• 제목/요약/키워드: Diastole

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게이트 심장 혈액풀 스캔에서 좌전사위상 각도의 변화에 따른 정량적 지표 비교 (The Comparison of Quantitative Indices by Changing an Angle of LAO View in Multi-Gated Cardiac Blood Pool Scan)

  • 윤순상;남기표;류재광;김성환
    • 핵의학기술
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    • 제16권1호
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    • pp.57-61
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    • 2012
  • 게이트 심장 혈액풀 스캔(Gated cardiac blood pool scan, MUGA)은 좌심실의 기능을 평가하는 데 유용한 검사로 심근독성 항암제를 투여 받는 환자에서 심박출 계수(Ejection Fraction, EF)를 추적, 감시하는데 이용되어 많은 검사가 시행되고 있다. EF를 산출하기 위해 좌전사위상(Left Anterior Oblique, LAO)에서 좌우 심실이 분리되도록 각도를 조절해야 하는데 이때 LAO 각도의 설정은 정량분석 값에 영향을 미칠 가능성이 있어, 이에 본 연구는 LAO 각도의 변화가 정량분석 값에 영향을 미치는지 살펴보고자 한다. 2011년 06월부터 09월까지 본원에서 MUGA 검사를 시행한 환자 49명(남 8명, 여 41명)을 대상으로 하였다. 먼저 최적 중격상(Best septal view)으로 촬영 후, 전면과 측면 측으로 LAO 각도를 가감하여 총 3회 촬영하였다. ${\pm}5^{\circ}$로 환자 20명, ${\pm}10^{\circ}$로 29명을 촬영하였고, 관심영역을 자동 및 수동으로 각각 설정하여 좌심실의 EF와 확장기말계수, 수축기말계수를 비교하였다. 먼저 관심영역을 자동으로 분석하였을 때, ${\pm}5^{\circ}$의 경우, LAO, LAO $-5^{\circ}$, LAO $+5^{\circ}$에서의 EF의 평균값은 각각 $61.0{\pm}7.5%$, $62.1{\pm}7.1%$, $60.9{\pm}6.7%$ ($p$=0.841)이었고, 이때의 확장기말계수, 수축기말계수 역시 통계적으로 유의한 차이가 없었다($p$<0.05). ${\pm}10^{\circ}$의 경우, EF의 평균값은 각각 $62.4{\pm}9.54%$, $62.3{\pm}10.8%$, $61.6{\pm}9.3%$ ($p$=0.938)이었고, 이때의 확장기말계수, 수축기말계수 역시 통계적으로 유의한 차이가 없었다($p$<0.05). 또한 관심영역을 수동으로 분석하였을 때, ${\pm}5^{\circ}$의 경우, EF의 평균값은 각각 $62.8{\pm}7.1%$, $63.6{\pm}7.5%$, $62.7{\pm}7.3%$ ($p$=0.903)이었고, 이때의 확장기말계수, 수축기말계수 역시 통계적으로 유의한 차이가 없었다($p$<0.05). ${\pm}10^{\circ}$의 경우, EF의 평균값은 각각 $65.5{\pm}9.0%$, $66.3{\pm}8.7%$, $63.5{\pm}9.3%$ ($p$=0.473)이었고, 이때의 확장기말계수, 수축기말계수 역시 통계적으로 유의한 차이가 없었다($p$<0.05). 최적 중격상을 기준으로 하였을 경우, ${\pm}5{\sim}10^{\circ}$의 영상의 차이는 EF에 유의한 변화를 주지 않을 것으로 판단된다. 다만 최적 중격상에서 벗어난 영상은 좌심실의 벽 운동 등과 같은 심장의 운동상태를 정성적으로 평가함에 있어서 판독자에 따라 편차가 발생할 수 있으므로 주의해야 할 것이다.

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Hemodynamics of a Connecting conduit Between the Left Ventricle and the Left Decending Coronary Artery

  • Shim, Eun-Bo;Sah, Jong-Yub
    • International Journal of Vascular Biomedical Engineering
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    • 제1권2호
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    • pp.20-29
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    • 2003
  • A new treatment for coronary artery occlusive disease is being developed in which a shunt or conduit is placed directly connecting the left ventricle with the diseased artery at a point distal to the obstruction. To aid in assessing and optimizing its benefit, a computational model of the cardiovascular system was developed and used to explore various design conditions. Simulation results indicate that in complete LAD occlusion, flow can be returned to approximately 65% of normal if the conduit resistance is equal for forward and reverse flow, increasing to 80% in the limit in which backflow resistance is infinite. Increases in flow rate produced by asymmetric flow resistance are considerably enhanced in the case of a partial LAD obstruction since the primary effect of resistance asymmetry is to prevent leakage back into the ventricle("steal") during diastole. Increased arterial compliance has little effect on net flow with a symmetric shunt, but leads to considerable augmentation when the resistance is asymmetric. These results suggest that an LV-LAD conduit will be beneficial when stenosis resistance(Rst) > 27 PRU if resistance is symmetric.

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인공심장 sac내의 3차원 유체-구조물 상호작용에 대한 수치적 연구 (Numerical analysis of the 3D fluid-structure interaction in the sac of artificial heart)

  • 박명수;심은보;고형종;박찬영;민병구
    • 한국전산유체공학회:학술대회논문집
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    • 한국전산유체공학회 2000년도 춘계 학술대회논문집
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    • pp.27-32
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    • 2000
  • In this study, the three-dimensional blood flow within the sac of KTAH(Korean artificial heart) is simulated using fluid-structure interaction model. The numerical method employed in this study is the finite element commercial package ADINA. The thrombus formation is one of the most critical problems in KTAH. High fluid shear stress or stagnated flow are believed to be the main causes of these disastrous phenomenon. We solved the fluid-structure interaction between the 3D blood flow in the sac and the surrounding sac material. The sac material is assumed as linear elastic material and the blood as incompressible viscous fluid. Numerical solutions show that high shear stress region and stagnated flow are found near the upper part of the sac and near the comer of the outlet during diastole stage.

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외상성 심장파열의 외과적 고찰 (Traumatic Cardiac Perforation)

  • 성시찬
    • Journal of Chest Surgery
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    • 제12권4호
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    • pp.365-370
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    • 1979
  • The first Mitral Commissurotomy was performed for tight mitral stenosis on March 1957. The patient was at that time 22-year-old male, student. The longest follow 9p for 22 years and 8 months has been obtained. During the follow up period, late deterioration due to restenosis developed 4 years after initial good result and reoperation was succeeded by transventricular Mitral Valvotomy with Tubb`s ilator on April 1964. The possible cause of restenosis was attributed to recurrent rheumatic activity. After more than 13 years long-good life following 2nd operation, Endocarditis such as episode of high fever & chill intermittently followed by mild fever and night sweat, I t. tibial artery embolization and rupture of aortic cusp. At present, patient complained of no subjective symptom, enjoying ordinary life {NYHA II]. Blood pressure has been 110/50-60 mmHg, trivial diastolic murmur at apex and moderate degree of mechanical murmur on diastole at Erb`s rea. Neither signs of RVH for mitral stenosis nor sign of LVH. ST-T change for aortic regurgitation appeared yet during last 2 yrs. The patient`s are for prevention of Rheumatic activity and development of endocarditis is important for obtaining the better long-term result.

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유한요소법을 이용하여 확장기때 압력에 따른 심실심근의 응력 해석 (Stress analysis of ventricular myocarda according to heart pressure in diastole using finite element method)

  • 한근조;김상현;신정욱
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1994년도 춘계학술대회
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    • pp.131-135
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    • 1994
  • In order to study the shape and dimensions of heart, the procedures to reconstruct a three dimensional left ventricular geometry from two dimensional echocardiographic images is studied including the coordinate transformation, curve fitting and interpolation utilizing three dimensional position registration arm. Nonlinear material property of the left ventricular myocardium was obtained by finite element method performed on the reconstructed geometry and optimization techniques which compare the computer predicted 3D deformation with the experimentally determined deformation. Afterwards using the obtained nonlinear material propertry the stress distribution related with oxyzen consumption rate was analyzed.

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Performance Comparison Between the Envelope Peak Detection Method and the HMM Based Method for Heart Sound Segmentation

  • Jang, Hyun-Baek;Chung, Young-Joo
    • The Journal of the Acoustical Society of Korea
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    • 제28권2E호
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    • pp.72-78
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    • 2009
  • Heart sound segmentation into its components, S1, systole, S2 and diastole is the first step of analysis and the most important part in the automatic diagnosis of heart sounds. Conventionally, the Shannon energy envelope peak detection method has been popularly used due to its superior performance in locating S1 and S2. Recently, the HMM has been shown to be quite suitable in modeling the heart sound signal and its use in segmenting the heart sound signal has been suggested with some success. In this paper, we compared the two methods for heart sound segmentation using a common database. Experimental tests carried out on the 4 different types of heart sound signals showed that the segmentation accuracy relative to the manual segmentation was 97.4% in the HMM based method which was larger than 91.5% in the peak detection method.

Congenital mitral valve stenosis in a Chinchilla cat

  • Lu, Ta-Li;Hung, Yong-Wei;Choi, Ran;Hyun, Changbaig
    • 대한수의학회지
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    • 제56권3호
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    • pp.197-200
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    • 2016
  • A one-year-old, 3.25 kg intact male Chinchilla cat presented with acute right hind limb paralysis. Diagnostic imaging studies found cardiomegaly with interstitial lung pattern, abnormal mitral valve leaflets without maximum opening at the end of the ventricular diastole and during atrial systole and severe mitral inflow obstruction. Based on these findings and its young age, the case was diagnosed as congenital mitral valve stenosis. Treatment was directed to stabilize clinical conditions related to heart failure, to prevent further formation of thrombus and to relieve pain associated with thromboembolism. After one month of therapy, hind limb motor function was fully recovered.

PID 제어기를 이용한 좌심실보조장치의 제어 (PID control of left ventricular assist device)

  • 정성택;김훈모;김상현
    • 제어로봇시스템학회논문지
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    • 제4권3호
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    • pp.315-320
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    • 1998
  • In this paper, we present the PID control method for the controlling flow rate of highly complicated nonlinear Left Ventricular Assist Device(LVAD) with pneumatically driven mock circulatory system. Beat Rate (BR), Systole-Diastole Rate (SDR) and flow rate are used as the main variables of the LVAD system. System modeling is completed using the neural network with input variables (BR, SDR, their derivatives, actual flow) and an output valiable(actual flow). Then, as the basis of this model, we perform the simulation of PID control to predict the performance and tendency of the system and control the flow rate of LVAD system using the PID controller. The ability and effectiveness of identifying and controlling a LVAD system using the proposed algorithm will be demonstrated through computer simulation and experiments.

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PPG 기반 심박동수 추정 알고리즘 (Tracking Heart Rate Algorithm Based on PPG)

  • 백용현;이근상;박영철
    • 한국정보전자통신기술학회논문지
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    • 제2권3호
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    • pp.71-78
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    • 2009
  • 본 논문에서는 측정된 PPG 신호로부터 심박동수를 추정 하는 방법을 제시한다. PPG 신호는 현관에 흐르는 혈류량을 측정한 것으로 심장의 수축과 이완에 영향을 받아 단일 주파수적인 특성을 가지며 이러한 특성을 이용하여 PPG 주파수를 2차 IIR 적응 놋치 필터로 추적한다. 적응 알고리즘을 통하여 지속적으로 필터 계수를 갱신하여 얻어진 PPG 주파수를 바탕으로 사람의 심박동수를추정한다.

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An Unusual Biatrial Cardiac Myxoma in a Young Patient

  • Azari, Ali;Moravvej, Zahra;Chamanian, Soheila;Bigdelu, Leila
    • Journal of Chest Surgery
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    • 제48권1호
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    • pp.67-69
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    • 2015
  • This is a report of a biatrial cardiac myxoma in a young man with a 10-month history of exertional dyspnea and palpitation. The echocardiogram revealed biatrial myxoma prolapsing through the mitral and tricuspid valves during diastole. All cardiac chambers were enlarged and dysfunctional. The electrocardiogram revealed a rapid ventricular response with atrial flutter rhythm. The masses were resected and diagnosed as myxoma by a histological examination. The follow-up echocardiogram revealed significant improvement in ventricular function and reduction in the cardiac chambers' volume. There was no evidence of myxoma recurrence. The most probable cause of the patient's heart failure was considered to be tachycardia-induced cardiomyopathy.