• Journal of Chest Surgery
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• v.34 no.11
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• pp.848-853
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• 2001

Background: Sternal infection or dehiscence after cardiac surgery through median sternotomy is rare. If suitable treatment is not performed for the complication, however, the mortality is high. For 12 patients with sternal dehiscence or infection, we performed wide excision of the infected and necrotic tissue and covered with muscle flap(s) to obliterate the mediastinal dead space. Material and method: Sternal infection or dehiscence occurred in 13 of patients who underwent cardiac surgery One patient, who died of cerebral infarction before the sternal complication was treated, was excluded in this study. The sternal wound complication occurred in 6 of patients with valve replacement and 6 of patients with coronary bypass surgery, respectively. Since 1991, 9 patients underwent definite surgical debridement and muscle transposition as soon as fever was controlled with closed irrigation and drainage. The necrotic tissue and bone was widely excised and the sternal dead space was eradicated with the single flap or the combined flaps of right pectoralis flap(turnover flap), left pectoralis flap(turnover flap or rotation-advancement flap), and right rectus muscle flap. Result : There was no mortality in 12 patients with coverage of muscle flap(s) for sternal infection or dehiscence The mean interval between the diagnosis of sternal complication and the myoplasty was 6.6$\pm$3.9 days. In 4 patients, one pectoralis muscle flap was used, and in 8 patients both pectoralis muscle flaps were used. For each 1 patient and 2 patients in each group, right rectus muscle flap was added. For the last 3 patients, a single pectoralis flap was used to eradicate the mediastinal dead space and the longer placement of the mediastinal drain catheter was needed. One patient, who had suffered from necrosis of left pectoralis flap(rotation-advancement flap) with subsequent chest wall abscess after coverage of both pectoralis flaps, was managed with reoperation using right rectum flap. Conclusion : Sternal dehiscence or infection after cardiac operation can be readily managed with wide excision of necrotic infected tissue(including bone) and muscle flap coverage after short-term irrigation of sternal wound. The sternal(mediastinal) dead space may be completely eradicated with right pectoralis major muscle flap alone.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.1
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• pp.1-9
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• 2013

Purpose: The purpose is to perform objective evaluation for rotator cuff using ultrasonography and validate factors influencing cuff integrity as well as efficacy of follow-up ultrasonography after unreamed antegrade intramedullary nailing for humerus fracture. Materials and Methods: Seventeen patients with an average age of $55.7{\pm}18.6$ years underwent antegrade intramedullary nailing for humerus fracture and follow-up ultrasonography of shoulder joint. Mean follow-up period was $43.5{\pm}32.2$ months. Intraoperative evaluation for preoperative cuff tear was performed, of which four cuffs were repaired by single row repair technique. Clinical evaluation included visual analogue scale (VAS), range of motion, Korean Shoulder Scoring System (KSS) and American Shoulder and Elbow Society (ASES) score. Ultrasonographic evaluation was performed on cuff integrity and protrusion of proximal nail tip as well. Radiographic evaluation included time to union, protrusion of proximal nail tip and migration of proximal interlocking screw which could affect shoulder joint function. Results: Mean VAS at last follow-up was $1.65{\pm}1.84$ points. Range of motion showed forward flexion of $137.0{\pm}33.5^{\circ}$, external rotation of $43.5{\pm}12.7^{\circ}$ and internal rotation of $16.4{\pm}2.0^{\circ}$ while KSS score and ASES score were $79.6{\pm}20.7$ and $83.7{\pm}17.0$ points, respectively. Bone union was demonstrated in all cases and average time to union was $3.4{\pm}1.3$ months. Migration of proximal interlocking screw was shown in 6 cases (35%). On ultrasonographic evaluation, there were normal in 8 (47%), weaving in 4 (24%), partial tear in 5 cases (29%), but no complete tear. Protrusion of proximal nail tip was demonstrated in 8 cases (47%) on plain radiographs whereas in 11 cases (65%) on ultrasonography and was associated with increasing age (p=0.038). Ultrasonographic weaving and partial tear was associated with protrusion of proximal nail tip (p=006), but not with repair of preoperative tear (p>0.05). Conclusion: Because weaving and partial tear on ultrasonography originated from protrusion of proximal nail tip, careful insertion of nail and meticulous repair of cuff during operation lead to stable fixation with satisfactory recovery of shoulder function follow-up ultrasonography can be a useful tool for evaluating protrusion of nail tip and rotator cuff tear, of which diagnosis is difficult on plain X-ray after antegrade intramedullary nailing for humerus fracture.

• Journal of Advanced Marine Engineering and Technology
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• v.33 no.8
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• pp.1116-1122
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• 2009

As a result of this study, we reached the following conclusions. With appropriate setting of oil pressure and flow rate, it operated same rotation speed with existing cooler by electrical transmission. In initial operation, a temperature of a cold storage is lower rapidly. As an internal temperature of a cold storage is lower, a decreasing rate of temperature is lower. As a result of comparing the both type, the cooler of oil pressure type showed the following results. The decreasing rate of temperature was more faster and shorter operating time was more shorter than existing cooler of electric type. The actual case of a cold storage, the cooler of oil pressure type can prevent quality deterioration and decrease power consumption. As an internal temperature of a cold storage is lower, power consumption increased rapidly, the oil pressure type showed lower power consumption. COP of two of these types decreased continuously as the internal temperature of a cold storage being reach setting temperature, and that of oil pressure type showed higher amount about 25%. As a setting temperature is lower, the number of refrigerator's operating times are less and operating time is longer, so power consumption is increased in the maintenance of a cold storage's internal temperature, power consumption of hydraulic type showed lower amount about 21~25% in two of these types.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.13 no.3
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• pp.63-69
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• 2013

This paper related with the performance of SE-MMA (Signed-Error MMA) that is the reduction of computational operation number in algorithm than MMA blind eualization algorithm which are possible to elimination of intersymbol interferance in the band limited and time dispersive nonlinear communication channel. In MMA algorithm which are possible to reduction of amplitude and phase rotation by intersymbol interference that is occurred in channel without using the training sequence, it uses the error signal that is the difference of the equalizer output and constant modulus, the statisticlly characteristic of transmitted signal. But in SE-MMA, it uses the polarity of the error signal, then it is possible to reduce the updating the tap coefficient and to simplify the H/W implementation. The computer simulation were performed in order to compare the performance of SE-MMA and conventional MMA algorithm. For this, the recovered signal constellation that is the output of the equalizer, the convergence performance by MSE, MD (maximum distortion) and residual isi characteristic learning curve, SER were used. As a result of simulation, the SE-MMA has more fast convergence speed than the MMA. But in the other index after reaching the seady state, it gives more worst performance values in the used index.

• Journal of Advanced Marine Engineering and Technology
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• v.39 no.6
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• pp.642-648
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• 2015

Recently, there have been many studies pertaining to reducing energy consumption on ships. As part of those studies, the energy consumption of ships can be reduced by understanding and controlling the varying loads, excluding fixed loads. In existing ships, engine room fans are usually operated based on the actual experience of the crew without any special guidelines. To realize energy reduction, we investigate the characteristics of engine-room fans, and we propose an energy-management system called the engine room fan control system (ERFCS) and the ERFCS algorithm. The ERFCS controls the fan speed depending on the temperature and pressure, where one to four fans are operated depending on changes in the load. In addition, the minimum rotation speed of the engine-room fan was limited to 50% to prevent the surging phenomenon, which is due to fan damage or low pressure resulting from mechanical friction or heating at low fan speeds. We develop a fan control system simulation model using LabVIEW that is based on the proposed algorithm and ISO 8861. Finally, we perform simulations to confirm that operation of the proposed fan control system is possible using only 46.4% of the power required by the existing method.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.375-379
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• 2010

Introduction: In the management of dentofacial deformities, variable movement of the maxilla can be made possible by a Le Fort I osteotomy. Posterior impaction of the maxilla necessary for rotation of the maxillomandibular complex enhances the functions and esthetic results. In cases of posterior impaction of the maxilla, an increase in the figure of the occlusal plane angle and incisor inclination can occur. This study reports the relationship between the amount of posterior impaction and the change in the occlusal plane angle and incisor inclination in a Le Fort I osteotomy by preoperative and postoperative lateral cephalograms. Materials and Methods: Twenty patients who had undergone orthognathic surgery in Dong-A University Medical Center participated in this study. Lateral cephalometrics, within 3 weeks prior to surgery and 3 days after surgery, were used for analysis. Pre and postoperative measurements of the occlusal plane angle and incisal inclination based on the Frankfort horizontal (FH) plane were performed. X and Y were defined as the amount of vertical change in the upper incisor tip and the amount of vertical change in the upper first molar mesial cup tip through the operation. The amount of final posterior maxillary impaction was determined by subtracting Y from X, which is the difference in vertical height. According to the amount of posterior maxillary impaction, the change in the occlusal plane angle and incisal inclination was measured. Results: The average posterior maxillary impaction was 2.91 mm and the average change in the occlusal plane angle and incisal inclination was $6.54^{\circ}$after surgery. As a result, each mm of posterior maxillary impaction changed the occlusal plane angle and incisal inclination by $2.25^{\circ}$. Statistically, there was high significance. Two cases were observed: one with the same amount of posterior maxillary impaction performed on both the right and left showing $2.20^{\circ}$, and the other with a different amount of posterior maxillary impaction performed showing $2.35^{\circ}$. In this case, there was no significance difference between the two cases. Conclusion: Each mm of posterior maxillary impaction changes the occlusal plane angle and incisal inclination by an average of $2.25^{\circ}$. In posterior maxillary impaction, there was no significant difference in the amount of change in the occlusal plane angle and incisal inclination regardless of whether there was an equal amount of posterior maxillary impaction on both sides. This study is expected to help in the presurgical orthodontic preparation and presurgical treatment planning.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.40 no.4
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• pp.423-428
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• 2016

The last stage blades of a low pressure (LP) turbine get frequently fractured because of stress corrosion cracking. This is because they operate in a severe corrosive environment that is caused by the impurities dissolved in condensed steam and high stress due to high speed rotation. To improve the reliability of the blades under severe conditions, 12% Cr martensitic stainless steel, having excellent corrosion resistance and higher strength, is widely used as the blade material. This paper shows the result of root cause analysis on a blade which got fractured suddenly during normal operation. Testing of mechanical properties and microstructure examination were performed on the fractured blade and on a blade in sound condition. The results of testing of mechanical properties of the fractured blade showed that the hardness were higher but impact energy were lower, and were not meeting the criteria as per the material certificate specification. This result showed that the fractured blade became embrittled. The branch-type crack was found to have propagated through the grain boundary and components of chloride and sulfur were detected on the fractured surface. Based on these results, the root cause of fracture was confirmed to be stress corrosion cracking.

• Journal of Biosystems Engineering
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• v.3 no.1
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• pp.20-36
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• 1978

The effect of binder kicking forces on the shattering losses of paddy rice, which has been widely understood as an outstanding loss factor in harvesting with a binder, were experimentally assessed in this thesis.Through the field tests the optimum time of harvest, in terms of grain moisture contents, was found by considering harvesting losses for two rice varieties, harvested by two different binders, at four or five grain moisture levels.A device was designed and manufactured to apply various kicking forces to the bundles and was used in the bundle kicking tests. It was intended to find out the optimum range of kicking force to minimize the kicking losses. Based on the study, modification of the existing binder kicking mechanism was suggested. The following is a summary of the results of this thesis. 1. In Suweon 258 variety, as the grain moisture content is reduced, so the cutting loss and the kicking loss increase. The grain losses range from 0.77 to 0.82 percent of total field yield for the cutting loss, from 1.83 to 2.01 percent for the kicking loss, and from 2.60 to 2.83 percent for the field loss, when the moisture content is about 22 percent. 2. In Jinheung variety , the field losses increased as the grain moisture content decreased . When the moisture content was 20 percent, the field loss, cutting loss and kicking loss was 0.42-0.49 % , 0.30-0.35, and 0.12 -0.14% of the total field yield, respectively. 3. The difference in the field loss , cutting loss, and kicking loss for the two binders was 0.23% , 0.05% and 0.18% respectively in Suweon 258 variety, and 0.07% , 0.02% and 0.05% respectively ini Jinheung variety. The grain losses for binder B were slightly higher than those for binder A. 4. In the statistical analysis of each variety , the kicking force and the moisture content of the grain, and its interaction were all highly significant at 1% level by T test .The optimum kicking force was found to be in the 3.0-0.4kg range. This does not interrupt the binder operation, while ioses are kept to an acceptale level. 5. To reduce the kicking force of the eXlstmg binder mechanism, the speed of rotation of the kicking arm needs to be redued by increasing the number of driving sprocket teeth, and the position and gear ratio of the knotter-bill and driving bevelgear have to be change to give a !motter-bill speed of 1110 rpm. It is also desirable to attach a belt conveyor which smoothly carries the bundle to the ground. 6. The optimum harvesting time cased on maximum field yield was found to be at a grain moisture content of around 22 percent for Suweon 258 variety, and 20 percent for Jinheung variety. Tota] field yield and field yield at the time amounted to 9, 812.5 kg/ha, 9, 302. 5kg/ha respectively for the Suweon 258, and 7, 819.5 kg/ ha, 7, 158.7 kg/ha respectively for the Jinheung variety.

• 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.)

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.129-136
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• 2010

Purpose: Anatomically, the foot is provided with insufficient blood supply and is relatively vulnerable to venous congestion compared to other parts of the body. Soft tissue defects are more difficult to manage and palliative treatments can cause hyperkeratosis or ulcer formation, which subsequently requires repeated surgeries. For weight bearing area such as the heel, not only is it important to provide wound coverage but also to restore the protective senses. In these cases, application of flaps for hind foot reconstruction is widely recognized as an effective treatment. In this study, we report the cases of soft tissue reconstruction for which various types of flaps were used to produce good results in both functional and cosmetic aspects. Methods: Data from 37 cases of hind foot operation utilizing flaps performed between from June 2000 to June 2008 were analyzed. Results: Burn related factors were the most common cause of defects, accounting for 19 cases. In addition, chronic ulceration was responsible for 8 cases and so forth. Types of flaps used for the operations, listed in descending order are radial forearm free flap (18), medial plantar island flap (6), rotation flap (5), sural island flap (3), anterolateral thigh free flap (2), lattisimus dorsi muscular flap (2), and contra lateral medial plantar free flap (1). 37 cases were successful, but 8 cases required skin graft due to partial necrosis in small areas. Conclusion : Hind foot reconstruction surgeries that utilize flaps are advantageous in protecting the internal structure, restoring functions, and achieving proper contour aesthetically. Generally, medial plantar skin is preferred because of the anatomical characteristics of the foot (e.g. fibrous septa, soft tissue for cushion). However alternative methods must be applied for defects larger than medial plantar skin and cases in which injuries exist in the flap donor / recipient site (scars in the vicinity of the wound, combined vascular injury). We used various types of flaps including radial forearm neurosensory free flap in order to reconstruct hind foot defects, and report good results in both functional and cosmetic aspects.