• Journal of Chest Surgery
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• 제18권4호
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• pp.623-634
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• 1985

One of the most widely recognized problems in patients with TGA [transposition of the great arteries] after the Senning operation is the occurrence of arrhythmias. From June 1982 through October 1984, 22 patients, 11 with "simple" and 11 with "complex" TGA, underwent correction of TGA by a modification of the Senning operation designed to avoid dysrhythmias. 16 were males and 6 females, with ages ranging from 3 months to 27 months. [mean age 10.8 months] 7 patients [31.8%], 1 with simple TCA and 6 with complex TGA, died in the early post-operative period. The operative mortality was 9.1% in "simple" TGA, and 54.9% in "complex" TGA. There were 4 late deaths but only one of these patients died of a dysrhythmia as a possible factor. The standard ECG [Electrocardiography] checked preoperatively showed sinus rhythm in 17 [77.3%], 1 AV block in 5 [22.7%]. In 22 patients studied postoperative 1st day, the incidence of arrhythmias was 63.6%, with significant incidence compared with preoperative study. [P<0.05]. But, in 15 patients studied postoperatively at intervals from 1 month to 26 months, the incidence of arrhythmias was 26.7%, with no significant incidence compared with preoperative study [P>0.1]. Our results indicate that a modified Senning operation may reduce the frequency of surgically induced arrhythmias. The mean frontal plane P-wave axis also revealed significant deviation to the right side [P<0.05], compared with preoperative study. These findings raise the possibility that what has been called sinus rhythm postoperatively may have a different origin and conduction sequence from normal. But the rhythm seems to be functionally similar.rhythm seems to be functionally similar.

• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.94-98
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• 2014

Background: We analyzed the changes in QT dispersion (QTd) in children with Kawasaki disease (KD), and determined the presence of repolarization abnormality in these children even in the absence of coronary artery abnormalities. Methods: Ninety-one children with KD and 20 healthy controls were enrolled in this retrospective study. Serial echocardiographic and electrocardiographic (ECG) measurements in the beginning of treatment, 2nd month and 6th month after the diagnosis were compared. Fifty-one of 91 children had at least 2 serial ECG data. The number of patients who had 3 consecutive ECG data was 23. Results: Among the 67 KD patients with no coronary artery changes, the consecutive mean QTd values were 41.86 ms, 37.84 ms, and 25.47 ms, respectively (26 ms for controls). In the analysis of changes among KD patients without coronary artery abnormalities, QTd showed a significant decrease with time (p=0.01). Especially, the 1st month and the 6th month QTd values were significantly different (p=0.028). The mean QTd values in KD patients with coronary artery changes were significantly higher than those in KD patients with no coronary artery changes at each time (1st, 2nd, and 6th month exam). Conclusion: QTd is significantly increased in children during the early stage of KD. Repolarization abnormality may exist during the acute stage of KD, regardless of the echocardiographic changes.

• 한국군사과학기술학회지
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• 제22권2호
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• pp.287-297
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• 2019

Monitoring for the physiological state of a solider is essential to the realization of individual combat system. Despite all efforts over the last decades, there is no report to point out the optimal location of the wearable biosensors considering both monitoring accuracy and operational robustness. In response, we quantitatively measure body temperature and heartrate from 34 body parts using 2 kinds of biosensor arrays, each of which consists of a thermocouple(TC) sensor and either a photoplethysmography(PPG) sensor or an electrocardiography(ECG) sensor. The optimal location is determined by scoring each body part in terms of signal intensity, convenience in use, placement durability, and activity impedance. The measurement leads to finding the optimal location of wearable biosensor arrays. Thumb and chest are identified as best body parts for TC/PPG sensors and TC/ECG sensors, respectively. The findings will contribute to the successful development of individual combat system.

• Healthcare Informatics Research
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• 제24권4호
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• pp.309-316
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• 2018

Objectives: Both the valence and arousal components of affect are important considerations when managing mental healthcare because they are associated with affective and physiological responses. Research on arousal and valence analysis, which uses images, texts, and physiological signals that employ deep learning, is actively underway; research investigating how to improve the recognition rate is needed. The goal of this research was to design a deep learning framework and model to classify arousal and valence, indicating positive and negative degrees of emotion as high or low. Methods: The proposed arousal and valence classification model to analyze the affective state was tested using data from 40 channels provided by a dataset for emotion analysis using electrocardiography (EEG), physiological, and video signals (the DEAP dataset). Experiments were based on 10 selected featured central and peripheral nervous system data points, using long short-term memory (LSTM) as a deep learning method. Results: The arousal and valence were classified and visualized on a two-dimensional coordinate plane. Profiles were designed depending on the number of hidden layers, nodes, and hyperparameters according to the error rate. The experimental results show an arousal and valence classification model accuracy of 74.65 and 78%, respectively. The proposed model performed better than previous other models. Conclusions: The proposed model appears to be effective in analyzing arousal and valence; specifically, it is expected that affective analysis using physiological signals based on LSTM will be possible without manual feature extraction. In a future study, the classification model will be adopted in mental healthcare management systems.

• Clinical and Experimental Pediatrics
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• 제62권6호
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• pp.224-234
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• 2019

Purpose: Pompe disease (PD) is an autosomal recessive disorder caused by a deficiency of acid alpha-glucosidase resulting from pathogenic GAA variants. This study describes the clinical features, genotypes, changes before and after enzyme replacement therapy (ERT), and long-term outcomes in patients with infantile-onset PD (IOPD) and late-onset PD (LOPD) at a tertiary medical center. Methods: The medical records of 5 Korean patients (2 male, 3 female patients) diagnosed with PD between 2002 and 2013 at Samsung Medical Center in Seoul, Republic of Korea were retrospectively reviewed for data, including clinical and genetic characteristics at diagnosis and clinical course after ERT. Results: Common initial symptoms included hypotonia, cyanosis, and tachycardia in patients with IOPD and limb girdle weakness in patients with LOPD. Electrocardiography at diagnosis revealed hypertrophic cardiomyopathy in all patients with IOPD who showed a stable disease course during a median follow-up period of 10 years. Patients with LOPD showed improved hepatomegaly and liver transaminase level after ERT. Conclusion: As ERT is effective for treatment of PD, early identification of this disease is very important. Thus, patients with IOPD should be considered candidates for clinical trials of new drugs in the future.

• Journal of Cardiovascular Imaging
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• 제26권4호
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• pp.229-237
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• 2018

BACKGROUND: Statins are thought to have little effect on the progression of aortic stenosis, but the data on their role in patients with aortic valve sclerosis (AVS) are limited and inconsistent. METHODS: We retrospectively analyzed 541 consecutive patients (214 men, age: $70{\pm}11$ years) with AVS. Each patient underwent two or more electrocardiography examinations at least 6 months apart at Kangwon National University Hospital from August 2010 to August 2015. AVS is defined as irregular thickening of the leaflets, focal increases in echogenicity and minimal elevation of the peak aortic valve velocity (> 1.5 and < 2 m/s). The progression rate of AVS was expressed as the increase in peak velocity per year (m/s/yr). RESULTS: The mean follow-up duration was $24.9{\pm}13.3$ months in the statin-treated group and $24.1{\pm}12.4$ months in the non-statin-treated group (p = 0.460). There were no differences between the statin-treated and non-statin-treated groups in mean age, gender or smoking status. Relative to the non-statin-treated group, a higher number of patients in the statin-treated group had hypertension, diabetes, ischemic heart disease, and stroke. The progression rate of AVS did not differ between the statin-treated and non-statin-treated groups ($0.012{\pm}0.340m/s/yr$ vs. $0.014{\pm}0.245m/s/yr$, p = 0.956). Multivariate analysis showed initial peak aortic jet velocity was significantly associated with AVS progression (${\beta}=0.153$, p = 0.009). CONCLUSIONS: Our study demonstrated that statins had no effect on the progression of AVS. However, well-designed studies are needed to define the prognosis and management of AVS.

• Journal of Trauma and Injury
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• 제33권4호
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• pp.207-218
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• 2020

The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).

• 대한임상검사과학회지
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• 제55권3호
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• pp.213-218
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• 2023

일본에서 '팀 의료'는 임상병리사가 당뇨병팀, 영양지원팀, 감염관리팀, 진료지원팀 등 다양한 종류의 팀에서 활발하게 활동하고 있다. 전반적으로 최근 의료환경이 지속적으로 변화함에 따라 임상병리사는 채혈, 검체 채취, 검사, 심전도 등을 수행할 뿐만 아니라 의사, 간호사와 협력하여 '진료보조나 지원'에 적극적으로 참여할 것이 요구되고 있다. 따라서 국내 병동이나 응급실에 상주하는 임상병리사는 임상검사실과 연결고리 역할을 수행함으로써 의료의 질 향상과 의료안전 확보에 더 잘 기여할 수 있을 것이고, 의사와 간호사는 업무부담이 경감되고 보다 나은 환자관리를 위해 헌신할 수 있을 것으로 기대된다.

• Korean Journal of Radiology
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• 제21권6호
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• pp.756-763
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• 2020

Objective: To evaluate the effects of attenuation threshold on CT pulmonary vascular volume ratios in children and young adults with congenital heart disease, and to suggest an optimal attenuation threshold. Materials and Methods: CT percentages of right pulmonary vascular volume were compared and correlated with percentages calculated from nuclear medicine right lung perfusion in 52 patients with congenital heart disease. The selected patients had undergone electrocardiography-synchronized cardiothoracic CT and lung perfusion scintigraphy within a 1-year interval, but not interim surgical or transcatheter intervention. The percentages of CT right pulmonary vascular volumes were calculated with fixed (80-600 Hounsfield units [HU]) and adaptive thresholds (average pulmonary artery enhancement [PA_avg] divided by 2.50, 2.00, 1.75, 1.63, 1.50, and 1.25). The optimal threshold exhibited the smallest mean difference, the lowest p-value in statistically significant paired comparisons, and the highest Pearson correlation coefficient. Results: The PA_avg value was 529.5 ± 164.8 HU (range, 250.1-956.6 HU). Results showed that fixed thresholds in the range of 320-400 HU, and adaptive thresholds of PA_avg/1.75-1.50 were optimal for quantifying CT pulmonary vascular volume ratios. The optimal thresholds demonstrated a small mean difference of ≤ 5%, no significant difference (> 0.2 for fixed thresholds, and > 0.5 for adaptive thresholds), and a high correlation coefficient (0.93 for fixed thresholds, and 0.91 for adaptive thresholds). Conclusion: The optimal fixed and adaptive thresholds for quantifying CT pulmonary vascular volume ratios appeared equally useful. However, when considering a wide range of PAavg, application of optimal adaptive thresholds may be more suitable than fixed thresholds in actual clinical practice.

• Clinical and Experimental Pediatrics
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• 제52권12호
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• pp.1364-1369
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• 2009

목 적 : 이번 연구에서는 소아기에 흔한 선천성 심장병 환자들을 대상으로 개심술 이후 생긴 반흔과 수술로 인한 용적 또는 압력 과부하 상태의 변화로 초래되는 비정상적인 심실 활성화를 신호 평준화 심전도를 이용하여 분석하고자 하였다. 방 법 : 선천성 심장병으로 개심교정술을 시행한 환자 52명을 대상으로 하였다. 환자군은 우심실 용적 과부하군(심방 중격 결손군, 1군), 좌심실 용적 과부하군(심실 중격 결손군, 2군), 우심실 압력 과부하군(활로씨 4징군, 3군)으로 나누었다. 대상 환자 모두에서 표준 12 유도 심전도와 신호 평준화 심전도 검사를 시행하였고, 평균 QRS 기간, QT와 QTc 간격, f-QRS, HFLA, RMS in terminal 40 ms를 구하였다. 결 과 : 수술 전에는 1군에서 다른 군에 비해 의미 있게 긴 QRS 기간을 보였고(P=0.011), 수술 후에는 3 군에서 다른 군에 비해 QTc 간격이 의미 있는 증가가 있었다(P=0.004). 그러나 신호 평준화 심전도는 수술 전후 환자군 간에 차이가 없었다. 전체 대상 환자 중 신호 평준화 심전도 측정값이 한가지 이상 후전위의 진단 기준에 해당되는 경우가 수술 전 12명(23%)에서 수술 후 21명(40%)로 증가하였다. 특히 2군과 3군에서는 수술 전에 비해 수술 후에 신호 평준화 심전도의 이상 소견을 보이는 경우가 의미있게 많았다(2군: 20% versus 28%, P<0.001, 3군: 14% versus 64%, P<0.001). 결 론 : 비정상적인 신호 평준화 심전도 값은 수술 후 반흔뿐만 아니라 개심술 자체, 심실의 과부하에 의해서도 발생할 수 있다.