• Journal of Chest Surgery
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• 제3권2호
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• pp.73-90
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• 1970

Clinical perfusion data on 16 cases of cardiopulmonary bypass using Sigmamotor pump and RyggKyvsgaard Oxygenator which performed at Seoul National University Hospital during the period of Aug. 1968 to Aug. 1970 was analized. AIl cases were hemodiluted and the perfusion was carried out under the normothermic condition. The age of the patients ranged between 6 and 43 years. The b:dy weight varied between 18.3 and 54.0 kg and the body surface area between 0.78 and 1. 59$M^2$. The priming solution was consiste:I with fresh ACD blood. Hartmann solution and Mannitol. The average amount of priming was approximately 2242 ml. The average hemodilution rate was 17%. The flow rate ranged from 1.7L to 3.5L/Min/$M^2$ and averaged 2.4L/Min/$M^2$ or 78mI/Min/kg. The duration of perfusion varied from 22 to 110 min with average of 56.9 minutes. Some hemodynamic responses were observed. The arterial pressure dropped immediately after the initiation of partial perfusion and was more marked after the total perfusion foIlowed by gradual increase to the safety level. The central venous pressure reflected the reduced blood volume especially in the cases of prolonged perfusion which lasted over 60 min. In most of the cases, red blood cell count decreased and white blood ceIl count increased after the perfusion. Hemoglobin level was decreased, averaging of 12.5mg%, Hct 3.3% and platelets count of 18% postoperatively. Plasma hemoglobin increased mildly, from pre-perfusion average value of 4. 06mg% to postperfusion value of 22.5mg%. Serum potassium was 4.4mEq/L pre-operatively and was decreased to 3.7mEq/L postoperatively. Five cases showed definite hypopotassemia immediately after the operation. Sodium and chloride decreased mildly. These electrolyte changes are thought to be related with hemodilution. diuretics and reduced blood volume during and after the perfusion. Arterial blood pH value revealed minimal to moderate elevation from preperfusion average value of 7.376 to 7.461 during perfusion and then 7.365 after perfusion. The pC02 and hicarbonate showed minimal to moderately lowered values. The total CO2 was decreased. Buffer base decreased during perfusion (Av. 42.6mEq/L) and further decreased after the perfusion (Av. 40.8mEq/L). These arterial blood acid base changes suggested that the metabolic acidosis was accompanied by respiratory alkalosis during and immediately after the perfusion. Authors belived that the acidosis could more effectively be corrected with the more additional dose of bicarbonate than we used by this study. The chest tune drainage during the first 24 hours following operation was 1158 ml in average. One case (Case No. 15) showd definite bleeding tendency and it was believed that the cause might be due to the defect of heparin and protamine titration. The average urinary out put during 24 hours post-perfusion was 1291ml. One case (Case No. ]) showed definite post perfusion oliguria. As conclusion hemodilution using fresh ACD blood. Hartmann and Mannitol solution added with Bivon and high flow rate unler normothermia. was thought to amelioratc the severity of mctabolic acidosis during and after perfusion with relatively satisfactory effect on the diuresis and bleeding tendency.

• Clinical and Experimental Pediatrics
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• 제52권4호
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• pp.494-498
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• 2009

목 적 : 심방중격결손의 기구 폐쇄술은 현재 소아 영역에서 수술을 대체할 치료법으로 광범위하게 사용되고 있으나 수술과 비교하였을 때 적절한 시행 시기는 명확하지 않다. 본 연구에서는 3세 미만의 심방중격결손 소아에서 기구 폐쇄술의 안전성, 효용성 및 임상 결과를 평가하여 시술을 시행하기에 적절한 시기를 알아보고자 하였다. 방 법 : 2003년 5월부터 2005년 12월까지 연세대학교 의과대학 심장혈관병원 소아심장과에서 Amplatzer septal occluder(ASO)를 이용한 심방중격결손의 기구 폐쇄술을 시행 받은 환자 295명 중 3세 미만 소아 51명을 대상으로 하였다. 시술 소요 시간, 투시 검사 시간, 폐쇄 성공률, 잔류 단락율, 합병증의 종류 및 발생 빈도를 조사하였고, 기구 장착 전후의 체폐순환비, 폐동맥압, 우심실압을 측정하였으며 시술 후 1일, 1개월, 6개월, 12개월 및 이후 1년 간격으로 경흉부 심초음파를 시행하여 추적 관찰하였다. 결 과 : 대상 환자의 75% (38/51)가 여자였으며, 시술 당시 연령은 $2.0{\pm}0.6$세, 체중은 $11.8{\pm}1.7$ kg, 심방 중격 결손의 크기는 $16.6{\pm}3.6$ mm, 이들의 체폐순환비는 $2.4{\pm}0.9$이었고, 기구 폐쇄술 시행 후 추적 관찰 기간은 $19.8{\pm}6.4$개월이었다. 시술의 폐쇄성공률은 98% (50/51), 소요 시간은 $87.7{\pm}23.6$분, 방사선 투시 시간은 $31.8{\pm}14.7$분이었으며 잔류 단락은 시술 후 24시간 뒤 51명중 7명(15%)에서 관찰되었으나, 최종 추적 관찰 시에는 모두 폐쇄되었다. 폐쇄술 시행 전과 시행 직후의 체폐순환비는 $2.4{\pm}0.9$에서 $1.4{\pm}0.3$ (P<0.001)으로, 주폐동맥압은 $28.4{\pm}6.4$ mmHg에서 $25.5{\pm}5.6$ mmHg (P=0.04)로, 우심실압은 $41.3{\pm}11.8$ mmHg에서 $32.6{\pm}7.9$ mmHg (P<0.001)로 감소하였다. 대상 환자 중 2명에서 시술과 관련한 합병증이 있었으며 기구 이탈과 관련한 우심방 색전증 1예, 서혜부에 발생한 혈종 1예가 관찰되었다. 결 론 : 심방중격결손 소아에서 ASO를 이용한 경피적 심방중격결손 폐쇄술은 3세 미만의 작은 소아에서 안전하고 효과적으로 시행할 수 있으며 더 성장하기까지 시술을 연기할 필요는 없는 것으로 생각된다. 작은 영아에서의 효용성과 안전성에 대해서는 더 광범위한 연구가 필요하다.

• Journal of Chest Surgery
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• 제39권6호
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• pp.434-439
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• 2006

배경: 대동맥궁 이상 수술 시 완전 순환정지 방법은 신경학적 문제나 심근의 손상을 줄 수 있다. 이를 피하기 위해서 저자들은 대동맥궁 이상이 동반된 선천성 심장병 수술 시 뇌 및 심장의 국소 관류법을 사용하고 있으며 이번 조사를 통하여 그 결과를 알아보고자 한다. 대상 및 방법: 2000년 3월부터 2004년 12월까지 대동맥궁 이상이 동반된 선천성 심장병으로 양심실 일차 완전 교정을 시행한 62명의 신생아 및 영아를 대상으로 하였다. 대동맥궁 이상은 축착이 46명, 대동맥 단절이 12명, 좌심실 저형성 증후군 2명, 총동맥관 2명이었으며 동반된 심기형은 심실중격 결손 51명, 총정맥 환류 이상 1명, 부분 정맥 환류 이상 1명, 방실 중격 결손 2명 있었다. 수술시 대동맥궁 기형 교정하는 동안 모든 환자에서 무명동맥과 관상 동맥 혈류를 유지하였다 결과: 국소 관류 시간은 평균 $28{\pm}10$분이었다. 수술 사망은 없었고, 평균 11개월의 관찰 기간동안 1명의 만기 사망(1.6%)이 있었다. 술 후 신경계 합병증은 1명에서 일시적인 무도증이 발생한 것 외에는 없었다. 대동맥궁 기형 교정과 관계된 재수술은 없었다. 1명에서 대동맥궁 기형 교정과 관계되어 기관지 합병증이 발생하였으며 대동맥고정(aortopexy)으로 교정되었다. 결론: 국소 순환법을 이용한 대동맥궁 기형 교정 방법은 완전 순환 정지사용 시 야기될 수 있는 신경 및 심근의 손상을 최소화 할 수 있는 방법이다.

• 한국미생물·생명공학회지
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• 제39권4호
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• pp.364-373
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• 2011

인간배아줄기세포는 인간배아줄기세포가 가지는 전 분화능 등의 특이적 특성으로 인해 재생의학 분야에서 세포 치료제의 근원으로 널리 각광받고 있다. 그러나, 미분화 상태의 인간배아줄기세포를 세포치료제로 이용하기 위해서는 인간배아줄기세포 주 유래 기능성 세포를 확립이 반드시 요구된다. 본 연구에서는, 미분화 상태의 인간배아줄기세포주로부터 기능성 세포의 확립을 위해, 혈관계통의 세포로 분화를 유도하였으며, 분화 유도 후 세포의 크기 차이를 이용하여 특정 세포군 만을 분리하여 그 기능성을 비교 분석하였다. 그 결과, VEGF를 이용하여 분화 시킨 세포군에서 약 10%의 PECAM 양성 세포군을 확인할 수 있었으며, 분리 및 세포 이식을 위해 세포를 단일 세포군으로 만들었다. 단일 세포군의 형성 후, 유세포 분석기를 이용한 세포 분리 기법을 이용하여 FCS를 기준으로 한 세포 크기의 차이를 이용하여 특정 세포군 만을 분리하여, 하지 허혈 동물 모델로의 이식을 통해, 비 분리 세포군과 치료 효능을 비교 분석을 실시하였다. 세포 이식 4주 후, 혈류량 복구율이 FSC 기준 분리 군의 경우 54%, 비 분리군의 경우 17%를 보이는 것을 확인하였다. 이 결과는, 초기 분화 유도 후 세포 크기차이를 이용한 세포 분리법이 기능성 세포 획득에 이용될 수 있음을 시사한다. 이와 같은 방법을 통해 다양한 종류의 기능성 세포 분리에 이용될 수 있을 것이라 생각된다.

• Clinical and Experimental Pediatrics
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• 제45권3호
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• pp.413-417
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• 2002

증후군은 원위세뇨관 Na-Cl 공동운반체 유전자 이상으로 발생하는 상염색체 열성 유전질환으로, 저칼륨혈증, 저마그네슘혈증, 대사성 알칼리증, 그리고 저칼슘뇨증 등의 임상적 특징을 보이는 질환이다. 저자들은 Bartter 증후군과의 감별진단과 Gitelman 증후군의 확진을 위해 임상적으로 Gitelman 증후군이 의심되는 두명의 환아에서 신장청소검사를 시행하였다. 각각의 환아는 밤사이 금식을 시킨 후 물 20 mL/kg를 30분에 걸쳐 경구 투여하였고, 곧 이어 half saline을 정맥을 통해 분당 5 mL의 속도로 투여하기 시작하였다. 소변양이 분당 10 mL에 도달했을 때의 검체로 삼투질제거율, 유리수분제거율, 염소제거율, 원위분획염소재흡수율을 계산하였다. 그 후에 첫째 날은 furosemide, 둘째 날은 hydrochlorothiazide를 각각 투여하고 나서 같은 신장청소검사를 시행하였다. 이뇨제를 투여하기 전 원위분획염소재흡수율은 각각 73%, 75%로 정상범위에서 약간 감소되어 있었다. furosemide를 투여한 후 삼투질제거율은 증가하였고 유리수분제거율은 감소하였다. 염소제거율은 10배 이상 증가하였으며, 원위분획염소재흡수율은 현저한 감소를 보였다. Thiazide를 투여한 후에는 위와 같은 청소율의 변화들을 관찰할 수 없었다. 신장청소 검사의 소견은 본 연구의 환아들이 헨레의 고리 상행각의 이상보다는 원위세뇨관 Na-Cl 공동운반체의 이상이 있음을 보여주고 있어 Gitelman 증후군의 병태 생리와 잘 일치한다고 사료된다.

• Journal of Chest Surgery
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• 제28권6호
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• pp.571-578
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• 1995

Rastelli operation in which right ventricle[RV and pulmonary artery[PA is connected with an artificial graft is effective in increasing the pulmonary blood flow in certain types of congenital heart disease but, in many, it requires a reoperation because of the relative stenosis of graft that develops as the patients become old. The purpose of this study is to evaluate the various factors which many influence the long term outcome of such patients following a Rastelli operation. A total of 47 patients underwent a Rastelli operation during a 15 year period between November, 1978 and October 1993. The mean follow-up period is 76.1 51.3 months.1 Among the 47 patients, a valved conduit was used in 30[63.8% , and non-valved conduit in 17[36.2% patients. In the 8 patients[17.0% who died postoperatively, a valved conduit was used in 5 [16.6% and a non-valved conduit in 3[17.6% . There was no statistical difference in mortality between the 2 groups. There was a good linear correlation between the body surface area[X and the conduit size[Y [Y=3.86X + 14.6, R=0.55, P=0.01 .2 Ten patients underwent replacement of the conduit during the follow-up period. The type of conduit used and the frequency of subsequent replacement were as follows: Ionescu-Shiley, valved-33.3%, Carpentier-Edwards, valved-30.8%, Hancock, valved-80% and non-valved conduit-9.1%. The median period free of reoperation was 110 months for the valved and 79 months for the non-valved group, there being no statistical difference between the 2 groups. 3 The patients who did not require reoperation are all doing well [New York Heart Association Functional Classification: Class I . Pressure gradient between the RV and the PA was 20 mmHg in 10 randomly selected patients who did not require reoperation and 92 9 mmHg in 10 patients who did require reoperation.4 In the 10 patients who underwent a conduit replacement procedure.5 Among patients undergoing reoperation, 2 died from endocarditis.The remaining 8 patients are doing well without limitation in physical activity at a mean follow-up period of 32.7 33.9 months [range 2 to 89 months . 6 At 5, 7, and 10 years, the reoperation-free rates among all patients were 96%, 91% and 29% and the survival rates were 82%, 82% and 71%. In conclusion, Rastelli operation is an effective procedure in ameliorating symptoms in a select group of patients with congenital heart disease. Because of the inherent nature of relative graft stenosis and degeneration, a long-term follow-up is required under the proper selection of the graft material.

• Composites Research
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• 제12권6호
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• pp.74-82
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• 1999

폴리 우레탄 폼 코아 샌드위치 복합재료의 정적 및 피로 특성에 대하여 연구하였다. 유리 섬유강화 스킨과 중합의 폼 코아를 갖는 비스티칭, 스티칭, 스티프너의 세 종류 시편이 사용되었다. 특히 스티칭 샌드위치 구조는 두께 방향에 대하여 폴리에스터와 유리섬유를 꼬아서 부가적인 구조 보강이 코아의 상하 표면을 통하여 꿰멘 구조로 층간분리를 최소화하기 위해 샌드위치 구조 패널을 스티칭하여 만들고 수지는 수지의 유동 온도에서 수지의 낮은 점도 특성을 이용하여 스티칭 섬유에 침투시켜 함께 경화하였다. 스티칭 섬유가 $50{\times}50{\;}mm$의 간격으로 스티칭된 시편 및 스티프너 시편의 굽힘강도는 비스티칭 시편과 비교하여 각각 50%및 10배 이상으로 향상되었다. 최대 하중의 20%크기로 $10^6$ 피로 사이클을 받은 후, 비스티칭 시편의 굽힘 피로강도는 정적 굽힘강도와 비교하여 27%까지 감소되었고, 스티칭된 시편은 39%,그리고 스티프너에 의하여 보강된 시편은 20%정도 감소되었다. 폴리우레탄 폼 코아의 에이징 효과를 입증하기 위해, 피로 시험 후 샌드위치 시편의 표면 적층의 손상은 초음파 C-scan장비를 사용하여 검출하였다. 초음파 C-scan결과로부터 피로 시험동안 손상 받은 어떤 결함도 없었다 이는 피로 사이클동안 폼 코아 샌드위치 구조에 대한 굽힘강도의 감소는 폴리우레탄 폼이 에이징되어 발생하는 것을 의미한다.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2011년도 제41회 하계 정기 학술대회 초록집
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• pp.148-148
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• 2011

Recently, there have been many research activities to develop the large-area plasma source, which is able to generate the high-density plasma with relatively good uniformity, for the plasma processing in the thin-film solar cell and display panel industries. The large-area CCP sources have been applied to the PECVD process as well as the etching. Especially, the PECVD processes for the depositions of various films such as a-Si:H, ${\mu}c$-Si:H, Si3N4, and SiO2 take a significant portion of processes. In order to achieve higher deposition rate (DR), good uniformity in large-area reactor, and good film quality (low defect density, high film strength, etc.), the application of VHF (>40 MHz) CCP is indispensible. However, the electromagnetic wave effect in the VHF CCP becomes an issue to resolve for the achievement of good uniformity of plasma and film. Here, we propose a new electrode as part of a method to resolve the standing wave effect in the large-area VHF CCP. The electrode is split up a series of strip-type electrodes and the strip-type electrodes and the ground ones are arranged by turns. The standing wave effect in the longitudinal direction of the strip-type electrode is reduced by using the multi-feeding method of VHF power and the uniformity in the transverse direction of the electrodes is achieved by controlling the gas flow and the gap length between the powered electrodes and the substrate. Also, we provide the process results for the growths of the a-Si:H and the ${\mu}c$-Si:H films. The high DR (2.4 nm/s for a-Si:H film and 1.5 nm/s for the ${\mu}c$-Si:H film), the controllable crystallinity (~70%) for the ${\mu}c$-Si:H film, and the relatively good uniformity (1% for a-Si:H film and 7% for the ${\mu}c$-Si:H film) can be obtained at the high frequency of 40 MHz in the large-area discharge (280 mm${\times}$540 mm). Finally, we will discuss the issues in expanding the multi-electrode to the 8G class large-area plasma processing (2.2 m${\times}$2.4 m) and in improving the process efficiency.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2009년도 제38회 동계학술대회 초록집
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• pp.74-74
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• 2010

One-dimensional nanosturctures such as nanowires and nanotube have been mainly proposed as important components of nano-electronic devices and are expected to play an integral part in design and construction of these devices. Silicon carbide(SiC) is one of a promising wide bandgap semiconductor that exhibits extraordinary properties, such as higher thermal conductivity, mechanical and chemical stability than silicon. Therefore, the synthesis of SiC-based nanowires(NWs) open a possibility for developing a potential application in nano-electronic devices which have to work under harsh environment. In this study, one-dimensional nanowires(NWs) of cubic phase silicon carbide($\beta$-SiC) were efficiently produced by thermal chemical vapor deposition(T-CVD) synthesis of mixtures containing Si powders and hydrocarbon in a alumina boat about $T\;=\;1400^{\circ}C$ SEM images are shown that the temperature below $1300^{\circ}C$ is not enough to synthesis the SiC NWs due to insufficient thermal energy for melting of Si Powder and decomposition of methane gas. However, the SiC NWs are produced over $1300^{\circ}C$ and the most efficient temperature for growth of SiC NWs is about $1400^{\circ}C$ with an average diameter range between 50 ~ 150 nm. Raman spectra revealed the crystal form of the synthesized SiC NWs is a cubic phase. Two distinct peaks at 795 and $970\;cm^{-1}$ over $1400^{\circ}C$ represent the TO and LO mode of the bulk $\beta$-SiC, respectively. In XRD spectra, this result was also verified with the strongest (111) peaks at $2{\theta}=35.7^{\circ}$, which is very close to (111) plane peak position of 3C-SiC over $1400 ^{\circ}C$ TEM images are represented to two typical $\beta$-SiC NWs structures. One is shown the defect-free $\beta$-SiC nanowire with a (111) interplane distance with 0.25 nm, and the other is the stacking-faulted $\beta$-SiC nanowire. Two SiC nanowires are covered with $SiO_2$ layer with a thickness of less 2 nm. Moreover, by changing the flow rate of methane gas, the 300 sccm is the optimal condition for synthesis of a large amount of $\beta$-SiC NWs.

• 대한예방한의학회지
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• 제4권2호
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• pp.72-92
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• 2000

This research has conducted studies on an Oriental medicine-based method of diagnosing of occupational musculoskeletal system diseases. This researcher has searched through existing relevant medical literature. Also, this researcher has worked on a moire topography using moire topography. In this course, this researcher has reached the following conclusion in relation to the possibility of using a moire topography as a diagnosing device of musculoskeletal system diseases under Oriental medicine . 1 The Western medicine outlines its criteria of screening occupational musculoskeletal system diseases as follows A. The occupational musculoskeletal diseases must clearly include one or more of the subjective symptoms characterized by pain, hypoesthesia dysaesthesia, anaesthesia. etc . B, There should be clinically admitted objective observations and diagnosis outlining that the disease concerned shows symptoms such as tenderness, induration. and edema that can appear with occupational musculoskeletal system diseases. dyscinesia should be admitted with the disease concerned, or there should be observations and diagnosis outlining that abnormality exists in electric muscular or nervous diagnosis and examination . C. It should be admitted that prior to the occurrence of symptoms or observations and diagnosis on musculoskeletal system-related diseases, a patient has been engaged in works with conditions requiring improper work posture or work movement. That is, this is an approach whereby they see abnormality in the musculoskeletal system come from material and structural defect, and adjust and control abnormality in the musculoskeletal system and secreta . 2. The Oriental medicines sees that a patient develops the pain of occupational musculoskeletal diseases as he cannot properly activate the flow of his life force and blood thus not only causing formation of lumps in the body and blocking the flow of life force and blood in some parts of the body. Hence, The Oriental medicine focuses on resolving the cause of weakening the flow of life force and blood, instead of taking material approach of correcting structural abnormality Furthermore , Oriental medicine sees that when muscle tension builds up, this presses blood vessels and nerves passing by, triggering circulation dyscrasia and neurological reaction and thus leading to lesion. Thus, instead of taking skeletal or neurophysiological approach. it seeks to fundamentally resolve the cause of the flow of the life force and blood in muscles not being activated. As a result Oriental medicine attributes the main cause of musculoskeletal system diseases to muscle tension and its build-up that stem from an individual's long formed chronicle habit and work environment. This approach considers not only the social structure aspect including companies owners and work environment that the existing methods have looked at, but also individual workers' responsibility and their environmental factors. Hence, this is a step forward method. 3 The diagnosis of musculoskeletal diseases under Oriental medicine is characterized by the fact that an Oriental medicine doctor uses not only photos taken by himself, but also various detection devices to gather information and pass comprehensive judgment on it. Thus, it is the core of diagnosis under Oriental medicine to develop diagnosing devices matching the characteristics of information to be induced and to interpret information so induced from the views of Oriental medicine. Diagnosis using diagnosing devices values the whole state of a patient and formal abnormality alike, and the whole balance and muscular state of a patient serves as the basis of diagnosis. Hence, this method, instead of depending on the information gathered from devices under Western medicine, requires devices that provide information on the whole state of a patient in addition to the local abnormality information that X-ray. CT, etc., can offer. This method sees muscle as the central part of the abnormality in the musculoskeletal system and thus requires diagnosing devices enabling the muscular state. 4. The diagnosing device using moire topography under Oriental medicine has advantages below and can be used for diagnosing musculoskeletal system diseases with industrial workers . First, the device can Provide information on the body in an unbalanced state. and thus identify the imbalance and difference of height in the left and right stature that a patient can not notice at normal times. Second, the device shows the twisting of muscles or induration regions in a contour map. This is not possible with existing shooting machines such as X-ray, CT, etc., thus differentiating itself from existing machines. Third, this device makes it possible for Oriental medicine to take its unique approach to the abnormality in the musculoskeletal system. Oriental medicine sees the state and imbalance state in muscles as major factors in determining the lesion of musculoskeletal system, and the device makes it possible to shoot the state of muscles in detail. In this respect, the device is significant. Fourth, the device has an advantage as non-aggression diagnosing device.