• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.177-180
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• 2010

Purpose: As PET test came to be covered by the pay system of medical insurance (July 1, 2006) and the needs for it becoming increased for laboratory purpose, it became necessary to purchase expensive medical equipments to solve those problems. However, as most of equipments that are operated by cyclotron are very expensive as to amount from tens of millions up to hundreds of millions of won, it is difficult to purchase those equipments from the point of medical organizations. It may be possible to self manufacture those equipments with least costs if their parts functions that meets the operators demands. The Nuclear Medicine department of National Cancer Center (NCC) is trying to manufacture and use equipments that can be made with least costs, including introducing 2 medical equipments that can improves the operator's works. Materials and Methods: Example 1: Self production of radioisotope($^{18}F$) divider was fabricated. The NCC's Nuclear Medicine department acquired one acrylic panel, seven 3-way valve, tubing etc. that can be found in the market to make the main body of divider in cooperation with biomedical engineering, and placed them inside hot cell, and installed switching box outside of hot cell to make it possible to control them from outside. This main body of divider were placed in radioisotope transfer line that are manufactured in the cyclotron. Example 2: Self production of $^{18}F$-FDG automated divider was fabricated. The NCC's Nuclear Medicine department used cavro pump syringe that consists the main body of divider in cooperation with biomedical engineering, biomedical engineering developed programs that divides a certain amount. $^{18}F$-FDG automated divider is placed inside hot cell, and cable chords were used in the equipment, and then it was connected to PC outside hot cell to make it possible to control the $^{18}F$-FDG automated divider. Results: From the NCC's Nuclear Medicine department tests that were carried out from March, 2007 until now, we found out that radioisotope can be sent to radiopharmaceuticals composite module we want, and from the tests that are carried out at NCC's Nuclear Medicine department using $^{18}F$-FDG automated divider since August, 2009 it was possible to distribute radiopharmaceuticals into vial intended. Conclusion: Through the two examples above, we found out that costs can be reduced by self manufacturing expensive equipments from NCC's cyclotron room with least costs. Also, it decreased radiation exposure dose on workers, and set up problem solving processes in cooperation with lots of parties related.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1049-1055
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• 1998

Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

• Journal of Veterinary Clinics
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• v.29 no.4
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• pp.271-276
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• 2012

In humans, N-terminal pro-B-type natriuretic peptide (NT-proBNP) was shown to be inversely related to obesity; in addition, its association with contributing factors for obesity such as insulin, lipids, and glucose profiles has been demonstrated in the literature. However, this association between NT-proBNP and the severity of obesity has not been investigated in veterinary medicine. Our study hypothesis is that plasma levels of NT-proBNP may be related to body condition score (BCS) and contributing factors to obesity in dogs with heart diseases. To achieve our study goal, we collected blood samples from 73 client-owned dogs of small breeds at different stages of heart failure due to chronic mitral valvular insufficiency (CMVI). Fasting glucose concentrations, lipid profiles (i.e., total triglycerides [TG], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C]), fructosamine, insulin and NT-proBNP concentrations were measured. The insulin/glucose ratio was also determined. NT-proBNP showed not only a significant correlation with the severity of CMVI related heart failure but also an inverse relationship to body condition scores (BCS), insulin plasma levels and fructosamine concentrations. We found the presence of an inverse relationship between plasma levels of NT-proBNP and the severity of obesity. In addition, NT-proBNP was associated with lower levels of contributing factors to obesity such as fructosamine and insulin, creating a possible link between the obesity and NT-proBNP in dogs with heart disease. This is also the first report demonstrating an inverse association between obesity and NT-proBNP in dogs with heart failure.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.624-628
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• 2007

Between 2001 and 2006, 3 neonates that had multilevel left ventricular outflow tract obstruction and a ventricular septal defect underwent the Norwood-Rastelli procedure. The body weights ranged from 2.9 to 3.1 kg. The patients had a near normal sized mitral valve and left ventricle. We simultaneously performed a modified Norwood procedure with native tissues-to-tissue anastomosis without circulatory arrest, and a Rastelli type procedure using a non-valved conduit from the right ventricle to the pulmonary artery and intracardiac patch baffling from the left ventricle to the pulmonary valve via the ventricular septal defect. The postoperative courses were uneventful. During follow-up, there was one late mortality caused by a cardiac catheterization related complication at 7 months after surgery, One patient required a Rastelli conduit change. Two patients are doing well during a follow-up period of 1 and 5 years, respectively.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.1-11
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• 2008

Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.

• Journal of the Korea Computer Graphics Society
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• v.24 no.3
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• pp.93-100
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• 2018

This paper proposes a small-scale rehabilitation system that allows stroke patients to perform daily rehabilitation training in a virtual home. Stroke patients have limited activities of daily living due to paralysis, and there are many rehabilitation exercises for them to reproduce activities that take place in the house, such as turning lights on and off, door opening and closing, gas valve locking. In this paper, we have implemented a virtual home with the above mentioned daily rehabilitation training elements, by using virtual reality technology. We use Leap Motion, a hand motion recognition device, for rehabilitation of hands and fingers. It is expected that stroke patients can rehabilitate small muscles without having to visit the clinic with uncomfortable body, and will be able to get interesting rehabilitation training by avoiding monotony of existing rehabilitation tools.

• Clinical and Experimental Pediatrics
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• v.61 no.2
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• pp.59-63
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• 2018

Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Results: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older ($16.25{\pm}1.85years$) than those in the nonventilator group ($14.73{\pm}1.36years$) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity ($1,038{\pm}620.41mL$) than the nonventilator group ($1,455{\pm}603.2mL$). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio ($1.7{\pm}0.44$) was lower in the home ventilator group than in the nonventilator group ($2.02{\pm}0.62$. The mitral valve annular systolic velocity was higher in the home ventilator group (estimated ${\beta}$, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Conclusion: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.565-570
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• 1995

Seventy-three patients with isolated total anomalous pulmonary venous connection the patients associated with other major cardiac anomalies such as single ventricle, DORV[Double Outlet Right Ventricle and large VSD[Ventricular Septal Defect were excluded were underwent surgical repair from January 1980 through October 1993. There were 45 boys and 28 girls. The mean age at operation was 19.9 months[range 6 days to 24 years and mean body weight was 7.1kg[range 2.6kg to 45kg . The anomalous locations of connection were supracardiac in 38, cardiac in 21, infracardiac in 5, and mixed in 9. In 38 patients[52% , the venous drainage was obstructed. The obstruction ratios according to the connection type were as follows: 53%[28/38 in supracardiac, 52%[11/21 in cardiac, 100%[5/5 in infracardiac, 22%[2/9 in mixed type. The associated cardiac anomalies were persistent left SVC[2 , tricuspid valve regurgitation[3 , cor triatriatum[1 , and mitral cleft[1 . And associated noncardiac anomalies were imperforate anus[1 and Neil Weightman syndrome[1 . The operative mortality was 23%. The causes of death were pulmonary hypertensive crisis, perioperative myocardial failure, pneumonia with sepsis, arrhythmia and etc. The statistically significant factors in postoperative mortality were the pulmonary venous obstruction and age [p<0.01 . The operative mortality was high in groups of age under 1 month and pulmonary venous obstruction. The mean follow-up was 27.1 months. There were two late deaths. The first patient was three months old boy with supracardiac type and severe obstructive symptoms. The postoperative echocardiography was showed anastomotic stenosis and reoperations were performed twice but the patients expired due to pneumonia and sepsis. The second patient was three month old boy with supracardiac type and total correction was done and was doing well postoperatively. Eight years later, he expired suddenly due to arrhythmia. But all the other patients were in NYHA Fc I and received no medications. The 5-year survival rate excluding early expired patients is 97.1 $\pm$ 0.03 %. In conclusion, although the operative mortality of total anomalous pulmonary venous connection was relatively high compared to other major cardiac anomalies, we could expect excellent long-term results by early surgical correction.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.3
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• pp.1229-1235
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• 2014

At the LPG vehicle air intake system, most of dust particles in the air cleaner are removed. However very small particles are not removed and accumulated. The accumulation of carbon in air intake system is going to affect the idle speed control and sensor signal. It also causes engine chattering and transmission troubles of automatic transmission. This is study about cleaning up intake system using cleaning chemical. We can clean up the intake system by spraying cleaning liquid onto intake device when the engine is idling after intake hose is removed from warmed up vehicle. We can obtain the following experimental results by cleaning up ISC, surge tank, intake manifold, intake valves and combustion chamber. According to this results, the stroll valve works correctly and power rate of engine is up to the standard, it is smoothy to control the idling speed when a vehicle pulls up. After cleaning up CO grow down about 0.15%, HC does about 20~100 ppm.

• Journal of Veterinary Clinics
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• v.26 no.2
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• pp.160-165
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• 2009

A 4-month-old intact male Boxer dog(9 kg of body weight) was presented with the primary complaints of heart murmur and exercise intolerance. Diagnostic studies revealed severe subaortic stenosis. Since the pressure gradient(PG) in stenotic aortic valve area was higher than ${\sim}120mmHg$(5.4 m/s of peak velocity), the dog was underwent balloon valvuloplasty. With this procedure, the peak aortic velocity was reduced to 3.9 m/s(${\sim}60mmHg$ of PG) and the clinical condition of dog was markedly improved. Periodic re-evaluations performed at monthly interval revealed no further deterioration. This is the first case report of subaortic stenosis treated by non-surgical palliative balloon valvuloplasty in Korea.