• 대한의용생체공학회:의공학회지
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• 제35권5호
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• pp.119-124
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• 2014

A Ventricular assist device (VAD) is one of the most efficient treatments to raise the survivability of the end stage heart failure patient. However, some of LVAD patients have died for the failures and improper control of LVAD. To detect critical dangers in LVAD, the monitoring methods of LVAD outflow have been requested, because it can be affected by patient's hemodynamic states and abnormal conditions of LVAD. In the case of an external pulsatile LVAD, the air movement through the air line can be used to estimate LVAD outflow. In this study, the air movement in the air-line of the extracorporeal pulsatile LVAD was measured with a differential pressure sensor between different points. The precise estimation of air movement could be achieved by additional measurement of air pressure. In a series of in-vitro experiments, the LVAD outflow were changed according to the afterload of LVAD and the differential pressure of LVAD didn't have close correlation with the LVAD outflow that were measured with an ultrasonic flowmeter at the same time. However, new precise estimation with the data from differential pressure and one point pressure in the air-line showed higher correlations with LVAD outflow.

• Journal of Chest Surgery
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• 제18권4호
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• pp.718-731
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• 1985

Renal dysfunction is a common complication of open-heart surgery: a form of controlled hemorrhagic shock, and successful perioperative management of renal dysfunction depends on recognition of the risk factors and optimal management of factors influencing renal function, including cardiopulmonary bypass, and early detection of renal failure. Changes in renal functional parameters including Ccr, Cosm, CH2O, FENa, and RFI were observed prospectively in forty five patients operated on at Dept. of Thoracic and Cardiovascular Surgery, S.N.U.H., from April to June, 1985. They were 23 males and 22 females with 35 acquired and 10 congenital heart diseases and the mean age and body surface area of them were 38.010.3 years [22-63] and 1.5518 M2[1.151.92] respectively. Followings are the conclusion. 1. The Ccr, representative of renal function, is significantly improved from 90.231.3 ml/min/M2 preoperatively to 101.536.4 ml/min/M2 postoperative and day [P<0.05], and all patients were classified as postoperative renal functional class I of Abel, which representing adequate renal protection during our cardiopulmonary bypass. 2. The Cosm is significantly elevated at immediate postperfusion time and remained high at postoperative one day representing osmotic diuresis at that time, but CH2O shows no significant changes at immediate postperfusion period and is decreased significantly at postoperative one day, representing recovery of renal concentrating ability at that time with decreasing urine flow. 3. The absolute value and changing tendency in FENa and RFI during perioperative period shows no diagnostic reliability on these parameters, but those of CH2O appear to reveal future renal function more accurately than Ccr 4. The depth of hypothermia may be protective upon renal function against the ill effects of prolonged nonpulsatile cardiopulmonary bypass. 5. The depth of the hypothermia, pump time of more than 150 minutes, poor cardiac function, and intraoperative events such as embolism appear to be related with immediate postperfusion renal function. 6. Hemoglobinuria and hemolysis, poor preoperative renal function, history of cardiac surgery, and massive transfusion associated with bleeding appear not to be related with renal dysfunction.

• Journal of Chest Surgery
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• 제18권4호
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• pp.537-541
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• 1985

Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.

• 한국임상수의학회지
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• 제34권1호
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• pp.1-6
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• 2017

Heartworm disease (HWD) in dogs is a life-threatening mosquito-borne disease resulting in right-sided congestive heart failure and inflammatory pulmonary disease. Due to complications from adulticidal therapy with melarsomine, slow kill protocol either with preventive dose of ivermectin or combined with doxycycline has been proposed for an alternative adultcidal therapy in dogs with HWD. Therefore, this study evaluated the clinical outcome of adultcidal therapy in dogs with class II stage of HWD after treating either American Heartworm Society (AHS) or slow kill protocol for 10 months. Clinical outcome after therapy was evaluated by clinical, radiographic and echocardiographic examination along with hematology before (D0) and after therapy (D300). Although clinical signs associated with HWD were all resolved after therapy in both groups, the infection was not cleared out 67% of dogs treated by slow kill protocol at the end of therapy. Furthermore, pulmonary arterial flow of acceleration time to ejection time ratio (AT/ET) and the right pulmonary artery distensibility index (RPADI) have been firstly used for detecting pulmonary hypertension in this study group. The pulmonary hypertension was more common in dogs with mild clinical signs, although tricuspid and pulmonary regurgitation were not detectable in most dogs in this study. Our study findings suggested that the slow kill protocol might not be efficacious enough to clear out HWD in dogs and more attention on the presence of pulmonary hypertension might be necessary for effective management of HWD in dogs.

• 설비공학논문집
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• 제18권11호
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• pp.915-922
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• 2006

Considering heat pipe design principles in fabrication and operational performances, water is one of the most recommended working fluids to make mid to low tempera lure heat pipes. But the conventional water heat pipes might encounter the failure in a cold start-up operation when socked at a chilling temperature lower than the freezing point. If they are subjected to a heat supply for start-up at a temperature around $-20^{\circ}C$, the rate of the vapor flow and the corresponding heat transfer from the evaporator to the condenser is so small that the vapor keeps to stick on the surface of the chilling condenser wall, forming an ice layer, resulting in a liquid deficiency in the evaporator. This kind of problems was resolved by Kang et al. in 2004 by adopting a gas loading heat pipe technology to the conventional water heat pipes. This study was conducted to examine a chilling start-up procedure of gas loading heat pipes by investigating the behaviors of heat pipe wall temperatures. And the thermal resistance of the gas loaded heat pipe that depends on the operating temperatures and heat loads was measured and examined. Two water heat pipes were designed and fabricated for the comparison of performances, one conventional and the other loaded with $N_2$ gas. They were put on start-up test at a heat supply of 30 W after having been socked at an initial temperature around $-20^{\circ}C$. It was observed that the gas loaded one had succeeded in chilling start-up operation.

• Tuberculosis and Respiratory Diseases
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• 제84권3호
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• pp.217-225
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• 2021

Background: Despite the proven benefits of dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients, the optimum time for the administration of dexamethasone is unknown. We investigated the progression of COVID-19 pneumonia based on the timing of dexamethasone administration. Methods: A single-center, retrospective cohort study based on medical record reviews was conducted between June 10 and September 21, 2020. We compared the risk of severe COVID-19, defined as the use of a high-flow nasal cannula or a mechanical ventilator, between groups that received dexamethasone either within 24 hours of hypoxemia (early dexamethasone group) or 24 hours after hypoxemia (late dexamethasone group). Hypoxemia was defined as room-air SpO₂ <90%. Results: Among 59 patients treated with dexamethasone for COVID-19 pneumonia, 30 were in the early dexamethasone group and 29 were in the late dexamethasone group. There was no significant difference in baseline characteristics, the time interval from symptom onset to diagnosis or hospitalization, or the use of antiviral or antibacterial agents between the two groups. The early dexamethasone group showed a significantly lower rate of severe COVID-19 compared to the control group (75.9% vs. 40.0%, p=0.012). Further, the early dexamethasone group showed a significantly shorter total duration of oxygen supplementation (10.45 days vs. 21.61 days, p=0.003) and length of stay in the hospital (19.76 days vs. 27.21 days, p=0.013). However, extracorporeal membrane oxygenation and in-hospital mortality rates were not significantly different between the two groups. Conclusion: Early administration of dexamethasone may prevent the progression of COVID-19 to a severe disease, without increased mortality.

• Geomechanics and Engineering
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• 제18권4호
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• pp.407-415
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• 2019

A controlled low strength material (CLSM) is a highly flowable cementitious material used for trench backfilling. However, when applying vertical loads to backfilled trenches, shear failure or differential settlement may occur at the interface between the CLSM and natural soil. Hence, this study aims to evaluate the characteristics of the interface friction between the CLSM and soils based on curing time, gradation, and normal stress. The CLSM is composed of fly ash, calcium sulfoaluminate cement, sand, silt, water, and an accelerator. To investigate the engineering properties of the CLSM, flow and unconfined compressive strength tests are carried out. Poorly graded and well-graded sands are selected as the in-situ soil adjacent to the CLSM. The direct shear tests of the CLSM and soils are carried out under three normal stresses for four different curing times. The test results show that the shear strengths obtained within 1 day are higher than those obtained after 1 day. As the curing time increases, the maximum dilation of the poorly graded sand-CLSM specimens under lower normal stresses also generally increases. The maximum contraction increases with increasing normal stress, but it decreases with increasing curing time. The shear strengths of the well-graded sand-CLSM interface are greater than those of the poorly graded sand-CLSM interface. Moreover, the friction angle for the CLSM-soil interface decreases with increasing curing time, and the friction angles of the well-graded sand-CLSM interface are greater than those of the poorly graded sand-CLSM interface. The results suggest that the CLSM may be effectively used for trench backfilling owing to a better understanding of the interface shear strength and behavior between the CLSM and soils.

• Structural Engineering and Mechanics
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• 제70권2호
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• pp.169-178
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• 2019

The replacement of damaged components is an important task for long-span bridges. Conventional strategy for component replacement is to close the bridge to traffic, so that the influence of the surrounding environment is reduced to a minimum extent. However, complete traffic interruption would bring substantial economic losses and negative social influence nowadays. This paper investigates traffic control technologies without interruption for component replacement of long-span bridges. A numerical procedure of traffic control technologies is proposed incorporating traffic microsimulation and site-specific data, which is then implemented through a case study of cable replacement of a long-span cable-stayed bridge. Results indicate traffic load effects on the bridge are lower than the design values under current low daily traffic volume, and therefore cable replacement could be conducted without traffic control. However, considering a possible medium or high level of daily traffic volume, traffic load effects of girder bending moment and cable force nearest to the replaced cable become larger than the design level. This indicates a potential risk of failure, and traffic control should be implemented. Parametric studies show that speed control does not decrease but increase the load effects, and flow control using lane closure is not effectual. However, weight control and gap control are very effective to mitigate traffic load effects, and it is recommended to employ a weight control with gross vehicle weight no more than 65 t or/and a gap control with minimum vehicle gap no less than 40 m for the cable replacement of the case bridge.

• 대한토목학회논문집
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• 제41권3호
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• pp.237-246
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• 2021

기후변화로 극한강우에 의해 발생하는 얕은 비탈면 붕괴와 침식으로 토석류 유발이 잦아지고 있다. 앵커나 네일링 공법으로 보강하기 보다는 원지반을 이용하여 식생이 되는 비탈면 보강이 경제적이면서 친환경적인 공법으로 연구되고 있다. 본 연구에서는 충분한 식생이 가능하도록 부엽토와 한약재 찌꺼기를 활용하여 토양개량제를 개발하였다. 그리고 표면침식을 방지하기 위해 첨가제로 마이크로 시멘트와 반수석고 등을 사용하여 전단강도를 증가시켰다. 이러한 주재료와 첨가제 결정은 실내시험을 통하여 강우로 인한 지반 표층의 침식 진행을 확인하여 전단강도의 증가를 확인할 수 있었다. 원지반을 활용하는 토양개량제의 보강은 식생이 가능하고 침식에 대해 저항력이 크게 증가한다. 이러한 보강은 사면 불안정성의 주요 원인인 인장균열 발생을 방지하고 침식에 의한 토석류 유발을 막을 수 있기 때문에 다른 공법들보다 장마철 폭우에 대한 대처방안으로 효율적인 방법이라고 판단된다.

• Structural Engineering and Mechanics
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• 제85권3호
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• pp.337-351
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• 2023

In this paper, the shear behavior of soft filling in rectangular-hollow concrete specimens was simulated using the 2D particle flow code (PFC2D). The laboratory-measured properties were used to calibrate some PFC2D micro-properties for modeling the behavior of geo-materials. The dimensions of prepared and modeled samples were 100 mm×100 mm. Some disc type narrow bands were removed from the central part of the model and different lengths of bridge areas (i.e., the distance between internal tips of two joints) with lengths of 30 mm, 50 mm, and 70 mm were produced. Then, the middle of the rectangular hollow was filled with cement material. Three filling sizes with dimensions of 5 mm×5 mm, 10 mm×5 mm, and 15 mm×5 mm were provided for different modeled samples. The parallel bond model was used to calibrate and re-produce these modeled specimens. Therefore, totally, 9 different types of samples were designed for the shear tests in PFC2D. The shear load was gradually applied to the model under a constant loading condition of 3 MPa (σc/3). The loading was continued till shear failure occur in the modeled concrete specimens. It has been shown that both tensile and shear cracks may occur in the fillings. The shear cracks mainly initiated from the crack (joint) tips and coalesced with another one. The shear displacements and shear strengths were both increased as the filling dimensions increased (for the case of a bridge area with a particular fixed length).