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Surgical Repair of Single Ventricle (Type III C solitus) (단심실 -III C Solitus 형의 수술치험-)

  • naf
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.281-288
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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Surgical Repair for Ebstein's Anomaly (Ebstein 기형의 수술 -2례 보고-)

  • naf
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.289-296
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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Analysis of Air Circulation in Oyster Mushroom Farm

  • Jeong, Won-Geun;Lim, Hack-Kyu;Kim, Tae-Han
    • Journal of Biosystems Engineering
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    • v.37 no.2
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    • pp.75-81
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    • 2012
  • Oyster mushroom farm which could not meet optimum temperature range yields non-uniform sized, low quality products. Thus, this study, utilizing STAR CCM+, one of the computational fluid dynamics (CFD) programs, analyzed the impact of air circulation and temperature distribution. Methods: After we visited numerous mushroom farms, we measured the temperature at the discharge ports of heaters, fan capacity, and the locations of the air circulators in the farms. According to the data, most mushroom growers installed the heaters near the entrance and discharge ports of the heaters at the third growing bed on the same height as the heaters in the entrance. The temperature at the discharge port of heater was $1,26^{\circ}C$, and the fan capacity was 4,500 $m^3$/hr. The air circulator was placed in the center of the mushroom farm 50cm above the ground, and its capacity of inlet port was 1,100 $m^3$/hr and discharge port 1,600 $m^3$/hr. The mushroom farm was insulated. Results: According to the analysis of the temperature distribution in the vertical plane of the entrance side, no air circulation causes the high temperature zone of 296~299K at the discharge port of the heater to take up 34% of area while the operation of air circulators causes it to occupy only 9%. This means that not using air circulators leads to a concentration of high temperature at the discharge port near the entrance. In addition, with the results of the analysis of the temperature distribution in the vertical planes of the center, no air circulation causes the temperature zone of 295~298K at the discharge port of the heater to take up 48% of area while the operation of air circulators causes it to occupy 80%. This shows that the high outlet port temperature disseminated to the center. Conclusions: After ninety minute operation of both heater and air circulator, the interior temperature became stabilized in the mushroom farm. Air circulation made the high temperature at the discharge port disseminate to the center and exit in the farm and equalize the temperature distribution.

Simulation of Agricultural Water Supply Considering Yearly Variation of Irrigation Efficiency (연단위 관개효율 변화를 고려한 관개지구 용수 공급량 모의)

  • Song, Jung Hun;Song, Inhong;Kim, Jin Taek;Kang, Moon Seong
    • Journal of Korea Water Resources Association
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    • v.48 no.6
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    • pp.425-438
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    • 2015
  • The objective of this study was to evaluate simulation of agricultural water supply considering yearly variation of irrigation efficiency. The water supply data of the Idong reservoir from 2001 through 2009 was collected and used for this study. Total 6 parameters including irrigation efficiency (Es), drainage outlet height, and infiltration, were used for sensitivity analysis, calibration, and validation. Among the parameters, the Es appeared to be the most sensitivity parameter. The Es was calibrated on a yearly basis considering sensitivity and time-varying characteristic, while other parameters were set to fixed values. The statistics of percent bias (PBLAS), Nash-Sutcliffe efficiency (NSE), and root means square error to the standard deviation of measured data (RSR) for a monthly step were 2.7%, 0.93, and 0.26 for the calibration, and 3.9%, 0.89, and 0.32 for the validation, correspondently. The results showed a good agreement with the observations. This implies that the modeling only with appropriate parameter values, apart from modeling approaches, can simulate the real supply operation reasonably well. However, the simulations with uncalibrated parameters from previous studies produced poor results. Thus, it is important to use calibrated values, and especially, we suggest the Es's yearly calibration for simulating agricultural water supply.

Mean Size of Droplets Ejected from Humidifier and Distributions of Relative Humidity As Affected by Different Humidifying Methods in Graft-taking Enhancement System (가습 방식에 따른 가습입자의 평균 입경 및 활착촉진 시스템 내의 상대습도 분포)

  • 박현수;최유화;김용현
    • Journal of Bio-Environment Control
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    • v.12 no.1
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    • pp.12-16
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    • 2003
  • The effect of humidifying methods on the mean size of droplets ejected from humidifier and distributions of relative humidity in a graft-taking enhancement system (GTES) was investigated. The mean sizes of droplets ejected from an ultrasonic humidifier and a steam humidifier with electrodes were 7.58$\pm$0.14 and 9.01$\pm$0.06 $\mu$m, respectively. Assuming that the particles ejected from humidifiers were mutually combined with distance, the mean diameter of droplets became larger as the distance apart from the outlet of humidifiers increased. When the relative humidity in GRS was controlled at 90% using the ultrasonic humidifiers, the average relative humidity at the height of 0.4, 1.1 and 1.8 m were 92.1$\pm$5.3, 90.9$\pm$5.6, and 89.7$\pm$6.8%, respectively. However, the average relative humidity using the steam humidifier with electrodes showed 93.4 $\pm$5.4, 90.7$\pm$5.9, and 89.3$\pm$7.0%, respectively. Therefore, it was concluded that humidification by ultrasonic humidifier would be appropriate for the uniform distribution of relative humidity in GTES.

Characteristics of the Segregation Sedimentation for Dredged Soil Depending on Fines Content (세립분 함량에 따른 준설토의 분리 퇴적 특성)

  • Park, Minchul;Lee, Jongkyung;Shin, Hyohee;Lee, Song
    • Journal of the Korean GEO-environmental Society
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    • v.12 no.6
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    • pp.25-34
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    • 2011
  • Dredged and reclaimed ground in progress at the West Coast has a high content of coarse particles. There will be different behaviors depending on the location of outlet and engineering properties of soil when its ground is dredged by a pump. Therefore, the experiments were conducted that were manufactured about the chamber equipment of length 2,650mm, width 770mm, height 735mm, experimented step filling method and water content about 300%, 500% and 700% respectively with SM and ML samples in order to realize segregating sediment characteristics of dredged ground with changing much fine. With results of analysis, ML sample by higher initial water content was reached to the period of complete sedimentation and coefficient of sedimentation consolidation increased with increases of diffusion distance. SM samples showed behavior of coarse soil with diffusion distance 120cm, diffusion distance of more than 120cm showed a similar tendency with ML sample under the influence of fines. In ML sample, it could be also found that lower depth and the more increasing diffusion distance increase in percentage of sieve #200 but water content decreases. In SM sample, it could be also found that coarse soil was piled at near the diffusion distance zone but fine soil was piled at the far diffusion distance zone and prominent difference showed between percentage of sieve #200 and water content(%) by boundary point 120cm~160cm of both samples. Also, shear strength was expressed ML-maximum 2.97kPa, SM-maximum 10.2kPa with diffusion distance.

Evaluation of Surface Temperature Variation and Heat Exchange Rate of Concrete Road Pavement with Buried Circulating Water Piping (열매체 순환수 배관이 매설된 콘크리트 도로 포장체의 표면 온도 변화와 방열량 평가)

  • Byonghu Sohn;Yongki Kim
    • Journal of the Korean Society for Geothermal and Hydrothermal Energy
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    • v.19 no.3
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    • pp.1-13
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    • 2023
  • Hydronic heated road pavement (HHP) systems have been well established and documented to provide road safety in winter season over the past two decades. However, most of the systems run on asphalt, only a few are tested with concrete, and there rarely is a comparison between those two common road materials in their performance. The aim of this study is to investigate the thermal performance of the concrete HHP systems, including surface temperature variations of experimental pavements in winter season. For preliminary study a small-scale experimental system was installed to evaluate the heat transfer characteristics of the concrete HHP in the test field. The system consists of 3 concrete slabs made of 1 m in width, 1 m in length, and 0.25 m in height. In these slabs, circulating water piping was embedded with different pipe depths of 0.08 m (Case A), 0.12 m (Case B), and 0.20 m (Case C) and same horizontal space of 0.16 m. Heating performance in winter season was tested with different inlet temperatures of 25℃, 30℃, 35℃ and 40℃ during the entire measurement period. Overall, the surface temperature of the concrete HHPs remained above 3℃ in all experimental conditions applied in this study. The results of the surface temperature measurement with respect to the pipe depth showed that Case B was the highest among the three cases. However, the closer the circulating water pipe was to the pavement surface, the greater the heat exchange rate. This results is considered that the heat is continuously accumulated inside the pavements and then the temperature inside the pavements increases, while the amount of heat dissipation decreases as the temperature difference between the inlet and outlet of circulating water decreases. In this preliminary test the applicability of the concrete HHP on road deicing was confirmed. Finally, the results can be used as a basis for studying the effects of various variables on road pavements through numerical analysis and for conducting large-scale empirical experiments.

Analysis of Air Temperature and Humidity Distributions and Energy Consumptions according to Use of Air Circulation Fans in a Single-span Greenhouse (단동온실 내 공기순환팬 사용에 따른 온습도 및 에너지소비량 비교 분석)

  • Lee, Tae Seok;Kang, Geum Choon;Kim, Hyung Kweon;Moon, Jong Pil;Oh, Sung Sik;Kwon, Jin Kyung
    • Journal of Bio-Environment Control
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    • v.26 no.4
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    • pp.276-282
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    • 2017
  • The aim of this study was to compare and analyze air temperature and humidity distribution and energy consumptions according to using air circulation fans in single-span greenhouses. The greenhouses located in Cheongnam-myeon, Cheongyang-gun, Chungcheongnam-do, Korea. There were cherry tomatoes in the greenhouses and the size of greenhouses was as follows;ridge height : 3.2 m, wide : 6 m, length : 95 m. The heating system was composed of a hot-water boiler and 6 FCUs(Fan Coil Unit)-4 FCUs were on bottom with duct and 2 FCUs were installed at 2.0 m. A total of 18 air circulation fans(impeller's diameter : 230 mm) were bilaterally arranged in 2 rows in the experimental greenhouse. The sensors for measuring air temperature and humidity were located at a quarter and three quarters of a length. The height of sensors were 0.8 m, 1.8 m. To calculate energy consumption in greenhouses, water temperature at inlet and outlet in a water pump, volume of water were measured. Form February 3rd to March 23th, temperature, humidity and energy consumptions were measured during heating time(6pm~7am). In a greenhouse without fans, the average differences of temperature and humidity were $0.75^{\circ}C$, 2.31%, respectively. The operation of fans showed their differences to $0.42^{\circ}C$, 1.8%. The standard deviation of temperature and humidity between measuring points in the greenhouse with fans was lower than the greenhouse without fans. Total energy consumptions in a greenhouse without fans were 4,673 kWh. In the greenhouse with fans, the total energy consumptions were 4,009 kWh. The energy consumptions in a greenhouse with fans 14.2% were less than the greenhouse without fans. Therefore, air circulation makes temperature and humidity uniform and saves energy consumptions for heating.

Dynamics of Phosphorus-Turbid Water Outflow and Limno-Hydrological Effects on Hypolimnetic Effluents Discharging by Hydropower Electric Generation in a Large Dam Reservoir (Daecheong), Korea (대청호 발전방류수의 인·탁수 배출 역동성과 육수·수문학적 영향)

  • Shin, Jae-Ki;Hwang, Soon-Jin
    • Korean Journal of Ecology and Environment
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    • v.50 no.1
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    • pp.1-15
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    • 2017
  • Daecheong Reservoir was made by the construction of a large dam (>15 m in height) on the middle to downstream of the Geum River and the discharge systems have the watergate-spillway (WS), a hydropower penstock (HPP), and two intake towers. The purpose of this study was to investigate the limnological anomalies of turbid water reduction, green algae phenomenon, and oligotrophic state in the lower part of reservoir dam site, and compared with hydro-meteorological factors. Field surveys were conducted in two stations of near dam and the outlet of HPP with one week intervals from January to December 2000. Rainfall was closely related to the fluctuations of inflow, outflow and water level. The rainfall pattern was depended on the storm of monsoon and typhoon, and the increase of discharge and turbidity responded more strongly to the intensity than the frequency. Water temperature and DO fluctuations within the reservoir water layer were influenced by meteorological and hydrological events, and these were mainly caused by water level fluctuation based on temperature stratification, density current and discharge types. The discharges of WS and HPP induced to the flow of water bodies and the outflows of turbid water and nutrients such as nitrogen and phosphorus, respectively. Especially, when hypoxic or low-oxygen condition was present in the bottom water, the discharge through HPP has contributed significantly to the outflow of phosphorus released from the sediment into the downstream of dam. In addition, HPP effluent which be continuously operated throughout the year, was the main factor that could change to a low trophic level in the downreservoir (lacustrine zone). And water-bloom (green-tide) occurring in the lower part of reservoir was the result that the water body of upreservoir being transported and diffused toward the downreseroir, when discharging through the WS. Finally, the hydropower effluent was included the importance and dynamics that could have a temporal and spatial impacts on the physical, chemical and biological factors of the reservoir ecosystem.