• Journal of Chest Surgery
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• 제19권4호
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• pp.683-687
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• 1986

A direct communication between the left ventricle and right atrium is a relatively uncommon defect. Familiarity with this anomaly has become increasingly important, however, since the preoperative findings may be identical with those of an atrial septal defect. The left ventricle is directly related to the right atrium over. an area of the membranous ventricular septum which extends superior to the septal attachment of the right atrioventricular valve in the LV-RA communication. The clinical triad of a ventricular septal defect murmur, cardiac enlargement, and an arteriovenous shunt at atrial level is characteristic of the malformation. A 2-year-old boy with left ventriculo-right atrial communication has operated at the Maryknoll Hospital. Under the cardiopulmonary bypass, the atrium was opened, there was a jet-blood stream just above the atria-ventricular portion adjacent to the septal leaflet of the tricuspid valve.

• Journal of Chest Surgery
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• 제48권1호
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• pp.52-54
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• 2015

Idiopathic pulmonary arterial hypertension eventually leads to right-sided heart failure and sudden death. Its mortality rate in children is still high, despite improvements in pharmacological therapy, and therefore novel treatments are necessary. The Potts shunt, which creates an anastomosis between the left pulmonary artery and the descending aorta, has been proposed as a theoretically promising palliative surgical technique to decompress the right ventricle. We report the case of a 12-year-old girl with suprasystemic idiopathic pulmonary hypertension and right ventricular failure who underwent a Potts shunt for palliation with good short-term results.

• Journal of Chest Surgery
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• 제15권3호
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• pp.316-320
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• 1982

We had operated 5 cases of residual ventricular septal defect after primary repair of isolated ventricular septal defect from 1975 to 1981. Three were male and two were female. Their ages ranged from 7 to 25 years old. In 4 cases previous patch was detached and one case had left ventricular - right atrium communication. They had had residual symptoms after primary operation and chest x-ray showed cardiomegaly. Cardiac catheterization was performed in all cases. Residual left to right shunt was more than 1.4: 1 with pulmonary hypertension. Their postoperative course were uneventful and long term follow up revealed that they were good health until one to 4 years.

• Journal of Chest Surgery
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• 제33권3호
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• pp.257-261
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• 2000

Pulmonary arteriovenous fistula can occur in a variety of clinical situations including liver diseases, infections, metastatic carcinomas, systemic disorders, and after the palliation of congenital heart diseases. A 72-day-old male infant with Tetralogy of Fallot and pulmonary atresia underwent surgical correction without difficulty. However, ventilator weaning in the ICU failed initially because of an unexplained postoperative hypoxemia(FiO2: 0.8, PaO2: 40 mmHg, SaO2: 80∼90%). Postoperative follow-up lung perfusin scan at postoperative 15 days showed right-to-left shunt(33.6%) and ventilator weaning was performed on the 20th day after the operation (FiO2: 0.4, PaO2, 50mmHg, SaO2: 86.9%). Arterial oxygen saturation under room air was 80∼85% at 7 months postoperatively. One and half year follow-up lung perfusion scan showed decreased amount of right-to-left shunt (11.2%). We report a case with a review of the literatures.

• 대한의생명과학회지
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• 제15권1호
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• pp.17-23
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• 2009

The prevalence of patent foramen ovale (PFO) in healthy persons was estimated as about $10{\sim}25%$ and was up to 40% in patients with stroke. Transesophageal echocardiography (TEE) was considered to be the most sensitive method to detect PFO and was used as the gold standard. Transcranial doppler sonography (TCD) of the middle cerebral artery (MCA) during a contrast (saline bubble) injection has recently been proposed as an alternative detecting method for PFO. In this study, we would like to know the difference between TCD value and TEE value in subjects with cryptogenic ischemic stroke. We performed TCD and TEE tests to detect PFO on 64 patients (30 women and 34 men, mean age was 59.4 years) with cryptogenic ischemic stroke. PFO prevalence through TCD was 45.3% (29 of 64 patients) and the prevalence through TEE was 34.4% (22 of 64 patients). There was no statistical significance between PFO test and TCD test (P=0.206). But TCD had a sensitivity of 90.9% (20 of 22 patients), specificity of 78.6% (33 of 42 patients), positive predictive value of 69.0% (20 of 29 patients), and negative predictive value of 94.3% (33 of 35 patients). We concluded that TCD was a highly sensitive method for detecting a right-left shunt. Therefore, the non-invasive TCD test is a method more effective than the anti-invasive TEE test in the cost and evaluation of the existence or nonexistence of right to left shunt in addition to the screening method of the cerebrovascular disorder. Considering these points, TCD test could be recommended for patients with cryptogenic ischemic stroke as a useful and convenient method for screening of the existence or nonexistence of a right to left shunt caused by PFO.

• 전자공학회논문지
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• 제50권9호
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• pp.12-20
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• 2013

본 논문에서는 주파수 재구성 기능이 가능한 방사 구조 갖는 co-planar waveguide (CPW) 급전 방식의 영차 공진 안테나를 제작하고 측정하였다. 제안된 안테나의 단위 셀은 직렬 metal-insulator-metal (MIM) 형태의 커패시터와 두개의 단락된 병렬 스터브 인덕터로 구성되어 있다. 제안된 안테나는 두 개의 단위 셀을 갖는 composite right/left-handed (CRLH) 전송 선로에 근거하여 설계되었으며 선로의 끝단을 개방하여 선로의 병렬부에서 주된 전자파 에너지 방사가 이루어지도록 하였다. 안테나의 크기를 소형화시키는 동시에 다이오드 스위치 부착을 통하여 주파수 재구성 안테나를 구현하기 위하여 비아를 통하여 접지 면과 연결되어지는 4개의 $90^0$ 접혀진 단락 스터브 선로를 병렬 인덕터 구조로 사용하였다. 제안된 안테나의 영차 공진주파수는 3.09 GHz이고 전체 크기는 $0.22{\lambda}_0{\times}0.16{\lambda}_0$이다. 제작된 안테나의 측정 결과 영차 공진 주파수 2.97 GHz에서 안테나의 최대 이득과 임피던스 대역폭은 각각 3.1 dBi와 56MHz를 나타내었으며, 삼중 대역에서 동작하는 주파수 재구성 안테나시스템에 응용이 가능하다.

• Journal of Chest Surgery
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• 제28권8호
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• pp.759-765
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• 1995

We reviewed our experiences on 33 patients who underwent a bidirectional cavopulmonary shunt[BCPS from February 1992 to July 1994. There were 19 male an 14 female patients, and their weight ranged from 4.4 to 13.3 Kg[mean weight 8.4 $\pm$2.9 Kg . The age ranged from 2 to 55 months [mean age 16.7 $\pm$15.5 months . Their diagnosis included single ventricle group in 16, unbalanced ventricles in 8 whose associated anomalies were double outlet right ventricle, transposition of great arteries and total anomalous pulmonary venous return, tricuspid atresia in 7, hypoplastic left heart syndrome in 1 who underwent a Norwood procedure and double outlet right ventricle with pulmonic stenosis and tricuspid stenosis in 1 who underwent biventricular repair. Among them 10 patients had received other palliative operation before [Norwood procedure 1, pulmonary artery banding 3, modified Blalock-Taussig shunt 6 . The BCPS operations were performed under the cardiopulmonary bypass. 16 patients underwent unilateral BCPS and 17 patients who had bilateral SVC underwent bilateral BCPS. Three patients whose associated anomalies were interruption of IVC underwent total cavopulmonary shunt. There were 5 operative deaths [mortality rate 15.1 % and 2 late deaths. The risk factor for the operation was high mean pulmonary artery pressure [p value<0.05 . The survivors showed good postoperative course and their postoperative oxygen saturation was increased significantly compared to that of preoperative status[p value<0.05 .Conclusively, BCPS operation is effective and safe palliative procedure for the many cyanotic complex congenital anomalies with decreased pulmonary blood flow especialy for the patients who have the high risk factors for Fontan operations.

• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.270-272
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• 2012

A 31-year-old man was admitted to our hospital due to hydrocephalus with neurosarcoidosis. Ventriculo-peritoneal shunting was performed in the right lateral ventricle with intravenous methylprednisolone. Subsequently, after 4 months, additional ventriculo-peritoneal shunting in the left lateral ventricle was performed due to the enlarged left lateral ventricle and slit-like right lateral ventricle. After 6 months, he was re-admitted due to upward gaze palsy, and magnetic resonance image showed an isolated fourth ventricle with both the inlet and outlet of fourth ventricle obstructed by recurrent neurosarcoidosis. Owing to the difficulty of using an endoscope, we performed neuronavigator-guided ventriculo-peritoneal shunting via the left lateral transcerebellar approach for the treatment of the isolated fourth ventricle with intravenous methyl prednisolone. The patient was discharged with improved neurological status.

• 대한핵의학회지
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• 제36권3호
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• pp.203-208
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• 2002

만성간질환 환자에서 호흡곤란을 초래하는 간폐 증후군 발생한다는 사실은 잘 알려져 있다. 단락을 입증하기 위해서는 대비증강심초음파, 폐혈관조영술, $^{99m}Tc-MAA$ 폐관류스캔 등을 이용할 수 있다. 이 중에서도 $^{99m}Tc-MAA$를 이용한 폐관류스캔은 매우 안전하고 간편하게 단락의 존재 여부를 확인할 수 있으며, 단락의 양을 계산할 수도 있다. 정량이 가능하므로 병의 경과를 추적하는 지표로서도 유용할 것이다. 저자들은 $^{99m}Tc-MAA$ 폐관류스캔으로 진단한 간폐증후군의 증례를 문헌고찰과 함께 보고하였다.

• Journal of Chest Surgery
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• 제29권9호
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• pp.945-950
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• 1996

경북대학교병원 흉부외과학교실에서 1982년 4월부터 1995년 3월사이에 개심술을 시행하였던 좌심실-우심방 단락 12례에 대한 치료경험을 보고한다. 환자들의 연령은 3세에서 26세까지로, 평균연령은 8.5세 이 었고, 성별은 남자가 7명, 여자가 5명이었다. 술전의 단순흉부 X-선소견상 심흉비의 평균치는 0.59이었고, 폐혈관음영의 증가가 3례, 우심방의 확장이 4례에서 있었다. 기록을 확인할 수 있었던 9례에서의 술전 심초음파검사소견에 의하면, 진단명은 좌심실-우심방 단락 2례, 심실중격결손 6례 및 심방중격 결손 1례로 되어 있었다. 따라서 이 검사에 의한 좌심실-우심방판락의 진단률은 22.2%(219)였다. 술전의 심혈 관조영소견으로는, 좌심실-우심방 단락 5례, 심실중격결손 5례, 심방중격결손 1례, 그리고 심실중격 결손 및 심방중격결손 1례로 진단되었다. 그러므로 이 검사에 의한 진단률은 41.6% (5112)였다. 수술소견상, 좌심실-우심방 단락의 형태는 판막상부형 결손 5례(42%), 판막하부형 결손4례(33%)및 복합형 결손3 례 (25%)로 분류되었다. 한편 판막하부형 결손례들은 모두 삼첨 판막 중격엽의 이상을 동반하고 있었는데, 즉 천공이 3례, 구열\ulcorner 1례에서 있었다. 그러나 판막상부형이나 복합형 결손에서는 삼첨판의 이상은 볼 수 없었다. 수술은 1례를 제외하고는 모두 우심방절개하에 결손부의 일차봉합을 시행하였고, 수술사 망례는 없었다. 그러나 잔존 심실중격 결손이 1례에서 발견되어 술후 6개월에 재수술을 시행하여 완치되었다. 그밖의 환자들에서의 술후 경과는 모두 양호하였다.