• Journal of Chest Surgery
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• 제10권2호
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• pp.230-240
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• 1977

Atrial septal defect is one of the most frequently encountered congenital heart disease. Up to December 31, 1976, 1682 cardiac patients received cardiac catheterization in the cardiac department of Yonsei university medical college. Out of the 1682 cardiac patients 723 cases had congenital heart disease and only 116 cases had congetial atrial septal defect. This amounted to 16.04% of all those with congenital heart disease. 58 cases of congenital atrial septal defect operated in the chest surgery department were presented. Of these 58 cases of atrial septal defect, 27 cases were male and 31 cases were female. Their ages ranged from 5 years to 54 years. The systolic pressure of the main pulmonary artery of 40 out of the 58 cases of atrial septal defect was below 40% of that of the systemic blood pressure: in 6 cases, the range of the systolic pressure of the main pulmonary artery was 50-90mmHg; in 12 cases, the range of the systolic pressure of the main pulmonary artery was 40-50mmHg. Average age of these was 30. 1 years. This study tends to show that Korean patients with atrial septal defect even though younger have a slight higher systolic pressure of the main pulmonary artery than Western patients have. The pulmonary blood is 1.5-2.5 times of systemic blood flow in 52 cases out of 58 cases of atrial septal defect.In only one of the 58 cases of atrial septal defect, the Rp was found to be as high as 45% of Rs. All other cases were below this level.51 cases had ostium secundum defect, 4 out of these cases had ostium secundum defect combined with mitral incompetence and 6 out of them had double ostium secundum defect. The remaining 7 cases had ostium primum defect. Their atrial defects were repaired under direct vision utilizing extracorporeal circulation, by hemodilution technic combined with moderate hypothermia. 44 cases [2nd atrial septal defect] were repaired by direct sutures while 14 cases, including the 7 cases ostium primum defects needed patches [1 pericardium and 13 teflon patch]. In 4 cases there were single defects while showed two defects. However the associated septal defect was so small that it could be closed by direct sutures. The size of the defect ranged between 6.0cm2and 10.0cm2 in 19 cases[33.7%]: the smallest being 0. 5cm2 and the largest 24cm2. The surgical mortality was 2 cases [3.4%]. These one case with ostium primum defect, could not be resuscitated on operation table. The cause of death in this case was myocardial failure and MI. The other, a case of ostium primum defect had a second operation on the first operative day due to massive bleeding from LV vent-line insertion site.The patient died on 26th post-operative day due to sepsis.

• 한국정보과학회논문지:정보통신
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• 제28권4호
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• pp.586-601
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• 2001

본 논문에서는 에드 혹 망을 위한 메쉬 기반의 새로운 멀티캐스트 라우팅 프로토콜인 HMMRP (Hierarchical Mesh-based Multicast Routing Protocol)를 제안한다. HMMRP는 송신원 중 일부를 코어 송신원으로 두고 타 송신원들이 코어 송신원 중 하나에 반드시 연결되도록 한다. 그리고 송신원별 트리의 합집합으로 구성되는 메쉬에 의해 송신원과 수신원이 연결되도록 한다. HMMRP는 이들 연결 경로 상의 노드들로써 데이타 전달 메쉬를 형성하고 이를 정기적으로 재구성한다. 특히, 일반 송신원으로부터 코어 송신원에 이르는 경로와 코어 송신원으로부터 수신원에 이르는 트리에 해당하는 메쉬에 대해서는 정기적인 재구성 기간보다 훨씬 짧은 기간마다 국부적으로 메쉬 단절 가능성을 감시하고 복구하도록 함으로써, 임의의 송신원 수신원간에 최소한 송신원 코어 수신원을 경유하는 메쉬를 통해 데이타를 전달할 수 있도록 한다. 이렇게 함으로써 이동성이 높은 에드 혹 네트워크일지라도 정기적인 메쉬 재구성 기간을 짧게 잡지 않고 높은 데이타 전달율을 제공할 수 있다. 시뮬레이션을 통한 성능 분석 결과，HMMRP는 이동성에 대한 성능저하가 상대적으로 적으며, 특히 멀티캐스트 그룹의 규모가 커질수록 이동성에 대한 성능저하가 더욱 경미해짐을 알 수 있었다.

• 전자공학회논문지
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• 제51권4호
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• pp.131-143
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• 2014

본 논문에서는 자연 이미지가 갖는 통계적 일관성과 안개를 인식하는 시지각적 통계 특성을 이용하여 단일 안개 영상에서, 안개가 없는 참조 영상과의 비교 없이, 시지각적으로 안개 영상의 가시성을 예측한다. 제안하는 모델은 기존 안개 영상의 가시성 예측 방법들이 불가피하게 사용했던 추가 정보들, 예를 들면, 다수의 다양한 안개 영상, 차량 탑재 카메라의 지리적 위치 정보, 사람의 가시성 평가에 대한 학습 결과, 도로 선 혹은 교통 신호와 같이 안개 영상의 돋보이는 특정 물체 정보 등을 사용하지 않는다. 본 논문의 모델은 오직 테스트 안개 영상이 자연 현상에 의한 안개 영상 혹은 안개가 전혀 없는 영상에서 일관적으로 발견되는 통계적 특성으로부터 얼마나 떨어져 있는지 측정함으로써 안개 영상의 가시성을 예측한다. 시지각적으로 안개를 인식하여 일관된 통계를 나타내는 특징 인자들은 공간상의 자연 이미지 통계 모델과 안개 영상의 특징 (명암대비의 감소, 색상과 채도의 감소, 밝기의 증가)으로부터 유도된다. 제안하는 모델은 안개 영상의 전체 영역에 대한 가시성뿐만 아니라 각 관심 영역에서 패치 크기에 따른 지역적 안개 영상의 가시성도 예측할 수 있다. 본 모델의 성능분석을 위하여 사람이 직접 인지하는 가시성 측정 실험을 100 장의 다양한 안개 영상에 대해 수행하였다. 본 논문에서 제시한 모델을 통해 예측된 안개 영상의 가시성과 사람이 체감한 안개 영상의 가시성을 비교한 결과, 둘 사이에 매우 높은 상관관계가 있는 것으로 평가되었다. 본 논문이 제안하는 무참조 안개 영상의 가시성 예측 모델은 사람의 시지각적 특성을 활용한 새로운 방법으로, 향후 안개 영상의 가시성 향상 알고리듬 개발과 선 개발된 안개 제거 및 가시성 향상 알고리듬들의 성능을 정확히 평가할 수 있는 새로운 측정방법 개발 등에 매우 유용할 것으로 기대된다.

• 한국전자파학회논문지
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• 제16권3호
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• pp.300-310
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• 2005

본 논문에서는 사각 패치와 사각 링 스트립선로가 전자기적으로 결합된 3층 구조의 소형화된 EBG구조를 제안하였다. 제안한 EBG 구조는 상층의 사각 패치와 하층의 사각 링 스트립선로가 비아에 의해 접지면에 연결되었다. 반사위상 EM시뮬레이션을 통해 EBG구조 표면에서의 반사위상을 계산하여 EBG구조의 밴드갭 특성을 연구하였고, 반사위상에서 나타나는 밴드갭과 투과계수(S$_{21}$)에서 나타나는 밴드갭이 일치하는 것을 EM 시뮬레이션을 통해 확인하였으며, 측정은 제작이 용이한 프로브 안테나를 사용하여 EBG 구조의 표면을 진행하는 표면파의 투과계수를 측정하였다. 제안한 EBG구조는 동일한 크기의 기존 3층 구조에 비하여 밴드갭이 나타나는 주파수가 약 34 $\%$ 감소되었다. 측정한 결과 제안한 구조는 0.930 GHz에서 0.945 GHz까지의 밴드갭을 갖는다.

• 전자공학회논문지
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• 제54권5호
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• pp.74-84
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• 2017

휴대용 지뢰 탐지기의 특성상 병사가 직접 손에 들고 운용하기 때문에 빠르고 정확하게 표적 탐지를 수행하는 시스템을 개발해야한다. 그러나 우리나라의 군에서 사용하고 있는 휴대용 지뢰 탐지기는 금속 성분의 지뢰만 탐지가 가능하다는 문제점이 있다. 이러한 문제를 해결하고, 우리나라 환경에 알맞은 휴대용 지뢰 탐지 시스템을 개발하는 것이 중요하다. 본 논문에서는 지면 투과 레이더를 이용하여 지뢰를 탐지 하고, 우리나라 환경에 알맞은 휴대용 지뢰 탐지 시스템을 제안한다. 제안하는 시스템은 전처리 단계로 깊이 보상, 정합 필터링, 주파수 이동 필터링을 이용하고, 탐지 단계에서 에지 비율을 통해 최종적으로 표적을 탐지한다. 제안하는 시스템의 성능을 검증하기 위하여 우리나라 토양의 대부분을 차지하는 사양토를 이용하였고, 탐지해야하는 지뢰를 매설한 후 휴대용 지뢰 탐지기를 이용하여 데이터를 획득하였다. 획득한 데이터를 기반으로 패치의 크기 및 위치와 이동 주파수에 대한 실험을 진행하여 최적의 성능을 나타내는 값을 찾아내고, 해당 값을 이용하여 탐지 성능을 확인하였다. 실험 결과, 제안하는 전처리 알고리즘이 낮은 오경보율에서 모든 지뢰를 탐지하는 우수한 성능을 나타내는 것을 확인하였고, 기존 연구와의 비교를 통해 제안하는 시스템의 성능이 우수함을 확인하였다.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1318-1326
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• 1992

Backgroud. To determine the influence of age at operation upon surgical outcome in patients with isolated secundum atrial septal defect, retrospective clinical analysis was done. Material and method. From June, 1976 to December, 1991, 146 patients, 63 male and 83 female patients ranging in age from 13 months to 56 years, were operated on for isolated secundum atrial septal defect. The patients were divided into 3 groups according to their age at operation: Group I [<20 years old], 91 patients[62.3%]; Group II [21 to 40 years old], 44 patients[30.1%]; GroupIII[>41 years old], 11 patients[7.6%]. Significant differences in clinical features, hemodynamic function, early and late results between age groups were speculated. Results. One hundred thirty-one patients[89.6%] were symptomatic at the time of operation, the most common symptoms being dyspnea on exertion, recurrent respiratory infection, palpitation and chest pain. Patients in NYHA class III or IV were 3.3% in group I, 25% in groupIII, and 54.5% in group Ill. Hemodynamic data was available for 138 patients [94.5%]. Significant pulmonary hypertension [MPA systolic pressure $^3$ 40mmHg] was noted in 22 patients [15.9%]. Patients with pulmonary vascular disease [Rp/Rs>1.25] were 2% in group I, 7.3% in group Il, and 9.1% in groupIII. But there were no significant differences between the age groups in the size of the shunt or the ratio of pulmonary to systemic flow. Atrial septal defects were closed with direct suture in 144 patients and patch repair was performed in 2 patients with high defect. Atrial arrhythmia [8.2%] was the most common postoperative complication. The mean [LSD] duration of follow-up in all patients was 16$\pm$22 months [range, 1~96 months]. Functional result was excellent regardless of the age groups. During follow-up period, late cardiovascular events were arrhythmia [7 cases], reoperation for recurrent ASD [2 cases], and premature late death due to bacterial endocarditis [1 case]. Incidence of preoperative and late atrial fibrillation was significantly higher in older age group. Conclusion. Age at operation is one of the most important predictor of early and late surgical outcome with its impact on the following factors : 1] hemodynamic alterations and ventricular dysfunction due to longstanding volume and pressure overload, 2] pulmonary vascular disease, and 3] atrial arrhythmia including atrial fibrillation as a result of atrial dilatation. Therefore, among patients with surgically repaired atrial septal defects, those operated on over the age of 20 require careful supervision on the long-term basis.

• Journal of Chest Surgery
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• 제12권3호
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• pp.281-288
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of Chest Surgery
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• 제12권3호
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• pp.289-296
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of Chest Surgery
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• 제22권2호
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• pp.220-224
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• 1989

In candidates for aortic valve replacement [AVR]it is our primary intention to implant the largest possible vale prosthesis of at least 23 mm in diameter in patients with severe valvular aortic stenosis. However, in many patients there is an additional subvalvular asymmetric septal hypertrophy which in some cases may cause an postextrasystolic increase of the LV-aortic gradient. Another component of the aortic stenosis syndrome is a narrow valvular ring, or a combination of both. After complete removal of the diseased valve and decalcification the narrow aortic ring [< 23 mm] can be widened firstly by transaortic subvalvular septal myectomy- [TSM] thus unfolding the left ventricular outflow tract[LVOT]and secondly by extending the oblique aortic incision into the aortic valve ring or further down into the anterior leaflet of the mitral valve. The sub-and supra-valvular defect will be closed by patch enlargement of the aortic root [PEAR] using autologous pericardium. These techniques allow a considerable enlargement of the valvular ring of about 4 to 10 mm in circumference. In a retrospective study using a computerized program, 847 patients with AVR [1980-1984]were reviewed to evaluate the intraoperative hemodynamic results mainly concerning relief of the transvalvular gradient. In 626 patients AVR was performed, 151 patients had double valve replacement [AVR+MVR], and 70 patients had AVR plus additional surgical procedures. Concentrating on the AVR-group [n=626] there were 103 patients with TSM, 24 patients with PEAR and 20 patients with TSM+PEAR which demonstrated that in a total, of 147 patients of this groups [23.5%] an additional procedure was necessary. The Statistical evaluation of the intraoperative pressure measurements before and after AVR in relation to the size of the implanted prostheses indicated the lowest preoperative mean gradient in patients with AVR alone, the highest in patients who afforded TSM plus PEAR. However, after AVR the mean gradients in all three groups were very low [mean 5 to 10 mmHg]. These data indicate that in patients with a narrow aortic ring and additional considerable ASH, TSM and PEAR are suitable techniques to enlarge the aortic root to enable the implantation of an adequate aortic valve prosthesis. Long-term controls have shown that autologous pericardium is a qualified graft material for the ascending aorta.

• Journal of Chest Surgery
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• 제21권2호
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• pp.254-269
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• 1988

52 cases of ventricular septal defect [VSD] associated with aortic insufficiency [Al] were found among 1271 patients with simple VSD operated during 27-year period [1959, August-1987, June] at Seoul National University Hospital. Their preoperative data, intraoperative findings and postoperative short-term and long-term follow-up data were evaluated to find the proper timing and method of surgical treatment. The result of this survey shows as follows: 1. To obtain the proper surgical indication, cardiac catheterization and angiography, especially root aortography, was essential. 2. Of all 52 patients, the VSD were type I in 40 patients [77%], type II in 8 [15%] and combination of type I and II in 4 [3%]. Patch closure of VSD were performed in 46 patients and direct suture closure of small VSD in 6. Most common pathologic findings of Al were prolapse of right coronary cusp [40 cases, 77%]. Aortic valve reconstruction were performed in 19 patients, aortic valve replacement in 6 and VSD closure alone in 27. 3. There were 3 surgical deaths [mortality 5.8%], and the long-term follow-up shows that VSD closure alone might have been sufficient to arrest progression of Al in younger patients [less than 10-year old], particularly in those with mild insufficiency. Valve reconstructions, when necessary, were more effective when done at an early age [less than 15-year old]. In a conclusion, we could recommend followings: 1. If patient at any age having VSD with Al is diagnosed, prompt operation is recommended. As for the surgical method, VSD closure only may be fit for mild degree of Al when patient is less than 10-year old, but the management of valve itself may be needed for moderate to severe degree of Al, especially when patient is over 10 year old. The management of valve itself may be variable, but valve reconstruction should be considered as a first choice in less than 15-year old patient. If patient is diagnosed less than 5-year old without evidence of Al, close follow-up observation is recommended. But if Al evidences of clinical findings and/or echocardiography during follow-up examination are notified, corrective operation should be accomplished while the Al is mild. If cusp prolapse and/or even type I VSD of significant size is demonstrated on aortogram, without Al, it should be corrected as early as possible before the patient is about 5 years old.