• Journal of Chest Surgery
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• v.36 no.5
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• pp.343-347
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• 2003

Background: The femoral artery is the most common site of canuulation for cardiopulmonary bypass in surgery for type A aortic dissection. Recently, many surgeons prefer the axillary artery to the femoral artery as the arterial cannulation site for several benefits. We evaluated the safety and usefulness of axillary artery cannulation in surgery for acute type A aortic dissection. Material and Method: Between Oct. 1995 and Sep. 2001, 71 patients underwent operations for acute type A aortic dissection. The arterial cannula was inserted into the axillary artery in 31 patients (AXILLARY group, mean age=56), and into the femoral artery in 40 patients (FEMORAL group, mean age=57). We retrospectively compared the incidence of mortality, morbidities, and hospital course. Result: The mean duration of cardiopulmonary bypass and circulatory arrest were significantly shorier in the AXILLARY group (207 min and 39min, respectively) than in the FEMORAL group (263min and 49 min, respectively; P<0.05). Postoperative hospital stay was significantly shorter in the AXILLARY group than in the FEMORAL group (mean 15 days vs. 35 days, p<0.05). Although there was no difference in the incidence of new-onset permanent neurological dysfunction (3.2%, in the AXILLARY group, 2.5% in the FEMORAL group), the incidence of transient neurological dysfunction was significantly lower in the AXILLARY group (12.9% vs. 25%, p<0.05). In the FEMORAL group, two patients needed urgent conversion to cannulation site due to arch vessel malperfusion. In the AXILLARY group, there was only one patient who had a complication related to the cannulation, i.e., median nerve injury. Conclusion: Axillary artery cannulation was safe and helpful in decreasing the cerebral ischemic time and incidence of transient neuroligcal dysfunction in surgery for acute type A aortic dissection, It enabled us to approach the patients with aortic arch pathology more aggressively.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.177-184
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• 1996

Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.827-836
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• 1998

Background: Effective cardiopulmonary resuscitation (CPR) should provide acceptable hemodynamics for the vital organs during cardiac arrest and early restoration of spontaneous circulation that guarantees long-term, neurologically intact survival. CPR using heart-lung bypass has been suggested as an option for that use. This study was designed to determine the effectiveness of standard CPR techniques, closed-vs. open-chest CPR, which could be used in the future study verifying the role of heart-lung bypass CPR. Material and Method: By using adult mongrel dogs, closed-chest CPR (CCCPR, n=4) and open-chest CPR (OCCPR, n=5) were compared with respects to hemodynamics, restoration of spontaneous circulation(ROSC), and survival. Ventricular fibrillation-cardiac arrest (VF-CA) was induced by electrical shock in all animals. After 4 minutes of cardiac arrest, basic life support (BLS) was applied for 15 minutes and followed by advanced life support (ALS). ALS was maintained until achi ving ROSC but not longer than 30 minutes regardless of the recovery. Resuscitation procedures in either group were standardized by adopting the protocol of American Heart Association. Result: Prearrest baseline hemodynamic data was not different between two groups. During resuscitation, substantially higher systolic pressure was maintained in OCCPR group than in CCCPR group (45$\pm$15 vs. 33$\pm$11 mmHg during BLS, 83$\pm$36 vs. 44$\pm$15 mmHg during ALS; p=NS). Mean pulmonary arterial pressure went up to the level of mean systemic arterial pressures in CCCPR group and to half of that in OCCPR group, and had kept higher in CCCPR group throughout CPR (32$\pm$10 vs. 22$\pm$4 mmHg during BLS and 32$\pm$15 vs. 24$\pm$10 mmHg during ALS; p=NS). ROSC was obtained in 4 of 5 dogs receiving open-chest CPR and 2 of 4 closed-chest CPR. Prolonged survival was noted in all dogs in OCCPR group (6 to 1440 hours) but not in CCPR group (p<.05). Conclusion: These findings indicate that open-chest CPR can be more effective t maintain hemodynamics during cardiac arrest and to obtain restoration of spontaneous circulation and survival. Further experiment will be designed to compare heart-lung bypass CPR with open-chest CPR.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.523-529
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• 2002

Background: Previous reports present that the early results of coronary artery bypass grafting (CABG) has been improving with the accumulation of surgical experience. We conducted a retrospective analysis of the patients who received CABG to evaluate the recent results of CABG. Material and Method: Between January 1996 and August 2001, 154 patients underwent CABG at Hanyang University Hospital. There were 47 patients(group I) who were operated between 1996 and 1998, and 107 patients(group II) who were operated thereafter. The preoperative diagnosis, operative procedure, mortality, and complications were analyzed retrospectively. Result: There were 35 males and 12 females in group I, and 78 males and 29 females in group II, which shows similar ratio of sexes between the two groups. The average age of patients for group I and group II was $55.9{\pm}6.2$ years and $61.0{\pm}8.0$ years, respectively, showing a significant increase in group II(p<0.05). The average left ventricular ejection fraction(LVEF) for group I and group II was $54.6{\pm}11.8$% and $56.9{\pm}13.0$%, respectively. The number of patients who had previous MI in group I and group II were 13 patients(27.7%) and 14 patients(13.1%), respectively, which shows a significant difference (p<0.05). All procedures were performed using the cardiopulmonary bypass(CPB) and moderate systemic hypothermia. Myocardial protection was achieved using intermittent hypothermic ischemia under ventricular fibrillation state or cold crystalloid cardioplegic solution for most of group I patients, whereas cold blood cardioplegic solution was used for group II patients. The mean CPB times for group I and group II were $149.2{\pm}48.7$ minutes and $113.1{\pm}30.6$ minutes, respectively. The mean aortic cross clamp times for group I and group II were $81.3{\pm}26.5$ minutes $72.2{\pm}23.9$ minutes, respectively. These figures show that CPB and aortic cross clamp times were significantly reduced in group II(p<0.05). The use of the left internal thoracic artery(LITA) was increased from 42%(20/47) for group I to 81% (87/107) for group II. The mean number of grafts also significantly increased from $2.5{\pm}0.6$ for group I to $3.0{\pm}1.1$ for group II(p<0.05). Intra-aortic balloon pump(IABP) was applied in 7 cases in group I and 17 cases in group II. Of these, 28.6%(2/7) and 52.9%(9/17) were broadly applied preoperatively in patients with LVEF<40% or congestive heart failure. The operative mortalities for group I and II were 10.6%(5/47) and 0.9%(1/107), respectively, which shows significant decrease for group II(p.0.05). Conclusion: This report suggest that CABG using CPB can recently be performed more safely in virtue of the accumulation of surgical experience with reduction in CPB and aortic cross clamp times and improved surgical techniques and myocardial protection. And we think that the optimal treatment of patients with left ventricular dysfunction associated with congestive heart failure and the extended application of IABP, especially have contributed to the reduction of operative mortality and morbidity.

• Journal of the Institute of Convergence Signal Processing
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• v.16 no.2
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• pp.74-82
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• 2015

In this study, a BMW plant process control system model which produces BMW is suggested and the BMW plant process controller with the following functions is developed. The first function is to operate the electronic overload relays to stop the blower for a certain period of time and to re-operate it again when the blower is overloaded. The second function is to close the motor operated valve automatically in case of power failure to prevent the circulation from the guided tank to the compost throwing tank and to block leak from the compost throwing tank due to the failure of ball valve. The third function is to transfer produced BMW from the concentration tank to 4 storage tanks for automatic managing of the BMW output. A device to measure the signal of the BMW plant process controller and a test equipment are developed. The designed BMW plant process controller is checked to see if it operates correctly according to the design specifications. The sequence control method based on BMW plant process controller is developed at a low cost in this study, so it is expected to bring improvements in the stability and the efficiency of system and to cause reductions in the operation and the management costs in the future.

• Korean Journal of Remote Sensing
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• v.28 no.4
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• pp.421-434
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• 2012

Colored Dissolved Organic Matter (CDOM) is one of the important components of optical properties of seawater to determine ecosystem dynamics in a given marine area. The optical characteristics of CDOM may depend on the various ecosystem and environmental variables in the sea and those variables may vary region to region. Therefore, the retrieval algorithm for determining light absorption coefficient of CDOM ($a_{CDOM}$) using satellite remote sensing reflectance ($R_{rs}$) developed from other region may not be directly applicable to the other region, and it must be validated using an in-situ ground-truth observation. We have tested 6 known CDOM algorithms (three Semi-analytical and three Empirical CDOM algorithms) developed from other regions of the world ocean with laboratory determined in-situ values for the East Sea using field data collected during seven oceanographic cruises in the period of 2009~2011. Our field measurements extended from the coastal waters to the open oceanic type CASE-1 Waters. Our study showed that Quasi-Analytical Algorithm (QAA_v5) derived $a_{CDOM}$(412) appears to match in-situ $a_{CDOM}$(412) values statistically. Semi-analytical algorithms appeared to underestimate and empirical ones overestimated $a_{CDOM}$ in the East Sea. $a_{CDOM}$(412) value was found to be relatively high in the relatively high satellite derived-chlorophyll-a area. $a_{CDOM}$(412) value appears to be influenced by the amount of chlorophyll-a in seawater. The outcome of this work may be referenced to develop $a_{CDOM}$ algorithm for the new Korean Geostationary Ocean Color Imager (GOCI).

• Proceedings of the Korean Society for Agricultural Machinery Conference
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• 2017.04a
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• pp.164-164
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• 2017

스마트 돈사 환경의 복지 및 생산성 향상을 위하여 정량 분석법을 기반으로 한 모돈 관리의 중요성이 증가하고 있다. 모돈은 교배, 임신, 분만, 포유, 이유를 순환적 반복하여 이루어지는데 모돈의 관리는 돈사 농장의 생산성 및 경제성과 직결된다. 모돈 관리에 필요한 환경 및 계측정보를 획득하고 이 정보로부터 모돈의 개체관리를 극대화시키고 최적의 방안을 찾고자 지속적으로 계측이 가능한 모돈의 돈사 모니터링 시스템이 필요하다. 모돈의 행동특성 계측이 가능한 시스템이 필요한 이유는 모돈의 행동 특성(섭식 및 지제불량 등)에 상응하는 대사 불량, 질병 및 발정 징후 등을 조기에 발견할 수 있기 때문이다. 돈사 내에서 정지 상태로 판별이 되는 모돈의 지제상태(기립상태, 누운 상태, 앉은 상태)와 다르게 연속적인 움직임으로부터 판별되는 모돈의 섭식상태를 분석하기 위해서는 계측 시스템과 이를 분석해주는 시스템간의 시간적 차이를 최소화 할 수 있는 실시간 신호 처리 기술이 필수적이다. 모돈의 섭식을 정량적으로 지수화하기 위한 센서의 최소 SPS(sample per second)는 600 Hz($100Hz{\times}6$개)로서 최소 6개 ADC 채널과 최소 1,200 Hz 이상으로 샘플링 할 수 있는 마이크로 컨트롤러가 필요하다. 또한 16 비트의 분해능으로 1분 동안 연속 계측을 수행할 경우 필요한 정보량은 153,600 KByte ($1,200sample/s{\times}16bit/sample{\times}8Byte/bit$)으로 실시간 처리를 수행하기에 매우 큰 정보량이라 판단할 수 있다. 수행하고자 하는 정보처리 기법에 따라 다소 상이할 수 있으나, 1분을 주기로 모돈의 섭식 분석을 수행하고자 할 경우 최도 150 MByte의 정보량을 처리하기 위한 최소의 클럭수는 단순 대입의 경우 2.5 Mhz (clock/second) ($=1clock/Byte{\times}150MByte/60seconds$) 이며 덧셈(4 clock)의 경우 10 Mhz, 곱셈(16 clock)의 경우 40 Mhz의 클럭이 필요하다. 또한 정보의 저장 및 도시를 위해 필요한 부가적인 회로(LCD, SD메모리) 구동을 위해 필요한 클럭을 고려할 경우 추가적인 클럭이 필요하다. 이를 종합적으로 고려하여 120 Mhz ($= 40Mhz{\times}3$) 이상의 클럭이 필요하다고 판단할 수 있다. 또한 센서 계측 주기의 시간 분해능을 균등하게 유지하기 위해선 계측->도시->저장의 과정을 교차적으로 수행해야 한다. 이러한 과정을 거처 최종적으로 선정한 마이크로 프로세서는 ARM Cortex-M4이며 168 MHz로 연산 수행이 가능하여 목표하고자 하는 신호처리를 수행 할 수 있다. 현장 예비 실험을 통해 기대 성능을 만족하였으며, 시간 복잡도가 높은 연산을 대비하여 최적 시분할 스케쥴링 기법에 대한 보완이 필요하다고 판단되었다.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.96-101
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• 2009

Regional odontodysplasia(ROD) is relatively rare localized developmental anomaly of tooth formation in which hard tissue is affected. The maxilla is typically affected than the mandible, and especially the maxillary left quadrant is the most commonly involved. Females are affected twice as often as males, and there is no association with race. Its etiology remains undetermined, but local circulatory disorders, somatic mutations, virus infections, local trauma, hyperpyrexia, irradiation, metabolic disturbances, and hereditary transmission are considered as possible etiologic factors. The affected teeth are likely to be small, hypoplastic, brown, and grooved. Eruption failure or delay is frequently seen as well as abscess or fistulae formation in absence of caries. Radiographically, there is a lack of contrast between the enamel and dentin, both of which are less radiopaque than unaffected counterparts. Moreover, enamel and dentin layers are thin, giving the teeth a “ghost-like appearance”. The pulp chambers and canals are large, the roots seem like to be short and indistinct. A 2-year-3-month old boy came to the department of pediatric dentistry, Yonsei University, with the chief complaint of delayed eruption and abnormal tooth shape on the lower left quadrant. He was diagnosed as regional odontodysplasia based on the clinical and radiographic findings.

• Journal of Chest Surgery
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• v.33 no.11
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• pp.886-893
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• 2000

배경: 흉복부 대동맥류는 질환 자체가 광범위하고 수술 중 척수를 포함한 각종 장기의 보호 및 허혈 방지라는 면에서 아직도 수술 합병증이 높은 질환이다. 본 연구에서는 그 동안의 임상경험을 바탕으로 치료성적, 합병증 발생, 사망률 등을 검토하였다. 대상 및 방법: 1990년 1월부터 1999년 12월까지 흉복부동맥류로 수술을 시행한 38명의 환자를 대상으로 의무 기록 검토을 통한 후향적 분석을 시행하였다. 결과: 남자가 22명, 여자가 16명, 평륜 연령은 46.2$\pm$12.3세였고, 크로포드 진단분류 상 1형 이 13례(34.2%), 2형이 19례(50%), 3형이 4례(11%), 4형이 2례(4.8%)였다. 만성 대동맥박리증에 관련된 경우가 29례(76.3%)로 가장 많았고, Marfan 증후군이 동반된 경우가 9례(23.7%)에서 있었다. 원위부 대동맥 관류를 35례에서 시행하였으며, 고동맥-고정맥 심폐바이패스를 31례에서, 좌심방-고동맥 바이패스를 4례에서 시행하였다. 심폐바이패스를 이용한 31례중 4례에서 초저체온하 완전순환정지를 이용하였다. 대동맥 차단 중 복강내 주요 대동맥 분지로의 선택적 관류를 시행하였다. 대동맥류의 최대직경은 평균 8.2$\pm$2.4cm이었고, 동맥류가 파열된 경우는 11례(28.9%)에서 있었다. 전례에서 인조혈관을 이용한 대동맥의 치환술을 시행하였다. 단계적으로 흉복부 대동맥을 겸자하면서 인공혈관을 문합하였고, Adamkiewicz 동맥으로 생각되는 부위의 늑간 동맥을 문합해주었는데, 8번째부터 12번째 흉추 사이의 늑간 동맥 중 역류혈류가 나타나고 상대적으로 내경이 큰 것들을 문합해 주었다. 술 후 조기사망은 3례에서 있었으며, 사인은 심폐기 이탈 실패 (2례), 저혈압 및 산증(1례) 등이었다. 조기 합병증으로는 애성 5례, 출혈 5례, 창상간염 3례, 장기간의 인공호흡기보조가 3례 등이 있었다. 치명적인 조기 합병증인 하지마비는 2례(5.3%)에서 발생하였고, 이 중 1례는 대동맥의 심한 석회화로 늑간동맥을 문합해 주지 못했던 경우였다. 35명의 환자에서 평균 추적기간은 103.1$\pm$6.1 개월, 2년 생존율은 93.8%, 5년 생존율은 86.1%, 8년 생존율은 80.7%였다. 추척기간 동안 4례의 만기사망이 관찰되었고, 사인은 2례에서는 갑작스런 의식소실이 발생하여 규명하기 어려웠으며, 대동맥-식도루 발생에 의한 경우가 1례, 경동맥류 파열에 의한 경우가 1례 등이었다. 만기 합병증으로는 복부 대동맥류(2례), 상행 대동맥 및 대동맥 근부 확장(1례), 대동맥-늑막루(1례), 창상 부위 탈장(1례), 역행성 사정(1례) 등이 있었다. 결론: 저자들은 흉복부대동맥류의 수술에 있어 심폐우 회술 혹은 좌심방-고동맥 바이패스를 통한 원위부 관류 및 저체온법, 수술 시 척수의 혈류공급과 관련된 늑간동맥의 연결 등으로 주요 신경합병증의 발생을 줄이고 좋은 성적을 거두고 있다고 판단하였으며 향후 임상 경험 축적과 함께 보다 정련된 위험인자의 분석이 필요하다고 본다.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.1
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• pp.175-179
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• 2001

Regional odontodysplasia is a relatively rare condition in which both enamel and dentin are hypoplastic and hypocalcified. The result is localized arrest in tooth development. The etiology of regional odontodysplasia is uncertain, but, disturbance in vascular supply, somatic mutation, latent virus infection, trauma, hyperpyrexia, irradiation, nutrition, metabolic disorders and hereditary transmission are supported to be etiologic factors. Females are more often affected than males. (1.4 : 1). The maxillary arch is more often affected than the mandibular arch with the maxillary left quadrant being the most commonly involved. Affected teeth are hypoplastic, typically discolored yellow or yellowish brown, smaller in size and display a variety of surface marking including pitting and grooving. Radiographically, the teeth affected have been described to have a "ghost like" appearance or "fuzzy" appearance. Pulp calcification and denticles may be present within the pulp chambers of the affected teeth. In it's case, a 2 years old male visited for a treatment of uneruption of lower right teeth. Partial eruption of lower right deciduous central incisor and unerupted deciduous lateral incisor, deciduous canine and deciduous first molar showed severly delayed eruption state. On radiographic appearance, "Ghost like appearance", shortened root and opened apexes on lower right region were observed. It was suspected regional odontodysplasia with clinical and radiographic condition.