• 한국정보전자통신기술학회논문지
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• 제5권1호
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• pp.13-19
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• 2012

본 논문에서는 계층적 삼차원 블록 영상분석을 이용한 폐결절 자동 검출 방법을 제안한다. 제안하는 블록 기반 폐 영상 분석 방법은 크게 두 부분으로 나눌 수 있다. 첫 번째는 블록을 분할하고 분석하고자 하는 대상 블록을 선택하는 과정이며 두 번째는 선택된 분석 대상 블록을 분석하는 과정이다. 첫 번째 과정을 통하여 선택된 분석대상 블록들은 다음 단계인 분석과정을 통해 결절과 비결절로 분리될 수 있다. 분석대상 블록의 중심에 있는 object에서 분석을 위한 형태 특징을 추출 하고, 추출된 형태 특징 값을 Support Vector Machine을 이용하여 결절과 비 결절로 분리한다.

• Journal of Chest Surgery
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• 제50권3호
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• pp.211-214
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• 2017

Outcomes of ventricular septal rupture (VSR) as a complication of acute myocardial infarction are extremely poor, with an in-hospital mortality rate of 45% in surgically treated patients and 90% in patients managed with medication. Delaying surgery for VSR is a strategy for reducing mortality. However, hemodynamic instability is the main problem with this strategy. In the present case, venoarterial extracorporeal membrane oxygenation (ECMO) was used to provide stable hemodynamic support before the delayed surgery. Awake ECMO was also used to avoiding the complications of sedatives and mechanical ventilation. Here, we describe a successful operation using awake ECMO as a bridge to surgery.

• Journal of Chest Surgery
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• 제49권3호
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• pp.199-202
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• 2016

A 7-month-old girl with no medical history was treated with mechanical circulatory support due to myocarditis. Her cardiac contractility did not improve despite more than one week of extracorporeal membrane oxygenation treatment. Thus, we planned a heart transplant. However, a high level of cytomegalovirus was found in blood laboratory results by quantitative polymerase chain reaction. The patient's heart contractility recovered to normal range four days after ganciclovir treatment. She was discharged with slightly decreased cardiac contractility with a left ventricular ejection fraction of 45%.

• 동서간호학연구지
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• 제11권1호
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• pp.25-32
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• 2005

Purpose: This study was aimed to identify the factors that related the dietary behavior in coronary artery disease patients and to made the data for nursing which is thought to improve the dietary behavior. Method: The study population was the coronary artery disease patients who were treated at outpatient base. The study method was the dietary behavior, diet self-efficacy, perceived-healthy behavior, social support measurement & characteristics. All of the above tool was validated for its composition propriety and confidence. The statistical analysis was done by SPSS PC 11.0 program. and frequency, percentage, mean, standard deviation, Pearson's correlation was used for analysis. Results: The score of dietary behavior in the coronary artery disease patients was 4.57 point. The score of perceived-benefits was the highest among the association factor(point) and the score of perceived-barriers(m=2.78), diet self-efficacy(m=5.12), social support(m=4.86 point), exercise and chest pain. Conclusion: The development of the program for the efficient dietary education that prevents the progression of the coronary artery disease is needed.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1550-1555
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• 1992

From June 1989 to July 1992, we used centrifugal Biomedicus pump[CBP] in 20 patients In 9 cases, CBP was used as ventricular assistance after heart surgery for those who could not be weaned off bypass even with intra-aortic balloon counter-pulsation and with maximal inotropic support In 8 patients, CBP was used as partial left heart bypass during repair of aortic aneurysms or congenital aortic anomalies. And in 3 patients, CBP was used as vena caval bypass during resection of renal cell carcinoma with tumor extension into the inferior vena cava. In 2 of 9 patients with ventricular assistance, they were weaned off the device successfully after 16 hours and 7 days respectively. But the patients died of intracranial hemorrhage and sepsis, 7 and 29 days after weaning from cardiac support, respectively. In all the patients who underwent aortic of vena caval surgery using CBP as shunt, there were no complications such as postoperative bleeding necessitating reoperation, renal failure or neurologic sequelae. In conclusion, the centrifugal type of ventricular assistance may be potentially life saving treatment modality in patients with severe postoperative low cardiac output syndrome. The CBP can be safely employed for resection of renal cell carcinoma with vena caval tumor extension and for repair of aortic aneurysms.

• 보건의료산업학회지
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• 제1권1호
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• pp.90-109
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• 2007

This Study aims to examine the relative importants of various tasks of EMT and to examine knowledge level and problems associated with AED. It is based on the survey of paramedics and rescurers. The instrument by Hoe Sum Lim(1999) was used. as the questionaire for this research. The collected data were analyzed by means of $x^2$ test, t-test, and measured by percents. The results for this study were follows: 1) Among the tasks of EMI, "Basic Life Support" were rated as the most important, followed by "O2 supply" and foreign-body removal from mouth. 2) Some of the lower level of importance in task were Intubation, IV, dextrose infusion of Hypoglycemia, NTG S/L for chest pain, hydration for fluid therapy, brochodilator IV for Bronchial Asthma. 3) Some of the lower level of importance in task were apply of MAST, Vital Sign check and administration of traction & spine immobilization & air splint. 4) The most important reason that the used of AED is delayed is "unclear boundary of treatment directed by medical control".

• Journal of Chest Surgery
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• 제53권2호
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• pp.79-81
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• 2020

Treatment options for children with end-stage heart failure are limited. We report the first case of a successful pediatric heart transplantation bridged with a durable left ventricular assist device in Korea. A 10-month-old female infant with dilated cardiomyopathy and left ventricular non-compaction was listed for heart transplantation. During the waiting period, the patient's status deteriorated. Therefore, we decided to provide support with a durable left ventricular assist device as a bridge to transplantation. The patient was successfully bridged to heart transplantation with effective support and without any major adverse events.

• Journal of Chest Surgery
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• 제27권2호
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• pp.122-127
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• 1994

A retrospective study of 737 consecutive patients surviving the first 24 hours who underwent valve replacement surgery from July 1980 to June 1993 was undertaken to determine the prevalence, variables that could be used to predict outcome and results of therapy for postoperative acute renal failure[ARF]. Twenty-one patients[2.8 %] developed acute renal failure. Positive risk factors noted in the development of postoperative renal failure included age, New York Heart Association class III & IV, endocarditis and elevated preoperative concentration of serum creatinine. The duration of cardiopulmonary bypass, aortic cross-clamping and the total duration of the operation also closely correlated with the incidence of ARF. The mortality rate for established ARF was 38.1% and ARF was associated with a significant increase in the length of hospitalization, ventilator support and intensive care unit stay. The incidence and mortality rate of oliguric renal failure was 38.1% and 85.7%. The highest mortality rate was associated with two or more postoperative complications and serum creatinine value exceeded 5 mg/dl. We concluded that therapy should be aimed at prevention of oliguric renal failure, or at least its conversion to nonoliguric renal failure, and early institution of renal replacement therapy with intensive support probably gives the best chance for survival.

• Journal of Chest Surgery
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• 제57권3호
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• pp.312-314
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• 2024

A 3-year-old boy with Glenn physiology exhibited refractory heart failure with reduced ejection fraction. To improve the patient's oxygen saturation, he underwent ventricular assist device (VAD) implantation with concomitant Fontan completion. The extracardiac conduit Fontan operation was performed with a 4-mm fenestration. For VAD implantation, Berlin Heart cannulas were positioned at the left ventricular apex and the neo-aorta. Following weaning from cardiopulmonary bypass, a temporary continuous-flow VAD, equipped with an oxygenator, was utilized for support. After a stabilization period of 1 week, the continuous-flow VAD was replaced with a durable pulsatile-flow device. Following 3 months of support, the patient underwent transplantation without complications. The completion of the Fontan procedure at the time of VAD implantation, along with the use of a temporary continuous-flow device with an oxygenator, may aid in stabilizing postoperative hemodynamics. This approach could contribute to a safe transition to a durable pulsatile VAD in patients with Glenn physiology.

• Journal of Chest Surgery
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• 제56권4호
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• pp.274-281
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• 2023

Background: Patients who require initial venoarterial extracorporeal membrane oxygenation (VA ECMO) support may need to undergo veno-arteriovenous ECMO (VAV ECMO) conversion. However, there are no definitive criteria for conversion to VAV ECMO. We report 9 cases of VAV ECMO at Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine. Methods: Of 158 patients who received ECMO support between January 2017 and June 2019, 82 were supported by initial VA ECMO. We retrospectively reviewed the medical records of 9 patients (7 men and 2 women; age, 53.1±19.4 years) who had differential hypoxia and required VAV ECMO support. Percutaneous transaortic catheter venting was used to detect the differential hypoxia. Results: Among the 82 patients who received VA ECMO support, 9 (10.9%) had differential hypoxia and required conversion to VAV ECMO support. The mean time from VA ECMO support to VAV ECMO support and the mean duration of the VAV support were 2.1±2.2 days and 1.9±1.5 days, respectively. The average peak inspiratory pressure before and after VAV ECMO application was 23.89±3.95 cmH₂O and 20.67±5.72 cmH₂O, respectively, decreasing by an average of 3.2±3.5 cmH₂O (p=0.040). The PaO₂/FiO₂ ratio was kept below 100 mm Hg in survivors and non-survivors for 116±65.4 and 250±124.9 minutes, respectively (p=0.016). Six patients underwent extracorporeal cardiopulmonary resuscitation, of whom 4 survived (67%). The overall survival rate of patients who underwent conversion from VA ECMO to VAV ECMO was approximately 56%. Conclusion: Rapid detection of differential hypoxia is required when VA ECMO is applied, and efficient conversion to VAV ECMO may be critical for patient survival.