• International journal of advanced smart convergence
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• 제7권2호
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• pp.1-6
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• 2018

In this paper, we propose an automatic left ventricle segmentation method in computed tomography angiography (CTA) using separating energy function. First, we smooth the images by applying anisotropic diffusion filter to remove noise. Secondly, the volume of interest (VOI) is detected by using k-means clustering. Thirdly, we divide the left and right heart with split energy function. Finally, we extract only left ventricle from left and right heart with optimizing cost function including orientation term.

• Clinical and Experimental Pediatrics
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• 제56권3호
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• pp.101-106
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• 2013

Despite developments in surgical techniques and other interventions, right ventricular (RV) failure remains an important clinical problem in several congenital heart diseases (CHD). RV function is one of the most important predictors of mortality and morbidity in patients with CHD. RV failure is a progressive disorder that begins with myocardial injury or stress, neurohormonal activation, cytokine activation, altered gene expression, and ventricular remodeling. Pressure-overload RV failure caused by RV outflow tract obstruction after total correction of tetralogy of Fallot, pulmonary stenosis, atrial switch operation for transposition of the great arteries, congenitally corrected transposition of the great arteries, and systemic RV failure after the Fontan operation. Volume-overload RV failure may be caused by atrial septal defect, pulmonary regurgitation, or tricuspid regurgitation. Although the measurement of RV function is difficult because of many reasons, the right ventricle can be evaluated using both imaging and functional modalities. In clinical practice, echocardiography is the primary mode for the evaluation of RV structure and function. Cardiac magnetic resonance imaging is increasingly used for evaluating RV structure and function. A comprehensive evaluation of RV function may lead to early and optimal management of RV failure in patients with CHD.

• Journal of Chest Surgery
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• 제26권1호
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• pp.36-43
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• 1993

Sixty four children [aged 2 days to 9 years] , 58 with complete transposition of the great arteries, 5 with Taussig-Bing double outlet right ventricle, and 1 with double outlet left ventricle plus left ventricular type single ventricle, have undergone anatomic correction from November 1987 to August 1992. Eleven underwent previous operations: pulmonary artery banding[7], modified Blalock-Taussig shunt[2], coarctoplasty[2], aortic arch reconstruction[1] . Of 58 patients with TGA, Type A coronary arteries of Yacoub were seen in 50[86%]. U-shaped coroanry arterial flaps were transfered to the neoaorta using trap door technique, and neopulmonary arterial tract was constructed using glutaraldehyde fixed autopericardium with Lecompte maneuver. There were 18 hospital deaths [28.1%] with no late mortality. Mean follow-up of 20.4\ulcorner11.9 months were achieved in all survivors. Postoperative cardiac catheterizations were done in 14 cases. Mean pressure gradients of pulmonary and aortic outflow tract were 15.0 $\pm$2.6 and 4.2$\pm$1.4mmHg, mild aortic valve insufficiencies were found in 2, and mean cardiac index was 5.18$\pm$0.19 L/min/M2. We conclude that we should continue anatomic correction for the complex congenital heart anomalies with the malposition of the great arteries because myocardial function seems to be well preserved, though we are still on the learning curve.

• Clinical and Experimental Pediatrics
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• 제50권11호
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• pp.1055-1060
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• 2007

Right-sided heart failure is a major problem among patients with congenital heart diseases, due to the prevalence of congenital heart defects and the association of pulmonary hypertension. More attention is focused on the structure of the right heart particularly in association with congenital heart defects and chronic lung disease. The right ventricle (RV) may support the pulmonary circulation, and sometimes the systemic circulation (systemic RV) in congenital heart defects. Despite major progress being made, assessing the RV remains challenging, often requiring a multi-imaging approach and expertise (echocardiography, magnetic resonance imaging, nuclear and cineangiography). Evidence is accumulating that RV dysfunction develops in many of these patients and leads to considerable morbidity and mortality. While there is extensive literature on the pathophysiology and treatment of left heart failure, the data for right-sided heart failure is scarce. Therefore RV function in certain groups of congenital heart disease patients needs close surveillance and timely and appropriate intervention to optimise outcomes. An understanding of RV physiology and hemodynamics will lead to a better understanding of current and future treatment strategies for right heart failure. This will review right-sided heart failure with the implications of volume and pressure loading of the RV in congenital heart diseases.

• 융합정보논문지
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• 제8권5호
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• pp.131-135
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• 2018

현대인의 사망원인 2위를 차지하고 있는 심장병은 자각 증세 없이 갑자기 돌연사를 당할 수 있는 무서운 질병으로 예방이 중요하다. 심장병 중 대동맥판막 협착증을 판단하기 위해서 physioNet에서 제공하는 심음 데이터 중 S1과 S2 사이의 수축 심음 데이터를 이용하여 병명을 진단하였다. 대동맥 판막은 좌심실에서 대동맥으로 피가 유출되는 부위의 판막이다. 심장병 중 대동맥판막 협착증은 대동맥판막이 좁아져 좌심실의 수축 시 판막이 열리지 않는 질환이다. 위 논문에서는 정상인과 대동맥판막 협착증 환자를 합쳐 특징이 180개로 이루어진 3126개의 샘플 심음 데이터를 실험데이터로 사용하였다. 정상과 대동맥판막 협착증 환자를 구분하기 위해 가중퍼지신경망(NEWFM, Neural Network with Weighted Fuzzy Membership Function)이용하였다. 가중퍼지신경망의 특징선택 방법으로 가중치의 평균 방법을 이용하였으며, 분류 결과는 91.0871%의 정확도를 나타내었다.

• 한국멀티미디어학회논문지
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• 제6권3호
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• pp.444-454
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• 2003

심장 운동의 분석은 인체에 혈액을 공급하는 역할에 대한 평가이다. 심근의 움직임을 평가하기 위해서 본 논문에서는 좌심실 심근 모델을 수학적으로 구축하였으며, 심장의 움직임에 대한 파라미터를 이용하여 운동성을 상세화 하였다. 구축한 모델을 심장의 생화학적 반응을 보이는 게이트 심근 SPECT 영상에 적용시켜서, 모델과 게이트 심근 SPECT 영상 사이의 운동성을 분석하였다. 심근 모델은 sinusoidal 함수를 이용한 3차원 super-ellipsoidal 모델을 기반으로 생성하였으며 움직임과 형태의 변화를 주기 위한 파라미터 함수를 이용하여 좌심실 심근의 형태와 움직임에 대한 유사성을 모델화 하였다. 이 모델과 심근 게이트 SPECT 영상 데이터와 LSF 알고리즘을 이용하여 fitting 시킨 후 생성된 모델을 토대로 하여 심근 게이트 SPECT 영상의 영역별 운동성 방향과 크기를 산출하여 분석하였으며, 지역적 운동성의 표현을 위해 심장기능 평가에 사용되는 Bull's Eye형식의 map을 만들었다. SPECT를 이용한 심장의 기능평가로 움직임과 수축능, 혈류 등을 이용해서 하고 있으나 운동량에 대한 평가는 없다. 본 논문에서 제안한 모델을 이용한 심근 SPECT의 운동성 분석은 심장 기능 평가에 유용한 지표가 될 것으로 기대한다.

• Journal of Chest Surgery
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• 제29권1호
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• pp.86-89
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• 1996

심실중격 결손을 동반한 대 혈관전위 에서 심방교체술(denning Procedure)후에 동맥전환술로 성공적인 치료를 했기에 보고하는 바이다 15개월 남아는 생후 8개월에 심방교체술(Senning operation)을 받은 이후에 심부전의 악화로 입원하였다. 혈관조영술상 우심부전, 삼천판막 폐쇄부전 및 잔류 심실중격 결손이 있었고, 심도자 검사에서 폐동맥심실/(LV/RV) 압력비는 75185여서 Senning (심방교체술)을 해체하고, 심실중격 결손은 포편 (patch)봉합하였으며, 폐동맥 밴딩하지않고 동맥전환술을 시행하였다. 수술후 심실기능이 정상으로 회복되었고 잘지내고 있다.

• Journal of Chest Surgery
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• 제45권4호
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• pp.213-224
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• 2012

Tetralogy of Fallot (TOF) is an index lesion for all paediatric and congenital heart surgeons. In designing an appropriate operation for children with TOF, the predicted postoperative physiology must be taken into account, both for the short and long term. A favourable balance between pulmonary stenosis (PS) and pulmonary insufficiency (PI) may be critical for preservation of biventricular function. A unified repair strategy to limit both residual PS and PI is presented, along with supportive experimental evidence. A strategy for dealing with coronary anomalies and some comments regarding best timing of operation are also included.

• Investigative Magnetic Resonance Imaging
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• 제22권1호
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• pp.26-36
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• 2018

Purpose: Children born with single ventricle physiology demonstrate poor growth rate and suffer from malnutrition, which lead to increased morbidity and mortality in this population. We assume that an anabolic steroid, oxandrolone, will promote growth in these infants by improving myocardial energy utilization. The purpose of this paper is to study the efficacy of oxandrolone on myocardial energy consumption in these infants. Materials and Methods: We modeled single ventricle physiology in a lamb by prenatally shunting the aorta to the pulmonary artery and then postnatally, we monitored cardiac energy utilization by quantitatively measuring the first order reaction rate constant, $k_f$ of the creatine-kinase reaction in the heart using magnetization transfer $^{31}P$ magnetic resonance spectroscopy, home built $^1H/^{31}P$ transmit/receive double tuned coil, and transmit/receive switch. We also performed cine MRI to study the structure and dynamic function of the myocardium and the left ventricular chamber. The spectroscopy data were processed using home-developed python software, while cine data were analyzed using Argus software. Results: We quantitatively measured both the first order reaction rate constant and ejection fraction in the control, shunted, and the oxandrolone-treated lambs. Both $k_f$ and ejection fraction were found to be more significantly reduced in the shunted lambs compared to the control lambs, and they are increased in oxandrolone-treated lambs. Conclusion: Some improvement was observed in both the first order reaction rate constant and ejection fraction for the lamb treated with oxandrolone in our preliminary study.

• The Korean Journal of Physiology and Pharmacology
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• 제6권3호
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• pp.149-154
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• 2002

The blood pressure (BP) is regulated by the nervous system and humoral factors, such as renin- angiotensin system, vasopressin and others. In the present study, we examined the central effects of glutamate and GABA on the cardiovascular regulation by injection of these substances into the lateral ventricle and also investigated the relationship between these central effects and the action of angiotensin II (Ang). Male Sprague Dawley rats, $350{\sim}400$ g, were anesthetized with urethane and instrumented with an arterial catheter for direct measurement of BP and heart rate (HR), and an guide cannula in the lateral ventricle for drug injection. A glass microelectode was inserted into the rostral ventrolateral medulla (RVLM) for recording single unit spikes. Barosensitive neurons were identified by changes of single unit spikes in RVLM following intravenous injection of nitroprusside and phenylephrine. The effects of GABA and glutamate injected into the lateral ventricle were studied in single neuronal activity of the RVLM in addition to changes in BP and heart rate, and compared the results before and after treatment with intravenous losartan, nonpeptide Ang II-type 1 receptor antagonist (1 mg/100 g BW). Intracerebroventricular administration of GABA decreased systolic blood pressure (SBP) and HR, but increased the firing rates in the RVLM. However, intracerebroventricular glutamate injection produced effects opposite to GABA. After pretreatment of intravenous losartan, the central effects of GABA on BP and firing rate in the RVLM were significantly attenuated and that of glutamate showed a tendency of attenuation. These results suggested that central GABA and glutamate regulated BP and firing rates in RVLM were inversely related to BP change. The central effects of GABA or glutamate on the autonomic nervous function were modulated by humoral factor, Ang II, by maintaining BP.