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Clinical Results of Mitral Valvular Surgery in Patients with Moderate Ischemic Mitral Regurgitation Undergoing Coronary Artery Bypass Grafting (중등도의 허혈성 승모판막 폐쇄부전 환자의 관상동맥 우회로 조성술 시 승모판막 수술의 유무에 따른 원상 결과)

  • Yu Song-Hyeon;Chang Byung-Chul;Yoo Kyung-Jong;Kang Meyun-Shick;Hong You-Sun
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.611-618
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    • 2006
  • Background: There have been controversies whether mitral valvular surgery is necessary in the patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting. The purpose of this study is to evaluate the long term clinical results of patients with moderate ischemic mitral regurgitation. Material and Method: Between January 1992 and February 2005, 44 patients with moderate ischemic mitral regurgitation underwent coronary artery bypass grafting. Concomitant mitral valvular procedure was performed in 20 patients (group 1) and isolated coronary artery bypass grafting was performed in 24 patients (group 2). There were no significant difference between groups except cardiopulmonary bypass time (p<0.01). Postoperative follow up duration was $30.1{\pm}29.6$ months and last follow up echocardiographic examination was performed at $21.2{\pm}28.0$ months. Result: There was no difference in operative mortality between groups (group 1 vs group 2, 15.0% vs 8.3%, p=0.493). Grade of mitral regurgitation ${(0.81{\pm}0.91\;vs\;1.50{\pm}0.05,\;p=0.046)}$ and reduction in regurgitation grade ${(1.75{\pm}0.93\;vs\;0.70{\pm}1.26,\;p=0.009)}$ were different between two groups. But there were no significant differences in left ventricular ejection fraction ${(34.1{\pm}11.4%\;vs\;41.6{\pm}12.9%)}$, left ventricular end systolic volume ${(118.2{\pm}63.9\;ml%\;vs\;85.6{\pm}281\;ml)}$, New York Heart Association functional class ${(2.1{\pm}0.2\;vs\;2.4{\pm}1.2)}$ and 5 year survival rate ${(85{\pm}8%\;vs\;82{\pm}8%)}$. There was no risk factor for operative mortality and the only risk factor for late death was preoperative atrial fibrillation (p=0.042). There was no significant correlation between mitral valvular surgery and late death. Conclusion: Concomitant mitral valvular procedure in patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting had no significant positive effect on survival and ventricular function compared with isolated coronary artery bypass grafting. Prospective randomized study may be needed to evaluate the necessity of concomitant mitral procedure and to find more effective method for the improvement of ventricular function.

4-way Search Window for Improving The Memory Bandwidth of High-performance 2D PE Architecture in H.264 Motion Estimation (H.264 움직임추정에서 고속 2D PE 아키텍처의 메모리대역폭 개선을 위한 4-방향 검색윈도우)

  • Ko, Byung-Soo;Kong, Jin-Hyeung
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.46 no.6
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    • pp.6-15
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    • 2009
  • In this paper, a new 4-way search window is designed for the high-performance 2D PE architecture in H.264 Motion Estimation(ME) to improve the memory bandwidth. While existing 2D PE architectures reuse the overlapped data of adjacent search windows scanned in 1 or 3-way, the new window utilizes the overlapped data of adjacent search windows as well as adjacent multiple scanning (window) paths to enhance the reusage of retrieved search window data. In order to scan adjacent windows and multiple paths instead of single raster and zigzag scanning of adjacent windows, bidirectional row and column window scanning results in the 4-way(up. down, left, right) search window. The proposed 4-way search window could improve the reuse of overlapped window data to reduce the redundancy access factor by 3.1, though the 1/3-way search window redundantly requires $7.7{\sim}11$ times of data retrieval. Thus, the new 4-way search window scheme enhances the memory bandwidth by $70{\sim}58%$ compared with 1/3-way search window. The 2D PE architecture in H.264 ME for 4-way search window consists of $16{\times}16$ pe array. computing the absolute difference between current and reference frames, and $5{\times}16$ reusage array, storing the overlapped data of adjacent search windows and multiple scanning paths. The reference data could be loaded upward and downward into the new 2D PE depending on scanning direction, and the reusage array is combined with the pe array rotating left as well as right to utilize the overlapped data of adjacent multiple scan paths. In experiments, the new implementation of 4-way search window on Magnachip 0.18um could deal with the HD($1280{\times}720$) video of 1 reference frame, $48{\times}48$ search area and $16{\times}16$ macroblock by 30fps at 149.25MHz.

The Clinical Summary of the Coronary Bypass Surgery (심장 관상동맥 외과)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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Postoperative Arrhythmia after Open Heart Surgery - Cause, Incidence and It`s Management - (개심수술후 심장부정맥에 대한 임상적 연구: 원인,빈도 및 치료)

  • 장병철
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.843-852
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    • 1991
  • We prospectively studied postoperative cardiac arrhythmia after open heart surgery to analyze the types and incidence of cardiac arrhythmia and to predict preoperative risk factors. And also we evaluated the effectiveness of atrial and ventricular epicardial electrodes which were placed during operation Between March 1990 and August 1990, We had operated on in 211 patients and we studied 201 consecutive patients excluding 10 patients. The study group included 99 males and 102 female patients, ages 1 month to 75 years[Mean$\pm$SD=28.0$\pm$21.7 years]. Postoperatively, all patients were regularly seen by the cardiac surgeon and cardiologist, They had continuous electrocardiographic monitoring for the first 3 days, initially in the intensive care unit and were checked routine electrocardiography on the postoperative 7 days, The postoperative cardiac arrhythmia were analyzed and possible associations of this arrhythmia with various pre, intra, and postoperative factors were studied by univariate and multivariate discriminant analysis, The overall incidence of postoperative cardiac arrhythmia except relative sinus bradycardia was 36.8%;[74/201], The incidence of postoperative cardiac arrhythmia in acyanotic congenital heart disease: 19.4%, cyanotic congenital heart disease: 20.8%, cardiac arrhythmia surgery: 33.3%, acquired valvular heart disease: 60.9% and coronary artery occlusive disease: 38.9%. Both univariate and multivariate studies indicated the pre operative symptom duration[p = 0013], the duration of medication[p=0.003], presence of preoperative arrhythmia[p<0.001] and pre-operative left atrial dimension in echocardiography to be the factor promoting postoperative cardiac arrhythmia. Multivariate discriminant analysis showed that the presence of preoperative cardiac arrhythmia, bypass time and the duration of preoperative symptom duration conveyed considerable risk factor on post-operative arrhythmia. The atrial wire electrodes were used diagnostically in 36 and were used therapeutically in 89 among 201 patients. Atrial pacing were used to treat relative sinus bradycardia, accelerated junctional tachycardia or premature atrial or ventricular contractions in 51 patients. Atrioventricular sequential pacing were used in 16 patients and ventricular pacing were used in 20 patients. Hemodynamics were evaluated in 2 patients of relative sinus bradycardia before and after atrial pacing. The atrial pacing increased the amount of cardiac output to 15% more. Because of their great utility in the diagnosis and treatment of arrhythmias, we conclude that routine placement of atrial and ventricular electrodes at the time of operation is indicated regardless of the nature of the open-heart procedure.

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SKELETAL PATTERN ANALYSIS OF FACIAL ASYMMETRY PATIENT USING THREE DIMENSIONAL COMPUTED TOMOGRAPHY (삼차원 전산화 단층촬영술을 이용한 안모 비대칭환자의 골격 분석)

  • Choi, Jung-Goo;Min, Seung-Ki;Oh, Seung-Hwan;Kwon, Kyung-Hwan;Choi, Moon-Ki;Lee, June;Oh, Se-Ri;Yu, Dae-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.6
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    • pp.622-627
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    • 2008
  • In orthognathic surgery, precise analysis and diagnosis are essential for successful results. In facial asymmetric patient, traditional 2D image analysis has been used by lateral and P-A Cephalometric view, Skull PA, Panorama, Submentovertex view etc. But clinicians sometimes misdiagnose because they cannot find exact landmark due to superimposition, moreover image can be magnified and distorted by projection technique or patient's skull position, when using these analysis and method. For overcome these defects, analysis by using of 3D CT has been introduced. In this way we can analysis precisely by getting the exact image free of artifact and finding exact landmark with no interruption of superimposition. So we want to review of relationship between various skeletal landmarks of mandible or cranial base and facial asymmetry by predictable analysis using 3D CT. We select the cases of the patients who visited our department for correction of facial asymmetry during 2003-2007 and who were taken image of 3D CT for diagnosis. 3D CT images were reconstructed to 3D image by using V-Work program (Cybermed Inc., Seoul, Korea). And we analysis the relationship between facial asymmetry and various affecting factor of skeletal pattern. The mandibular ramus hight difference between right and left was most affecting factor that express facial asymmetry. And in this research, there was no relationship between cranial base and facial asymmetry. The angulation between facial midline and mandibular ramus divergency has significant relationship with facial asymmetry

A Study of the Abalone Outlook Model Using by Partial Equilibrium Model Approach Based on DEEM System (부분균형모형을 이용한 전복 수급전망모형 구축에 관한 연구)

  • Han, Suk-Ho;Jang, Hee-Soo;Heo, Su-Jin;Lee, Nam-Su
    • The Journal of Fisheries Business Administration
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    • v.51 no.2
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    • pp.51-69
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    • 2020
  • The purpose of this study is to construct an outlook model that is consistent with the "Fisheries Outlook" monthly published by the Fisheries Outlook Center of the Korea Maritime Institute(KMI). In particular, it was designed as a partial equilibrium model limited to abalone items, but a model was constructed with a dynamic ecological equation model(DEEM) system taking into account biological breeding and shipping time. The results of this study are significant in that they can be used as basic data for model development of various items in the future. In this study, due to the limitation of monthly data, the market equilibrium price was calculated by using the recursive model construction method to be calculated directly as an inverse demand. A model was built in the form of a structural equation model that can explain economic causality rather than a conventional time series analysis model. The research results and implications are as follows. As a result of the estimation of the amount of young seashells planting, it was estimated that the coefficient of the amount of young seashells planting from the previous year was estimated to be 0.82 so that there was no significant difference in the amount of young seashells planting this year and last year. It is also meant to be nurtured for a long time after aquaculture license and limited aquaculture area(edge style) and implantation. The economic factor, the coefficient of price from last year was estimated at 0.47. In the case of breeding quantity, it was estimated that the longer the breeding period, the larger the coefficient of breeding quantity in the previous period. It was analyzed that the impact of shipments on the breeding volume increased. In the case of shipments, the coefficient of production price was estimated unelastically. As the period of rearing increased, the estimation coefficient decreased. Such result indicates that the expected price, which is an economic factor variable and that had less influence on the intention to shipments. In addition, the elasticity of the breeding quantity was estimated more unelastically as the breeding period increased. This is also correlated with the relative coefficient size of the expected price. The abalone supply and demand forecast model developed in this study is significant in that it reduces the prediction error than the existing model using the ecological equation modeling system and the economic causal model. However, there are limitations in establishing a system of simultaneous equations that can be linked to production and consumption between industries and items. This is left as a future research project.

Effects of Catalpa Ovata on the Collagen-induced Arthritis in Lewis Rats (개오동이 흰쥐의 Collagen 유발 관절염에 미치는 영향)

  • Kim, Sun-Jung;Seo, Il-Bok;Yoon, Je-Pil
    • The Journal of Korea CHUNA Manual Medicine
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    • v.4 no.1
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    • pp.75-88
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    • 2003
  • Objectives : The purpose of this study is to find out the effects of Catalpa Ovata on the collagen-induced arthritis in the lewis rats. and we infere the effects of Catalpa Ovata on the rheumatoid arthritis in the human body. Methods : We investigated the effect of Catalpa Ovata on the Collagen-induced arthritis in Lewis rats via morphology, histology and serology as an experimental group, a control group, and a normal group. We feed Catalpa Ovata. only to an experimental group. Results : According to this research, the abnormal finding In Moire topography was 53.7% (1,018 students), and students needed X-ray re-examination were 11.2% (213 students). Students diagnosed scoliosis by X-ray re-examination were 1.8%. According to statistical analysis, interval between vertical base line of pelvis and vertical base line of neck, gap between left distance and right distance to the vertical base line of pelvis and difference of contour lines have strong correlations with deformity degree of the body surface examined by Moire. Conclusions : 1. The weight of an experimental group were lower than control group with statistically significant at 15 days later. 2, The paw edema volume of an experimental group were lower than control group at 10 days, 15 days later. but couldn't be found meaning. 3. The size of the tarsal joint of an experimental group were lower than control group at 5 days, 10 days, 15 days later, but couldn't be found meaning. 4. The volume of tumor necrosis factor-a at an experimental group were lower than control group with statistically significant. 5. The volume of interleukin-$1{\beta}$ at an experimental group were lower than control group with statistically significant. 6. An experimental group and a control group were showed ankylosing osteoarthritis, but an experimental group compared with a control group, alleviated In the fibrous ankylosis, destruction of articular cartilage and destruction of subchondral bony tissue. According to the above results, it might be considered that Catalpa Ovata has the suppression of the advance of the Collagen-induced arthritis and that result were presumed to bo connected with suppression of volume of the tumor necrosis $factor-{\alpha}$ and $interleukin-1{\beta}$ in the blood.

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Affecting Factor Analysis for Respiration Rate Measurement Using Depth Camera (깊이 카메라를 이용한 호흡률 측정에 미치는 영향 요인 분석)

  • Oh, Kyeong-Taek;Shin, Cheung-Soo;Kim, Jeongmin;Jang, Won-Seuk;Yoo, Sun-Kook
    • Science of Emotion and Sensibility
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    • v.19 no.3
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    • pp.81-88
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    • 2016
  • The purpose of this research was to analyze several factors that can affect the respiration rate measurement using the Creative Senz3D depth camera. Depth error and noise of the depth camera were considered as affecting factors. Ambient light was also considered. The result of this study showed that the depth error was increased with an increase of the distance between subject and depth camera. The result also showed depth asymmetry in the depth image. The depth values measured in right region of the depth image was higher than real distance and depth values measured in left of the depth image was lower than real distance. The difference error of the depth was influenced by the orientation of the depth camera. The noise created by the depth camera was increased as the distance between subject and depth camera was increased and it decreased as the window size was increased which was used to calculate noise level. Ambient light seems to have no influence on the depth value. In real environment, we measured respiration rate. Participants were asked to breathe 20 times. We could find that the respiration rate which was measured from depth camera shows excellent agreement with that of participants.

Risk Factors of Coronary Artery Bypass Grafting According to Ventricular Function (좌심실기능에 따른 관상동맥우회술의 위험인자)

  • 이헌재;현성렬
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.885-890
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    • 1997
  • Patients with coronary artery disease and depressed ventricular function have better longterm benefits after coronary artery bypass grafting compared with medical therapy. But operative mortality remains high. This study was designed to identify the risk factors for coronary artery bypass grafting according to ventricular function. The records of 103 patients who underwent coronary artery bypass grafting from truly 1994 to June 1996 were analysed. The patients were divided into two groups based on preoperative ejection fraction: Low EF group(Ejection fraction < 40%, n=24) and Normal EF group(Ejection fraction $\geq$ 40%, n=79). The indication of operation was significantly different between the two groups (p=0.00003). Postinfarction angina was frequent in Low EF group but unstable angina was frequent in Normal EF group. The frequency of cardiomegaly(p=0.0012), serum creatinine abnormality(p=0.0473) and preoperative use of IABP(Intra Aortic Balloon Pump, p=0.0095) were higher in Low EP group. The left internal thoracic artery was used less frequently in Low EP group(p=0.00416). The operative mortality was 8.3% in Low EF group and 5.1% in Normal EF group, but without statistical difference(p=0.5492). In Normal EF group, age (p=0.041) was identified as a significant risk factor for operative mortality. In Low EF group, age(p=0.018), preopertive use of IABP(p=0.0036), hypercholesterolemia(p=0.0007), and emergency of operation(p=0.0037) were identified as significant risk factors. Postoperative morbidity was 50% in Low EF group and 33olo in Normal EP group, but without s atistical significance(p=0.1007). These results suggest that in patients with coronary artery disease and depressed ventricular function, more aggresive coronary artery bypass grafting is needed to improve the symptom and long-term benefit.

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The Clinical Study of Biyun(sinusitis) in Children (소아비연(小兒鼻淵)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Park Eun-Jeong;Lee Hae-Ja
    • The Journal of Pediatrics of Korean Medicine
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    • v.12 no.1
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    • pp.111-131
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    • 1998
  • 1. In oriental medicine, the case of sinusitis can be explained, not only external invasion such as PUNG HAN(wind-cold), PUNG YUL(wind-hot), SHUP YUL(damp-heat), but also functional disorder of internal organ such as spleen(脾), lung(肺), kidney(腎) The western medicine classified the cause of sinusitis as two factors. That is bacterial infection factor-Haemophilus influenza, streptococcus pyogeues, streptococcus pneumonia- and viral infection factor-Rhinovirus, parainfluenza, Echo28, Coxsacki21, Sinusitis is complicated to allergic rhinitis, chronic otitis media purulent, chronic tonsilitis, sinubronchitis. On the condition of nasal septum deformity, turbinates deformity, nasal septum deviation, sinusitis can be developed. the predisposing factors of sinusitis is swimming, air pollution, malnutrition, shortage of immunity.2. According to survey, sinusitis occurred that children from 4 to 12 years old and from 5 to 7 years old occupied 70% 3. From the past history data, they experienced chronic tonsillar hypertropy(20%), otitis media, atopic dermatitis, allergic rhinitis, bronchial asthma, pneumonia, bronchiolitis, chronic sore throat, urticaria, milk allergy in sequence. 4. the symptoms of sinusitis is nasal obstruction, postnasal dripping, purulunt(yellow)or white discharge, cough, nose bleeding in sequence. nasal obstruction take the portion of 95%, postnasal dripping 65%, night time or early morning cough 60%. 5. The suffering period of sinusitis is 6 month minimum, 4 years maximum, most cases are included in a year. The suffering period of children was shorter than adult. 6. Diagnosis depend on inspection of nasal cavity, postnasal dripping, X-ray finding. 75% of patient(15case) showed both maxillary sinusitis, 25%(5cases) showed left or right maxillary sinusitis. 7. Treatment of oriental medicine, consist of Herb-medicine, acupuncture and exposing of Lazer beam. Kamihyunggyeyungyotang(加味荊芥蓮翹湯) is administered mainly as the medical therapy, Kamigwaghyangjeungkisan(加味藿香正氣散) Kimizwakwieum(加味左歸飮), Kamihyangsosan(加味香蘇散) is administered for a additional symptoms which occurred by influenza recurrence. Kamijeonxibackchulsan(加味錢氏白朮散) is administered to treat gastro-intestine trouble patients who have sinusitis. 8. The period of treatment is varied with patient conditions and X-ray finding. The minimal period is 35days, maximal period is 202days. So it took about 86days in average and about 50% of patient(10cases) is recovered in one or two month.

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