• Journal of Chest Surgery
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• v.42 no.2
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• pp.184-192
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• 2009

Background: Although complications from transfusion are known to happen, transfusion is performed during most open heart surgeries. The aim of this study was to investigate the possibility of performing cardiac surgery without allogenic blood transfusion. Material and Method: Between January to August 2007, 44 consecutive patients who underwent open heart surgery with using various blood conservation methods were retrospectively enrolled. They were divided into group I (the onpump group, n=17) and group II (the offpump group, n=27). The blood conservation methods were intraoperative autologous donation, cell saver, retrograde autologous priming, conventional ultrafiltration and modified ultrafiltration. Antianemic agents were administered to all the patients postoperatively. We analyzed the possibility of bloodless operations, the causes of homologous transfusion, the serial change of the hematocrit and the postoperative chest tube drainage, and we compared the results between the two groups. If comparison between the two groups was not reasonable, then we compared two groups with the individual control groups I and II (49 patients) in 2006. Result: 40 (90.9%) of 44 patients were successfully operated on without transfusion and the success rate was 88.2% (15/17) for group I and 92.6% (25/27) for group II. There was no statistical difference between the two groups (p=NS). The causes of transfusion were 2 cases of postoperative bleedings, 1 case of intraoperative bleeding and 1 mistake of the indication for transfusion. There was no statistical difference of the total chest tube drainage (Group I: $417{\pm}359mL$, Group II: $451{\pm}237mL$) (p=NS), but the total chest tube drainages of the two groups were less than each of the control groups 1 and II (p<0.05). The lowest hematocrit level of Group I was $16.4{\pm}2%$, and this occurred just after infusion of cardioplegics and the hematocrits of both groups were recovered to the preoperative level at 2 months postoperatively. Conclusion: In this study, bloodless open heart surgery could be performed in 90.9% of the patients with intraoperative autologous donation, cell saver, retrograde autologous priming, conventional ultrafiltration and modified ultrafiltration. A combination of various blood conservation methods is the most important and bloodless cardiac surgery could be performed with meticulous bleeding control and strictly following the transfusion indications.

• Journal of Chest Surgery
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• v.48 no.2
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• pp.105-111
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• 2015

Background: The aim of this study was to establish whether pulmonary lobectomy using video-assisted thoracic surgery (VATS) can be safely performed by trainees with limited experience with open lobectomy. Methods: Data were retrospectively collected from 251 patients who underwent VATS lobectomy at a single institution between October 2007 and April 2011. The surgical outcomes of the procedures that were performed by three trainee surgeons were compared to the outcomes of procedures performed by a surgeon who had performed more than 150 VATS lobectomies. The cumulative failure graph of each trainee was used for quality assessment and learning curve analysis. Results: The surgery time, estimated blood loss, final pathologic stage, thoracotomy conversion rate, chest tube duration, duration of hospital stay, complication rate, and mortality rate were comparable between the expert surgeon and each trainee. Cumulative failure graphs showed that the performance of each trainee was acceptable and that all trainees reached proficiency in performing VATS lobectomy after 40 cases. Conclusion: This study shows that trainees with limited experience with open lobectomy can safely learn to perform VATS lobectomy for the treatment of lung cancer under expert supervision without compromising outcomes.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.404-410
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• 2003

Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.

• Journal of the Korean Society of Marine Environment & Safety
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• v.24 no.6
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• pp.803-809
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• 2018

Generally, the gap-and-sag method is used in the shipbuilding stage before coupling the shafts to check whether they are installed at the same position as designed and derived from shaft alignment calculation. The primary installed propeller shaft becomes a reference point, the position of the remaining shafts are sequentially determined through the gap-and-sag value derived from the deflection and deflection angle at each shaft flange by own weight. If the reference point varies against the design value, it would have a series of effects on the installation of the remaining shafts. Moreover, after coupling the shafts, even if the bearing reaction forces derived from measurement are satisfied by the allowable limit range, consequently it might have an adverse effect on the stability of the shafting system by not being able to estimate the relative slope angle between the propeller shaft and the after-stern tube bearing. In this paper, to deal with above-mentioned phenomenon, the theoretical calculations related to designing an effective support point of the aft stern tube bearing and analysis by measurement is conducted through a case of open-up inspections. Based on this, a shaft installation guideline is proposed to minimize the misalignment related to preventing wiping damage of the after-stern tube bearing.

• Proceedings of the Korean Society for Technology of Plasticity Conference
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• 2009.10a
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• pp.297-300
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• 2009

The roll forming process is often used to manufacture long, thin-walled products such as a pipe. The final cross-section is a comparatively simple open-channel, a closed tube section or a complex profile with several bends. In recent years, that process is often applied to the bumper beam in the automotive industries. In this study, a optimal Center Floor Cross Member manufacturing technology, model deign and proper roll-pass sequences can be suggested by forming number of roll-pass and bending angle, and also effects of the process parameters on the final shape formed by roll forming defects were evaluated.

• Proceedings of the Korea Water Resources Association Conference
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• 2006.05a
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• pp.22-27
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• 2006

This paper describes the development of the stream-tube based dispersion model for modeling contaminant transport in open channels. The operator-splitting technique is employed to separate the 2D contaminant transport equation into the pure advection and pure dispersion equations. Then the total variation diminishing (TVD) schemes are combined with the second-order Lax-Wendroff and third-order QUICKEST explicit finite difference schemes respectively to solve the pure advection equation in order to prevent the occurrence of numerical oscillations. Due to various limiters owning different features, the numerical tests for 1D pure advection and 2D dispersion are conducted to evaluate the performance of different TVD schemes firstly, then the TVD schemes are applied to experimental data for simulating the 2D mixing in a straight trapezoidal channel to test the model capability. Both the numerical tests and model application show that the TVD schemes are very competent for solving the advection-dominated transport problems.

• Korean Journal of Microbiology
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• v.18 no.3
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• pp.148-152
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• 1980

The microwave of 2450 MHz, generated by a household cooking oven, was evaluated for its applicability to melt various rehydrated media and to remove dissolved oxygen from tubed media for anaerobic culture. The effect on the sterilization of E. coli in selective media was also evaluated. The following results were obtained. 10 The microwave oven was useful in saving time for melting media and in eliminating heat and combustion gas from the laboratory, which were inevitable by-products in the conventional flame method. 2) Dissolved oxygen could be removed without boiling over by exposing the tubes of anaerobic culture medium after putting them in a wire basket in a beaker with water. 30 The count of E. coli during the melting of MacConkey and EMB agar were similar to those treated with open flame. The microwave treatment was not considered a possible mean to replace autoclaving even in these selective media.

• Journal of computational fluids engineering
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• v.10 no.4 s.31
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• pp.59-65
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• 2005

A numerical analysis was made to investigate the simple silencer for high pressure blast flow fields. Reynolds-Averaged Navier-Stokes equations were solved for an axisymmetric computational domain constructed by multi block grids. A blast flow field without the silencer was also calculated to validate the present numerical method. The effect of pressure diminution for the silencer was calculated by comparing with and without silencer at the atmosphere region. It was found that the tested silencer could achieve 89.4 percent pressure diminution.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.271-275
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• 1992

One hundred forty patients with empyema thoracis were managed under the general anesthesia at the Seoul National University Hospital between 1980 and 1990. The patients, who were managed by thoracentesis or intercostal tube drainage alone, were excluded in this study. There were 92 males and 48 females, ranging from 8 to 80 years of age. Underlying pathologic lesions of empyema thoracis were primary bronchopulmonary infection [84%], postoperative empyema[11%], malignancy, paragonimiasis, spontaneous pneumothorax and so on. A single causal organism was isolated only in 17 patients[the most common being staphylococcus aureus, pseudomonas, & streptacoccus pneumoniae], multiple organism in 31, and no growth in 32. Surgical treatment modalities were decortication[75], pleuropneumonectomy[30], decortication with lobectomy[10], empyemectomy[9], open drainage[13], Clagett procedure [6], thoracoplasty with or without muscle transposition[9]. Hospital mortality were in 2 cases[1.4%], one empyema related and the other nonrelated. In this study, bacteriologic findings were nonspecific and often polymicrobial. We conclude that early thoracotomy can be lifesaving in the presence of a benign clinical course.

• Journal of Chest Surgery
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• v.15 no.3
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• pp.274-277
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• 1982

A Clinical analysis of 59 patients of thoracic empyema was done who were received surgical intervention at dept. of thoracic surgery of the C.A.F.G.H. in the period of 2.5 years from January 1979 to June 1982. Occurrence ratio of Left and Right side pleural cavity of empyema was 1: 1.4. The predisposing factors of empyema were pulmonary Tbc. [49%], Chest pain [25%], Cough [8%], in order. B.P.F. was associated with empyema in 5 cases. The pleural cavity empyema was treated with several surgical procedures and conservative measures. Among of the 59 cases, the 30 cases [50%] were treated with decortication, 12 cases [20%] with closed thoractomy drainage, 9 cases with frequent thoracenteses, 5 cases with partial decortication and thoracoplasty and 3 cases with open thoracostomy tube drainage. Among of the 59 cases thoracic empyema, the full recovery were in 32 cases [54%], partial recovery in 20 cases [34%], not improved in 3 cases [5%] and 3 cases were died. The mortality rate was 5% and the recovery rate was 89%.