• Title/Summary/Keyword: Valve open rate

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

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    • 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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Development of the HPM System to Improve Efficiency of the Hydraulic Excavator (유압식 굴삭기 효율 향상을 위한 HPM 시스템 개발)

  • Kwon, Yong Cheol;Lee, Kyung Sub;Kim, Sung Hun;Koo, Byoung Kook
    • Journal of Drive and Control
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    • v.16 no.4
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    • pp.1-8
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    • 2019
  • The HPM (High-speed Power Matching) system is an electro-hydraulic control system. It directly controls the swash plate of the pump by selecting four-loop logic based on joystick signals, pump flow, and pressure signal to improve the efficiency and controllability of construction machines. In the NFC (Negative Flow Control) system, a typical pump control system using conventional open center type MCV, the loss is continuously generated by flow through the center bypass line even when the excavator is not in operation. Also, due to the slow response of the pump that indirectly controls the flow rate using the pressure regulator, peak pressure occurs at the start or stop of the operation. Conversely, the HPM system uses an MCV without center-by-pass flow path and the swash plate of a pump for the HPM is controlled by a high-speed proportional flow control valve. As a result, the HPM system minimizes energy loss in standby state of the excavator and enables peak pressure control through rapid electro-hydraulic control of a pump. In this paper, the concept of the HPM system algorithm is introduced and the hydraulic system efficiency is compared with the NFC system using the excavator SAT (System Analysis Tool).

Analysis of Elastic Wave Based Leakage Detection Technology Using Accelerometers (가속도계를 이용한 탄성파 기반 누수탐지 기술 분석)

  • Choi, Kwangmook;Lee, Hohyun;Shin, Gangwook;Hong, Sungtaek
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.24 no.9
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    • pp.1231-1240
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    • 2020
  • Water pipes are laid on the ground, making it impossible to visually detect leaks due to aging of pipes, and technology to detect leaks in pipes is mainly used to detect leaks in pipes by detecting leaks. In this paper, two accelerometers were attached to both ends of the constant water piping to calculate the time difference between the acquired data to detect leakage points. The leak test of piping was performed by installing valves at 4.3m, 8.6m, and 12.9m points on piping 17.2m, and changing the development rate of valves to 30% and 70%. Leakage can be detected for pressure drop in piping, which is 30% and 70% open valve. It is very important to detect leakage in the early stage, and it is judged that detection of the initial leak point from the algorithm applied in this paper will be possible.

The Effect of Cardiopulmonary Bypass on Serum Magnesium (체외순환에 의한 혈청 Magnesium의 변화)

  • Chae, Hurn;Rho, Joon Ryang;Suh, Kyung Phill;Lee, Yung-Kyoon
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.239-244
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    • 1976
  • Alterations in the serum magnesium level were studied in twenty patients who had open-heart surgery during the period from August 1974 to May 1975. The patients were chosen at random. The operative procedures included repair for congenital heart diseases in fifteen patients and cardiac valve replacement for acquired valvular heart diseases in five patients. The age ranged from 8 to 46 years, with an average of 19 years. None of the patients had a history of gross neuromuscular abnormalities. Cardiopulmonary bypass was carried out using a roller pump and a disposable oxygenator. The prime solution consisted of 2 units of ACD banked blood and approximately an equal volume of non-blood additives in adults, while a relatively smaller volume was added in children. The average flow rate was 2,733 ml per minute. Blood samples for magnesium and arterial blood pH were obtained the day after admission 25 minutes after initiation of the bypass and on the morning the day after operation. Preoperative data were then compared with those obtained during the bypass and postoperatively by a paired test. During the bypass, the serum magnesium level decreased significantly from $1.425{\pm}0.029$ to $1.210{\pm}0.063mEq.$ liter (p<0.001). Also, there was a significant decrease in serum magnesium from $1.425{\pm}0.029$ preoperatively to $1.255{\pm}0.083mEq$. per liter (p<0.001). Also, there was a significant decrease in serum magnesium from $1.425{\pm}0.029$ preoperatively to $1.255{\pm}0.083mEq$. per liter postoperatively (p<0.01). The duration of bypass was less than 90 minutes in 10 patients (group A) and exceeded 90 minutes in the remaining 10 (group B). There was no statistical correlation between the groups A and B ($p{\gg}0.20$). Statistical analyses of the serum magnesium level and arterial blood pH showed no significant correlation with correlation coefficient; being -0.3485(pre-op), -0.2971(during bypass), and -0.1008(post-op), respectively. In all the patients, no gross neuromuscular abnormalities were found postoperatively. At present, the clinical significance of the serum magnesium level during and after bypass is controversial. In the near future, however, it is expected that improvements in prime solution and heart-lung machine will solve this problem.

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