• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.79-79
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• 2003

심실의 내부는 유두근이나 trabecular와 같은 해부학적 구조물들로 인해 복잡한 형태를 띄고 있다. 그러한 복잡한 구조는 MR 영상을 이용한 심박출량 측정시 오차를 유발시킬 수 있으며, 만약 오차를 줄이기 위해 수작업을 하게 된다면 많은 수고와 시간이 필요하게 될 것이다. 본 연구에서는 threshold 기법을 이용하여 짧은 시간동안에 정확하게 복잡한 구조를 가진 심실의 심박출량을 측정하고자 하였다. 7 명의 환자에 대해 l.5T 급 MR 장치 (INTERA, Philips, Netherlands)를 이용하여 short-axis cardiac MR 영상을 획득하였다. 한 환자에 대해서 8개에서 10개의 슬라이스 영상을 8-10 mm의 두께로, 하나의 심장주기(cardiac cycle)동안 일정한 시간간격으로 25 개의 영상을 획득하였으며, 펄스시퀀스로는 ECG-gated segmented balanced fast field echo (TR/TE = 3ms/1.56ms)를 사용하였다. 획득된 영상은 PC(threshold 기법)와 workstation (기존의 수동 및 자동 segmentation 기법)로 DICOM 형태로 전송되었다. 측정은 IDL을 이용하여 자체 제작된 소프트웨어와 상용화된 소프트웨어 (MASS 5.0, MEDIS, Netherlands)를 이용하여 분석되었다. MR 영상에서 심내벽 부위를 추출하기 위하여 자체제작된 소프트웨어로는 threshold 기법을, 상용 소프트웨어로는 기존의 수동 및 자동 기법을 이용하였다. 심박출량은 최대수축기와 이완기 사이의 용적 차이로써 계산되었으며, 좌심실 및 우심실 모두에 대해 수행되었다. 또한, 해부학적 구조의 복잡도에 따른 측정방법의 정확도를 확인하기 위해 유두근 및 trabecular의 hypertrophy의 정도를 3 단계로 구분하고 측정된 값들을 통계적으로 분석하였다. Hypertrophy가 약한 그룹에서는 기존의 수동방식과 threshold 기법간의 의미있는 차이가 없었으며 (p=0.372), 기존의 수동 및 자동방식 간에도 큰 차이가 없었다 (p=0.298). 그러나, hypertrophy가 심한 그룹에서는 수동방식 및 자동방식 측정치 사이에 통계적으로 유의한 차이를 보임을 알 수 있었다 (p=0.044). 그러나, threshold 기법과 수동방식 사이에는 유의한 차이가 없었다 (p=0.l94). 분석시간은 threshold 기법이 기존의 수동방식에 비해서 두배정도 빠르다는 것을 알 수 있었다, Threshold 기법은 심박출량 측정에 있어서 정확하면서도 빠른 결과의 도출이 가능했으며, 특히 심내벽의 구조가 복잡한 경우에 그 효과가 증대됨을 알 수 있었다.

• Journal of Chest Surgery
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• v.33 no.12
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• pp.963-967
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• 2000

정상심실중격의 폐동맥협착은 흔한 선천성 심장질환이지만 신생아기에 심한 증세를 보이는 위기적 폐동맥 협착은 드물며 예후도 대단히 나쁘다. 경피적 풍선 판막성형술의 발달과 함께 폐동맥협착의 외과적 치료는 더욱 줄어드는 추세이다. 본 증례는 정상심실중격의 위기적 폐동맥협착증으로 진단받은 생후 2일된 남자 신생아로 심한 청색증과 저산소증을 보여 응급실로 내원하였다. 환아는 산소공급 및 Prostaglandin E$_1$을 투여 후 동맥혈 산소 분압이 19 mmHg에서 54mmHg로 증가하였다. 경피적 풍선 판막성형술을 시도하였으나 유도도관(Guide wire)이 판막의 개구부를 통과하지 못하였고 시술도중 심낭내로 조영제가 고이는 소견을 보여 우심실 천공이 의심되었으므로 응급으로 정상체온의 체외순환하에서 폐동맥 절개후 폐동맥 판막절개술을 시행하였다. 수술 후 중환자실에서의 수술경과는 양호하였고 현재 수술 6개월째 외래 추적관찰중이다.

• Journal of Chest Surgery
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• v.36 no.10
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• pp.776-779
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• 2003

An eight-year-old boy was referred to our hospital with cough and high fever. His past medical history included a small sized ventricular septal defect (VSD) at birth. Transthoracic echocardiography disclosed a 10 x 6 mm vegetation on tricuspid valve, a small VSD and the moderate tricuspid valve insufficiency were found. Blood cultures grew methicillin-resistant staphylococcus aureus. Despite proper antibiotic therapy, fever was not controlled and his course was complicated by pulmonary infarction. The patient simultaneously underwent pulmonary resection and open heart surgery. Through the median sternotomy we performed open thrombectomy and lobectomy (right lower lobe) at first, and then vegetectomy, tricuspid valve repair, and direct closure of VSD were done under cardiopulmonary bypass.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.219-224
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• 2021

Leiomyosarcoma (LMS) is a soft tissue sarcoma that originates from smooth muscle cells. It is commonly found in the uterus but can occur throughout the body, including the retroperitoneal space, abdominal cavity, and any vascular structure. Although there are many case reports of uterine or vascular LMS metastasizing to the heart, cardiac metastasis from nonvisceral lesions has only been reported in two cases. Herein we report a rare case of a patient presenting metastatic LMS from the left flank in the right ventricle observed with echocardiography and enhanced computed tomography.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.320-329
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• 2003

Background : The serum B-type natriuretic peptide (BNP) is released from the ventricles as a response to volume or pressure overload of the ventricles. A few studies have reported that the BNP measurements are useful in differentiating between heart failure and pulmonary causes in patients who visited the emergency department with dyspnea as the chief complaint. It is difficult to differentiate a right heart failure from a left heart failure in the emergency room. However, there is no report on the application of a BNP assay to differentiate in right heart failure from left heart failure. In this study, the BNP levels were measured from dyspneic patients in the emergency department to determine whether or not the BNP level would be useful in differentiating the cause of the dyspnea from right ventricular failure and left ventricular failure. Method : 89 patients who visited emergency department of the Bundang Cha Hospital with dyspnea from June 2002 to March 2003 were selected. The 29 patients from the outpatient clinics and inpatients were randomly selected as the control. Results : The BNP levels of patients in the left heart failure group were significantly different from that of the patients in the right heart failure group ($682{\pm}314$ pg/mL vs. $149{\pm}94$ pg/mL, p=0.000). When the BNP cut-off level was designated as 219 pg/mL using the receiver operating characteristic curve, the sensitivity was 94.3%, and specificity was 92.9%. In addition, the positive predictive value was 97% and the negative predictive value was 86.7% in differentiating right heart failure from left heart failure. Conclusion : Measurements of the serum BNP levels is an accurate and rapid method that can aid in distinguishing between right heart failure and left heart failure.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.1010-1014
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• 2004

Though acute pulmonary thromboembolism is usually managed medically with the use of thrombolytics or anticoagulants, an emergent life-saving surgery would be required. In a case of acute pulmonary thromboembolism with acute severe right heart failure and deferment of it could result in fatal outcomes in a short time. In addition, the mortality is raised considerably if it is combined with right heart thrombi. Despite paradoxical thromboembolism via patent foramen ovale was reported, few report might be presented, in which showed the thrombus in right atrium has traversed atrial septal defect into left atrium and left ventricle like this case as the evidence of paradoxical thromboembolism. We report a case of acute pulmonary thromboembolism with acute right heart failure arising from deep vein thrombosis, developed immediately after low anterior resection for colon cancer in a 63-year-old male, who was managed successfully by emergent thromboembolectomy with cardiopulmonary bypass.

• Journal of KIISE:Computer Systems and Theory
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• v.27 no.7
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• pp.629-638
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• 2000

The main difference between mono-volume rendering and multi-volume rendering is data intermixing. In this paper, we first propose a selective rendering method for fast visualizing specific volume according to the surface level and then present data intermixing method for multiple volumes. The selective rendering method is to generate distance transformed volume using a distance transform to determine the minimum distance to the nearest interesting part and then render it. The data intermixing method for multiple volumes is to combine several volumes using intensity weighted intermixing method, opacity weighted intermixing method, opacity weighted intermixing method with depth information and then render it. We show the results of selective rendering of left ventricle and right ventricle generated from EBCT cardiac images and of data intermixing for combining original volume and left ventricular volume or right ventricular volume. Our method offers a visualization technique of specific volume according to the surface level and an acceleration technique using a distance transformed volume and the effective visual output and relation of multiple images using three different intermixing methods in three-dimensional space.

• Journal of Veterinary Clinics
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• v.26 no.1
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• pp.48-53
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• 2009

A 4-year-old intact male Shih Tzu dog (5.4 kg of body weight) was referred with primary complaints of heart murmur and exercise intolerance. Diagnostic studies found severe valvular pulmonic stenosis (peak velocity of 6.4 m/s, pressure gradient 165 mmHg). The dog was treated with 3 cm (length) ${\times}$ 1.5 cm (diameter) of Palmaz biliary stent. The outcome of stent placement was favorable and remarkably reduced the severity of PS (6.4 m/s to 3.0 m/s of peak velocity). Clinical condition was remarkably improved with the absence of cardiac murmur, although mild pulmonic regurgitation existed from the day of stent placement. To our best knowledge, this case is the first clinical trial for treating PS with intravascular stent in Korea.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.382-384
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• 2005

Background: It is very difficult to choose the ideal valved conduit used in right ventricle outflow reconstruction in child. We can use the cryopreserved homograft but there is a limit of application because of its difficulties in the size matching and supply capacity. The $Shelhigh^{(R)}$porcine-valved conduit is commercially available and used as an alternative choice in these days. We report two cases of early Shelhigh conduit failure in right ventricular outflow tract after Ross operation in congenital aortic stenosis.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.2
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• pp.265-269
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• 2019

Ebstein's anomaly is attached to the right ventricle with the tricuspid leaf attached to the lower right ventricle without any attachment to the tricuspid annulus. Most patients in their 20s are alive. Patients older than 25 years of age are similar in the incidence of heart failure and sudden death, and survive approximately 70% from 2 years, and 50% from 3 years, from 5% to over 50 years of age. Through this example, Ebstein's anomaly exists in various forms. A 22 year old case with WPW syndrome and those who survived to 77 years of age are reported. The normal heart structure in the apical four-chamber view should be observed on similar lines, even though the tricuspid annulus is slightly lower than the mitral annulus. If not, there will be some doubt regarding this anomaly. Furthermore, echocardiography plays an important role in the diagnosis and prognosis of congenital heart disease.