• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.360-362
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• 2002

Myocardial tagging technique such as spatial modulation of magnetization (SPAMM) allows the study of myocardial motion with high accuracy. Tagging contrast of such a tagging images can affect to the accuracy of the estimation of tag intersection in order to analyze the myocardial motion. Tagging contrast can be affected by tagline spacing. The aim of this study was to investigate the relationship between tagline spacing of SPAMM image and tagging contrast-to-noise ratio (CNR) experimentally. One healthy volunteer was undergone electrocardiographically triggered MR imaging with SPAMM-based tagging pulse sequence at a 1.5T MR scanner (Gyroscan Intera, Philips Medical System, Netherland). Horizontally modulated stripe patterns were imposed with a range from 3.6mm to 9.6mm of tagline spacing. Images of the left ventricle (LV) wall were acquired at the mid-ventricle level during cardiac cycle with FEEPI (TR/TE/FA=5.8/2.2/10). Tagging CNR for each image was calculated with a software which developed in our group. During contraction, tagging CNR was more rapidly decreased in case of short tagline spacing than in case of long tagline spacing. In the same heart phase, CNR was increased corresponding with tag line spacing. Especially, at the fully contracted heart phase, CNR was more rapidly increased than the other heart phases as a function of tagline spacing.

• Journal of Chest Surgery
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• 제40권9호
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• pp.624-628
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• 2007

2001년부터 2006년까지 심실중격결손이 동반된 여러 부위의 좌심실유출로 협착 진단을 받은 3명의 신생아를 대상으로 하여 Norwood-Rastelli 술식을 시행하였다. 대상 신생아들의 체중은 $2.9{\sim}3.1 kg$ 이었으며 승모판막과 좌심실의 크기 및 형태는 정상이었다. 수술은 완전순환정지 없이 국소 관류하에서 자가 조직만을 이용하여 광범위하게 좌심실 유출로를 재건하는 수정된 Norwood 술식, 판막이 없는 우심막 도관을 이용하여 우심실과 폐동맥을 연결하는 Rastelli 형태의 술식 및 좌심실에서 폐동맥 판막으로 혈류가 가도록 연결하는 심실중격결손 폐쇄술을 시행하였다. 모두 수술 후 특별한 문제는 없었다. 추적 관찰 중 1명에서 수술 7개월 뒤 우심실유출로 도관의 협착으로 심도자술 도중 발생한 심정지와 이로 인한 합병증으로 사망하였다. 생존한 2명 중 1명은 우심실유출로 도관 협착으로 재수술을 받았으며 5년째 건강한 상태이며 나머지 환아도 1년째 건강한 상태로 외래 추적 중이다.

• Journal of Chest Surgery
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• 제18권4호
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• pp.692-699
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• 1985

Fifty cases of Open Heart Surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 1985. 1. The age of the congenital heart disease was from 7 to 29 years, the mean age was 14.5 years. In the acquired heart disease, the age was from 14 to 48 years, and the mean age was 22.3 years. The ratio of male to female was about 1.8:1. 2. The number of congenital cyanotic heart disease were 7 patients, congenital acyanotic heart disease were 17 patients and acquired valvular heart disease were 26 patients. All of the acquired heart disease was one or more valve disease. 3. Preoperative symptoms of the congenital heart disease were exertional dyspnea [cyanotic 100%, acyanotic 70.6%] and palpitation [cyanotic 28.6%, acyanotic 76.1%], and the acquired heart diseases were exertional dyspnea [92.3%], palpitation [34.1 %], and chest discomfort [30.8%]. 4. The method of the myocardial protection during the cardiopulmonary bypass were mild or moderate hypothermia, intermittent coronary perfusion of the cardioplegic solution, topical myocardial hypothermia with 4oC Hartmann`s solution. 5. In the cases of the valve replacement, postoperative oral anticoagulant therapy was started at oral intake of food using the warfarin and persantin, and the prothrombin time was maintained 30-50% of control value during 3-6 months for tissue valve replacement and permanently for metal valve replacement. 6. The postoperative complications were appeared in 24 cases and the complications were wound infection, occipital alopecia, hemorrhage etc. 7. The mortality after open heart surgery was 8 percents and the cause of death was low cardiac output syndrome, right heart failure, DIC, and Left ventricle rupture.

• 한국임상수의학회지
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• 제33권4호
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• pp.221-224
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• 2016

An 8 month-old male Maltese (weighing 2.0 kg) was referred with loud heart murmur at routine physical exam in local animal clinic. Electrocardiogram found left ventricular hypertrophy pattern (4.5 mV R-wave). Diagnostic imaging studies revealed the elongation of left ventricle (LV) with classic triple bumps on the main pulmonary artery, aorta and left atrium on the ventrodorsal view of radiograph. Echocardiography revealed patent ductus arteriosus (PDA) duct and continuous turbulent shunt flow (maximal velocity 4.83 m/s) between the aorta and pulmonary artery with left to right direction. The PDA in this dog was successfully closed through femoral vein (transvenous approach) using a 5 mm Amplatz$^{(R)}$ Canine Duct Occluder. To the best of author's knowledge, this is the first case of PDA occlusion treated with Amplatz Canine Duct Occluder through femoral vein.

• 대한수의학회지
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• 제50권1호
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• pp.49-53
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• 2010

A 5-year-old female Cocker spaniel dog (body weight 7.0 kg) was presented with primary complaints of exercise intolerance and loud precordial thrill which was noticed since she was a puppy. Physical examination revealed a grade V/VI continuous murmur over the maximal point of the left basal area, bounding femoral pulse, but no differential cyanosis. Tall R waves were detected in electrocardiogram, suggesting left ventricular enlargement. Diagnostic imaging studies showed enlarged left ventricle, bulged descending aorta (dAo), markedly dilated right pulmonary artery, and continuous shunt flow between the dAo and main pulmonary artery. Based on these findings, the dog was diagnosed as left to right shunted patent ductus arteriosus (PDA). The patent ductus arteriosus was treated by lodging a PDA duct occluder via the transvenous approach. Clinical signs were markedly improved after the ductal occlusion, the shunt flow was mildly persistent. The case presented is the first case of PDA occluded by the PDA duct occluder via the transvenous approach in a small breed of dog. Although the residual shunt flow was mildly persisted, the dog was clinically normal without detectable murmurs.

• Journal of Chest Surgery
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• 제19권1호
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• pp.68-74
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• 1986

15 patients with constrictive pericarditis who underwent interphrenic pericardiectomy from January, 1981 to April, 1983 and 11 patients who underwent radical pericardiectomy from May, 1983 to September, 1984 were compared to the clinical improvement and the results of pre- and postoperative cardiac catheterization. In the group of partial pericardiectomy the pericardium was removed anteriorly from the left phrenic nerve to the right phrenic nerve and in the group of radical pericardiectomy the pericardium was removed from almost entire surface of the heart including diaphragmatic surface and posterior wall of the left ventricle. The following results were obtained. 1. Both group of the patients showed marked symptomatic improvement early after operation. 2. The central venous pressure was decreased significantly after operation in both group of the patients. 3. The right atrial mean pressure and pulmonary arterial mean pressure decreased significantly after operation in both group of the patients and there was no significant difference in the amplitude of decrease between the two groups. 4. The right ventricular end-diastolic pressure and left ventricular end-diastolic pressure were decreased postoperatively in both group of the patients and the patients of the radical pericardiectomy showed more decrease than the patients of interphrenic pericardiectomy, and in the group of radical pericardiectomy the right and left ventricular end-diastolic pressure were normalized postoperatively but in the group of partial pericardiectomy they showed abnormally high pressure persistently. 5. The ejection fraction showed normal level pre- and postoperatively in both group of the patients.

• Journal of Chest Surgery
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• 제23권5호
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• pp.962-967
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• 1990

The anomalous pulmonary venous return of the entire left lung was an extremely rare congenital anomaly. The reported surgical experience with correction of this disorder was limited. The 3-year-old female patient underwent an operation upon the unilateral total anomalous pulmonary venous return from the left lung, in which the left superior pulmonary vein drained into innominate vein and the left inferior pulmonary vein into the coronary sinus, in Yeungnam University Hospital. The symptoms were nonspecific except frequent upper respiratory infection. Cyanosis was not seen. On auscultatory findings, a grade 2/6 systolic ejection murmur was audible over left second intercostal space of left sternal border and second heart sound had an increased pulmonary component which was widely splitted. The electrocardiogram demonstrated a right ventricular hypertrophy and right axis deviation and chest X-ray showed slightly increased pulmonary vascularity and bulged pulmonary conus. The echocardiogram demonstrated increased right atrial, ventricular, and pulmonary arterial dimension, and also secundum atrial septal defect and enlarged coronary sinus. The cardiac catheterization confirmed the left-to-right with a Qp/Qs of 2.0: 1 and oxygen step-up was seen in pulmonary artery, right ventricle, right atrium, and left innominate vein, and the catheter was not been introduced into the left pulmonary vein. A median sternotomy incision was done. Left superior pulmonary vein was drained to the innominate vein through anomalous vertical vein and the left inferior pulmonary vein drained to right atrium through the coronary sinus. The diversion of the left inferior pulmonary vein to posterior wall of left atrium was done after division in the proximity of coronary sinus. The anomalous vertical vein was diverted to base of left atrial auricle and then a atrial septal defect was sutured directly. The postoperative course was uneventful and she was discharged on the eleventh postoperative day. In the postoperative follow-up-2 months, she has been well without specific problems.

• 한국화재소방학회논문지
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• 제27권5호
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• pp.75-79
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• 2013

임신부의 경우 심폐소생술동안 좌측 기울림을 적용하도록 권장하고 있다. 하지만, 이 좌측으로 기울리면 임신부의 자궁 뿐만이 아니라 좌심실도 좌측으로 편위되어 심폐소생술의 심장펌프기능이 떨어질 가능성이 있다. 이에 좌측 기울림이 심폐소생술동안 흉골 운동 방향을 대변하는 전후축과 좌심실의 공간적 관계에 미치는 영향을 알아보고자 하였다. 컴퓨터 단층촬영을 이용한 가상내시경검사를 받은 90명의 환자를 대상으로 의무기록과 컴퓨터단층촬영결과를 후향적으로 조사하였다. 가상내시경은 앙와위와 좌측 기울림 위치 모두에서 실시되었다. 좌심실 단면적이 가장 넓은 축면에서 전후축과 좌심실축사이의 각도($Angle_{AP-LV}$), 전후축과 좌심실 중앙사이 최단거리($D_{AP-MidLV}$), 및 전후축과 좌심실첨부사이 최단거리($D_{AP-Apex}$)를 측정하였다. 대상환자 중 87명(96.7%)에서는 앙와위에서 좌심실이 전후축의 좌측에 위치하였다. 좌측으로 기울인 영상에서의 기울림 각도는 $43.4{\pm}11.0^{\circ}$였다. $D_{AP-MidLV}$와 $D_{AP-Apex}$는 좌측 기울린 위치에서 의미있게 길었지만 (p<0.001), AngleAP-LV는 두 자세 사이에 비슷했다. 심장정지인 임신부에서 좌측으로 기울림은 흉부압박의 심장펌프 효과를 떨어뜨릴 수도 있다.

• Journal of Chest Surgery
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• 제36권8호
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• pp.566-575
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• 2003

저자들은 본 연구에서 양대혈관우심실기시증에 대한 양심실 교정의 18년간의 임상 성적을 보고하고자 하였다 대신 및 방법: 1986년 5월부터 2002년 9월까지 양대혈관우심실기시증으로 양심실교정을 받은 112명의 환자를 대상으로 하여(남자 80명, 여자 32명) 형태학적 특성, 수술방법, 조기 사망과 재수술에 대한 위험 인자를 분석하였고, 생존율과 무재수술 생존율을 살펴보았다. 결과: 심실중격결손의 유형은 대동맥하형이 가장 흔하였고(n=58, 52%) 비교통형이 두 번째로 많은 유형이었다 n=32, 29%). 수술 방법은 심실 내 배플 수술(n=71, 63%),좌심실-대동맥 배플 후 우심실-폐동맥 인조도관 삽입술 또는 REV수술(n=24, 21.4%), 동맥전환술(n=14, 12.5%), Senning 술식(n=3, 2.7%) 등이었다. 34명(30%)에서는 교정 수술 전 고식 수술이 필요하였으며, 23명(21%)의 환아에서는 교정술 후 재수술이 필요하였다. 조기 사망은 12명(10.7%)이었고, 4예의 만기 사망이 있었다. 조기 사망의 위험인자로는 수술 당시 3개월 이하의 연령군(p=0.003), 심폐기 가동시간 및 대동맥 차단시간(p=0.015, p=0.067), 수술방법(동맥전환술)(p <0.001)과 심실중격결손의 유형(폐동맥하형(p=0.002)이 있었고, 다변량 석에서 3개월 이하의 수술 연령이 의미있는 위험 인자였다(p=0.011). 재수술의 위험인자는 교정술시 연령(1세 미만, p=0.02), 교정술 시 폐동맥분지성형술(p=0.024), 심실중격결손증의 유형(비교통형)(p=0.001), 수술 유형(인조도관 삽입술 및 REV수술)(p=0.028, p=0.017)이었고, 다변량분석에서 의미 는 위험 인자는 발견되지 않았다. 추적 관찰은 91명에서 이루어졌으며 평균 추적 관찰 기간은 10.8$\pm$56.4 (2~201)개월이었다. 5년, 10년 및 15년 생존율은 86.5%, 85%, 85%이었고 무재수술 생존율은 85%, 71.5%, 70% 이었다. 결론: 연구 결과 3개월 이하의 수술 연령군, 폐동맥하형 심실중격결손의 경우 조기 사망률이 의미있게 높았으며 이들 대부분은 동맥전환술을 받은 환아였다. 또한 비교통형 심실중격결손 환아와 페동맥 인조도관 삽입술 및 REV수술에서 재수술률이 높았다. 본 연구를 통해, 형태학적 특성과 연령을 고려하여 양대혈관우심실기시증에 대한 수술 전략을 수립하면 양심실 교정은 좋은 장기 성적을 기대해 볼 수 있다는 사실을 확인하였다.

• 대한의용생체공학회:의공학회지
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• 제14권4호
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• pp.307-314
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• 1993

Plasma protein adsorption is the first event in the blood-material interaction and influenc- es subsequent platelet adhesion towards thlㅈombus formation. Thiㅈomboembolic events are strongly influenced by surface characteristics of materials and fluid dynamics inside the blood pump. In vitro flow visualizaion and an amimal experiment with the moving actuator type TAH were Performed in order to investigate fluid dynamic effects on the protein adsorption. The diffel'encl level, j of shear rate inside the ventricle Lvere determined by consid- ering the direction of the major opening of four healt valves in the implanted TAH and the visualized flow patterns as well. Each ventricle of the explanted TAH was sectionalized into 12 segments according to the shear rate level. The adsorbed protein on each segment was quantified using the ELISA method after soaking in 2% (wye)SDS/PBS for two days. Adsorbed protein layer thicknesses Itvere measured by the Immunogotd method under TEM. The SEM observation show that right ventricle (RV) , immobilized with albumin, displayed different degrees of platelet adhesion on each segment, whereas the left ventricle (LV), grafted by PEO-sulronate, indicated nearly , iame platelet adhesion behavior, regardless of shear rates. The surface concentrations of adsorbed proteins in the low shear rate region are hlghel'than those in the high region, which was confirmed statistically. A modified adsorption model of plasma protein onto polyurethane surface was suggested by considering the effect of the fluid dynamic characteristics.