• Tuberculosis and Respiratory Diseases
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• v.72 no.6
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• pp.481-485
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• 2012

Background: Tracheostomy is a common procedure for patients requiring prolonged mechanical ventilation. However, the timing of tracheostomy is quite variable. This study was performed to find out the factors determining the timing of tracheostomy in medical intensive care unit (ICU). Methods: Patients who were underwent tracheostomy between January 2008 and December 2009 in the medical ICU of Seoul National University Hospital were included in this retrospective study. Results: Among the 59 patients, 36 (61.0%) were male. Median Acute Physiology And Chronic Health Evaluation (APACHE) II scores and Sequential Organ Failure Assessment scores on the admission day were 28 and 7, respectively. The decision of tracheostomy was made on 13 days, and tracheostomy was performed on 15 days after endotracheal intubation. Of the 59 patients, 21 patients received tracheostomy before 2 weeks (group I) and 38 were underwent after 2 weeks (group II). In univariate analysis, days until the decision to perform tracheostomy (8 vs. 14.5, p<0.001), days before tracheostomy (10 vs. 18, p<0.001), time delay for tracheostomy (2.1 vs. 3.0, p<0.001), cardiopulmonary resuscitation (19.0% vs. 2.6%, p=0.049), existence of neurologic problem (38.1% vs. 7.9%, p=0.042), APACHE II scores (24 vs. 30, p=0.002), and $PaO_2/FiO_2$ <300 mm Hg (61.9% vs. 91.1%, p=0.011) were different between the two groups. In multivariate analysis, APACHE II scores${\geq}20$ (odds ratio [OR], 12.44; 95% confidence interval [CI], 1.14~136.19; p=0.039) and time delay for tracheostomy (OR, 1.97; 95% CI, 1.11~3.55; p=0.020) were significantly associated with tracheostomy after 2 weeks. Conclusion: APACHE II scores${\geq}20$ and time delay for tracheostomy were associated with tracheostomy after 2 weeks.

• Advances in pediatric surgery
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• v.17 no.2
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• pp.133-138
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• 2011

Extracorporeal membrane oxygenation (ECMO) has been utilized in congenital diaphragmatic hernia (CDH) patients with severe respiratory failure unresponsive to conventional medical treatment. We retrospectively reviewed 12 CDH patients who were treated using ECMO in our center between April 2008 and February 2011. The pre ECMO and on ECMO variables analyzed included gestational age, sex, birth weight, age at the time of ECMO cannulation, arterial blood gas analysis results, CDH location, timing of CDH repair operation, complications and survival. There were 9 boys and 3 girls. All patients were prenatally diagnosed. Mean gestational age was $38.8{\pm}1.7$ weeks and mean birth weight was $3031{\pm}499$ gram. Mean age at the time of ECMO cannulation was $29.9{\pm}28.9$ hours. There were 4 patients who survived. Survivors showed higher 5 min Apgar scores ($8.25{\pm}0.96$ vs. $7.00{\pm}1.20$, p=0.109), higher pre ECMO mean pH ($7.258 {\pm}0.830$ vs. $7.159{\pm}0.986$, p=0.073) and lower pre ECMO $PaCO_2$ ($48.2{\pm}7.9$ vs. $64.8{\pm}16.1$, p=0.109) without statistical significance. The hernia was located on the left side in 10 patients and the right side in 2 patients. The time interval from ECMO placement to operative repair was about 3~4 days in 5 early cases and around 24 in the remaining cases. There were 3 cases of post operative bleeding requiring re operation and 2 cases of abdominal compartment syndrome requiring abdominal fascia reopening. ECMO catheter reposition was required in 4 cases. Three cases of arterial or venous thrombosis were detected and improved with follow up. Our data suggests that ECMO therapy could save the lives of some neonates with CDH who can not be maintained on other treatment modalities. Protocolized management and accumulation of case experience might be valuable in improving outcomes for neonates with CDH treated with ECMO.

• Journal of Drive and Control
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• v.17 no.2
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• pp.9-18
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• 2020

The purpose of this study was to analyze the effect of the soil cone index (CI) on the tractor work load. A load measurement system was constructed for measuring the field data. The field sites were divided into grids (3×3 m), and the cone index was measured at the center of each grid. The work load measured through the plow tillage was matched with the soil cone index. The matched data were grouped at 600 kPa intervals based on the cone index. The work load according to the cone index was analyzed for engine, axle, and traction load, respectively. The results showed that when the cone index increased, engine torque decreased by up to 9%, and the engine rotational speed and brake-specific fuel consumption increased by up to 5% and 3%, respectively. As the cone index increased, the traction and tillage depth were inversely proportional to the cone index, decreasing 7% and 18%, respectively and the traction and tillage depth were directly proportional to the cone index, increasing 13% and 12%, respectively. Thus, it was found that the cone index had a major influence on the engine, axle, and traction loads of the tractor.

• Proceedings of the Korean Vacuum Society Conference
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• 2015.08a
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• pp.183-183
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• 2015

Indium tin oxide (ITO)는 넓은 밴드갭을 가지는 n-type의 축퇴 반도체로 태양전지, 스마트윈도우, 터치 센서, organic light emitting displays (OLEDs) 등에 널리 적용된다. 최근 touch screen panels (TSPs)의 높은 전기적 특성 및 고해상도 요구에 따라 고품질 ITO 박막개발의 수요도 증가하는 추세이다. 지금까지 ITO 박막의 물성 및 기계적 특성에 관한 많은 연구가 진행되어 왔지만 ITO 초박막 에서의 근본적인 물성 변화에 대한 연구는 미흡한 실정이므로, 이러한 연구는 필수적이라 할 수 있다. ITO 초박막은 광학적 특성은 우수하나, 낮은 결정성으로 인해 전기적 특성이 나쁘다는 단점을 가지며, 이러한 ITO 박막의 결정성은 초기 박막 성장과정에 많은 영향을 받는다. ITO 박막의 초기성장과정은 핵이 생성된 후(nucleation), 각각의 위치에서 성장하게 되고(growth), 합쳐지면서(coalescence) 연속적인 막을 형성 하는데(continuous), 이러한 초기 박막 성장 과정 중에 핵 생성 밀도를 증가시키고 박막이 연속적으로 되는 두께를 감소시킨다면, 더욱 더 고품질의 ITO 초박막을 얻을 수 있을 것이다. 따라서, 본 연구에서는 박막 초기 형성 과정 중 섬들이 합체되는 두께를 최소화시키기 위하여 EMF(electromagnetic field strength) 시스템을 이용하였다. EMF 시스템은 DC 캐소드에 전자석 코일을 장착하여 전자기장을 추가로 부가한 것으로, 이를 이용할 경우 스퍼터 원자가 중성상태로 기판에 도달하는 것이 아니라, 이온화되어 Vp-Vf의 차이로 가속되어 추가적인 에너지를 공급받음으로써 기판표면상에서 확산을 촉진시키므로 박막이 연속적으로 되는 임계 두께를 감소시킬 수 있는 것으로 기대된다. 실험은 실온에서 DC 마그네트론 스퍼터링법을 이용하였으며, 유리기판위에 4, 6, 8, 10, 12, 20 nm의 두께로 ITO 박막을 제작하였다. 스퍼터링 파워는 150 W (3.29 W/cm3), 작업 압력은 0.13 Pa, 기판과 타깃 사이의 거리는 70 mm였다. 각각의 두께에서 EMF 파워 0, 5, 10, 15, 20, 25, 30 W로 인가하여 박막을 제작한 후, EMF 파워에 따른 ITO 박막의 초기 성장 과정중 표면상태를 AFM (atomic force microscope) 이미지를 통하여 관찰하였다. 또한, 두께 약 8 nm에서와 20 nm일 때의 전기적 특성 및 광학적 특성을 관찰하였으며, 두 박막 모두 EMF 파워 15 W를 인가하였을 때 그 특성이 가장 향상되는 것을 확인하였다. 이러한 결과를 통하여 박막은 초기 성장이 중요하므로, 매우 얇은 두께에서 좋은 특성을 가진 박막을 제작하여야 박막의 두께를 증가시켰을 때도 좋은 특성의 막을 얻을 수 있음을 알 수 있었다. 또한, EMF 파워를 증가시킴에 따라 자장강도를 증가시키는 것과 같은 효과 즉, 플라즈마 임피던스가 감소하는 효과를 내어 증착 중 고 에너지 입자 (Ar0, O-)에 의한 박막손상이 감소한 것으로 판단된다. 따라서 적정 EMF 파워 15 W를 인가하였을때 가장 물성이 좋은 ITO 박막을 얻을 수 있었다. 즉, EMF 시스템을 이용하여 저온 공정에서 결함농도가 적은 고품질의 ITO 초박막을 제작할 수 있었다.

• The korean journal of orthodontics
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• v.25 no.1 s.48
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• pp.13-18
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• 1995

Craniofacial asymmetry was analyzed in 39 patients with complete unilateral cleft lip and palate(UCLP). The samples are devided into three groups nine below 9 years, twenty three from 9 years 1 month to 14 years and seven over 14 years group. Seventeen measurements were obtained from the tracing of PA X-ray cephalometric headfilms to evaluate the asymmetric characteristics and changes accdording to aging in UCLP. The obtained results were as follows. 1. Facial asymmetry in UCLP is variable(1.22-3.47 $mm/^{\circ}$) and the length from midsagitta1 reference line to maxillary 1st molar, to upper central incisor and the length of mandibular ramus showed significant asymmetry 2. Nasal septum and anterior nasal spine were deviated In the cleft side and the lower border of nasal cavity was 1ower in cleft side. 3. The deviation of nasal septum was continued significantly till after 14 years old.

• Journal of Pharmacopuncture
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• v.9 no.3 s.21
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• pp.23-35
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• 2006

Objectives : The aim of this study was to investigate the effect of Asthma-depression and Immunoregulation with PR-HAS(Herbal-acupuncture with Platycodi Radix infusion solution) infection at Joksamni(St36) on ovalbumin-induced asthma in mice. Methods : C57BL/6 mice were sensitized and challenged with OVA(ovalbumin) for 12 weeks(once a week). The experimental group(OVA-PR-HA) was treated with concentrations(1%) of PR-HAS at Joksamni(St36) for the later 8 weeks(3times/week). The second experimental group(OVA-Needle prick) was treated with Needle-Prick at Joksamni(St36) for the later 8 weeks(3times/week). Results : 1. The weight and total cells in the mice lung treated with PR-HA decreased significantly compared with that of control group. 2. Total leukocytes and eosinophils in BALF of the mice group treated with PR-HA decreased remarkably compared with those of control group. 3. The sticking of collagen on histological analysis of lung sections, the mice group treated with PR-HA decreased significantly compared with those of control group. 4. The concentrations of IL-4, IL-5, IgE in BALF, and IL-4, IL-5, IL-13 in serum of the mice group treated with PR-HA decreased significantly compared with those of control group. 5. The number of Gr-1+/CD11b+ and CD11b+ cells in the lungs of the mice group treated with PR-HA decreased significantly compared with that of control group. 6. The numbers of CCR3+ cells, CD4+ cells and CD8+ cells in the lungs, and CD3e+/CD69+ in the lungs of the mice group treated with PA-HA decreased significantly compared with those of control group. 7. The mRNA expression of ${\beta}$-actin, TNF-${\alpha}$, IL-4, IL-5, IL-13 in the mice group treated with PR-HA with RT-PCR decreased significantly compared with those of control group. Conclusions : These result suggests that Platycodi Radix Herbal-acupuncture at Joksamni(St36) in C57BL/6mice may be an effictive part to OVA-induced asthma in C57BL/6 mice.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.118-124
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• 1984

Congenital Cystic Adenomatiod Malformation (C.C.A.M.) is rare, but one of the most common congenital pulmonary anomalies that cause acute respiratory distress in the newborn infants. It is characterized and differentiated from the diffuse pulmonary cystic disease pathologically, i.e. adenomatoid appearance due to marked proliferation of the terminal respiratory components. An 2/12 year old male patient was suffered from respiratory distress and cyanosis on crying since birth, but no specific therapy was given. With progression of symptoms, he came to Korea University Hospital for further evaluation and then transfered to Dept. of Chest Surgery for operative correction under the impression of Congenital Obstructive Emphysema suggested by a pediatrician. On gestational and family history, there was nothing to be concerned such as congenital anomaly. Physical examinations showed; moderate nourishment and development (Wt. 5.5kg), cyanosis on crying, both intercostal and lower sternal retraction on inspiration, Lt. chest building with tympany, Rt. shifting of cardiac dullness, decreased breathing sound with expiratory wheezing on entire Lt. lung field, decreased breathing sound on Rt. upper lung filed, and tachycardia. The remainders were nonspecific. Laboratory findings were normal except WBC $14000/mm^3$ (lymphocyte 70%), Hgb 9.8m%, Hct 28%, negative Mantaux test, and sinus tachycardia and counter-clockwise rotation on EKG. Preoperative simple Chest PA revealed marked hyperlucent entire Lt. lung, herniation of Lt. upper lobe to Rt., collapsed Rt. upper lobe, tracheal deviation and mediastinal shifting to Rt., and no pleural reaction. At operation, after Lt. posterolateral thoracotomy, 4th rib was resected. Operative findings were severe emphysematous changes limited to both lingular segmentectomy was done. The resected specimen showed slight solidity, measuring $8{\times}4.5{\times}2cm$ in size, and small multiple cystic spaces filled with air. Microscopically, entire tissue structures were glandular in appearance, cyst were lined by ciliated columnar epithelium, and occasional cartilages were noted around the cystic spaces. Bronchial elements were dilated but normal pattern on histologically. The patient had a good postoperative courses clinically and radiologically, and discharged on POD 10th without event. The authors report a case of Cogenital Cystic Adenomatoid Malformation (C.C.A.M.)

• International Journal of Highway Engineering
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• v.12 no.1
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• pp.1-8
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• 2010

Construction of road closed to mountains is inevitable in Korea because the mountainous region in Korea is more than 70% in area. Recently, due to global warming, typhoons or heavy rainfalls frequently occur, and accordingly, mountain roads are seriously damaged by landslides, debris flows, and uplift pressure below pavement. in this study, damage on pavement by uplift pressure was investigated. Various influencing factors such as slope angle, reinforcement of slope surface, thickness of soil cover underlain by rock, and types of drainage system were considered to evaluate uplift pressure acting on the bottom of pavement. Raising of water table up to the surface of slope may depend on the duration and intensity of rainfall. It shows that the installation of subdrain can reduce the uplift water pressure. Therefore, It is concluded that the use of subdrain system is effective to decrease uplift pressure and cement treated base is more endurable than typical crushed-stone base.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.90-97
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• 1982

Two hundred one patients of ventricular septal defect, which were operated at Seoul National University Hospital, were analysed on clinical background during the period from January, 1975 to December, 1980. The results were as follows: 1. Of the 201 patients, 118 patients were male [58.7%] and 83 patients were female [41.3%]. Their age ranged from 15 months to 40 years, and the mean age was 8.7 years. 40% of the patients were between 4 and 8 years. 2. The most common symptoms showed frequent U RI and exertional dyspnea. 3. On Kirklin`s anatomical classification, type I constituted 26.9%, type II 58.2%, type III 12.4%, and type IV 1.0%. We showed marked increased incidence of type I VSD as compared to Caucasians* 4. 46 cases were associated with other congenital cardiac diseases. They were PDA [13 cases], AI[11 ], ASD[6], PS[10], MI[4], and Double aortic arch [1]. 5. In 128 patients, who had complete hemodynamic data and were not associated with other congenital cardiac diseases, an attempt was made to correlate the EKG findings with the hemodynamic data, and defect size with the hemodynamic data. The children had variable distribution of PA syst. pr. and Rp/Rs. But most of adults had $R_P$/$R_S$of 0.15 or less. As $P_P$/$P_S$increased, the rate of operative complication increased also. 6. When a normal EKG pattern was present, $Q_P$/$Q_S$and $R_P$/$R_S$and $P_P$/$P_S$were relatively low. When EKG findings were LVH pattern, there was diastolic volume overload to left ventricle. As RVH, there was systolic pressure overload to right ventricle. And as BVH, there was mixed pattern of diastolic volume overload to left ventricle and systolic pressure overload to right ventricle. 7. Among patients in defect was less than 1 $cm^2$ per $M^2$ of BSA, $Q_P$/$Q_S$was less than 2:1, and $R_P$/$R_S$less than 0.25, and PAsyst. pr. less than 50 mmHg, and $P_P$/$P_S$was less than 0.5. But patients with the defect greater than 1 $cm^2$ per $M^2$ of BSA had no correlationship between $Q_P$/$Q_S$, $R_P$/$R_S$, PAsyst. pr. and defect size in each other. Most of patients with the defect greater than 2 $cm^2$/$M^2$ BSA, $R_P$/$R_S$was greater than 0.5. 8. Operative mortality rate was 9.5% [19 cases] among 201 patients. And complication rate including mortality rate was 22.9% [46 cases].

• Journal of Chest Surgery
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• v.17 no.4
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• pp.593-606
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• 1984

With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.