• Title/Summary/Keyword: Shunt operation

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Acute Pulmonary Edema and Congestion in the Right Upper Lobe after Waterston-Cooley Shunt for Tetralogy of Fallot: A Case Report (활로4증후에서 Waterston-Cooley 문합수술후에 발생한 우상엽 폐수종: 1례 보고)

  • 송충웅
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.113-117
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    • 1977
  • The tetralogy of Fallot is one of the most frequent and serious congenital cardiac malformation accompanied cyanosis. For relief of cyanosis, the Waterston operation is a successful, palliative procedure in infant & young child under age of five with obstructive lesions of the right: side of the heart who require a systemic-pulmonary arterial shunt for survival. A patient, aged 3 and weighing 13 kg., who had been cyanotic since one month after birth,. was admitted to the University of Severance Hospital under a diagnosis of tetralogy of Fallot, The side to side anastomosis between the right pulmonary artery & the ascending aorta was performed in March 1976. The anastomotic channel was made only 4 ram. in diameter, thereafter massive unilateral pulmonary congestion on the side of the anastomosis developed shortly after operation. And the. patient died of congestive heart failure within a hour. And so the purpose of this report is describe the immediate & late effect of systemic-pulmonary shunt for T.O.F. with review of literatures.

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Effectiveness of Early Surgery in Children with Traumatic Subdural Hygroma

  • Kim, Byoung-Ook;Kim, Seok-Won;Lee, Seung-Myung
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.432-435
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    • 2005
  • Objective: This study was performed to evaluate the usefulness of early operation in children with traumatic subdural hygroma. Methods: The subjects were nine patients (Glasgow coma scale (GCS) score was below 10 and age was below 10 years old) who developed subdural hygroma after trauma between January 2000 to December 2002. Subduroperitoneal shunt was performed in one group and not performed in the other group. We analyzed the GCS score on admission and at 1 year after operation. Overall clinical results were evaluated retrospectively. Results: Patients who underwent operation exhibited higher GCS scores at 1 year after trauma compared to those in the patients who were treated by conservative therapy(p<0.05). Conclusion: The early operation could be an effective treatment to children with subdural hygroma who showed delayed improvement of consciousness and to patients with hygroma that didn't decrease or was above moderate amount.

Syringo-Subarachnoid-Peritoneal Shunt Using T-Tube for Treatment of Post-Traumatic Syringomyelia

  • Kim, Seon-Hwan;Choi, Seung-Won;Youm, Jin-Young;Kwon, Hyon-Jo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.58-61
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    • 2012
  • Various surgical procedures for the treatment of post-traumatic syringomyelia have been introduced recently, but most surgical strategies have been unreliable. We introduce the concept and technique of a new shunting procedure, syringo-subarachnoid-peritoneal shunt. A 54-year-old patient presented to our hospital with a progressive impairment of motion and position sense on the right side. Sixteen years before this admission, he had been treated by decompressive laminectomy for a burst fracture of L1. On his recent admission, magnetic resonance (MR) imaging studies of the whole spine revealed the presence of a huge syrinx extending from the medulla to the L1 vertebral level. We performed a syringo-subarachnoid-peritoneal shunt, including insertion of a T-tube into the syrinx, subarachnoid space and peritoneal cavity. Clinical manifestations and radiological findings improved after the operation. The syringo-subarachnoid-peritoneal shunt has several advantages. First, fluid can communicate freely between the syrinx, the subarachnoid space, and the peritoneal cavity. Secondly, we can prevent shunt catheter from migrating because dural anchoring of the T-tube is easy. Finally, we can perform shunt revision easily, because only one arm of the T-tube is inserted into the intraspinal syringx cavity. We think that this procedure is the most beneficial method among the various shunting procedures.

Size-Efficient 3 GHz CMOS LNA (회로면적에 효율적인 3 GHz CMOS LNA설계)

  • Jhon, Hee-Sauk;Yoon, Yeo-Nam;Song, Ick-Hyun;Shin, Hyung-Cheol
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.44 no.10
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    • pp.33-37
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    • 2007
  • This paper presents the implementation technique to reduce circuit area occupation in designing Low Noise Amplifier (LNA) using vertical shunt symmetric inductor. We applied a vertical shunt symmetric inductor to match the input and output in 3 GHz CMOS LNA to reduce the circuit area. This size efficient amplifier has been designed in a $0.18\;{\mu}m$ digital logic CMOS process. In this paper, the case of conventional asymmetric inductor, and vertical shunt symmetrical inductor with a relatively higher number of turns have been compared in order to efficient a size efficient CMOS LNA design method while still retaining the circuit operation characteristics.

Bidirectional Cavopulmonary Shunt Operations as Palliation or Pre-Fontan Stage Operation - Early Results - (고식적 목적 혹은 Fontan 수술 전단계로서 시행한 양방향성 상공정맥 폐동맥 단락술의 조기 임상 결과)

  • 한재진
    • Journal of Chest Surgery
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    • v.25 no.4
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    • pp.406-411
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    • 1992
  • Thirty-four patients were received bidirectional cavopulmonary shunt[BCPS] from Aug. 1989 to Apr. 1991 at Sejong General Hospital, Puchon, Korea. Their ages were from 43 days to 21 years old with 19 cases of infant, 10 from 1 to 5 years old and 5 cases above 6 years old. Their diagnoses were as follows: 13 cases with uni-ventricular heart, 9 tricuspid atresia, 6 double outlet of right ventricle, 4 pulmonary atresia with intact ventricular septum, and 2 transposition of great arteries with pulmonary stenosis. Among them, 10 patients had received other palliative operations before. The BCPS operations were performed under the cardiopulmonary bypass and 10 patients who had bilateral superior vena cava received bilateral BCPS. Other associated procedures were 9 cases of takedown of Blalock-Taussig shunt, 3 pulmonary artery angioplasty, 1 unifocalization, 1 repair of total anomalous pulmonary venous return, 1 Damus procedure, 1 relief of sub-aortic stenosis, 1 right ventricular outflow tract reconstruction and one case of tricuspid valve obliteration. There were 3 operative deaths[8.8%] and two late deaths. The remainders show good postoperative state and their oxygen saturation was increased significantly. Conclusively, the bidirectional cavopulmonary shunt is very effective and safe palliative or pre-Fontan stage operation for the many complex congenital anomalies with low pulmonary blood flow especially for the patients who have the risk of Fontan repair.

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Calcified Chronic Subdural Hematoma : Late Sequele of Shunt Operation in a Child with Hydrocephalus - Case Report - (소아에서 뇌수두증의 단락술 이후 발생한 석회화된 만성 경막하 혈종 - 증례보고 -)

  • Park, Juno;Kwon, Taek-Hyun;Park, Youn-Kwan;Chung, Hung-Seob;Lee, Hoon-Kap;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.968-972
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    • 2000
  • Post-shunting subdural hemorrhages are usually small and self-limited, and they can be recognized on the routine post-operative CT examinations. However, delayed subdural bleeding may occur without any clinical symptoms or signs. Thus the hematoma remains undetected, and it can be increased in size and sometimes become calcified with time. We experienced a case of 15-year-old male with a large calcified subdural hematoma who had undergone shunt operation 10 years previously. With pertinent review of the literatures, we discuss the possible mechanism of calcification and the proper way of treatment in calcified chronic subdural hematoma.

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Modified Blalock-Taussig Shunt in Neonates (신생아에서 변형 Blalock-Taussig 단락술)

  • 조광조;성시찬
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.378-382
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    • 1997
  • To evaulate the effectiveness and risk factors for shunt failure of the Blalock-Taussig shunt in neonates, we analyzed the 21 neonates who were undergone Blalok-Taussig shunt operation at Dong-A University Hospital from December 1991 to Feburary 1996. We evaluated operative mortality, patency of the shunt. and distortion of pulmonary artery. We also determined the risk factors for the shunt failure. Age at operation was from 1 day to 30 days(mean 11.7 days). We ghts were 2.4 to 4.5kg(mean 3.1 kg). The underlying lesions included severe tetralogy of Fallot with pulmonary stenosls or atresia(N=11) and single ventricle varieties with. pulmonary stenosis or atresia(N=10). Prostaglandin El was given in 13 neonates prior to operation. The mean preoperative(prior to prostaglandin El therapy) and postoperative arterial oxygen tension were 30.1 mmHg and 46.3 mmHg respectively(P(0.01). The shunt was performed through a left thoracotomy in 11 patients and through a right thoracotomy In 10. A 5 mm graft was used in 15 patients and a 4 mm graft in 6 patients. The incidence of early shunt occlusion was 9.5%(2 patients). The hospital mortality was 9.5%(2 patients with early shunt occlusion). Univariate analysis revealed that body weight of 2.6 kg or less(p=0.021), pulmonary artery size of 3mm or less(p=0.008), and 4 mm graft (p=0.021) were risk factors predictive of early shunt failure. The patency rate of the shunt in hospital survivors was 100% at mean ollow-up of ll.3 months(There was not death or reoperation related to shunt failure). 10 patients were catheterized during postoperative follow-up. There was no significant distorsion of pulmonary artery. So we concluded that the modified Blalock-Taussig shunt in neonates was excellent in the hospital survivors.

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Analysis of the Phase Current Measurement Boundary of Three Shunt Sensing PWM Inverters and an Expansion Method

  • Cho, Byung-Geuk;Ha, Jung-Ik;Sul, Seung-Ki
    • Journal of Power Electronics
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    • v.13 no.2
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    • pp.232-242
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    • 2013
  • To obtain phase currents information in AC drives, shunt sensing technology is known to show great performance in cost-effectiveness and therefore it is widely used in low cost applications. However, shunt sensing methods are unable to acquire phase currents in certain operation conditions. This paper deals with the derivation of the boundary conditions for phase current reconstruction in three-shunt sensing inverters and proposes a voltage injection method to expand the measurable areas. As the boundary conditions are deeply dependent on the switching patterns, they are typically analyzed on the voltage vector plane for space vector pulse width modulation (SVPWM) and discontinuous pulse width modulation (DPWM). In the proposed method, the voltage injection and its compensation are conducted within one sampling period. This guarantees fast current reconstruction and the injected voltage is decided so as to minimize the current ripple. In addition to the voltage injection method, a sampling point shifting method is also introduced to improve the boundary conditions. Simulation and experimental results are presented to verify the boundary condition derivation and the effectiveness of the proposed voltage injection method.

Development of High Current Shunt Regulator for Beam Based Alignment in PLS 2GeV Storage Ring (포항방사광가속기 빔위치 정렬 용 정밀전원장치 개발)

  • Nam, S.H.;Suh, J.H.;Ha, K.M.;Huang, J.Y.;Ko, I.S.
    • Proceedings of the KIEE Conference
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    • 1997.07f
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    • pp.2249-2251
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    • 1997
  • Total 144 quadrupole magnets are installed in PLS. The magnets are connected in series with groups of two or 24. Each group is powered by a high-precision constant-current DC power supply. For the purpose of the beam based alignment of beam position monitors in the PLS, it is necessary to adjust the current of each quadrupole independently. To achieve this, a high current shunt regulator is designed. It can shunt a maximum 50 A of the quadrupole magnet current. The shunt regulator is programmable and the current amplitude can be varied linearly with a 12-bit resolution. Power transistors are used in the current shunt regulator. The operation of transistors is in linear region. The RS232C protocol is used for remote control and status report of the shunt regulator to the main control centre of the PLS. Preliminary result indicates that the calibration accuracy of the beam position monitor can be achievable in less than $10{\mu}m$.

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Optimization of the Anastomosis Angle and Diameter with the Systemic- To-Pulmonary Artery Shunt (대동맥-폐동맥 연결관의 접합각도와 직경의 최적화)

  • Kim, Sung-Min;Park, Sung-Yun;Jun, Jae-Hoon
    • Journal of the Korean Society for Precision Engineering
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    • v.24 no.10
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    • pp.123-130
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    • 2007
  • Hypoplastic left heart syndrome is currently the most lethal cardiac malformation of the newborn infant. Survival following a Norwood operation depends on the balance between systemic and pulmonary blood flow, which is highly dependent on the fluid dynamics through the interposition shunt between the two circulations. The purpose of this study is an optimization of the systemic-to-pulmonary artery shunt. In this study, We used computational fluid dynamic(CFD) models to determine the velocity profile in a systemic-to-pulmonary artery shunt and suggested a simplified method of calculating the blood flow in the shunt based on Ultrasound systems. We analyzed the flow characteristic variations and oscillatory shear index(OSI) due to the anastomosis angle and shunt diameter changing. Four different CFD models were constructed with the shunt sizes ranging from 3 to 3.5mm. The angle between the brachiocephalic trunk(BCT) and the shunt were $30^{\circ}$ and $45^{\circ}$, respectively. When the diameter is 3.0 mm, the oscillatory shear index decreased by 1.2% at $30^{\circ}$ as opposed to at $45^{\circ}$. When the diameter is 3.5 mm, it increased by 18% more at $30^{\circ}$ as opposed to at $45^{\circ}$. When the joint angle is $30^{\circ}$ and the diameter is 3.0 mm, the oscillatory shear index decreased by 4.1% in comparison with the 3.5 mm diameter. When the angle is $45^{\circ}$ and the diameter is 3.0 mm, the index increased by 14.6% in comparison with the 3.5 mm diameter.