• 정보처리학회논문지:컴퓨터 및 통신 시스템
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• 제9권2호
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• pp.37-44
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• 2020

본 논문에서는 딥 러닝 기반의 전-자동 심장 분할 알고리즘을 제안한다. 본 논문에서 제안하는 딥 러닝 모델은 기존 U-Net에 residual recurrent convolutional block과 residual multi-dilated convolutional block을 삽입하여 성능을 개선한 모델이다. 모델의 성능은 테스트 데이터 세트를 전-자동 분할한 결과와 영상의학 전문가의 수동 분할 결과를 비교하여 분석하였다. CT 영상에서 평균 96.88%의 DSC, 95.60%의 precision과 97.00%의 recall 결과를 얻었다. 분할된 영상은 3차원 볼륨 렌더링 기법을 적용하여 시각화한 후 관찰하여 분석할 수 있었다. 실험 결과를 통해 제안된 알고리즘이 다양한 심장 하부 구조를 분할하기에 효과적인 것을 알 수 있었다. 본 논문에서 제안하는 알고리즘이 전문의 또는 방사선사의 임상적 보조역할을 수행할 수 있을 것으로 기대한다.

• Journal of Chest Surgery
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• 제52권5호
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• pp.368-371
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• 2019

A unicuspid aortic valve is a rare congenital malformation that frequently presents with valvular dysfunction and dilatation or aortic aneurysm, requiring combined aortic valve surgery and aortic repair. Some patients show severe valve calcification extending into the interventricular septum, possibly resulting in damage to the conduction system during debridement for valve replacement. We present a rare case of severe aortic stenosis with a unicommissural unicuspid aortic valve diagnosed by preoperative transesophageal echocardiography in a 36-year-old man. After composite graft replacement of the aortic valve, aortic root, and ascending aorta, a permanent pacemaker was placed because of postoperative complete heart block.

• Pediatric Infection and Vaccine
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• 제27권3호
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• pp.184-189
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• 2020

라임병은 진드기를 매개로 하여 보렐리아속균 감염에 의해 발생하는 세균 질환이다. 가장 흔한 증상으로 초기에 유주성 홍반이 대부분의 환자에게서 관찰되며, 신경, 심혈관계 및 관절을 침범하는 증상이 발현할 수 있다. 저자들은 미국 코네티컷주로 여행력이 있는 13세 남자에게서 발현한 라임병을 진단하여 보고하는 바이다. 환자는 2016년 여름에 미국에서 숲 체험에 참여하던 중 발열, 두통, 양쪽 무릎 관절통을 호소하여 귀국하였으며, 내원 시 양 하지에 다수의 유주성 홍반이 관찰되었다. 심전도 검사에서 1도 방실 차단이 확인되었다. 간접면역형광항체법과 웨스턴블럿법 검사에서 라임병 특이 IgM 항체가 양성으로 확인되었다. 경구 doxycycline으로 4주간 치료하였으며, 유주성 홍반이 소실되고 심전도가 정상 소견으로 회복되었다. 라임병의 진단에 있어 호발 지역으로의 여행력을 확인하는 것이 중요하다. 라임병에 의한 심장염은 무증상 방실 전도차단으로 나타날 수 있고 고도 방실 차단으로 진행할 수 있어 주의를 요하며 적절한 항생제 치료를 통해 회복될 수 있다.

• Journal of Chest Surgery
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• 제12권4호
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• pp.336-338
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• 1979

The electrocardiographic changes produced at surgery in all patients undergoing total correction of tetralogy of Fallot at the Seoul National University Hospital from 1961 through August 1979, were reviewed. Particular attention was directed to the presence of postoperative right bundle branch block combined with left anterior hemiblock and its prognosis. 14 patients [9.4%] out of 149 who were survived for 30 days postoperatively, showed right bundle branch block with left anterior hemiblock pattern in electrocardiography. But no complete heart block was occurred in these l 4 patients during the follow up periods of 2-56 months.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.339-346
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• 2022

Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.36-44
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• 2000

Objective : The heart diseases are known as a major cause of sudden death, as well as a cause of poor life-quality of school-age children. But there have been few mass screening of heart diseases in these children in Korea. This study was done to estimate the prevalence of heart diseases of these population. Methods : We screened all elementary students(grade 1) in 12 cities and 16 counties(Gun) in Kyonggi province from 1992 to 1955. The first screening was done by auscultation of doctors and simultaneously by checking using 'auto-interpreter of EKG-cardiac sound' (Fukuda Densi ECP 50A). We conducted luther examinations to whom classified as being abnormal condition in first screening, by using EKG, chest x-ray, doppler echocardiograpy(if needed). Results : The total number of examined students was 161,308(92% of the population), the male were 83,238 and female were 78,070. The congenital heart diseases(CHD) patients were 290(18 per 10,000) - male 155(18.6 per 10,000) and female 135(17.3 per 10,000). The most frequent disease was ventricula septal defect(VSD, 45.5%), Atrial septal defect(ASD, 14.8%), Tetralogy of Follot(TOF, 11.7%), and Patent Dutus Arteriosis(PDA, 7.6%) in order. In female, the order was VSD(48.1%), ASD(13.3%), TOF(11.1%), and PDA(10.4%). The total number of EKG abnormality were 433(62.7 per 10,000) among 69,056 screened children in 1995. The complete right bundle branch block(CRBBB) and paroxymal ventricular contraction(PVC) were frequent(26.6%, 26.3% in each), and incomplete right bunddle branch block(IRBBB, 14.6%), paroxymal atrial contraction(PAC, 6.7%), abnormal Q(5.8%), Wolf-Pakinson-White syndrom (5.5%) in order. In female, the most frequent abnormality was PVC(29.8%), and CRBBB(19.9%) in order. Conclusion : We could present the stable prevalence of the rare heart disease. The prevalence of congenital heart diseases was 18.0 per 10,000 and of EKG abnormality was 62.7 per 10,000 among school children.

• The Korean Journal of Pain
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• 제7권2호
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• pp.175-180
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• 1994

The impact of cardiovascular changes occurred by endotracheal intubation is risky for patients with ischemic heart disease, or intracranial pathologic conditions typically impairing cerebral autoregulatory mechanisms. Therefore, multiple approaches have been utilized to limit the impact of intubation and reduce damage of central nervous and cardiovascular systems. These approaches include modifications in intubation technique to diminish circulatory stimuli and pharmacologic modifications of either the sensory afferent path or the circulatory response itself. We tried the stellate ganglion block, a kind of sympathetic block, for the same purpose and evaluated the results. The results of study are as follows, 1) Blood pressure and heart rate increased significantly after intubation as compared with preintubation in both control group and SGB group. 2) The difference of the two groups is not found. We conclude the above method does not control cardiovascular consequences of endotracheal intubation.

• Korean Circulation Journal
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• 제48권11호
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• pp.1012-1013
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• 2018

• 한국임상수의학회지
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• 제24권3호
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• pp.422-425
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• 2007

6개월령 수컷 진도종 개가 교통사고에 의한 골반 골절 교정술을 위하여 내원하였다. 일반적인 수술 전 검사에서 마취와 관련해 위험성 있는 이상은 발견되지 않았다. 이 개는 아트로핀으로 전처치하고, 유도마취로 thiopental을 주사하였으며 유지 마취 약물로 isoflurane을 사용하였다. 수술 시작 40분 후 갑자기 서맥이 발생하여 아트로핀(18ug/kg)을 천천히 정맥주사 하였으나 즉시 맥박이 증가하지 않고 오히려 heart rate가 감소하며 방실 전도 차단($2^{nd}$ degree type I)이 발생하였다. 따라서 ephedrin을 즉각적으로 주사하였으며, 투여 7분 후 정상 심박으로 회복되었다. 본 증례는 개에서 고용량 atropine 투여로 드물게 발생하는 역설적 방실전도 차단 임상예이다.

• 한국임상수의학회지
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• 제26권5호
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• pp.476-479
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• 2009

Enucleation of a 9-year-old, spayed female Pekingese's right eye was scheduled because of recurrent eyeball rupture caused by chronic corneal ulcer and descemetocele. Scoliosis of the thoracic vertebra was observed on thoracic radiography. Complete blood count, electrolytes, serum chemistry profiles were within normal ranges except of alkaline phosphatase, which was markedly improved, compared with that of five months ago. Severe respiratory sinus arrhythmia was observed before induction of anesthesia, it disappeared after induction. Retrobulbar block was performed with 0.5% bupivacaine, 2% lidocaine, 0.1% epinephrine combination (4 : 1 : 0.2 ratio of volume) before start of surgery. After retrobulbar block, heart rate decreased from 110 to 76 beats/min and sinus arrhythmia recurred. It was considered as oculocardiac reflex caused by increase of intraorbital pressure from retrobulbar block, atropine (0.025 mg/kg, IV) was administered and intermittent positive pressure ventilation was started. Three minutes after atropine administration, abnormal waveform of the electrocardiograph was appeared, it suspected as ventricular or supraventricular tachycardia, so lidocaine (2 mg/kg, IV) was administered. Then, heart rate was maintained around 130 beats/min, and the surgery was finished without the other problems. Although, retrobulbar block is performed to provide analgesia and to prevent oculocardiac reflex in ophthalmic surgery, occasionally it could induce oculocardiac reflex by infiltrated volume.