• 한국임상수의학회지
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• 제21권3호
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• pp.314-318
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• 2004

A 7-month-old 8.2 kg female Siberian Husky with history of exercise intolerance, delayed growth, and tachypnea was presented to Veterinary Medical Teaching Hospital, Kyungpook National University. A holosystolic murmur was identified in cardiac ausculation. In electrocardiography, thoracic radiographs, and ultrasonography, a right axis deviation, enlarged right ventricle, stenotic main pulmonary artery, large ventricular septal defect, marked right ventricle hypertrophy, and overriding aorta with dilation were identified. The color Doppler examination showed the left-to-right shunting of blood via interventricular septal defect and the blood flow streams converging from the right and left ventricles into the aorta. The dog was diagnosed as tetralogy of Fallot. The current state of the dog is well-tolerated without any specific medication.

• 한국임상수의학회지
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• 제16권2호
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• pp.523-528
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• 1999

Subaortic stenosis in a 2.9kg, 3-month-old pug dog and a 11 kg, 4-month-old Rott -weiler dog showing signs of dyspnea, tachypnea, anorexia, exercise intolerance and depression was diagnosed with electrocardiography, thoracic radiography and ultrasonographic evaluation. In electrocardiography, PR interval widening, R wave amplitude increase in lead II in case 2, ST segment depression and left axis deviation in case 1 and 2 were identified. In thoracic radiographs, enlarged left ventricle and atrium, caudal displacement of left crus of diaphragm and caudal part of cranial mediastinum widening were identified in ventrodorsal view. In lateral view, left ventricular enlargement, secondary dorsal deviation of trachea and post-stenotic dilation of aorta were seen. Also, edematous pulmonary changes were shown in peri-hilar area. In ultrasonographic examination, left ventricular dilatation, pericardial effusion and subaortic valvular ridge were seen with real time B-mode in right parasternal long axis view. Aortic valve regurgitation was identified in color-Doppler mode.

• 대한의용생체공학회:의공학회지
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• 제5권1호
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• pp.1-4
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• 1984

Balancing left/right cardiac output is essential for the automatic control of total artificial hearts(TAH). A fuzzy logic-based control method is presented. We use left atrial pressure(LAP) and right atrial pressure(RAP) as indicators for left/right balancing. The fuzzy controller has four input variables which are measured LAP and RAP and their gradients. Desired variations in left cardiac output(LCO) and right cardiac output(RCO) are calculated to keep LAP and RAP within the Physiological limits. Computer simulations were performed to adjust fuzzy membership functions for variables and verify this control method. Results from simulations showed that LAP and RAP returned to the physiological limits while AoP and PAP stayed within the physiological limits.

• Journal of Chest Surgery
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• 제24권10호
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• pp.979-986
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• 1991

From October 1988 to November 1989, seven patients underwent valve replacement during the active phase of native valve endocarditis. There were 4 males and 3 females whose mean age was 41 years[range, 16 to 68 years]. Preoperative two-dimensional and Doppler echocardiography showed vegetations and severe valvular regurgitation in all patients. Blood cultures were positive in 4, and negative in 3 patients Organisms were alpha-hemolytic Streptococcus in 2, Staphylococcus epidermidis in 1, Erysipelothrix rhusiopathiae in 1 patient Valve tissue cultures were negative in all patients. Intravenous antibiotic therapy had been done for 3 to 18 days in 5 patients pre-operatively and was not done in 2 patients, Indications for operation were heart failure in h, and systemic emboli in 1 patient. The aortic valve was involved in 3, mitral in 1, and both aortic and mitral in 3 patients, One operative death[14.4%] occurred in patient with cardiogenic shock before operation. Late death occurred in one on 14 months after operation. The remaining 5 patients were followed up over a two year period in good condition. In conclusion, native valve endocarditis with severe heart failure must be considered for early operation.

• 한국임상수의학회지
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• 제36권6호
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• pp.336-339
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• 2019

A castrated, 6-year-old, male Turkish Angora cat with a history of respiratory distress was referred to the hospital. Physical examination revealed a cardiac murmur, and thoracic radiographic findings revealed pleural effusion and cardiomegaly. Echocardiography showed abnormality of the tricuspid and mitral valve, and color-flow Doppler imaging revealed regurgitation between both atrium and ventricle. Based on the echocardiographic examination, tricuspid valve dysplasia concurrent with mitral valve dysplasia was diagnosed. However, the patient died a week after treatment. In necropsy, bilateral atrioventricular valve dysplasia and left ventricular hypertrophy were confirmed. This is the first report to describe a middle age Turkish angora cat having bilateral atrioventricular valve dysplasia which has high mortality and only been reported rarely in cats. This case report also describes its clinical signs, diagnostic imaging findings, treatment and discussions how the patient could live long.

• Clinical and Experimental Pediatrics
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• 제50권5호
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• pp.476-483
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• 2007

목 적 : 선천성 심장병을 가진 소아에서 체외 심폐 순환기를 이용한 개심술을 시행한 후 좌 우심실의 기능의 변화를 조직 도플러 영상을 이용하여 측정하고, 이를 개심술 이전과 비교함으로써 수술 이후의 심실 기능 변화를 살펴 보고자 하였다. 방 법 : 2005년 1월부터 2005년 12월까지 선천성 심장병으로 경북대학교병원 소아과에 입원하여 심초음파 및 진단적 심도자술 검사를 받은 후 개심술을 시행한 환자 총 78명 중 수술 전과 수술 후 1개월에서 3개월 사이에 심초음파를 시행하고, 두 번 모두 조직 도플러 영상이 기록된 환자 32명을 대상으로 하였다. 전체 환자군은 다시 3군으로 나누었는데, 좌심실 용적 과부하를 가지는 1군, 우심실 용적 과부하를 가지는 2군, 우심실 압력 과부하를 가지는 3군으로 분류하였다. 간헐파 도플러를 이용하여 승모판과 삼첨판 유입 혈류의 E, A 최대 속도를 측정하고, 조직 도플러 영상을 이용하여 심첨 4방도와 2방도에서 심실 중격, 승모판륜 및 삼첨판륜 외벽, 좌심실 후벽과 전벽의 기저부에서 Sm, Em, Am을 측정하였으며, E/Em을 구하였다. 결 과 : 개심술 당시 대상 환자 군의 평균 나이는 27개월(1개월-156개월)이었고, 남자 14명, 여자 18명이었다. 개심술을 시행한 심장병으로는 심실 중격 결손 13명, 심방 중격 결손 7명, 방실 중격 결손 3명, 단순 폐동맥 협착 2명, 및 활로씨 4징 7명이었다. 좌심실 용적 과부하 군인 1군의 승모판륜 외벽의 E/Em, 삼첨판륜 외벽의 Sm, Em, Am, 심실 전벽의 Em, Am, 우심실 용적 과부하 군인 2군의 삼첨판륜 외벽의 Sm, Em, Am, 심실 전벽의 Sm, Em, 심실 중격과 후벽의 Em, 우심실 압력 과부하 군인 3군의 삼첨판륜 외벽의 Sm, Em, Am, 심실 전벽의 Am 값들도 수술 전과 비교하여 수술 후에 통계학적으로 의미있는 감소가 있었다. 결 론 : 선천성 심장병 환자의 수술 전과 수술 후의 조직 도플러 영상 측정값을 비교하였을 때 모든 환자 군에서 삼첨판륜 외벽의 Sm, Em, Am 값의 감소를 보이고, 좌심실 용적 과부하군에서는 좌심실 이완기압을 반영한다고 할 수 있는 승모판륜 외벽의 E/Em 값이 수술 전에 비해 수술 후에 통계학적으로 유의한 감소를 보였다. 이들은 체외 심폐 순환기를 이용한 개심술의 심장에 대한 영향 및 선천성 심장병의 교정 후의 용적, 압력의 변화 영향을 모두 반영하는 것으로 생각된다. 그러나 이러한 결과가 어느 정도까지 체외 심폐 순환기를 이용한 개심술에 의한 영향을 반영하는지에 대해서는 더 많은 연구가 필요할 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제53권1호
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• pp.72-79
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• 2010

목 적 : 고혈압에서 이완기 기능 이상은 수축기 기능 장애가 나타나기 전에 질환 경과에 일찍 발견되고 흔하게 관찰된다. 이완기 심기능을 평가하기에는 TDI가 고식적 심초음파보다 더 우수한 것으로 알려져 있다. 그러나 소아 및 청소년에서의 연구는 많지 않은 실정이다. 청소년 고혈압에서 심실 기능 이상을 발견하는데 있어서 SRI의 유용성을 알아보고자 본 연구를 실시하였다. 방 법: 수축기 혈압이 140 mmHg 이상이거나 이완기 혈압이 90 mmHg이상인 고혈압을 가진 16-17세 사이의 38명의 청소년을 대상군으로 하였고, 같은 연령의 정상 혈압을 가진 청소년 19명을 대조군으로 하였다. M-mode 심초음파로 심실 중격 두께, 좌심실 후벽 두께를 측정하였고, 이면성 심초음파로 ejection fraction (EF), myocardial performance index (MPI)를 측정하였다. TDI를 이용하여 심근 수축기 심근속도, E 심근속도, A 심근속도를 측정하였고, SRI를 이용하여 strain과 strain rate을 측정하였다. 결 과: M-mode 심초음파 소견상 심실벽 두께, 좌심실 후벽 두께가 고혈압군에서 유의하게 증가하였다. EF, MPI와 modified MPI는 두군간에 유의한 차이가 없었다. 고식적 심초음파 검사결과 고혈압군에서 A 혈류속도가 유의하게 증가되었고, TDI 검사상 A 심근 속도는 고혈압군에서 유의하게 증가하였고 E/A 심근속도비는 유의하게 감소되었다. SRI에 의한 E strain rate은 고혈압군에서 기저, 중간 부위, 심첨부에서 유의하게 감소되었고, strain은 중격에서 고혈압군은 $19.15{\pm}8.65%$, 정상군은 $22.63{\pm}5.55%$으로 고혈압군에서 유의하게 감소하였다(P<0.05). 결 론 : 고식적 초음파로는 좌심실 이완기 기능 이상만 관찰되었으나 SRI로 좌심실 이완 기능 외에 수축 기능이 유의하게 감소됨을 알 수 있었다. SRI를 이용하여 심실 기능의 이상을 조기에 발견할 수 있었다. 앞으로 더 많은 고혈압 청소년을 대상으로 한 연구가 필요할 것으로 생각한다.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1031-1035
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• 1999

Background: ATS mechanical valve is a recently introduced pyrolytic carbon bileaflet prosthesis. This report is to evaluate the results of hemodynamic and anticoagulant therapy after ATS valve replacement. Material and Method: From May 1995 to October 1998, 53 patients received 65 ATS prosthesis; 38 Mitral(27-33 mm), 27 Aortic(19-25 mm). 2 CABGs and 5 Tricuspid annuloplasty were taken concomitantly. The follow up period was 769 patient-months(mean 16.2$\pm$10.0), varied from 1 month to 39 months with 92.5% follow up rate. All patients were evaluated with Doppler echocardiography, 7-14 days after operation. Result: NYHA functional class was improved significantly, from 2.6$\pm$0.8 preoperatively to 1.3$\pm$0.4 postoperatively. The average value of peak and mean transvalvular pressure gradients were 25.7$\pm$13.5 mmHg, 12.7$\pm$8.3 mmHg in aortic position. In the mitral position, the average values of peak and mean transvalvular pressure gradient and valve area were 5.9$\pm$2.5 mmHg, 3.1$\pm$0.8 mmHg and 2.9$\pm$0.5 $\textrm{cm}^2$, respectively. In the anticoagulant therapy, mean INR was 2.5$\pm$0.6 in mitral valve replacement and 1.9$\pm$0.5 in aortic valve replacement. There was no anticoagulant related complication. During that period, there were 3 hospital death(5.9%) and 1 late death(1.9%). Conclusion: The early clinical results of the ATS heart valve replacement is quite satisfactory, and low target INR reginmen is safe. And long term follow of hemodynamic characteristics is also necessary.

• Journal of Chest Surgery
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• 제31권12호
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• pp.1234-1237
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• 1998

Marfan 증후군과 같은 대동맥 질환의 경우 대동맥동 및 대동맥륜의 점진적인 확장 및 변형이 발생하여 대동맥판막의 폐쇄부전을 초래한다. 이런 경우 대부분 상행대동맥과 대동맥 판막을 composite graft의 형태로 치환하고 여기에 관상동맥을 문합하는 술식이 적용되어왔다. 본 증례는 Marfan 증후군이 동반된 22세 남자 환자로 대동맥 근부 확장과 승모판막 부전이 있었다. 수술은 대동맥 판막 및 좌심실유출로의 일부를 보존하면서 상행대동맥 및 Valsalva동의 동맥류를 제거하고, 대동맥 판막 및 관상동맥을 인조혈관에 다시 문합하는 술식을 적용하였다. 술후 심초음파 검사상 대동맥 판막의 기능은 정상이었다. 대동맥륜 확장증에 있어서 대동맥 판막이 정상적인 해부학적 구조를 가진다면 이상의 술식을 적용함으로써 자신의 대동맥 판막은 보존하면서 대동맥 근부를 치환할 수 있으리라 생각된다.

• 대한의생명과학회지
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• 제17권2호
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• pp.141-149
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• 2011

The purpose of this study was to find out any difference and correlation between the cardiac structure and its function according to the level of obesity as evaluated by waist measurement and BMI (body mass index) in healthy adults. For research subjects, the study selected a final 519 subjects excluding 198 subjects aged 55 or over out of 717 subjects who received echocardiography through a medical checkup at J General Hospital. For the criteria for obesity, men were defined as being obese in case their waist measurement was over 90 cm, whereas women were defined as being obese in case their waist measurement was over 80 cm. Also, regarding the BMI criteria, in case a person's BMI was 30 kg/$m^2$, the subject was classified as belonging to an obese group, and in case a person's BMI was between 25 kg/$m^2$ and 30 kg/$m^2$, the subject was classified as belonging to an overweight group. Concerning the evaluation of cardiac structure and function, they were evaluated using two-dimensional, M-mode, doppler echocardiography. According to the stage of obesity in accordance with waist measurement and BMI, the cardiac structure showed both eccentric and centripetal changes, and the cardiac function was also discovered to show differences according to the stage of obesity. In addition, also in the overweight group, which is a prior stage to obesity, out of the criteria for obesity classification according to BMI, there were differences in the cardiac structure and function. Also, both the waist measurement and BMI were found to have a correlation with cardiac structure and diastolic function. Consequently, cardiac structure and function are correlated with BMI and waist measurement, which are anthropometrical variables, and obesity is assumed to induce not only structural change but also functional change of the heart.