• Journal of Chest Surgery
• /
• 제16권2호
• /
• pp.164-169
• /
• 1983

The patient in whom corrected transposition of the great vessels is an isolated congenital anomaly has a physiologically normal circulation. A 19 year old male was perforemd with surgical correction for congenitally corrected transposition of great arteries (SLL) associated with ventricular septal defect (type I) and severe pulmonary stenosis. After right sided ventriculotomy, ventricular septal defect was repaired with Dacron patch and to provide adequate relief of severe valvar stenosis of pulmonary artery, valvulotomy was done. On immediate postoperative period, complete heart block and lower cardiac output state were ocurred, but adequate blood pressure could be maintained under using of inotropic agent and temporary pace-maker.

• KIEE International Transaction on Systems and Control
• /
• 제2D권2호
• /
• pp.120-124
• /
• 2002

A new methodology is presented to diagnose faults in equipment plasma. This is accomplished by using neural networks as a pattern recognizer of radio frequency (rf) impedance match data. Using a match monitor system, the match data were collected. The monitor system consisted mainly of a multifunction board and a signal flow diagram coded by Visual Designer. Plasma anomaly was effectively represented by electrical match positions. Twenty sets of fault-symptom patterns were experimentally simulated with variations in process factors, which include rf source power, pressure, Ar, and $O_$2 flow rates. As an input to neural networks, two means and standard deviations of positions were used as well as a reflected power. Diagnostic accuracy was measured as a function of training factors, which include the number of hidden neurons, the magnitude of initial weights, and two gradients of neuron activation functions. The accuracy was the most sensitive to the number of hidden neurons. Interaction effects on the accuracy were also examined by performing a 2$^$4 full factorial experiment. The experiments were performed on multipole inductively coupled plasma equipment.

• 지구물리
• /
• 제9권3호
• /
• pp.209-217
• /
• 2006

The major continental blocks in NE-Asia are the North China Block and the South China Blo, which have collided, starting from the Korean peninsula. The suture zone in NE China between two blocks is well defined from the QinIing-Dabie-Orogenic Belt to the Jiaodong (Sulu) Belt by the geological and geophysical interpretation. The discovery of high pressure metamorphic rocks in the Hongsung area of the Korean peninsula can be used to estimate the suture zone. This indicates that the suture zone in the Jiaodong Belt might be extended to Hongsung area. However, due to the lack of geological and geophysical data over the Yellow sea, the extension of the suture zone to the Korean peninsula across the Yellow Sea is obscure. To find out the tectonic relationship between NE China and the Korean peninsula it is necessary to complete U-ie homogeneous geophysical dataset of NE Asia, which can be provided by satellite observations. The CHAMP lithospheric magnetic field (MF3) and CHAMP-GRACE gravity field, combined with surface measured data, allow a much more accurate in-ference of tectonic structures than previously available. The CHAMP magnetic anomaly map reveals significant magnetic lows in the Yellow Sea near Nanjing and Hongsung, where are characterized by gravity highs on U-ie CHAMP-GRACE gravity anomaly map. To evaluate the depth and location of poten-tial field anomaly causative bodies, the Euler Deconvolution method is implemented. After comparing the two potential field solutions with the simplified geological map containing tectonic lines and the distribution of earthquakes epicenters, it is found that the derived structure boundaries of both are well coincident with the seismic activities as well as with the tectonic lineaments. The interpretation of the CHAMP satellite magnetic and GRACE satellite gravity datasets reveal two tectonic boundaries in U-ie Yellow Sea and the Korean peninsula, indicating U-ie norttiern and southern margins of the suture zone between the North China Block and the South China Block. The former is extended from the Jiaodong Belt in East China to the Imjingang Belt on the Korean peninsula, the later from Nanjing, East China, to Hongsung, the Korean peninsula. The tectonic movement in or near the suture zone might be responsible for the seismic activities in the western region of the Korean Peninsula and the development of the Yellow Sea sedimentary basin.

• 한국지구과학회지
• /
• 제43권1호
• /
• pp.23-29
• /
• 2022

열대저기압이 한반도로 접근할 때 중심최대풍속이 34 knot보다 약해졌더라도(weak tropical cyclone; WTC) 수도권 지역으로 상륙하면 상당한 피해를 일으키지만 WTC만 독립적으로 조사한 학술연구는 거의 없다. 본 연구에 따르면 WTC 활동은 Pacific Decadal Oscillation (PDO)와 관련되어 있는 것으로 보인다. PDO가 음의 위상일 때는 양의 위상일 때보다 95% 신뢰구간에서 유의하게 더 많은 WTC가 한반도에 영향을 미치는 것으로 나타났다. PDO 양의 위상에 비해 음의 위상 시기에는 북서태평양 북부에서 양의 상대소용돌이 아노말리가 나타난 반면, 북서태평양 남부에서는 강한 연직바람시어와 음의 상대소용돌이 아노말리가 나타났다. 이런 조건 하에서 열대저기압의 발생위치가 보다 북쪽으로, 즉 동아시아 대륙에 더욱 근접할 수 있었던 것으로 보이며 이에 따라 열대저기압의 전체 생애가 짧아졌을 것이다. 게다가 PDO 음의 위상 시기에 일본열도 상공에 자리한 고기압성 아노말리는 열대저기압의 진로를 좀 더 서쪽으로 밀어내어 육지에 의한 마찰과 황해 저층 냉수대의 영향도 증가하였을 것이다. 이에 따라 열대저기압의 생애최대강도와 상륙 시 강도가 약해져 PDO 음의 위상 때 WTC 활동이 한반도에서 증가한 것으로 분석된다.

• Journal of Chest Surgery
• /
• 제21권4호
• /
• pp.727-733
• /
• 1988

Two cases of the discrete membranous subaortic stenosis were experienced at the Department of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. Case I was 31 years old male with a history of aortic valve replacement[Ionescu-Shiley, 19mm] at the other hospital in 1980. Heart failure was noticed 6 years later. On cardiac catheterization, pressure gradient between left ventricle 4 aorta was 104 mmHg, but subvalvular aortic stenosis was not detected by preoperative 2-D echo <% left ventriculogram. Above case revealed stenoinsufficiency of the prosthetic valve. Under the diagnosis of the prosthetic valve failure, re-do aortic valve replacement[Bjork-Shiley, 23 mm] was done. During operation, the discrete membranous subaortic stenosis was incidentally found, and it was completely resected. So we thought that above discrete membranous subaortic stenosis was not detected at first operation, and it was progressed during 6 years, and accelerated the degeneration of the prosthetic valve. Case II was 20 years old female. Her complaints were exertional dyspnea, angina, syncope, which were aggravated since 5 years ago. 2-D echo <% left ventriculogram revealed the discrete membranous subaortic stenosis. Pressure gradient was 20 mmHg, but her symptoms were serious. Associated cardiac anomaly was the persistent left superior vena cava without connection with right superior vena cava. Complete excision of the membranous tissue was done. Post-operative pressure gradient between left ventricle & aorta was absent, and her complaints were nearly subsided. Both cases were type I according to the Newfeld classification of the discrete subvalvular aortic stenosis, and complete excision of the membranous tissue was done without myotomy or mymectomy. And short-term follow-up results[Case I:2 years, Case II: 1 ~ years] were good except soft systolic murmur[grade II/VI] at the aortic area in both cases.

• 대기
• /
• 제33권1호
• /
• pp.49-59
• /
• 2023

Blocking refers to a class of weather phenomena appearing in the mid and high latitudes, whose characteristics are blocked airflow of persistence. Frequently found over the Pacific and Atlantic regions of the Northern Hemisphere, blocking affects severe weather in the surrounding areas with different mechanisms depending on the type of blocking patterns. Along with lots of studies about persistent weather extremes focusing on the specific types of blocking, a new categorization using Rossby wave breaking has emerged. This study aims to apply this concept to the classification of blockings over the Pacific and examine how different wave breakings specify the associated cold weather in the Korean peninsula. At the same time, we investigate a strongly developing ridge around the Pacific by designing a new detection algorithm, where a reversal method is modified to distinguish ridge-type blocking patterns. As result, Kamchatka blocking (KB) and strong ridge over the Central Pacific are observed the most frequently during 20 years (2001~2020) of the studied period, and anomalous low pressures with cold air over the Korean Peninsula are accompanied by blocking events. When it considers the Rossby wave breaking, cyclonic wave-breaking is dominant in KB, which generates low-pressure anomalies over the Korean Peninsula. However, KB with anticyclone wave breaking appears with the high-pressure anomalies over the Korean Peninsula and it generates the warm temperature anomaly. Lastly, the low-pressure anomalies are also generated by the strong ridge over the Central Pacific, which persists for approximately three days and give a significant impact on cold surge on the Korean Peninsula.

• 대한지리학회지
• /
• 제43권1호
• /
• pp.1-19
• /
• 2008

본 연구에서는 20세기 후반 관측자료를 분석하여 최근 한반도 겨울철 강수현상에 나타난 변화 양상과 그 원인을 밝히고, 21세기 후반 기후모델(GFDL 2.1) 자료를 바탕으로 미래의 겨울강수 변화추세를 예측해 보고자 한다. 61개 지점 관측자료를 분석한 결과 에 따르면, 지난 35년 동안$(1973/74\sim2006/07)$ 우리나라 겨울철($11\sim4$월) 총 강수량은 변화가 없었지만, 강설량은 약 4.3cm/10년의 비율로 감소하였다. 1980년대 후반 이후 강설일수가 감소하고, 강설강도가 약해지고, 강설계절의 길이가 줄어들면서 설수일율(전체 강수일 수에서 강설일이 차지하는 비율)도 낮아졌다. 이러한 패턴은 겨울철 강수형태가 점차 강설에서 강우의 형태로 바뀌어가고 있음을 보여준다. 이러한 우리나라 겨울철 강수 형태의 변화는 겨울철 양(+)의 북극진동(Arctic Oscillation)에 의해 한반도 주변의 겨울철 기압이 상승함에 따라 나타난 기온상승과 관련되어 있다. 1980년대 후반 이후의 동북아시아 지역의 기압 상승은 한반도 주변의 대기와 해양 온도를 차별적으로 상승시킴으로써 대기안정도 증가에 의한 눈구름 형성 감소와 관련된 대기-해양간 온도경도를 감소시켰다. 모델생산 미래$(2081\sim2100)$ 기후자료와 20세기 후반$(1981\sim2000)$ 기후자료 비교 분석 결과, 21세기 말에는 대기 중 온실기체의 양이 증가할수록 온난화가 강화되어 겨울철 강설기간이 더 짧아지고 강설불가능일이 더 증가할 것으로 예상된다.

• Journal of Chest Surgery
• /
• 제12권3호
• /
• pp.289-296
• /
• 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
• /
• 제37권4호
• /
• pp.313-321
• /
• 2004

폐동맥하 심실중격결손을 동반한 양대혈관 우심실기시증에서 동맥전환술은 심실내 교정의 제한된 적응증과 동맥전환술의 우수한 임상성적으로 인해 최근 이 기형의 선택적 치료법으로 자리잡고 있다. 이 기형에 대한 동맥전환술의 단기 및 중기 성적을 검토하였다. 대상 및 방법 1994년 8월부터 2002년 7월까지 8년 동안 동아대학교 병원에서 심실중격결손증 교정과 동맥전환술을 시행한 폐동맥하 심실중격결손을 동반한 양대혈관 우심실기시증 환자 13명을 대상으로 후향적 조사를 하였다. 양대혈관 우심실기시의 진단은 50% rule을 적용하였다. 중심나이와 평균체증은 각각 27일(범위, 3-120일)과 3.8$\pm$0.7kg (범위, 2.92-5.3kg)이었다. 대동맥궁기형은 6명(46.2%)에서 동반되었고 모두 일차 완전교정(one-stage repair)으로 교정되었다. 양대혈관의 위치관계는 좌우로 위치한 것이 8예(61.5%), 전후로 위치한 것이 5예(38.5%)였다. 관상동맥의 형태는 1LCx-2R과 좌관상동맥이 폐동맥의 뒤로 돌아가는 형태가 각각 6예씩(46.2%)이었으며 1명(7.7%)에서 벽속 좌관상동맥기형이 관찰되었다. 심실중격결손의 확장 및 패치를 이용한 우심실유출로 성형술이 각각 1명(7.7%)에서 시행되었다 좌우 대혈관 위치관계를 갖고 있는 3명(23.1%)을 제외한 모든 환자에서 Lecompte 술식을 시행하였다. 결과: 3예(23.1%)의 수술사망이 발생하였다. 3예 모두 대동맥궁기형을 갖고 있었던 경우였다. 수술 생존자의 평균추적기간 41.3$\pm$30.7개월(범위 1.7-79.1개월) 동안 만기사망은 1예(10%)로 술 후 5개월 뒤 중추신경계 합병증으로 사망하였다. 1예(10.0%)에서 압력차 30mmHg 이상의 폐동맥판 협착이 발견되었고 2예에서 좌폐동맥 협착으로 풍선확장술이 필요하였으며 이 중 1예(10%)에서 술 후 52개월만에 재수술이 필요하였다. 무증상의 중등도 대동맥판 폐쇄부전증이 1예(10%)에서 발견되었다. 수술사망을 포함한 5년 생존율은 68.3%였다. 결론: 대동맥궁기형을 동반한 폐동맥하 심실중격결손의 양대혈관 우심실기시증 환자에서는 높은 수술사망률을 보였으나 동반하지 않은 경우는 낮은 수술사망률과 재수술률을 보여 동맥전환술이 이 심기형에서 유용한 수술방법으로 고려될 수 있을 것이라고 생각한다.

• Journal of Chest Surgery
• /
• 제24권3호
• /
• pp.310-321
• /
• 1991

Between April 1986 and September 1990, 34 patients with a single or dominant right ventricle underwent modified Fontan procedure for definite palliation in Seoul National University Children`s Hospital. Their age at operation ranged from 8 months to 14 years [Mean 5.5 years]. The ventricular chamber was solitary and of indeterminate trabecular pattern in 6 patients. 28 patients had posteriorly located rudimentary chamber, all of which were trabecular pouches having no communication with outlet septum. The patterns of atrioventricular connection were common inlet[9], double inlet [11], left atrioventricular valve atresia [12] and right atrioventricular valve atresia with L-loop [2]. Pulmonary outflow tracts were atretic in 7 patients and stenotic in 26 patients. Major associated anomalies included anomalous systemic venous drainage [15], dextrocardia [12] and total anomalous pulmonary venous connection[3]. Shunt operations were previously performed in 13 patients and pulmonary artery banding and atrial septectomy in 1 patients. Surgery included intraatrial baffling in 26 patients, bidirectional cavopulmonary shunt in 13 patients, atrioventricular valve obliteration in 3 patients and atrioventricular valve replacement in 3 patients. Central venous pressure measured postoperatively at intensive care unit ranged from 18cm H2O to 28cm H2O [mean 23.2cm H2O]. Hospital mortality was 35.3% [12/34], all died out of low output syndrome. Suspected causes of low output syndrome include ventricular dysfunction [8], hypoplastic or tortuous pulmonary artery [2] and elevated pulmonary vascular resistance [2]. 19 patients had 31 major complications including low output syndrome [18], arrhythmia [4], acute renal failure [3] and respiratory failure [3]. Mortality rate was significantly higher in the groups receiving intraatrial baffling and AV valve replacement respectively [p<0.05]. 20 patients were followed up postoperatively with the mean follow-up period 15.0$\pm$11.6 months. There were no late death and follow-up catheterization was performed in 10 patients. Mean right atrial pressure was 15.4$\pm$6.8mmHg and ventricular contraction was reasonable in all but one case. Thus, Fontan principle can be applied successfully to all the patients with complex cardiac anomaly of single ventricle variety and better results can be anticipated with judicious selection of patient and improvement of postoperative care.