• Journal of Chest Surgery
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• v.35 no.7
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• pp.511-516
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• 2002

Background: This study was undertaken in infant patients with isolated ventricular septal defect(VSD) to determine the effect of surgical closure on ventricular systolic time interval, as a parameter for ventricular performance, by echocardiography. Material and Method: Thirty patients were enrolled. Mean age of patients at operation was 6.5$\pm$3.2 months and all patients had non-restrictive VSD. We checked the left atrium/aorta(LA/Ao) ratio, left ventricle ejection fraction(EF), left ventricular systolic time interval(LVSTI), and right ventricular systolic time interval(RVSTI). Echocardiographic studies were done before surgical correction and postoperative periods(postopl: within 2 weeks, postop2: between 4 and 6 months, postop3: between 1 and 2 years). Result: LA/Ao ratio decreased significantly at immediate postoperative period compared to preoperative period and sustained during further follow-up period(from 1.74$\pm$0.37 to 1.36$\pm$0.24＊, 1.32$\pm$0.22＊, and 1.27$\pm$0.19＊, p<0.01). LV EF had not changed during follow-up periods(from 65.1$\pm$7.0 to 62.3$\pm$9.5, 62.8$\pm$5.7, and 64.1$\pm$6.9). LVSTI decreased significantly at postop2 and sustained during further follow-up period (from 0.46$\pm$0.13 to 0.46$\pm$0.11, 0.37$\pm$0.08＊, and 0.34$\pm$0.07＊, p<0.01). RVSTI decreased significantly at postop3(0.33$\pm$0.08 to 0.32$\pm$0.08, 0.31$\pm$0.07, and 0.27$\pm$0.05＊, p<0.01). Conclusion: We found that right and left ventricular systolic time intervals had decreased over the period of 1 year after surgical correction of VSD. Therefore, it is necessary to observe the change of ventricular function during that period.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.124-129
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• 1999

Background: Ventricular septal defect(VSD) that causes pulmonary hypertension increase right ventricular workload. Echocardiographic assessment of right ventricular systolic time interval (RVSTI) has been used to predict pulmonary artery pressure in various cardiopulmonary diseases. This study was undertaken in infants with simple VSD to observe the alteration of the right ventricular workload through the changes of RVSTI after repair of VSD. Material and Method: We evaluated heart rate, the ratio of the left atrium/aortic root diameter (LA/Ao), right ventricular pre-ejection period(RVPEP), right ventricular ejection time(RVET), and its ratio(RVPEP/RVET) as a predictor of right ventricular workload in 12 children with simple VSD. These were measured three times at the preoperative period, at the 3 month and between 6 month and 1 year(average 9.5${\pm}$1.8month) after repair of VSD by M-mode & Doppler echocardiograph from the pulmonic valve echogram. Result: Heart rate was decreased significantly after repair(137.1${\pm}$13.7 vs 114.4${\pm}$21.1 and 104.1${\pm}$10.2, p<0.01). LA/Ao ratio was decreased significantly after repair(1.71${\pm}$0.32 vs 1.47${\pm}$0.33 and 1.39${\pm}$0.23, p<0.05). RVPEP/RVET were decreased after repair (0.38${\pm}$0.09 vs 0.32${\pm}$0.08 and 0.29${\pm}$0.09, p<0.01). Heart rate corrected RVPEP/RVET were significantly decreased only after 6 months(0.32${\pm}$0.03 vs 0.30${\pm}$0.05 and 0.28${\pm}$0.06, p<0.05). Conclusion: We found elevated right ventricular workload was progressively decreased until more than 6 months after repair and the RVSTI may serve a useful guide in postoperative care for children with VSD.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.79-79
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• 2003

심실의 내부는 유두근이나 trabecular와 같은 해부학적 구조물들로 인해 복잡한 형태를 띄고 있다. 그러한 복잡한 구조는 MR 영상을 이용한 심박출량 측정시 오차를 유발시킬 수 있으며, 만약 오차를 줄이기 위해 수작업을 하게 된다면 많은 수고와 시간이 필요하게 될 것이다. 본 연구에서는 threshold 기법을 이용하여 짧은 시간동안에 정확하게 복잡한 구조를 가진 심실의 심박출량을 측정하고자 하였다. 7 명의 환자에 대해 l.5T 급 MR 장치 (INTERA, Philips, Netherlands)를 이용하여 short-axis cardiac MR 영상을 획득하였다. 한 환자에 대해서 8개에서 10개의 슬라이스 영상을 8-10 mm의 두께로, 하나의 심장주기(cardiac cycle)동안 일정한 시간간격으로 25 개의 영상을 획득하였으며, 펄스시퀀스로는 ECG-gated segmented balanced fast field echo (TR/TE = 3ms/1.56ms)를 사용하였다. 획득된 영상은 PC(threshold 기법)와 workstation (기존의 수동 및 자동 segmentation 기법)로 DICOM 형태로 전송되었다. 측정은 IDL을 이용하여 자체 제작된 소프트웨어와 상용화된 소프트웨어 (MASS 5.0, MEDIS, Netherlands)를 이용하여 분석되었다. MR 영상에서 심내벽 부위를 추출하기 위하여 자체제작된 소프트웨어로는 threshold 기법을, 상용 소프트웨어로는 기존의 수동 및 자동 기법을 이용하였다. 심박출량은 최대수축기와 이완기 사이의 용적 차이로써 계산되었으며, 좌심실 및 우심실 모두에 대해 수행되었다. 또한, 해부학적 구조의 복잡도에 따른 측정방법의 정확도를 확인하기 위해 유두근 및 trabecular의 hypertrophy의 정도를 3 단계로 구분하고 측정된 값들을 통계적으로 분석하였다. Hypertrophy가 약한 그룹에서는 기존의 수동방식과 threshold 기법간의 의미있는 차이가 없었으며 (p=0.372), 기존의 수동 및 자동방식 간에도 큰 차이가 없었다 (p=0.298). 그러나, hypertrophy가 심한 그룹에서는 수동방식 및 자동방식 측정치 사이에 통계적으로 유의한 차이를 보임을 알 수 있었다 (p=0.044). 그러나, threshold 기법과 수동방식 사이에는 유의한 차이가 없었다 (p=0.l94). 분석시간은 threshold 기법이 기존의 수동방식에 비해서 두배정도 빠르다는 것을 알 수 있었다, Threshold 기법은 심박출량 측정에 있어서 정확하면서도 빠른 결과의 도출이 가능했으며, 특히 심내벽의 구조가 복잡한 경우에 그 효과가 증대됨을 알 수 있었다.

• Tuberculosis and Respiratory Diseases
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• v.50 no.3
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• pp.343-352
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• 2001

Background : Advanced chronic obstructive pulmonary disease is characterized by progressive pulmonary hypertension leading to right heart dysfunction, which plays a Important role in clinical evaluation but remains difficult and challenging to quantify. The noninvasive doppler echocardiographic value referred to as the Tei index has been suggested as a simple, reproducible and reliable parameter of the right ventricular function. The purpose of this was to assess the right ventricular function in patients with chronic obstructive pulmonary disease using the Tei index and to evaluate its relationship with the pulmonary functional status. Methods : The study population comprised of 26 patients with chronic obstructive pulmonary disease and 10 normal control subjects. The Tei index was obtained by dividing the sum of the isovolumetric contraction and the relaxation times by the ejection time using a pulsed-wave doppler. It was compared with the other available Doppler echocardiographic parameters of systolic or diastolic function and with the pulmonary function of the patients. Results : The Tei indices of the patients with COPD were significantly higher than those of normal subjects($0.45{\pm}0.17$ vs. $0.27{\pm}0.03$, p<0.01). The isovolumetric contraction time/ejection time($0.32{\pm}0.08$ vs. $0.25{\pm}0.05$, p<0.05), the isovolumetric relaxation time/ejection time($0.29{\pm}0.16$ vs. $0.15{\pm}0.08$, p<0.05)and the preejection period/ejection time ($0.46{\pm}0.10$ vs. $0.38{\pm}0.06$, p<0.05) were prolonged and the ejection time ($255.2{\pm}32.6$ vs. $314.2{\pm}16.5$ msec, p<0.05) was significantly shortened in patients with COPD compared to normal subjects. The tei indices were inversely correlated with the $FEV_1$ (r=-0.46, p<0.05) and were prolonged significantly in patients with a severe obstructive ventilatory dysfunction(less than 35% of predicted $FEV_1$) compared to those with a mild and moderate ventilatory dysfunction. The tei indices showed an inverse correlation to with the ejection time (r=-0.469), the isovolumetric contraction time/ejection time(r=0.453), the isovolumetric relaxation time/ejection time(r=0.896) and the preejection period/ejection time(r=0.480). Conclusion : The tei index appeared to be a useful noninvasive means of evaluating the right ventricular function. It revealed a significant correlation with the pulmonary function in patients with COPD.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.754-762
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• 2001

Background: To evaluate the efficacy of arterial switch operation for transposition of great arteries, serial echocardiographic studies were performed in 8 patients who underwent the surgery between 1989 and 1998 at Dept. of Thoracic & Cardiovascular Surgery, Yeungnam University Hospital in Daegu City, Korea. Material and Method: Follow-up period ranged from 6 months to 11 years(average of 4.1 years). Body weight ranged from 2.6kg to 4.8kg, with average of 3.6kg. 5 of 8 patients were preoperatively diagnosed as TGA+VSD, and 3 as TGA+IVS. LV function was evaluated by the measurement of LV shortening fraction, LVSTI, and LVEF. RVSTI was also measured. Postoperative function of valve and growth of great vessels were analyzed by the measurement of PSPGV, valvular regurgitation, LA/AO ratio, root dimension of aorta and pulmonary artery, comparing with the age matched controls, respectively. Result: LVEF had an average of 65.0+9.03% which is tended to increase serially. LVAOPG had an average of 15.9mmHg. RVPAPG, 27.5mmHg. From the measurement of aortic root dimension of 6 patients at end-systole, aortic root growth was assumed to increase more than the mean value of normal growth. PA root dimension at end-systole showed a similar growth progress when compared with age matched normal controls. Postoperative pulmonic valve regurgitation was noted in 5 of total 8 patients, in which 1 patient who showed grade 2 and 4 showed below grade 1. AR, in 6 patients and all grade 1 Except 1 patient, all the valvular regurgitations were below grade 1, which was presumed to be clinically insignificant.

• Food Science and Preservation
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• v.10 no.3
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• pp.339-346
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• 2003

In order to improve some problems such as contamination of undesirable mold, mycotoxin production and excessive drying on the surface of traditional meju, we developed a capsule type-meju(CM) coated with steamed black bean and Aspergillus oryzae - rice koji(0.3％, w/w) mixture to surface of traditional meju and fermented at 25$^{\circ}C$ for 14 days under 80％ relative humidity. Contamination of undesirable mold on the surface of CM was not detected within 2 weeks and some genus Penicillium molds on control meju without koji were found naturally after 12 days of fermentation. The moisture content of meju was showed to be in the range of 34.7 - 29.4％ being 32.7％(w/w) of mean value. Titratable acidities in CMs prepared with black bean(BCM) and soybean(SCM) were much higher than that in control meju, and BCM was similar to SCM. Free sugar content in BCM(123.98 mg％) was 10 times and 2.1 times higher than that in control meju(15.02 mg％) and SCM(59.85 mg％), respectively. Amino type nitrogen content in control meju was 147.00 mg％ and its content in BCM(255.50 mg％) was 1.37 times higher than that in SCM(187.25 mg％). Total organic acid content in BCM(95.98 mg％) and SCM(1l9.98 mg％) were much higher than that in control meju(26.44 mg％), and then lactic and malic acid contents were markedly changed according to capsulation of meju. Lightness value(L) of Hunter color index was much higher in BCM than in SCM. Fatty acid composition of CM was not different as compared to control meju. Total free amino acid content in BCM(1039.70 mg％) was 4.4 times and 2.4 times higher than that in control meju(236.45 mg％) and SCM(556.07 mg％), respectively.