• Title/Summary/Keyword: Lateral Tunnel

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The Experimental Study of the Interaction Between the Flow rind Temperature Field and a Boundary Layer Due to a Variety of tole Height of a Vortex Generator (와동 발생기 높이 변화에 대한 경계층 내의 유동장과 온도장에 관한 실험적 연구)

  • Gwon, Su-In;Yang, Jang-Sik;Lee, Gi-Baek
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.26 no.1
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    • pp.82-93
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    • 2002
  • The effects of the interaction between the flow and temperature field and a boundary layer due to a variety of the height of a vortex generator are experimentally investigated. The test facility consists of a boundary-layer wind tunnel with the vortex generator protruding from the bottom surface. In order to control the strength of the longitudinal vortices, the angle of attack and the spacing distance of the vortex generator are 20 degree and 40 mm, respectively. The height of the vortex generator (H) is 15 mm, 20 mm and 30 mm and the cord length of it is 50 mm. Three-component mean velocity measurements are made using a 5-hole probe system and the surface temperature distribution is measured by the hue capturing method using thermochromatic liquid crystals. By using the method mentioned above, the following conclusions are obtained from the present experiment. The boundary layer is thinned in the downwash region where the strong downflow and the lateral outflow of the boundary layer fluid occur and thickened in the upwash re,3ion where the longitudinal vortex sweeps low momentum fluid away from the bottom surface. In case that the height of the vortex generator increases, the averaged circulation and the maximum vorticity of the vortex pair decrease. The contours of the non-dimensional temperature show the similar trends fur all the cases (H=15 mm, 20 mm and 30 mm). The peak augmentation of the distribution of the local non-dimensional temperature occurs in the downwash region near the point of minimum boundary-layer thickness.

Breast Reconstruction make use of Contralateral Breast Tissue after Mastectomy (유방절제술 후 반대편 유방조직을 이용하여 유방 재건한 증례)

  • Lee, Dong-Gwan;Seul, Jung-Hyun;Lim, Young Bin;Shin, Hea-Kyeong;Choi, Jun
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.503-506
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    • 2009
  • Purpose: Unilateral breast reconstruction after mastectomy confront the challenges of recreating a natural appearing breast mound and achieving symmetricalness of the breasts. If the patient's remaining breast is large compared to reconstructed breast, the most common procedure is reduction mammoplasty of the large breast side. The authors experienced a new method of breast reconstruction using the excess breast tissue from the contralateral breast after breast reduction. Methods: The excess tissue from the contralateral breast after vertical reduction mammoplasty with superior pedicle and remaining lower breast tissue were transferred to the mastectomy site breast through the subcutaneous tunnel on the chest wall. The main blood supplies of the flap are perforator branches of the 4th, 5th and 6th anterior intercostal artery. After elevating and detaching the flap on the lower lateral area of the breast, the turn overed flap is fixed on the upper portion of the chest wall of the mastectomy site. Results: On two cases of the breast reconstructions, remaining excess breast tissue from reduction mammoplasty was transferred to the contralateral breast side as pedicles. Both patient and operator were satisfied with the outcome of the reconstruction as the breasts were symmetrical and natural shape. Conclusion: We have performed unilateral breast reconstruction using the excess breast tissue after reduction mammoplasty of the contralateral breast. As Oriental women's breasts are relatively smaller than that of Caucasian women, delayed breast reconstruction cases of Oriental women with large breasts(macromastia) seem to be ideal for this procedure.

Aortic Root Reconstruction for Aortic Insufficiency Developed after Fontal Operation - 1 case - (Fontan 수술후 발생한 대동맥판막역류에 대한 aortic root의 재 건술 - 1례 보고 -)

  • Kyung, Mon-Chol;Whang, Song-Wok;Lee, Chol;Kim, Yung-Jin
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.137-140
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    • 2002
  • Aortic regurgitation in the pediatrics who had previous cardiac surgery is increased with their improved longterm survival rate and their complexity of heart disease. So the need of aortic valve surgery in pediatrics is also on the increase. A 10-year old boy was admitted for progressive cyanosis and dyspnea on exertion(DOE). The patient had been underwent lateral tunnel Fontan operation before. Echocardiography and cardiac catheterization study revealed hepatic vein drained to pulmonary atrium via intrahepatic collaterals, moderate atrioventricular regurgitation, and severe aortic regurgitation due to aortic root dilation. We report a case who had aortic root reconstruction, valvuloplasty of the atrioventricular valve, and hepatic vein ligation successfully Cyanosis and DOE was dramatically improved after the operation

Clinical Outcomes and Complications of Tendoscopic Treatment for Flexor Hallucis Longus Tenosynovitis (장무지굴건 건초염에 대한 건내시경적 치료의 임상적 결과 및 합병증)

  • Kim, Bom Soo;Choi, Geun Hong
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.294-301
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    • 2013
  • Purpose: To report the clinical outcomes and complications of flexor hallucis longus (FHL) tendoscopy using 3 portals. Materials and Methods: Between January 2012 and April 2013, 10 patients (10 ankles) received tendoscopic surgery for the treatment of FHL tenosynovitis. Patients complaining of pain and tenderness along the course of FHL despite over 6 months of conservative treatments were indicated for surgery. The mean age was 41.7 years (range: 18-57) and the follow up period was 12.7 months (range: 6-20). Tendoscopy was performed using posteromedial, posterolateral, and plantar portals. Clinical evaluations included preoperative and postoperative visual analogue scale (VAS), American orthopaedic foot and ankle society (AOFAS) score, and patients' satisfaction. Results: Tendoscopic findings included tenosynovitis in 10 cases, degenerated vinculae in 6 cases, stenosis of the tendon at its entrance into the fibro-osseous tunnel in 5 cases, and degenerative partial tendon tear in 3 cases. Two cases had associated symptomatic os trigonum and 3 cases had posterior ankle impingement syndrome. Preoperative pain decreased from median VAS 6 (range: 4-10) to 2.1 (range: 1-5) at the last follow up and AOFAS score improved from 50.1 (range: 36-63) to 82.1 (range: 61-89) (p<0.05). Nine patients were satisfied or very satisfied with the outcome. Injury of the lateral plantar nerve occurred in one case. Conclusion: FHL tendoscopy using 3 portals is a feasible and useful minimal invasive surgical technique for the management of FHL tenosynovitis.

Blast Design for Controlled Augmentation of Muck Pile Throw and Drop (발파석의 비산과 낙하를 조절하기 위한 발파 설계)

  • Rai, Piyush;Yang, Hyung-Sik
    • Tunnel and Underground Space
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    • v.20 no.5
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    • pp.360-368
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    • 2010
  • The paper presents a case study from a surface mine where the controlled augmentation of throw and drop of the blasted muck piles was warranted to spread the muck piles on the lower berm of the bench. While the augmentation of throw increased the lateral spread and the looseness of the broken muck, the augmentation of drop significantly lowered the muck pile height for easy excavation by the excavators. In this light, the present paper highlights and discusses some pertinent changes in the blast design parameters for such specialized application of cast blasting in a surface mine, where a sandstone bench, with average height of 22-24 m was to be made amenable for excavation by 10 m3 rope shovels, which possessed maximum digging capability of up to 14 m. The results of tailoring the blast design parameters for augmentation of throw and drop are compared with the baseline blasts which were earlier practiced on the same bench by dividing the full height of the bench in 2-slices; upper slice (10-14 m high) and lower slice (12-15 m high). Results of fragment size, its distribution and total cycle time of excavator (shovel) are presented, and discussed.

Numerical Study of Structural Behavior of Underground Silo Structures for Low-and-Intermediate-level Radioactive Waste Disposal Facility (중저준위 방폐물 처분 사일로 구조물의 구조거동 수치해석 연구)

  • Kim, Sun-Hoon;Kim, Kwang-Jin
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.35 no.3
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    • pp.183-190
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    • 2022
  • The construction of an underground silo structure was the first stage of erecting the Gyeongju low-and-intermediate-level radioactive waste disposal facility. The facility, completed in 2014, has a scale of 100 000 drums and is currently in operation. The underground silo structure, 25 and 50 m in diameter and height, respectively, consists of cylindrical (for storing waste packages) and dome parts. The dome is divided into lower (connected to the operation tunnel) and upper parts. The wall of the underground silo structure is an approximately 1-m-thick reinforced concrete liner. In this study, finite element analysis was performed for each phase of the construction sequence and operation of the underground silo structure. Two-dimensional axial symmetric finite element analysis was implemented using the SMAP-3D program. Three-dimensional finite element analysis was also performed to examine the reliability of the two-dimensional axial symmetric finite element model. The structural behavior of the underground silo structure was predicted, and its structural safety was examined.

Long term prognosis of patients who had a Fontan operation (폰탄 수술을 받은 환아들의 장기적 예후)

  • Kim, Hyun-Jung;Bae, Eun-Jung;Noh, Jung-Il;Choi, Jung-Yun;Yun, Yong-Su;Kim, Wong-Hwan;Lee, Jung-Yeul;Kim, Yong-Jin
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.40-46
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    • 2007
  • Purpose : This study assessed the long term survival rate and long term complications of patients who had a modified Fontan operation for functionally univentricular cardiac anomaly. Methods : Between June 1986 and December 2000, 302 patients with a functional single ventricle underwent surgical interventions and were followed up until February 2006. The mean follow-up period was $8.3{\pm}5.3years$ (range 3.5-18 years). Their median age was 2.4 years at the Fontan operation. The survival rate, the incidence and the risk factor of late complications were evaluated retrospectively. Results : The verall survival rate was 91 percent at 5 years and 87 percent at 10 years. In multivariate analysis, early calendar year of operation and significant regurgitation were risk factors of death. The surviving patients showed NYHA functional class I in 82 percent, class II in 15 percent, and class III in 3 percent. Redo Fontan operations were necessary in 8.8 percent of patients at average $12.8{\pm}3.6years$ after initial Fontan operation. The most common cause of Fontan conversion was atrial arrhythmia. The incidence of thromboembolic events was 9.3% and these complications were associated with the occurrence of atrial tachyarrhythmia. Supraventricular tachycardia including atrial flutter or fibrillation were reported on the follow-up examination by 11.2 percent of survivors after $8.4{\pm}5.6years$. Atriopulmonary connection showed higher rates of late tachycardia than lateral tunnel operation. Conclusions : This study revealed that the recent survival rate of Fontan type operation was satisfactory, but the occurrence of late complications after a Fontan type operation increased with the longer survival. There is a need for strict follow up and early treatment of late complications in patients who had a Fontan operation.

Reoperations after Fontan Procedures (폰탄 술식 후에 시행한 재수술)

  • Lee, Cheul;Kim, Yong-Jin;Lee, Jeong-Ryul;Rho, Joon-Ryang
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.457-462
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    • 2003
  • Background: Surgical results of the Fontan procedures in patients with a single ventricle have improved. As the perioperative mortality continues to decline and late outcome is forthcoming, attention is now being directed toward late complications of the Fontan procedures. We retrospectively analyzed our experience with reoperations after Fontan procedures. Material and Method: Between January 1988 and December 2002, 24 patients underwent reoperations after Fontan procedures. The median age at Fontan procedures and reoperation was 3.3 years and 9.2 years, respectively. Types of initial Fontan procedures were atriopulmonary connection (n=11), lateral tunnel Fontan (n=11), and extracardiac conduit Fontan (n=2). Indications for reoperation included atrioventricular valve regurgitation (n=7), atrial arrhythmia (n=8), Fontan pathway stenosis (n=7), residual right-to-left shunt (n=5), etc. Result: Procedures performed at reoperation included atrioventricular valve replacement (n=6), conversion to lateral tunnel Fontan (n=5), conversion to extracardiac conduit Fontan (n=3), cryoablation of arrhythmia circuit (n=7), etc. There was no operative mortality. There were 2 late deaths. Mean follow-up duration was 2.7$\pm$2.1 years. All patients except two were in NYHA class I at the latest follow-up. Among 8 patients with preoperative atrial arrhythmia, postoperative conversion to normal sinus rhythm was achieved in 7 patients. Conclusion: Reoperations after Fontan procedures could be achieved with low mortality and morbidity. Reoperation may lead to clinical improvement in patients with specific target conditions such as atrioventricular valve regurgitation, refractory atrial arrhythmia, or Fontan pathway stenosis, especially in patients with previous atriopulmonary connection.

Reconstruction of Anterior Cruciate Ligament in Adolescent (청소년기에 시행한 전방십자인대 재건술)

  • Song Eun Kyoo;Shim Sang Don;Kim Hyung Jong;Kim Hyung Won
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.101-108
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    • 2002
  • Purpose: To evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction and to know the results of physeal injury by transphyseal tunnel in adolescents who had remaining growth potential. Materials and Methods : This study involved 12 patients under 19 years old out of 445 patients, who underwent ACL reconstruction between 1993 and 2001. The mean age at the time of operation was 15.9 $(13.1\~16.9)$ years and fellow-up period was 45.1 $(24\~120.6)$ months in avrarge. Autologous quadrupled hamstring tendon was used as graft in 11 cases and bone-patellar tendon-bone in 1 case. Clinical results were evaluated by Lysholm Knee Scoring Scale, range of motion and return to preinjury sports activities. Radiologic results were evaluated by $Telos^{\circledR}$ device. Bone maturity were analyzed by chronological age, standing height and the width of growth plate in AP and lateral view of knee joint at preoperatively. The growth disturbances were evaluated by measuring femorotibial angle, anatomical and mechanical lateral distal femoral angle, mechanical medial proximal tibial angle and leg length and by comparing those of uninjured site in last follow-up teleoroentgenogram. Results : The mean Lysholm Knee score was 51 $(25\~63)$points preoperatively and 98 $(94\~100)$ points at last follow up. The mean anterior displacement of the tibia by using $Telos^{\circledR}$ device was improved from 13.5 $(6\~27)$ mm to 2.9 $(1\~4)$ mm and there were no significant instabilities of the knee in all cases. There were no leg length discrepancies over 1 cm and no statistically significant abnormal alignment of the knee joint in all cases. Conclusion: ACL reconstruction using transphyseal tunnel for restoring stability and knee function is assumed as a good mettled of treatment without significant leg length discrepancy and abnormal alignment of the knee joint.

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Improvement of Fontan Circulatory Failure after Conversion to Total Cavopulmonary Connection (완전 대정맥-폐동맥 연결수술로 전환 후의 폰탄순환장애 개선)

  • Han Ki Park;Gijong Yi;Suk Won Song;Sak Lee;Bum Koo Cho;Young hwan Park
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.559-565
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    • 2003
  • By improving the flow pattern in Fontan circuit, total cavopulmonary connection (TCPC) could result in a better outcome than atriopulmonary connection Fontan operation. For the patients with impaired hemodynamics after atriopulmonary Fontan connection, conversion to TCPC can be expected to bring hemodynamic and functional improvement. We studied the results of the revision of the previous Fontan connection to TCPC in patients with failed Fontan circulation. Material and method: From October1979 to June 2002, eight patients who had failed Fontan circulation, underwent revision of previous Fontan operation to TCPC at Yonsei University Hospital. Intracardiac anomalies of the patients were tricuspid atresia (n=4) and other functional single ventricles (n=4). Mean age at TCPC conversion was 14.0$\pm$7.0 years (range, 4.6~26.2 years) and median interval between initial Fontan operation and TCPC was 7.5 years (range, 2.4~14.3 years). All patients had various degree of symptoms and signs of right heart failure. NYHA functional class was 111 or IV in six patients. Paroxysmal atrial fibrillation (n:f), cyanosis (n=2), intraatrial thrombi (n=2), and protein losing enteropathy (PLE) (n=3) were also combined. The previous Fontan operation was revised to extracardiac conduit placement (n=7) and intraatrial lateral tunnel (n=1). Result: There was no operative death. Major morbidities included deep sternal infection (n=1), prolonged pleural effusion over two weeks (n=1), and temporary junctional lachyarrhythrnia (n=1). Postoperative central venous Pressure was lower than the preoperative value (17.9$\pm$3.5 vs. 14.9$\pm$1.0, p=0.049). Follow-up was complete in all patients and extended to 50,1 months (mean, 30.3$\pm$ 12.8 months). There was no late death. All patients were in NYHA class 1 or 11. Paroxysmal supraventricular tachycardia developed in a patient who underwent conversion to intraatrial lateral tunnel procedure, PLE was recurred in two patients among three patients who had had PLE before the convertsion. There was no newly developed PLE. Conclusion: Hemodynamic and functional improvement could be expected for the patients with Fontan circulatory failure after atriopulmonary connection by revision of their previous circulation to TCPC. The conversion could be performed with low risk of morbidity and mortality.