheet. Sciatic index of BDNF transfected group was $-53.66{\pm}13.43$ which was the best among three groups. The threshold of compound action potential was between 800 to $1000{\mu}A$ in experimental groups which is about 10 times higher than normal sciatic nerve. Conduction velocity and peak voltage of action potential of BDNF group was the highest among experimental groups. The myelin thickness and axonal density of BDNF group was significantly greater than the other groups. Conclusion : BDNF gene transfected Schwann cells could regenerate the sciatic nerve gap(14mm) of rat successfully.
KSCE Journal of Civil and Environmental Engineering Research
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v.33
no.1
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pp.149-155
/
2013
In this study, factors that affect the air entrainment within a closed conduit by air drawn in through an air vent are investigated using a hydraulic scale model, which represents a gated circular conduit system connected to the intake tower of an irrigation reservoir. In addition, using data obtained during the hydraulic experiments, experimental equations are developed to estimate the amount of air drawn in through the air vent. In case of pressurized flow conditions downstream of hydraulic jumps, the relationships between $\frac{Q_a}{Q_w}$ and $Fr_g-1$ of the data form a experimental equation, $\frac{Q_a}{Q_w}=0.0304(Fr_g-1)^{1.0622}$; in case of free surface flow conditions, $\frac{Q_a}{Q_w}=0.0271(Fr_g-1)^{1.8205}$. Comparing two data sets observed under the two flow regimes with the results of previous researchers, patterns of the data sets are similar to the results estimated using the equations presented previously, and this indicates that the quality of the data obtained during the hydraulic experiments is ensured. In addition, it is revealed that air entrainment phenomena in the regions close to air vents are affected by the characteristics of supercritical flows downstream of gates. Finally, it is concluded that the equation developed for pressurized flow conditions can be applied to design of air vents.
KSCE Journal of Civil and Environmental Engineering Research
/
v.37
no.2
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pp.311-324
/
2017
Energy loss at manholes under surcharged flow is considered as one of the major causes of inundation in urban area. Therefore, it is necessary to analyze the flow characteristics to reduce the energy loss in the surcharged four-way combining manhole. In this study, hydraulic experimental apparatus was constructed considering the results of the present survey. Square manholes and pipe diameters were reduced to 1/5 by applying sewer facility standards. Numerical simulations were carried out with the Fluent 6.3 model to derive the invert condition which can reduce the energy loss in the surcharged four-way combining square manhole. The hydraulic experiments were carried out according to the various conditions of the lateral flow rate($Q_{lat}/Q_{out}$), discharge of outflow pipe (2.0, 3.0, 4.0, 4.8 l/sec), and invert shape (rectangle and square open conduit type). The crossed invert was not found to improve the drainage capacity of the surcharged four-way rectangular combining manhole. However, the improved rectangle open conduit type invert and square open conduit type invert were analyzed to improve the drainage capacity by reducing the head loss coefficients by about 8% and 28%, respectively. Therefore, in order to increase the drainage capacity of urban facilities, it is possible to install and use the improved invert proposed in this study.
$[K^+]_o$ can be increased under a variety of conditions including subarachnoid hemorrhage. The increase of $[K^+]_o$ in the range of $5{\sim}15$ mM may affect tensions of blood vessels and cause relaxation of agonist-induced precontracted vascular smooth muscle $(K^+-induced$ relaxation). In this study, effect of the increase in extracellular $K^+$ concentration on the agonist-induced contractions of various arteries including resistant arteries of rabbit was examined, using home-made Mulvany-type myograph. Extracellular $K^+$ was increased in three different ways; from initial 1 to 3 mM, from initial 3 to 6 mM, or from initial 6 to 12 mM. In superior mesenteric arteries, the relaxation induced by extracellular $K^+$ elevation from initial 6 to 12 mM was the most prominent among the relaxations induced by the elevations in three different ways. In cerebral arteries, the most prominent relaxation was produced by the elevation of extracellular $K^+$ from initial 1 to 3 mM and a slight relaxation was provoked by the elevation from initial 6 to 12 mM. In superior mesenteric arteries, $K^+-induced$ relaxation by the elevation from initial 6 to 12 mM was blocked by $Ba^{2+}\;(30\;{\mu}M)$ and the relaxation by the elevation from 1 to 3 mM or from 3 to 6 mM was not blocked by $Ba^{2+}.$ In cerebral arteries, however, $K^+-induced$ relaxation by the elevation from initial 3 to 6 mM was blocked by $Ba^{2+},$ whereas the relaxation by the elevation from 1 to 3 mM was not blocked by $Ba^{2+}.$ Ouabain inhibited all of the relaxations induced by the extracellular $K^+$ elevations in three different ways. In cerebral arteries, when extracellular $K^+$ was increased to 14 mM with 2 or 3 mM increments, almost complete relaxation was induced at 1 or 3 mM of initial $K^+$ concentration and slight relaxation occurred at 6 mM. TEA did not inhibit $Ba^{2+}-sensitive$ relaxation at all and NMMA or endothelial removal did not inhibit $K^+-induced$ relaxation. Most conduit arteries such as aorta, carotid artery, and renal artery were not relaxed by the elevation of extracellular $K^+.$ Among conduit arteries, trunk of superior mesenteric artery and basilar artery were relaxed by the elevations of $[K^+]_o.$ These data suggest that $K^+-induced$ relaxation has two independent components, $Ba^{2+}-sensitive$ and $Ba^{2+}-insensitive$ one and there are different mechanisms for $K^+-induced$ relaxation in various arteries.
Tak, Yong Hun;Kim, Jae Dong;Kim, Young Do;Kang, Boosik
KSCE Journal of Civil and Environmental Engineering Research
/
v.36
no.3
/
pp.395-406
/
2016
Population and development are concentrated by urbanization. Consequently, the usage of underground area and the riverside area have been increased. By increasing impermeable layer, the urban basin drainage is depending on level of sewer. Flood damage is occurred by shortage of sewer capacity and poor interior drainage at river stage. Many of researches about flood stress the unavailability of connection at the river stage with the internal inundation organically. In this study, flood calculated considering rainfall and combined inland-river. Also, using urban runoff model analyze the overflow of sewer. By using results of SWMM model, using flood inundation analysis model analyzed internal drainage efficiency of drainage system. Applying SWMM model, which results to flood inundation analysis model, analyzes internal drainage efficiency of drainage system under localized heavy rain in a basin of the city. The results of SWMM model show the smoothness of internal drainage can be impossible to achieve because of the influence of the river level and sewer overflow appearing. The main manholes were selected as the manhole of a lot of overflow volume. Overflow reduction scenarios were selected for expansion of sewer conduit and instruction retention pond. Overflow volume reduces to 45% and 33~64% by retention pond instruction and sewer conduit expansion. In addition, the results of simulating of flood inundation analysis model show the flood occurrence by road runoff moving along the road slope. Flooded area reduces to 19.6%, 60.5% in sewer conduit expansion scenarios.
Suh, Bo Ik;Kim, Sang Woo;Chung, Ho Yun;Kim, Il Hwan;Yang, Jung Dug;Park, Jae Woo;Cho, Byoung Chae
Archives of Plastic Surgery
/
v.34
no.3
/
pp.279-284
/
2007
Purpose: The vein graft was considered as a useful conduit for nerve defect. But the problem is that it might be collapsed in long vein graft state. A new experimental model using vein graft filled with hyaluronic acid was considered. Methods: Thirty rats were used for the experimental animal. In group I, one side of the femoral nerve was exposed and a segment was removed about 15mm. The neural gap was connected with nerve graft. In group II, the nerve gap was connected with vein graft only. In group III, the nerve gap was connected with vein graft filled with hyaluronic acid. A walking track analysis was made periodically for 2 months and NCV(nerve conduction velocity) was executed at the end of the experiment. And morphologic studies were also done for all groups Results: In a walking track analysis, the toe-spread was widen and the foot-length was lengthened. The recovery of the toe-spread and foot length was checked 2 weeks interval, periodically for two months. The SFI (sciatic function index) was $-52.5{\pm}8.2$ in group I, $-68.1{\pm}4$ in group II, $-55.3{\pm}7.9$ in group III. In electrophysiological study, NCV(nerve conduction velocity) was $26.71{\pm}3.11m/s$ in group I, $17.94{\pm}4.35m/s$ in group II, $25.69{\pm}2.81m/s$ in group III. The functional recovery in group I and III was superior to that the group II statistically(p < 0.05) Under electromicroscopic study, the number of the myelinated axons were $1419.1{\pm}240$ in group I, $921.7{\pm}176.8$ in group II, $1322.2{\pm}318$ in group III. The number of the myelinated axons were much more in group I and III than group II statistically (p<0.05). Conclusion: This study suggested that the vein graft filled with hyaluronic acid is more effective than vein graft only for the conduit of the nerve gap. It was thought that the technique could be used in clinical cases with nerve defects as an alternative method to classical nerve grafts.
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