• Journal of Chest Surgery
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• v.22 no.3
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• pp.402-415
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• 1989

Extracorporeal circulation leads to functional disorder and structural damage of organs, especially hematologic and pulmonary system, mainly by sequestration of neutrophils and deposition of macrophages at lung. Then, proteases are secreted, which insult vascular basement membrane of pulmonary capillary and alveolar septa of the lung. Among these, the most important protease at lung is elastase, because major component of lung is elastin. For prevention of lung injury, inactivators or antidotes to elastase should be necessary and Alpha 1-Proteinase Inhibitor is the elastase inactivator. Clinical experimental study was carried out to investigate the immediate postoperative change of serum Alpha 1-PI level following cardiopulmonary bypass for 20 heart cases [congenital 16 cases, acquired 4 cases] and 10 control [subtotal gastrectomy] cases. Also preliminary study was performed for 31 cases of open heart patients. The results were as follows: l. Immediate postoperative serum levels of Alpha 1-PI was significantly decreased at open heart surgery group [P< 0.005], but not decreased at control group. 2. There were no significant difference in change of serum Alpha 1-PI level between and membrane and bubble oxygenator group.Z 3. There were no significant difference in changes of serum Alpha 1-PI level between CHD and AHD. Alpha 1-PI is consumed at lung during cardiopulmonary bypass and increase after operation compensatedly and protect multiple organic damage especially lung. Therefore, Alpha 1-PI can be indicator for evaluation of prevention and treatment of pump-lung syndrome.

• Nuclear Engineering and Technology
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• v.54 no.7
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• pp.2453-2466
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• 2022

Nuclear power plant operators in the main control room are exposed to stressful conditions in emergency situations as immediate and appropriate mitigations are required. While emergency operating procedures (EOPs) provide operators with the appropriate tasks and diagnostic guidelines, EOPs have static properties that make it difficult to reflect the dynamic changes of the plant. Due to this static nature, operator workloads increase because unrelated information must be screened out and numerous displays must be checked to obtain the plant status. Generally, excessive workloads should be reduced because they can lead to human errors that may adversely affect nuclear power plant safety. This paper presents a framework for an operator support system that can substitute the initial responses of the EOPs, or in other words the immediate actions and diagnostic procedures, in the early stages of an emergency. The system assists operators in emergency operations as follows: performing the monitoring tasks in parallel, identifying current risk and latent risk causality, diagnosing the accident, and displaying all information intuitively with a master logic diagram. The risk causalities are analyzed with a functional modeling methodology called multilevel flow modeling. This system is expected to reduce workloads and the time for performing initial emergency response procedures.

• KEPCO Journal on Electric Power and Energy
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• v.3 no.2
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• pp.133-140
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• 2017

The performance prediction software developed in this paper is a process analysis tool that enables one to foretell the behavior of processes when certain conditions of operation are altered. The immediate objective of this research is to predict the process characteristics of combined heat and power plant under varying operating conditions. A cogeneration virtual power plant that mimics the mechanical performance of the actual plant was constructed and the performance of the power plant was predicted in the following varying atmospheric conditions: temperature, pressure and humidity. This resulted in a positive outcome where the performance of the power plant under changing conditions were correctly predicted as well as the calorific value of low calorific gas fuel such as shale gas and PNG. The performance prediction tool can detect the operation characteristics of the power plant through the performance index analysis and thus propose the operation method taking into consideration the changes in environmental conditions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.5
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• pp.422-426
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• 2005

Purpose : The purpose of this study was to investigate the vertical stability after BSSRO surgery in skeletal class III malocclusion patients with mild anterior open bite and to present a method to increase the stability. Materials and methods : 36 patients, 11 male and 25 female, who received BSSRO surgery with the diagnosis of skeletal class III with anterior open bite at the Department of Oral and Maxillofacial Surgery in Samsung Medical Center, from January 2002 to August 2003, were selected for this study. The patients were between 18 to 45 years of age. Preoperative and postoperative (immediate, 6 months, and 1 year after operation) lateral cephalograms were compared to evaluate the vertical stability by measuring the distance of nasion-menton, mandibular plane angle, and overbite. Results : The nasion-menton distance decreased by 1.65mm immediately after the operation in comparison to the preoperative value. This distance further decreased by 0.60 mm at 6 months and 1.06mm at 1 year after the operation. The mandibular plane angle increased after the operation and further increased at 6 months and 1 year. The amount of overbite increased by the operation was 2.34mm and an additional increase of 0.70mm at 6 months and 0.94mm at 1 year were shown. Conclusion : Clinically, none of the patients showed relapse of anterior open bite and the vertical stability is highly influenced by orthodontic treatment after the operation. In this study, BSSRO surgery is considered to be a rather reliable procedure that restores stability to skeletal class III malocclusion patients with slight anterior open bite.

• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.659-663
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• 2000

The motality rate of acute subdural hematoma(ASDH) associated with closed head injury is high in spite of recent advances in neurosurgery. Many variables in regard to outcome of ASDH have been assessed. But among them, intracranial pressure(ICP) control and the time interval between injury and operative evacuation are the only things that can be affected by doctor. We introduced a simple method to the management of ASDH for reducing the time interval between injury and operation. When the immediate decompressive operation of ASDH was impossible by any causes, we made a burr hole at the center of hematoma, usually on 2-3cm above temporal squama and 1-2cm behind coronal suture under local anesthesia before main operation. Partial hematoma evacuation was achieved through the burr hole and it was effective in preventing further worsening of patients neurological status before main operation. Prompt hematoma evacuation through the burr hole seemed to be effective in delaying secondary ischemic brain damage and made easy to closing the dura opening and replacement of the bone flap at the end of main decompressive operation. This easy method may reduce the time interval between injury and operation. We represent surgical technique with two cases of ASDH managed with this simple method.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.2
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• pp.141-150
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• 2004

The cleft lip and palate charity operation team visited Binh Duong General Hospital in Vietnam from 17th Dec to 25th Dec 2004. Total 25 cleft lip and palate patients (male : female = 15:10) were undergone the operation. The mean age of the patients was 13.6 year. The types of surgical operation were primary cheilorrhaphy (8 cases), primary palatorrhaphy(10 cases), pharyngoplasty(2 cases), scar revision(3 cases), alveolorrhaphy(2 cases). There were no intraoperative and immediate postoperative complications. The year 2004 was the 10th charity operation in the same area so it is meaningful to review the start of this charity mission and the course, and the future of our activity.

• Archives of Craniofacial Surgery
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• v.14 no.2
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• pp.96-101
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• 2013

Background: Among facial fractures, nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture take a large portion. Among surgical operations for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture, closed reduction has been generally used but, unlike open reduction, there is a problem in evaluating its accuracy of reduction. Methods: An assessment was made from October 2011 until April 2013 prospectively on 37 patients. For all the operations, closed reductions were executed in a conventional way and simultaneously using C-Arm to verify the reduction of fractures. Two images of plain radiography, one taken before operation and another one taken one day after the operation, were compared. After obtaining images of plain radiography using C-Arm immediately after the correction upon operation, they were compared with the images of plain radiography taken one day after the operation. Results: The fracture reductions of 26 patients among 27 nasal fracture patients were satisfactory but one patient showed a marginal overcorrection of less than 1 mm. The fracture reductions of 7 patients among 8 zygomatic arch fracture patients were satisfactory but one patient showed a marginal undercorrection of less than 2 mm. All of two mandibular subcondyle fracture patients showed less than 2 mm undercorrection. Conclusion: Closed reduction guided by C-Arm for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture was clinically useful because it could make a real-time assessment on fractured areas and add immediate corrections during the operation.

• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.668-674
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• 2000

Objective : The classic and accepted surgical method of compound comminuted depressed skull fractures (FCCD) involves total resection of all the contaminated bone and fragments at the fracture site. A second operation for cranioplasty is then performed at a later date. However, we have believed that primary repair of these bony defects can be achieved by the replacement of bone fragments at the time of the initial debridement, and this can be accomplished without danger to patient. The authors retrospectively reviewed the surgical results to assess the advantages and disadvantages, and also propose the selection criteria of replacement of fractured bone fragments as a primary procedure in FCCD. Materials and Methods : The authors analyzed the data extracted from medical records, and radiological findings in 22 of 71 patients with FCCD, who underwent immediate replacement of fractured bone fragments between April 1993 and October 1998. The mean follow-up period was 13.7 months. The selection criteria for the operation included the patients with mild to moderate severity, regardless of the degree of contamination or dural violation, which presented in hospital within 24 hours of injury. Results : The ages of the patients varied from 4 to 63 years, and there were 20 males and 2 females. Seventeen of 22 patients were fully conscious on admission and the others also had relatively good Glasgow coma scales. Sixteen fractures were located in the frontal area, 9 with involvement of the frontal sinuses, and 6 in the parietal and temporoparietal areas. Of the 22 patients, 8(36.3%) had dural lacerations with 3 of these requiring patching with pericranium, and 12(54.5%) had intracranial hematoma requiring wide craniotomy. The degree of wound contamination was also variable. Fifteen patients had relatively clean wounds, while seven(31.8%) had seriously contaminated wounds with soil, sand, hair, and wood. Only one patient(4.5%) developed infection, and the bone fragments were removed. All wounds healed primarily without pulsatile defect, the skull has remained solid, and no complications have occurred, except the infected case. Conclusion : It is proposed that bone fragments removal for FCCD, regardless of the degree of contamination or dural violation, is not necessary and that primary bone fragments replacement avoids a second operation for cranioplasty.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.539-548
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• 2022

Objective : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669-35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941-41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.501-508
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• 2001

Objectives : Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. Patients and Methods : From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. Results : The ratio of male to female was 1:1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). Conclusion : In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.