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Text Mining-Based Emerging Trend Analysis for e-Learning Contents Targeting for CEO (텍스트마이닝을 통한 최고경영자 대상 이러닝 콘텐츠 트렌드 분석)

  • Kyung-Hoon Kim;Myungsin Chae;Byungtae Lee
    • Information Systems Review
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    • v.19 no.2
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    • pp.1-19
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    • 2017
  • Original scripts of e-learning lectures for the CEOs of corporation S were analyzed using topic analysis, which is a text mining method. Twenty-two topics were extracted based on the keywords chosen from five-year records that ranged from 2011 to 2015. Research analysis was then conducted on various issues. Promising topics were selected through evaluation and element analysis of the members of each topic. In management and economics, members demonstrated high satisfaction and interest toward topics in marketing strategy, human resource management, and communication. Philosophy, history of war, and history demonstrated high interest and satisfaction in the field of humanities, whereas mind health showed high interest and satisfaction in the field of in lifestyle. Studies were also conducted to identify topics on the proportion of content, but these studies failed to increase member satisfaction. In the field of IT, educational content responds sensitively to change of the times, but it may not increase the interest and satisfaction of members. The present study found that content production for CEOs should draw out deep implications for value innovation through technology application instead of simply ending the technical aspect of information delivery. Previous studies classified contents superficially based on the name of content program when analyzing the status of content operation. However, text mining can derive deep content and subject classification based on the contents of unstructured data script. This approach can examine current shortages and necessary fields if the service contents of the themes are displayed by year. This study was based on data obtained from influential e-learning companies in Korea. Obtaining practical results was difficult because data were not acquired from portal sites or social networking service. The content of e-learning trends of CEOs were analyzed. Data analysis was also conducted on the intellectual interests of CEOs in each field.

Grouting Improvement through Correlation Analysis of Hydrogeology and Discontinuity Factors in a Jointed Rock-Mass (절리 암반의 수리지질 및 불연속면 특성 간 상관분석을 통한 그라우팅 계획 수립의 개선 방안)

  • Kwangmin Beck;Seonggan Jang;Seongwoo Jeong;Minjune Yang
    • The Journal of Engineering Geology
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    • v.34 no.2
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    • pp.279-294
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    • 2024
  • Large-scale civil engineering structures such as dams require a systematic approach to jointed rock-mass grouting to prevent water leakage into the foundations and to ensure safe operation. In South Korea, rock grouting design often relies on the experience of field engineers that was gained in similar projects, highlighting the need for a more systematic and reliable approach. Rock-mass grouting is affected mainly by hydrogeology and the presence of discontinuities, involving factors such as the rock quality designation (RQD), joint spacing (Js), Lugeon value (Lu), and secondary permeability index (SPI). This study, based on data from field investigations of 14 domestic sites, analyzed the correlation between hydrogeological factors (Lu and SPI), discontinuity characteristics (RQD and Js), and grout take, and systematically established a design method for rock grouting. Analysis of correlation between the variables RQD, Js, Lu, and SPI yielded Pearson correlation (r) values as follows: Lu-SPI, 0.92; RQD-Lu, -0.75; RQD-Js, 0.69; RQD-SPI, -0.65; Js-Lu, -0.47; and SPI-Js, -0.41. The grout take increases with Lu and SPI values, but there is no significant correlation between RQD and Js. The proposed approach for grouting design based on SPI values was verified through analysis and comparison with actual curtain-grouting construction, and is expected to be useful in practical applications and future studies.

Analysis of Waterbody Changes in Small and Medium-Sized Reservoirs Using Optical Satellite Imagery Based on Google Earth Engine (Google Earth Engine 기반 광학 위성영상을 이용한 중소규모 저수지 수체 변화 분석)

  • Younghyun Cho;Joonwoo Noh
    • Korean Journal of Remote Sensing
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    • v.40 no.4
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    • pp.363-375
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    • 2024
  • Waterbody change detection using satellite images has recently been carried out in various regions in South Korea, utilizing multiple types of sensors. This study utilizes optical satellite images from Landsat and Sentinel-2 based on Google Earth Engine (GEE) to analyze long-term surface water area changes in four monitored small and medium-sized water supply dams and agricultural reservoirs in South Korea. The analysis covers 19 years for the water supply dams and 27 years for the agricultural reservoirs. By employing image analysis methods such as normalized difference water index, Canny Edge Detection, and Otsu'sthresholding for waterbody detection, the study reliably extracted water surface areas, allowing for clear annual changes in waterbodies to be observed. When comparing the time series data of surface water areas derived from satellite images to actual measured water levels, a high correlation coefficient above 0.8 was found for the water supply dams. However, the agricultural reservoirs showed a lower correlation, between 0.5 and 0.7, attributed to the characteristics of agricultural reservoir management and the inadequacy of comparative data rather than the satellite image analysis itself. The analysis also revealed several inconsistencies in the results for smaller reservoirs, indicating the need for further studies on these reservoirs. The changes in surface water area, calculated using GEE, provide valuable spatial information on waterbody changes across the entire watershed, which cannot be identified solely by measuring water levels. This highlights the usefulness of efficiently processing extensive long-term satellite imagery data. Based on these findings, it is expected that future research could apply this method to a larger number of dam reservoirs with varying sizes,shapes, and monitoring statuses, potentially yielding additional insights into different reservoir groups.

Analysis of Applicability of RPC Correction Using Deep Learning-Based Edge Information Algorithm (딥러닝 기반 윤곽정보 추출자를 활용한 RPC 보정 기술 적용성 분석)

  • Jaewon Hur;Changhui Lee;Doochun Seo;Jaehong Oh;Changno Lee;Youkyung Han
    • Korean Journal of Remote Sensing
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    • v.40 no.4
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    • pp.387-396
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    • 2024
  • Most very high-resolution (VHR) satellite images provide rational polynomial coefficients (RPC) data to facilitate the transformation between ground coordinates and image coordinates. However, initial RPC often contains geometric errors, necessitating correction through matching with ground control points (GCPs). A GCP chip is a small image patch extracted from an orthorectified image together with height information of the center point, which can be directly used for geometric correction. Many studies have focused on area-based matching methods to accurately align GCP chips with VHR satellite images. In cases with seasonal differences or changed areas, edge-based algorithms are often used for matching due to the difficulty of relying solely on pixel values. However, traditional edge extraction algorithms,such as canny edge detectors, require appropriate threshold settings tailored to the spectral characteristics of satellite images. Therefore, this study utilizes deep learning-based edge information that is insensitive to the regional characteristics of satellite images for matching. Specifically,we use a pretrained pixel difference network (PiDiNet) to generate the edge maps for both satellite images and GCP chips. These edge maps are then used as input for normalized cross-correlation (NCC) and relative edge cross-correlation (RECC) to identify the peak points with the highest correlation between the two edge maps. To remove mismatched pairs and thus obtain the bias-compensated RPC, we iteratively apply the data snooping. Finally, we compare the results qualitatively and quantitatively with those obtained from traditional NCC and RECC methods. The PiDiNet network approach achieved high matching accuracy with root mean square error (RMSE) values ranging from 0.3 to 0.9 pixels. However, the PiDiNet-generated edges were thicker compared to those from the canny method, leading to slightly lower registration accuracy in some images. Nevertheless, PiDiNet consistently produced characteristic edge information, allowing for successful matching even in challenging regions. This study demonstrates that improving the robustness of edge-based registration methods can facilitate effective registration across diverse regions.

Cohort Observation of Blood Lead Concentration of Storage Battery Workers (축전지공장 근로자들의 혈중 연농도에 대한 코호트 관찰)

  • Kim, Chang-Yoon;Kim, Jung-Man;Han, Gu-Wung;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.324-337
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    • 1990
  • To assess the effectiveness of the interventions in working environment and personal hygiene for the occupational exposure to the lead, 156 workers (116 exposed subjects and 40 controls) of a newly established battery factory were examined for their blood lead concentration (Pb-B) in every 3 months up to 18 months. Air lead concentration (Pb-A) of the workplaces was also checked for 3 times in 6 months interval from August 1987. Environmental intervention included the local exhaust ventilation and vacuum cleaning of the floor. Intervention of the personal hygiene included the daily change of clothes, compulsory shower after work and hand washing before meal, prohibition of cigarette smoking and food consumption at the work site and wearing mask. Mean Pb-B of the controls was $21.97{\pm}3.36{\mu}g/dl$ at the preemployment examination and slightly increased to $22.75{\pm}3.38{\mu}g/dl$ after 6 months. Mean Pb-B of the workers who were employed before the factory was in operation (Group A) was $20.49{\pm}3.84{\mu}g/dl$ on employment and it was increased to $23.90{\pm}5.30{\mu}g/dl$ after 3 months (p<0.01). Pb-B was increased to $28.84{\pm}5.76{\mu}g/dl$ 6 months after the employment which was 1 month after the initiation of intervention program. It did not increase thereafter and ranged between $26.83{\mu}g/dl\;and\;28.28{\mu}g/dl$ in the subsequent 4 tests. Mean Pb-B of the workers who were employed after the factory had been in operation but before the intervention program was initiated (Group B) was $16.58{\pm}4/53{\mu}g/dl$ before the exposure and it was increased to $28.82{\pm}5.66{\mu}g/dl$(P<0.01) in 3 months later (1 month after the intervention). The values of subsequent 4 tests remained between 26.46 and $28.54{\mu}g/dl$. Mean Pb-B of the workers who were employed after intervention program had been started (Group C) was $19.45{\pm}3.44{\mu}g/dl$ at the preemployment examination and gradually increased to $22.70{\pm}4.55{\mu}g/dl$ after 3 months(P<0.01), $23.68{\pm}4.18{\mu}g/dl$ after 6 months, and $24.42{\pm}3.60{\mu}g/dl$ after 9 months. Work stations were classified into 4 parts according to Pb-A. The Pb-A of part I, the highest areas, were $0.365mg/m^3$, and after the intervention the levels were decreased to $0.216mg/m^3\;and\;0.208mg/m^3$ in follow-up tests. The Pb-A of part II was decreased from $0.232mg/m^3\;to\;0.148mg/m^3,\;and\;0.120mg/m^3$ after the intervention. Pb-A of part III and W was tested only after intervention and the Pb-A of part III were $0.124mg/m^3$ in Jannuary 1988 and $0.081mg/m^3$ in August 1988. The Pb-A of part IV not stationed at one place but moving around, was $0.110mg/m^3$ in August 1988. There was no consistent relationship between Pb-B and Pb-A. Pb-B of the group A and B workers in the part of the highest Pb-A were lower than those of the workers in the parts of lower Pb-A. Pb-B of the workers in the part of the lowest Pb-A incerased more rapidly. Pb-B of group C workers was the highest in part I and the lowest in part IV. These findings suggest that Pb-B is more valid method than Pb-A for monitoring the health of lead workers and intervention in personal hygiene is more effective than environmental intervention.

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A Legal Study on liability for damages cause of the air carrier : With an emphasis upon liability of passenger (항공운송인의 손해배상책임 원인에 관한 법적 고찰 - 여객 손해배상책임을 중심으로 -)

  • So, Jae-Seon;Lee, Chang-Kyu
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.2
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    • pp.3-35
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    • 2013
  • Air transport today is a means of transport that is optimized for exchanges between nations. Around the world, has experienced an increase in operating and the number of airline route expansion that has entered into the international aviation agreements in order to take advantage of the air transport efficient, but the possibility of the occurrence of air transport accidents increased. When compared to the accident of other means of transport, development of air transport accidents, not high, but it leads to catastrophe aviation accident occurs. Air Transport accident many international transportation accident than domestic transportation accident, in the event of an accident, the analysis of the legal responsibility of the shipper or the like is necessary or passenger air carrier. Judgment of the legal order of discipline of air transport accident is a classification of the type of air transport agreement. Depending on the object, air transport agreements are classified into the contract of carriage of aviation of the air passenger transportation contract. For casualties occurs, air passenger transportation accident is a need more discussion of legal discipline for this particular. Korean Commercial Code, it is possible to reflect in accordance with the actual situation of South Korea the contents of the treaty, which is utilized worldwide in international air transport, even on the system, to control land, sea, air transport and welcoming to international standards. However, Korean Commercial Code, the problem of the Montreal Convention has occurred as it is primarily reflecting the Montreal Convention. As a cause of liability for damages, under the Commercial Code of Korea and the contents of the treaty precedent is reflected, the concept of accident is necessary definition of the exact concept for damages of passengers in particular. Cause of personal injury or death of passengers, in the event of an accident to the "working for the elevation" or "aircraft" on, the Montreal Convention is the mother method of Korea Commercial Code, liability for damages of air carrier defines. The Montreal Convention such, continue to be a matter of debate so far in connection with the scope of "working for the lifting of" the concepts defined in the same way from Warsaw Convention "accident". In addition, it is discussed and put to see if you can be included mental damage passenger suffered in air transport in the "personal injury" in the damage of the passenger is in the range of damages. If the operation of aircraft, injury accident, in certain circumstances, compensation for mental damage is possible, in the same way as serious injury, mental damage caused by aviation accidents not be able to live a normal life for the victim it is damage to make. So it is necessary to interpret and what is included in the injury to the body in Korea Commercial Code and related conventions, non-economic damage of passengers, clearly demonstrated from the point of view of prevention of abuse of litigation and reasonable protection of air carrier it must compensate only psychological damage that can be. Since the compensation of delay damages, Warsaw Convention, the Montreal Convention, Korea Commercial Code, there are provisions of the liability of the air carrier due to the delayed arrival of passenger and baggage, but you do not have a reference to delayed arrival, the concept of delay arrangement is necessary. The strict interpretation of the concept of delayed arrival, because it may interfere with safe operation of the air carrier, within the time agreed to the airport of arrival that is described in the aviation contract of carriage of passenger baggage, or, these agreements I think the absence is to be defined as when it is possible to consider this situation, requests the carrier in good faith is not Indian or arrive within a reasonable time is correct. The loss of passenger, according to the international passenger Conditions of Carriage of Korean Air, in addition to the cases prescribed by law and other treaties, loss of airline contracts, resulting in passengers from a service that Korean Air and air transport in question do damage was is, that the fact that Korean Air does not bear the responsibility as a general rule, that was caused by the negligence or intentional negligence of Korean Air is proof, negligence of passengers of the damage has not been interposed bear responsibility only when it is found. It is a clause in the case of damage that is not mandated by law or treaty, and responsible only if the negligence of the airline side has been demonstrated, but of the term negligence "for" intentional or negligent "Korean Air's Terms" I considered judgment of compatibility is required, and that gross negligence is appropriate. The "Korean Air international passenger Conditions of Carriage", airlines about the damage such as electronic equipment that is included in the checked baggage of passengers does not bear the responsibility, but the loss of baggage, international to arrive or depart the U.S. it is not the case of transportation. Therefore, it is intended to discriminate unfairly passengers of international flights arriving or departure to another country passengers of international flights arriving or departure, the United States, airlines will bear the responsibility for the goods in the same way as the contents of the treaty it should be revised in the direction.

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Analysis of Greenhouse Thermal Environment by Model Simulation (시뮬레이션 모형에 의한 온실의 열환경 분석)

  • 서원명;윤용철
    • Journal of Bio-Environment Control
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    • v.5 no.2
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    • pp.215-235
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    • 1996
  • The thermal analysis by mathematical model simulation makes it possible to reasonably predict heating and/or cooling requirements of certain greenhouses located under various geographical and climatic environment. It is another advantages of model simulation technique to be able to make it possible to select appropriate heating system, to set up energy utilization strategy, to schedule seasonal crop pattern, as well as to determine new greenhouse ranges. In this study, the control pattern for greenhouse microclimate is categorized as cooling and heating. Dynamic model was adopted to simulate heating requirements and/or energy conservation effectiveness such as energy saving by night-time thermal curtain, estimation of Heating Degree-Hours(HDH), long time prediction of greenhouse thermal behavior, etc. On the other hand, the cooling effects of ventilation, shading, and pad ||||&|||| fan system were partly analyzed by static model. By the experimental work with small size model greenhouse of 1.2m$\times$2.4m, it was found that cooling the greenhouse by spraying cold water directly on greenhouse cover surface or by recirculating cold water through heat exchangers would be effective in greenhouse summer cooling. The mathematical model developed for greenhouse model simulation is highly applicable because it can reflects various climatic factors like temperature, humidity, beam and diffuse solar radiation, wind velocity, etc. This model was closely verified by various weather data obtained through long period greenhouse experiment. Most of the materials relating with greenhouse heating or cooling components were obtained from model greenhouse simulated mathematically by using typical year(1987) data of Jinju Gyeongnam. But some of the materials relating with greenhouse cooling was obtained by performing model experiments which include analyzing cooling effect of water sprayed directly on greenhouse roof surface. The results are summarized as follows : 1. The heating requirements of model greenhouse were highly related with the minimum temperature set for given greenhouse. The setting temperature at night-time is much more influential on heating energy requirement than that at day-time. Therefore It is highly recommended that night- time setting temperature should be carefully determined and controlled. 2. The HDH data obtained by conventional method were estimated on the basis of considerably long term average weather temperature together with the standard base temperature(usually 18.3$^{\circ}C$). This kind of data can merely be used as a relative comparison criteria about heating load, but is not applicable in the calculation of greenhouse heating requirements because of the limited consideration of climatic factors and inappropriate base temperature. By comparing the HDM data with the results of simulation, it is found that the heating system design by HDH data will probably overshoot the actual heating requirement. 3. The energy saving effect of night-time thermal curtain as well as estimated heating requirement is found to be sensitively related with weather condition: Thermal curtain adopted for simulation showed high effectiveness in energy saving which amounts to more than 50% of annual heating requirement. 4. The ventilation performances doting warm seasons are mainly influenced by air exchange rate even though there are some variations depending on greenhouse structural difference, weather and cropping conditions. For air exchanges above 1 volume per minute, the reduction rate of temperature rise on both types of considered greenhouse becomes modest with the additional increase of ventilation capacity. Therefore the desirable ventilation capacity is assumed to be 1 air change per minute, which is the recommended ventilation rate in common greenhouse. 5. In glass covered greenhouse with full production, under clear weather of 50% RH, and continuous 1 air change per minute, the temperature drop in 50% shaded greenhouse and pad & fan systemed greenhouse is 2.6$^{\circ}C$ and.6.1$^{\circ}C$ respectively. The temperature in control greenhouse under continuous air change at this time was 36.6$^{\circ}C$ which was 5.3$^{\circ}C$ above ambient temperature. As a result the greenhouse temperature can be maintained 3$^{\circ}C$ below ambient temperature. But when RH is 80%, it was impossible to drop greenhouse temperature below ambient temperature because possible temperature reduction by pad ||||&|||| fan system at this time is not more than 2.4$^{\circ}C$. 6. During 3 months of hot summer season if the greenhouse is assumed to be cooled only when greenhouse temperature rise above 27$^{\circ}C$, the relationship between RH of ambient air and greenhouse temperature drop($\Delta$T) was formulated as follows : $\Delta$T= -0.077RH+7.7 7. Time dependent cooling effects performed by operation of each or combination of ventilation, 50% shading, pad & fan of 80% efficiency, were continuously predicted for one typical summer day long. When the greenhouse was cooled only by 1 air change per minute, greenhouse air temperature was 5$^{\circ}C$ above outdoor temperature. Either method alone can not drop greenhouse air temperature below outdoor temperature even under the fully cropped situations. But when both systems were operated together, greenhouse air temperature can be controlled to about 2.0-2.3$^{\circ}C$ below ambient temperature. 8. When the cool water of 6.5-8.5$^{\circ}C$ was sprayed on greenhouse roof surface with the water flow rate of 1.3 liter/min per unit greenhouse floor area, greenhouse air temperature could be dropped down to 16.5-18.$0^{\circ}C$, whlch is about 1$0^{\circ}C$ below the ambient temperature of 26.5-28.$0^{\circ}C$ at that time. The most important thing in cooling greenhouse air effectively with water spray may be obtaining plenty of cool water source like ground water itself or cold water produced by heat-pump. Future work is focused on not only analyzing the feasibility of heat pump operation but also finding the relationships between greenhouse air temperature(T$_{g}$ ), spraying water temperature(T$_{w}$ ), water flow rate(Q), and ambient temperature(T$_{o}$).

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The Effects of Hypercapnia and High Flow on Cerebral Metabolism During Cardiopulmonary Bypass (심폐바이패스 시 고탄산분압과 고관류법이 뇌대사에 미치는 영향)

  • 강도균;최석철;윤영철;최국렬;정신현;황윤호;조광현
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.472-482
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    • 2003
  • Recent studies have demonstrated that cerebral desaturation during rewarming period of CPB was associated with postoperative neurologic dysfunction. The prevention of cerebral desaturation during CPB may reduce the incidences of neurologic and neuropsychological complications. The present study was prospectively undertaken to compare the clinical effects between two strategies (hypercapnic CPB and high flow CPB) to prevent cerebral desaturation for establishing a proper CPB technique. Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized into either hypercapnic (Pa$CO_2$ 45~50mmHg, n=18) or high flow group (flow rate 2.75 L/ $m^2$/min and Pa$CO_2$ 35~40mmHg, n=18) during rewarming period of CPB. In each patient, middle cerebral artery blood flow velocity ( $V_{MCA}$), cerebral arteriovenous oxygen content difference (C(a-v) $O_2$), modified cerebral metabolic rate for oxygen (MCMR $O_2$), cerebral oxygen transport rate ( $T_{E}$ $O_2$), incidence of cerebral desaturation (internal jugular bulb blood oxygen saturation $\leq$ 50%), increased rate of S-100 $\beta$ concentration, and arterial and internal jugular bulb blood gas were measured during the five phases of the operation; Pre-CPB, CPB-10 min (steady-state CPB, nasopharyngeal temperature 29~3$0^{\circ}C$), Rewarm-1 (rewarming phase, nasopharyngeal temperature 33$^{\circ}C$), Rewarm-2 (nasopharyngeal temperature 37$^{\circ}C$), and CPB-off. Incidence of postoperative delirium and duration were assessed in all patients. All variables were compared between the two groups. Result: $V_{MCA}$ (157.88$\pm$10.87 vs 120.00$\pm$6.18%, p=0.006), internal jugular bulb $O_2$ saturation (68.01$\pm$2.75 vs 61.28$\pm$2.87%, p=0.03) and $O_2$ tension (41.01$\pm$2.25 vs 32.02$\pm$ 1,67 mmHg, p=0.03), and $T_{E}$ $O_2$(110.84$\pm$7.41 vs 81.15$\pm$8.11%, p=0.003) at rewarming periods were higher in the hypercapnic group than in the high flow group. C(a-v) $O_2$ (4.0$\pm$0.30 vs 4.84$\pm$0.38 mg/dL, p=0.04), COE (0.36$\pm$0.03 vs 0.42$\pm$0.03, p=0.04), increased rate of S- 100$\beta$ (391.67$\pm$23.40 vs 940.0$\pm$17.02%, p=0.003), and incidence of cerebral desaturation (2 vs 4 patients, p=0.04) at rewarming periods, and duration of postoperative delirium (18 vs 34 hr, p=0.02) were low in the hypercapnic group compared to the high flow group. Conclusion: These results indicate that hypercapnic CPB may provide relatively diminished cerebral injury and beneficial effects for cerebral metabolism relatively compared to high flow CPB.low CPB.

Outcomes of Combined Mitral Valve Repair and Aortic Valve Replacement (대동맥판막 치환술과 동반시행한 승모판막 성형술 결과)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Soo-Cheol;Lim, Cheong;Kim, Wook-Sung;Lee, Young-Tak;Choi, Hyun-Seok;Moon, Hyun-Soo;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.463-471
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    • 2003
  • The long-term results of combined mitral valve repair and aortic valve replacement (AVR) have not been well evaluated. This study was performed to investigate the early and long-term results of mitral valve repair with AVR. Material and Method: We retrospectively reviewed 45 patients who underwent mitral valve repair and AVR between September 1990 and April 2002. The average age was 47 years: 28 were men and 17 women. Twelve patients had atrial fibrillation and three had a previous cardiac operation. The mitral valve disease consisted of pure insufficiency (MR) in 34 patients, mitral stenosis (MS) in 3, and mixed lesion in 8. Mitral valve disease was due to rheumatic origin in 24 patients, degenerative in 11, annular dilatation in 8, and ischemia or endocarditis in 2. The functional anatomy of mitral valve was annular dilatation in 31 patients, chordal elongation in 19, leaflet thickening in 19, commissural fusion in 13, chordal fusion in 10, chordal rupture in 6, and so on. Aortic prostheses used included mechanical valve in 32 patients, tissue valve in 12, and pulmonary autograft in one. The techniques of mitral valve repair included annuloplasty in 32 patients and various valvuloplasty of 54 techniques in 29 patients. Total cardiopulmonary bypass and aortic cross clamp time were 204$\pm$62 minute and 153$\pm$57 minutes, respectively. Result: Early death was in one patient due to low output syndrome (2.2%). After follow up of 57$\pm$37 months, late death was in one patient and the actuarial survival at 10 years was 96$\pm$4%. Recurrent MR developed grade II or III in 11 patients and moderate MS in 3. Three patients required reoperation for valve-related complications. The actuarial freedom from recurrent MR, MS, and reoperation were 64$\pm$11%, 86$\pm$8%, and 89$\pm$7% respectively. Conclusion: Combined mitral valve repair with AVR offers good early and long-term survival, and adequate techniques and selection of indication of mitral valve repair, especially in rheumatic disease, are prerequisites for better long-term results.

Assessment of Cerebral Hemodynamic Changes in Pediatric Patients with Moyamoya Disease Using Probabilistic Maps on Analysis of Basal/Acetazolamide Stress Brain Perfusion SPECT (소아 모야모야병에서 뇌확률지도를 이용한 수술전후 혈역학적 변화 분석)

  • Lee, Ho-Young;Lee, Jae-Sung;Kim, Seung-Ki;Wang, Kyu-Chang;Cho, Byung-Kyu;Chung, June-Key;Lee, Myung-Chul;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.3
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    • pp.192-200
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    • 2008
  • To evaluate the hemodynamic changes and the predictive factors of the clinical outcome in pediatric patients with moyamoya disease, we analyzed pre/post basal/acetazolamide stress brain perfusion SPECT with automated volume of interest (VOIs) method. Methods: Total fifty six (M:F = 33:24, age $6.7{\pm}3.2$ years) pediatric patients with moyamoya disease, who underwent basal/acetazolamide stress brain perfusion SPECT within 6 before and after revascularization surgery (encephalo-duro-arterio-synangiosis (EDAS) with frontal encephalo-galeo-synangiosis (EGS) and EDAS only followed on contralateral hemisphere), and followed-up more than 6 months after post-operative SPECT, were included. A mean follow-up period after post-operative SPECT was $33{\pm}21$ months. Each patient's SPECT image was spatially normalized to Korean template with the SPM2. For the regional count normalization, the count of pons was used as a reference region. The basal/acetazolamide-stressed cerebral blood flow (CBF), the cerebral vascular reserve index (CVRI), and the extent of area with significantly decreased basal/acetazolamide- stressed rCBF than age-matched normal control were evaluated on both medial frontal, frontal, parietal, occipital lobes, and whole brain in each patient's images. The post-operative clinical outcome was assigned as good, poor according to the presence of transient ischemic attacks and/or fixed neurological deficits by pediatric neurosurgeon. Results: In a paired t-test, basal/acetazolamide-stressed rCBF and the CVRI were significantly improved after revascularization (p<0.05). The significant difference in the pre-operative basal/acetazolamide-stressed rCBF and the CVRI between the hemispheres where EDAS with frontal EGS was performed and their contralateral counterparts where EDAS only was done disappeared after operation (p<0.05). In an independent student t-test, the pre-operative basal rCBF in the medial frontal gyrus, the post-operative CVRI in the frontal lobe and the parietal lobe of the hemispheres with EDAS and frontal EGS, the post-operative CVRI, and ${\Delta}CVRI$ showed a significant difference between patients with a good and poor clinical outcome (p<0.05). In a multivariate logistic regression analysis, the ${\Delta}CVRI$ and the post-operative CVRI of medial frontal gyrus on the hemispheres where EDAS with frontal EGS was performed were the significant predictive factors for the clinical outcome (p =0.002, p =0.015), Conclusion: With probabilistic map, we could objectively evaluate pre/post-operative hemodynamic changes of pediatric patients with moyamoya disease. Specifically the post-operative CVRI and the post-operative CVRI of medial frontal gyrus where EDAS with frontal EGS was done were the significant predictive factors for further clinical outcomes.