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Open Heart Surgery During the first 3 Months of Life (3개월 이하의 영아에서의 개심술)

  • 서경필
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.180-185
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    • 1993
  • From February 1982 to December 1991, 49 neonates and 105 infants in less than 3 months of age underwent open heart surgery in Seoul National University Hospital. There were 98 males and 56 females, and their mean ages were 16 days in neonatal group and 67 days in early infant group. Their body weight and height were less than 3 percentile of normal developmental pattern. In order of decreasing incidence, the corrected conditions included Transposition of great arteries with or without ventricular septal defect [43], isolated ventricular septal defect [34], Total anomalous pulmonary venous return [21], Pulmonary atresia with intact ventricular septum [9] and others [47]. Various corrective or palliative procedures were performed on these patients; Arterial switch operation [36], patch closure for ventricular septal defect [34], Repair of total anomalous pulmonary venous return [21], RVOT reconstruction for congenital anomalies with compromised right ventricular outflow tract [17]. Profound hypothermia and circulatory arrest were used in 94 patients [ 61% ]: 42 patients [ 85.7% ] for neonatal group and 52 patients [ 49.5% ] for early infant group. The durations of circulatory interruption were within the safe margin according to the corresponding body temperature in most cases [ 84% ]. The hospital mortality was 36.4% ; 44.9% in neonatal group and 32.4% in infant group 1 to 3 months of age. The mortality was higher in cyanotic patients [ 46.6% ], in those who underwent palliative procedures [ 57.8% ], in patients whose circulatory arrest time was longer than safe periods [ 60% 0] and in patients who had long periods of cardiopulmonary bypss and aortic crossclamping. In conclusion, there has been increasing incidence of open heart surgery in neonates and early infants in recent years and the technique of deep hypothermia and circulatory arrest was applied in most of these patients, and the mortality was higher in cyanotic neonates who underwent palliative procedures and who had long cardiopulmonary bypass , aortic cross-clamping and circulatory arrest.

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Broad Band Microstrip Antenna with Saw Tooth Perturbations for Polarization Diversity (톱니 모양의 Perturbation을 갖는 편파 Diversity 용 광대역 마이크로스트립 안테나)

  • 김태홍;노근식;박천석
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.11 no.4
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    • pp.505-513
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    • 2000
  • This study suggests new antenna design for polarization diversity. For dual polarization, two port feeding lines are printed on two separate layers and cross-shaped aperture is located on ground between the substrates. For reducing back radiation, a reflector is attached around $\lambda$/4 behind feeding substrates. For wide bandwidth we use a perturbed patch with saw tooth shaped. This perturbation effect causes reduction of antenna size and also reduction of array size. With the antenna proposed here, $1\times4$ array dual polarization antenna for polarization diversity of PCS base station is built. One single element has as large as 10.3%, 11.3% bandwidths at each port, V.S.W.R less than 1.3 and the isolation is less than -40 dB, also array antenna has 13.2% 12.7% band bandwidth, V.S.W.R less than 1.3 the isolation below -36dB and the XPD of 10 dB.

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Involvement of Crosstalk Between cAMP and cGMP in Synaptic Plasticity in the Substantia Gelatinosa Neurons

  • Kim, Tae-Hyung;Chung, Ge-Hoon;Park, Seok-Beom;Chey, Won-Young;Jun, Sung-Jun;Kim, Joong-Soo;Oh, Seog-Bae
    • International Journal of Oral Biology
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    • v.36 no.2
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    • pp.83-89
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    • 2011
  • Substantia gelatinosa (SG) neurons receive synaptic inputs from primary afferent $A{\delta}$- and C-fibers, where nociceptive information is integrated and modulated by numerous neurotransmitters or neuromodulators. A number of studies were dedicated to the molecular mechanism underlying the modulation of excitability or synaptic plasticity in SG neurons and revealed that second messengers, such as cAMP and cGMP, play an important role. Recently, cAMP and cGMP were shown to downregulate each other in heart muscle cells. However, involvement of the crosstalk between cAMP and cGMP in neurons is yet to be addressed. Therefore, we investigated whether interaction between cAMP and cGMP modulates synaptic plasticity in SG neurons using slice patchclamp recording from rats. Synaptic activity was measured by excitatory post-synaptic currents (EPSCs) elicited by stimulation onto dorsal root entry zone. Application of 1 mM of 8-bromoadenosine 3,5-cyclic monophosphate (8-Br-cAMP) or 8-bromoguanosine 3,5-cyclic monophosphate (8-Br-cGMP) for 15 minutes increased EPSCs, which were maintained for 30 minutes. However, simultaneous application of 8-BrcAMP and 8-Br-cGMP failed to increase EPSCs, which suggested antagonistic cross-talk between two second messengers. Application of 3-isobutyl-1-methylxanthine (IBMX) that prevents degradation of cAMP and cGMP by blocking phosphodiesterase (PDE) increased EPSCs. Co-application of cAMP/cGMP along with IBMX induced additional increase in EPSCs. These results suggest that second messengers, cAMP and cGMP, might contribute to development of chronic pain through the mutual regulation of the signal transduction.

Developmentof Dual Polarized Base station Antenna with Electrical Down tilting (전기적 다운 틸팅 기능을 갖는 이중 편파 기지국 안테나 개발)

  • Lee, Chang-Eun;Yun, Jong-Sup;Moon, Young-Chan;Hur, Jung
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.41 no.7
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    • pp.81-88
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    • 2004
  • In case of mechanical down tilting, a horizontal pattern is distorted and beam width widens whenincreasing tilt angle, which causes an expansion of hand off region and burden base station equipment. In contrast, electrical down tilting has advantage that horizontal HPBW is kept constant with down tilting. In this paper, based on a phased array technology, dual polarized base station antenna with electrical down tilting was developed at 800MHz band. The antenna has down tilting range of 0$^{\circ}$ to 14$^{\circ}$, and 15㏈i gain. We use stacked microstrip patch as a radiated element and apply balanced feed technique to improve isolation between ports and discrimination of cross polarization. The effect of electrical down tilting was verified by field test.

Design and Manufacture of Modified Circular Ring antenna for WLAN/WiMAX Applications (WLAN/WiMAX 시스템에 적용 가능한 변형된 원형 링 안테나 설계와 제작)

  • Lim, Dae-Soo;Yoon, Joong-Han
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.18 no.2
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    • pp.268-275
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    • 2014
  • In this paper, a dual-band circular ring monopole antenna with stub and ground slot for WLAN(Wireless Local Area Networks)/WiMAX(World interoperability for Microwave Access) applications. The proposed antenna is based on a planar monopole design, and composed of one circular ring of radiating patch, cross strip in circular ring, modified feed line, and two rectangular slot in the ground plane for triple-band operation. To obtain the optimized parameters, we used the simulator, Ansoft's High Frequency Structure Simulator(HFSS) and found the parameters that greatly effect antenna characteristics. Using the obtained parameters, the antenna is fabricated. The numerical and experiment results demonstrated that the proposed antenna satisfied the -10 dB impedance bandwidth requirement while simultaneously covering the WLAN and WiMAX bands. And characteristics of gain and radiation patterns are determined for WLAN/WiMAX application.

NCS Learning Module Providing System Using CORS Based on Filter (CORS 기반 필터를 이용한 NCS 학습모듈 제공 시스템)

  • Kim, Dae-Kyeong;Na, Seung-Cheul;Kim, Chang-Bok
    • Journal of Advanced Navigation Technology
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    • v.19 no.2
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    • pp.161-167
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    • 2015
  • This paper proposed system for providing the national competency standards learning module, which has changed and updated from time to time. The provisioning server of the proposed system provides learning module, and the management server carry out fault management, billing, request management, statistics and aggregate, etc, and the target server requests the learning module in the provisioning server through the domain. The proposed system determines provide of the learning module by CORS based on filter, which is to determine whether matches or not with domain of the provisioning server and the target server. The proposed system can be patch and maintenance remotely about NCS based learning module to be new update and removed. Also, the proposed system may provide contents in conjunction with existing educational systems, and may be extended in the future to enable the management for domain of the target server.

Open Heart Surgery for Six Cases of the Conegnital Heart Disease (선천성(先天性) 심장병(心臟病)의 개심술(開心術) -6례(例) 수술경험(手術經驗) -)

  • Lee, Sung Haing;Lee, Sung Koo;Han, Sung Sae;Lee, Kihl Rho;Kim, Song Myung;Lee, Kwang Sook;Lee, Chong Kook
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.220-238
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    • 1976
  • Six cases of congenital heart disease were operated on by means of cardiopulmonary bypass between December, 1975 and April, 1976. Two cases of ventricular septal defects (VSD), two cases of VSD, associated with ruptured aneurysm of sinus Valsalva, two cases of atrial septal defects (ASD) and one case of pulmonic stenosis with patent ductus arteriosus were operated. Sarns roller pumps and Bentley Temptrol oxygenators were used for extracorporeal circulation. Pump oxygenator was primed with Ringer's lactate solution, 5% dextrose in water, mannitol, and ACD blood. Flow rate ranged from 2.0 to $2.4L/M^2/min$. Bicarbonate was added to the oxygenator with estimated amount as 15 mEq/L/hr. Venous catheters were introduced into superior and inferior vena cava, and oxygenated blood was returned to the body through aortic cannula inserted into ascending aorta. Moderate hypothermia ($30^{\circ}C$) was induced by core cooling. Aorta was cross clamped for 15 minutes and released for 3 minutes, and repeated clamping when necessary. Atrial and ventricular septal efects were closed by direct sutures. Aneurysms of sinus Valsalva ruptured into the right ventricle were repaired through right ventriculotomy by d:rect closure with Dacron patch reinforcement. Cardiopulmonary bypass time varied from 66 to 209 minutes, and aorta cross clamping time ranged from 13 to 56 minutes. Postoperative bleeding was minimal except one case who needed for evacuation of substernal hematoma. Intra- and postoperative urinary output was satisfactory. Acid-base balance, partial pressure of $O_2$, electrolytes, and hematological changes during intra- and post-perfusion period remained at the acceptable ranges. No mortality was experienced.

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Clinical Review about Corrective Surgery of Tetralogy of Fallot (팔로사징증의 근치 수술에 관한 임상적 고찰)

  • 조광현
    • Journal of Chest Surgery
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    • v.24 no.7
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    • pp.674-684
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    • 1991
  • The surgical treatment of tetralogy of Fallot [TOF] was initiated by Blalock and Taussig in 1945 with the establishment of the subclavian artery to pulmonary artery anastomosis. In an imaginative and daring effort, in 1954, Lillehei and collaborators [1955] using controlled cross-circulation, carried out the first intracardiac repair of TOF by closing the ventricular septal defect [VSD] and relieving the pulmonary stenosis under direct vision. Nowadays, total correction is the ideal operation for treatment of TOF and is accomplished with extracorporeal circulation. And the results of surgery for TOF have steadily improved over the years, thanks to important contributions of many surgeons. Nevertheless because of its protean physiologic and anatomic presentation, TOF continues to offer challenges to cardiologist and cardiac surgeons. Thirty two cases of TOF have undergone total corrective surgery using extracorporeal circulation in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, Inje University, from Oct. 1985 to Feb. 1990. Clinical considerations were applied to these cases and the results were obtained as follows. 1. The heart lung machine used for extracorporeal circulation was SarnsO 7000, 5-head roller pump, and the number and type of oxygenators were 10 of bubble type and 22 of membrane type. The mean bypass time was 148.9 minutes and the mean aortic cross clamp time was 123.8 minutes. The GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 2. 20 cases were male and 12 were female, the mean age was 8 years old and the mean body weight was 25Kg. 3. The preoperative symptoms were cyanosis [29 cases], squatting [27 cases] and etc. The mean values of preoperative Hb., Hct., and SaO2 were 16.5 gm /dl, 50.3%, and 78.5%. 4. Combined anomalies were noticed in 16 cases [50%]. Among them 10 cases were PFO and 6 cases were ASD. 5. The degree of aorta overriding were 25% in 5 cases, 25 ~ 50% in 22 cases and above 50% in 5 cases. The dPA/Ao [ratio of diameter of pulmonary artery trunk to ascending aorta] were below 25% in 5 cases, 25 ~ 50% in 10 cases, 50 ~ 70% in 6 cases and above 75% in 11 cases. 6. The types of RVOT [right ventricular outflow tract] stenosis were valvular and infundibular in 14 cases [43.6%], diffuse hypoplastic type in 12 cases [37.5%], infundibular in 5 cases, and valvular and supravalvular in 1 case. 7. One stage radical corrective surgery was applied to the all cases. In widening of the RVOT, 3 types of patches were used: MVOP [monocusp ventricular outflow patch, Polystan BioprosthesesO] in 3 cases, knitted Dacron vessel patches in 2 cases, and double layer with bovine pericardium and woven Dacron prosthesis in 26 cases. 8. Postoperative complications were occurred in 15 cases. Among them, low output syndrome were occurred in 10 cases [31.3%] and 2 of them were expired postoperatively.

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Scattering Model of TM Polarized Electromagnetic Wave by Finite I-Shaped Metamaterial Array Based on Surface Current Model (표면 전류를 기반으로 한 유한 배열 I-모양 메타물질의 TM 편파 전자기 산란 모델)

  • Jang, Ji-Woong;Lee, Haeseung;Koh, Il-Suek;Seo, Ilsung;Lee, Yongshik
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.25 no.6
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    • pp.664-670
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    • 2014
  • Generally, the properties of metamaterials are analyzed based on the infinite array of the unit cells. In real application of the metamaterial, however, the array has to be finite. Hence, it is important that a method can analyze the effect of the finite array of the metamaterial. In this paper, a model is proposed which can calculate the scattering by a large-size finite array of an I-shaped metamaterial without a full-wave simulation. The proposed model is based on the surface current estimation of each unit cells. The ratio of the current distribution on a finite array of the metamaterial to that of the infinite array of the same metamaterial for a TM polarized incident wave is approximated as a quartic polynomial. The coefficients of the polynomial are a function of the physical dimension of the metallic patch. Hence, the current distribution of the finite metamaterial can be estimated based on the proposed polynomial and the current of the infinite array. The scattered field is calculated by using the surface current model. The proposed model is numerically and experimentally verified by comparing calculated and measured RCS(Radar Cross Section) data.

An Analysis of Cold Air Generation Area Considering Climate-Ecological Function -A Case Study of Changwon, South Korea- (기후생태적 기능을 고려한 찬공기 생성지역 분석 -창원시를 대상으로-)

  • Song, Bong-Geun;Park, Kyung-Hun
    • Journal of the Korean Association of Geographic Information Studies
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    • v.13 no.1
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    • pp.114-127
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    • 2010
  • The purpose of this study is to find out cold and fresh air producing areas using climate-ecological functions in Changwon city, Gyeongsangnam-do, South Korea. The evaluation of climate-ecological functions were composed of the six factors: patch size with cold air generation and inflow functions, farmland and grassland ratio, mean slope degree, cross section types, mean slope length and roughness of bottom in valley. The analysis results of each evaluation factor in the study area were divided into 5 grades according to the capacity of cold air generation. The first-grade area with the highest factor values for cold air generation was take up 3.51% of the total study area, second grade was 13.48%, third grade was 31.65%, fourth grade was 27.28%, and fifth grade was 24.09%. According to the spatial distribution of cold air producing areas, the valleys around Mt. Bongnim, Changwon tunnel, and Anmin tunnel had higher evaluation grade. It will require the future research to establish the climate-ecological conservation areas and to construct the wind corridor based on the long-term microclimatic monitoring.