• Journal of Chest Surgery
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• v.31 no.1
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• pp.46-51
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• 1998

Treatment of esophageal perforation when diagnosed late remains controversial. Ten consecutive patients since 1990 were treated late(later than 24 hours) for esophageal perforation with primary repair. Four perforations were iatrogenic, 3 were spontaneous, 2 were foreign body aspiraton and 1 was trauma. The interval from perforation to operation was 116 hours in mean and 48 hours in median value. The principles of repair included (1) a local esophagomyotomy proximal and distal to the tear to expose the mucosal defect and intact mucosa beyond, (2) debridement of the mucosal defect and closure, (3) reapproximation of the muscle, and (4) adequate drainage. The repair was buttressed with parietal pleura or pericardial fat in 9 patients. Associated distal obstruction was treated with dilation and esophagomyotomy intraoperatively. There was one mortality and cause of death was massive gastric bleeding due to gastric ulcer on 33rd day after operation. Five patients had leak at the site of repair and these cases were treated completely with conservative treatment except a mortality case. In conclusion, in the absence of malignant or irreversible distal obstruction, meticulous repair of perforated esophagus and adequate drainage are preferred approach, regardless of the duration from the injury to the operation.

• Journal of Korean Neurosurgical Society
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• v.43 no.2
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• pp.90-96
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• 2008

Objective: Delayed ischemic deficit or cerebral infarction is the leading cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study is to reassess the prognostic impact of intraoperative elements, including factors related to surgery and anesthesia, on the development of cerebral infarction in patients with ruptured cerebral aneurysms. Methods: Variables related to surgery and anesthesia as well as predetermined factors were all evaluated via a retrospective study on 398 consecutive patients who underwent early microsurgery for ruptured cerebral aneurysms in the last 7 years. Patients were dichotomized as following; good clinical grade (Hunt-Hess grade I to III) and poor clinical grade (IV and V). The end-point events were cerebral infarctions and the clinical outcomes were measured at postoperative 6 months. Results: The occurrence of cerebral infarction was eminent when there was an intraoperative rupture, prolonged temporary clipping and retraction time, intraoperative hypotension, or decreased $O_2$ saturation, but there was no statistical significance between the two different clinical groups. Besides the Fisher Grade, multiple logistic regression analyses showed that temporary clipping time, hypotension, and low $O_2$ saturation had odds ratios of 1.574, 3.016, and 1.528, respectively. Cerebral infarction and outcome had a meaningful correlation (${\gamma}$=0.147, p=0.038). Conclusion: This study results indicate that early surgery for poor grade SAH patients carries a significant risk of ongoing ischemic complication due to the brain's vulnerability or accompanying cardio-pulmonary dysfunction. Thus, these patients should be approached very cautiously to overcome any anticipated intraoperative threat by concerted efforts with neuro-anesthesiologist in point to point manner.

• Plant Journal
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• v.17 no.1
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• pp.38-49
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• 2021

In order to increase power plant efficiency, the steam temperature was increased to 610 ℃ which deteriorates the durability of the boiler tube and as the use of low-calorie coal increases the post combustion and delayed combustion phenomenon, the overheating of the final reheater and the tube rupture are becoming frequent. In order to prevent overheating of the final reheater, desuperheater water injection was increased, leading to a decrease in boiler efficiency. In this study install a baffle plate at the back of some overheated tube groups, thereby reduce the temperature of the tube by reducing the amount of combustion gas, and the reduced combustion gas moves to an adjacent place to increase the temperature of other tubes. As a result of the study, the temperature deviation between tubes decreased 1.5. And the heat-reducing injection amount was reduced to 6,929 kg/h and the maximum tube temperature was reduced to 623.4℃ which is 6.6℃ more below than the control standard of 630℃.

• Nuclear Engineering and Technology
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• v.55 no.10
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• pp.3648-3658
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• 2023

The early localization of a fuel subassembly with a failed (wet rupture) fuel pin is very important in reactors to limit the associated radiological and operational consequences. This requires a fast and reliable system for failure detection and their localization in the core. In the Prototype Fast Breeder Reactor, the system specially designed for this purpose is Failed Fuel Location Modules (FFLM) housed in the control plug region. It identifies a failed sub-assembly by detecting the presence of delayed neutrons in the sodium from a failed sub-assembly. During the commissioning phase of PFBR, it is mandatory to demonstrate the FFLM effectiveness. The paper highlights the engineering and physics design aspects of FFLM and the integrated simulation towards its function demonstration with a source assembly containing a perforated metallic fuel pin. This test pin mimics a MOX pin of 1 cm² of geometrical defect area. At 10% power and 20% sodium flow rate, the counts rate in the BCCs of FFLM system range from 75 cps to 145 cps depending upon the position of DN source assembly. The model developed for the counts simulation is applicable to both metal and MOX pins with proper values of k-factor and escape coefficient.

• Journal of the Korea institute for structural maintenance and inspection
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• v.11 no.5
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• pp.144-152
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• 2007

This study investigated the failure mechanism of RC beams strengthened with AFRP sheets. Total 5 half-scale RC beams were constructed and tested to estimate the effectiveness of various methods to prevent the debonding failure of AFRP sheets. From the experimental results, it was found that increasing bonded length or end U-wrappings does not prevent debonding failure. On the other hand, the beams with center U-wrappings and shear-keys reached the ultimate state with their sufficient performance. The center U-wrappings tended to control debonding of the longitudinal AFRP sheets because the growth of the longitudinal cracks along the edges of the composites was delayed. In case of shear-keys, it was sufficient to eliminate debonding and the beams failed by AFRP sheets rupture due to the sufficient bond mechanism.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.705-710
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• 2001

Objective : Postoperative seizure is a well documented complication of aneurysm surgery. The purpose of the present study was to analyze risk factors for postoperative seizure. Methods : Between January 1990 and December 1996, we performed craniotomy for ruptured cerebral aneurysms in 321 patients. Among them 206 patients who could be followed up for more than 1 year(range, 1 to 4.6 years) were enrolled to present study. All patients were treated with anticonvulsants for 3 to 18 months postoperatively. We analyze the incidence of postoperative seizure in different sex and age groups, and risk factors associated with postoperative seizures following aneurysm rupture. For statistical processing chi-square test and Fisher's exact test were used. Results : In the follow-up period of 1 to 4.6 years(mean, 1.8 years) postoperative seizure appeared in 18 out of 206 patients(8.7%). Mean latency between the operation and the first seizure was 6 months(range, 3 weeks to 18 months). The age of the patients has significant influence on the risk of seizure, it occurred more often in younger patients(p =0.0014). Aneurysm location in the MCA was associated with a significantly a higher risk of seizure(p = 0.042). Eight patients(19%) out of 42 patients who suffered delayed ischemic neurologic deficit(DID) developed seizure. Delayed ischemic neurologic deficit was associated with significantly a higher risk of seizure(p =0.019). Infarct and hypertension were associated with significantly a higher risk of seizure(p <0.05). pre- or postoperative intracranial hematoma(intracerebral or epidural hematoma) was associated with significantly a higher risk of seizure(p <0.0001). H-H grade, Fisher grade, Glasgow Outcome Scale of patients and timing of operation after subarachnoid hemorrhage had no significant relation with the risk of seizure. Conclusion : Factors associated with the development of postoperative seizure were middle cerebral artery aneurysm, delayed ischemic neurologic deficit, infarct on late postoperative CT scan, hypertension, pre or postoperative intracranial hematoma(intracerebral or epidural hematoma). Identification of the risk factors may be help to focus the antiepileptic drug threapy in cases prone to develop seizures. Prospective evaluation is indicated.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1555-1562
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• 2000

Objects : Surgical management of the distal anterior cerebral artery(DACA) aneurysms presents several unique problems to surgeons, such as difficulty in early identification of parent arteries, high incidence of rebleeding and premature rupture, and requirement of unfamiliar approach other than conventional frontotemporal craniotomy. Therefore, preoperative anatomical knowledge of anterior interhemispheric fissure and entry point of dissection is prerequisite. Authors utilized a frontobasal approach for DACA aneurysms by using consistent external landmark for guidance to the deep structure. Materials and Methods : From Nov. 1995 to Jun. 1999, a surgical clipping of DACA aneurysms was carried out in 9 patients among a total 131 patients with intracranial aneurysms. In each case, the clinical and aneurysmal features were carefully reviewed through the angiograms, medical records, and intraoperative findings. Results : The incidence of DACA aneurysms was 6.9% from our series. All cases were arisen from juxtacallosal por-tion ; 6 cases from pericallosal-callosomarginal(PC-CM) junction and 3 from pericallosal-frontopolar(PC-FP) junction. Associated vascular anomalies were noted in 3 cases and multiple aneurysms in 3 cases, respectively. The preoperative clinical grades were generally poor. An early surgery was performed in 7 cases and frontobasal interhemispheric approaches in 7 cases. Postoperatively, two patients died of complications ; one delayed ischemic vasospasm and one aspiration pneumonia but remaining patients recovered well. Conclusion : The frontobasal interhemispheric approach was useful for DACA aneurysms in early surgery. Division of superior sagittal sinus(SSS) enabled a minimal retraction of brain on both sides, and prevention of intraoperative rupture was possible. Authors suggest the frontopolar(first frontal bridging) vein as a constant external landmark for approaching the genu of the corpus callosum and juxtacallosal DACA aneurysms.

• Tuberculosis and Respiratory Diseases
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• v.63 no.3
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• pp.268-272
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• 2007

A tuberculous pleural effusion may be a sequel to a primary infection or represent the reactivation of pulmonary tuberculosis. It is believed to result from a rupture of a subpleural caseous focus in the lung into the pleural space. It appears that delayed hypersensitivity plays a large role in the pathogenesis of a tuberculous pleural effusion. We encountered a 52 years old man with pleural effusion that developed several days after a CT guided percutaneous needle biopsy of a solitary pulmonary nodule. He was diagnosed with TB pleurisy. It is believed that his pleural effusion probably developed due to exposure of the parenchymal tuberculous focus into the pleural space during the percutaneous needle biopsy. This case might suggest one of the possible pathogeneses of tuberculous pleural effusion.

• Journal of the Korea Concrete Institute
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• v.19 no.6
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• pp.677-684
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• 2007

This study investigates the failure mechanism of RC beams strengthened with GFRP (glass fiber reinforced polymer) sheets. After analyzing failure mechanisms, the various methods to prevent the debonding failures, such as increasing bonded length of GFRP sheets, U-shape wrappings and epoxy shear keys are examined. The bonded length of GFRP sheets are calculated based on the assumed bond strengths of epoxy resin. The U-shape wrappings are either adopted at the end or center of the CFRP sheets bonded to the beam soft. The epoxy shear keys are embedded to the beam soft to provide sufficient bond strength. The end U-wrappings and the center U-wrappings are conventional, while epoxy shear keys are new details developed in this study. A total six half-scale RC beams have been constructed and tested to investigate the effectiveness of each methods to prevent debonding failure of GFRP sheets. From the experimental results, it was found that increasing bonded length or end U-wrappings do not prevent debonding failure. On the other hand, the beams with center U-wrappings and shear keys reached an ultimate state with their sufficient performance. The center U-wrappings tended to control debonding of the longitudinal GFRP sheets because the growth of the longitudinal cracks along the edges of the composites was delayed. In the case of shear keys, it was sufficient to prevent debonding and the beam was failed by GFRP sheets rupture.

• Journal of Chest Surgery
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• v.30 no.9
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• pp.876-884
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• 1997

Fourteen patients underwent orthotopic heart transplantation between March 1994 and May 1996 in Seoul National University Hospital. There were 9 male and 5 female patients, and the mean age was 40.8 $\pm$ 12.4 years ranged from 12 to 56 years. All patient were in NYHA Fc III or IV preoperatively. The underlying heart diseases were dilated cardiomyopathy in 11 and restrictive cardiomyopathy in 3. The mean age of donors was 24.9$\pm$ 10.2 years and the causes of the brain death were head trauma by traffic accidents in 8, subarachnoid hemorrhage in 2, 1 asphyxia, 1 fall down injury, 1 brain tumo , and 1 drowning, respectively The blood type was identical in 11, compatible in 2, and incompatible in 1 patient. The direct bicaval anastomosis technique was used in 11 cases, and standard right atrial anastomosis was done in the remaining 3 cases. The graft ischemic time was 158$\pm$44 minutes ranged 94 to 220 minutes. There were two hospital deaths(14.3%). The causes of deaths were 1 right ventricular failure followed by suspected cyclosporine induced hemolytic uremic syndrome and rejection, and 1 delayed massive bleeding, probably from rupture of the anastomotic pseudoaneurysm, respectively. The follow-up duration was 16$\pm$9 months(3 to 28 months). There was one late death(8.3%). All the other patients were in NYHA Fc I except one patient who was in hospital because of the acute rejection. The actuarial survival rates including hospital deaths were 93.7% at 1 month, 86.9% at 6 months, and 77$\pm$12% at 2 years. Conclusively, heart transplantation is the good strategy for the management of end stage heart disease with acceptable operative mortality and early follow-up results.