선천성심질환(先天性心疾患)의 심폐기(心肺器) 개심수술(開心手術) - 4례(例) 보고(報告) -

김근호,박영관,지행옥,김영태,이종배,정윤채,오철수,Kim, Kun Ho,Park, Young Kwan,Jee, Heng Ok,Kim, Young Tae,Rhee, Chong Bae,Chung, Yun Chae,Oh, Chull Soo 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.1

The present. study reports four cases of congenital heart diseases, who received open heart surgery by the Sarn's Heart-Lung-Machine in the department of Thoracic Surgery, Hanyang University Hospital during the period between July 1975 and May 1976. The Heart-Lung-Machine consisted of the Sarn's five head roller pump motor system (model 5000), heat exchanger, bubble trap, the Rygg-Kyvsgaard oxygenator, and monitors. The priming of pump oxygenator was carried out by the hemodilution method using Hartman's solution and whole blood. Of the four cases of the heart diseases, three whose body weight were below 30kg, received the partial hemodilution priming and the remaining one whose body weight was 52kg received the total hemodilution priming with Hartman's solution alone. The rate of hemodilution was in the average of 60.5ml/kg. Extracorporeal circulation was performed at the perfusion flow rate of the average 94.0ml/kg/min, and at the moderate hypothermia between 35'5"C and 30'5"C of the rectal temperature. In the total cardiopulmonary bypass, arterial blood pressure was anged between 30 mmHg and 85 mmHg, generally maintaining over 60 mmHg and venous pressure was measured between 4 and $23cmH_2O$, generally maintaining below $10cmH_2O$. The first case: The patient, a nine year old girl having the symptoms and physical signs typical to cardiac anomaly was definitely diagnosed as isolated pulmonary stenosis through the cardiac catheterization. There was, however, no cyanosis, no pathological finding by X-ray and E.C.G. tracings. The valvulotomy was performed through the arteriotomy of pulmouary artery under the total cardiopulmonary bypass. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The second case: A 12 year old boy with congenital heart anomaly was positively identified as having ventricular septal defect through the cardiac catheterization. As in the case with the first case, the patient exhibited the symptoms and physical signs typical to cardiac anomaly, but no pathological abnormality by X-ray and E.C.G. tracings. The septal defect was localized on atrioventricular canal and was 2 by 10 mm in size. The septal defect was closed by direct simple sutures under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle and pulmonary artery were decreased satisfactory. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The third case: The patient, a 19 year old girl had been experienced the clinical symptoms typical to cardiac anomaly for 16 years. The pink tetralogy of Fallot was definitey diagnosed through the cardiac catheterization. The patient was placed on an ablolute bed rest prior to the operation because of severe exertional dyspnea, fatigability, and frequent syncopal attacks. However, she exhibited very slight cyanosis. Positive findings were noted on E.C.G. tracings and blood picture, but no evidence of pathological abnormality on X-ray was observed. All of the four surgical approaches such as Teflon patch closure (3 by 4cm in size) of ventricular septal defect, myocardial resection of right ventricular outflow tract, valvulotomy of pulmonary valvular stenosis, and pericardial patch closing of ventriculotomy wound were performed in 95 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The fourth case: The patient, a 7 1/4 year old girl had the symptoms of cardiac anomaly for only three years prior to the operation. She was positively identified as having acyanotic tetralogy of Fallot by open heart surgery. The patient showed positive findings by X-ray and E.C.G. tracings, but exhibited no cyanosis and n

The effects of Nafion^Ⓡ ionomer content in dual catalyst layer on the performances ofPEMFC MEAs

김근호(Kim, Kun-Ho),전유택(Jeon, Yoo-Taek) 한국신재생에너지학회 2011 한국신재생에너지학회 학술대회논문집 Vol.2011 No.05

In order to achieve high performance and low cost for commercial applications, the development of membrane electrode assemblies (MEA), in which the electrochemical reactions actually occur, must be optimized. Expensive platinum is currently used as an electrochemical catalyst due to its high activity. Although various platinum alloys and non-platinum catalysts are under development, their stabilities and catalytic activities, especially in terms of the oxygen reduction (ORR), render them currently unsuitable for practical use. Therefore, it is important to decrease platinum loading by optimizing the catalysts and electrode microstructure. In this study, we prepared several different MEAs (non-uniform Nafion^{(R)} ionomer loading electrode) which have dual catalyst layers to find the optimal Nafion^{(R)} ionomer distribution in the electrodes. We changed Nafion^{(R)} ionomer content in the layers to find the ideal composition of the binder and Pt/C in the electrode. For MEAs with various ionomer contents in the anodes and cathodes, the electrochemical activity (activation overpotential) and the mass transport properties (concentration overpotential) were analyzed and correlated with the single cell performance. The dual catalyst layers MEA showed higher cell performance than uniformly fabricated MEA, especially at the high current density region.

갑상선유두암 재발 진단에서 18F-FDG PET/CT와 경부초음파검사 병용의 유용성: PET, 경부초음파검사 그리고 혈청 티로글로불린 (thyroglobulin)의 비교

김근호 ( Kun Ho Kim ),송민호 ( Min Ho Shong ),서영덕 ( Young Duk Seo ),김성민 ( Seong Min Kim ) 대한핵의학회 2009 핵의학 분자영상 Vol.43 No.5

목적: 이 연구의 목적은 갑상선유두암 환자를 대상으로 재발의 진단에서 18F-FDG PET/CT와 경부초음파검사를 함께 시행하는 것에 대한 유용성을 평가하고자 한다. 대상 및 방법: 2006년 12월부터 2008년 4월까지 갑상선유두암으로 갑상선 전절제술 및 고용량의 방사성옥소 치료를 시행 받은 환자 중에서 재발이 의심되어 18F-FDG PET/CT를 시행한 61명(91건)을 대상으로 후향적으로 연구를 진행하였다. 의심되는 병소는 조직검사를 시행하였고, 조직 검사결과와 PET 검사결과, PET/CT 검사결과, 경부초음파검사 결과를 비교하였다. 결과: 18F-FDG PET/CT (여자 57명, 남자 4명; 연령 범위, 24-81세, 평균 49세; 유두암 61개)의 민감도, 특이도, 정확도는 각각 환자 기준으로 87.2%, 59.0%, 77.0%였고, 병소 기준으로 92.3%, 64.1%, 80.2% 였다. 18F-FDG PET의 민감도, 특이도, 정확도는 각각 환자 기준으로 71.8% (p=0.03), 59.0% (p=1.00), 67.2% (p=0.03)였고, 병소 기준으로 78.8% (p=0.01), 64.1% (p=1.00), 72.5% (p=0.02)였다. 경부초음파검사의 경우 민감도, 특이도, 정확도는 각각 환자 기준으로 71.1% (p=0.07), 52.2% (p=0.75), 63.9% (p=0.08)였고, 병소 기준으로 71.2% (p<0.01), 61.5% (p=1.00), 67.0% (p=0.06)였다. 18F-FDG PET/CT와 경부초음파검사를 함께 판독한 경우 민감도, 특이도, 정확도는 각각 환자 기준으로 94.7% (p=0.50), 82.6% (p=0.13), 90.2% (p=0.03)였고, 병소 기준으로 96.2% (p=0.50), 89.7% (p<0.01), 93.4% (p<0.01)였다. 결론: 18F-FDG PET/CT는 갑상선유두암의 재발 진단에서 18F-FDG PET와 경부초음파검사와 비교하여 높은 민감도, 특이도, 정확도를 보였다. 게다가 18F-FDG PET와 경부 초음파를 함께 시행한 경우 갑상선유두암의 재발 진단에 있어서 더욱 향상된 민감도, 특이도, 정확도를 보였다. Purpose: The aim of this study was to investigate the usefulness of 18F-FDG PET/CT with neck ultrasonography (neck US) in patients with recurrent, papillary thyroid cancer. Material and methods: This retrospective study (December 2006 to April 2008) enrolled sixty-one patients (ninety-one lesions) who underwent high-dose 131I-ablation therapy after total thyroidectomy, and evaluated recurred papillary thyroid cancer. All lesions were confirmed by histopathology and compared histopathologic findings to PET, PET/CT, and neck US findings. Results: In sixty-one patients (57 women, 4 men; age range, 24-81 years, mean 49 years; 61 papillary carcinomas), the sensitivity, specificity, accuracy of 18F-FDG PET/CT was 87.2%, 64.0%, 78.1% on a patient basis and 92.3%, 66.7%, 80.9% on a lesion basis, respectively. The sensitivity, specificity, accuracy of 18F-FDG PET was 71.8% (p=0.03), 59.0% (p=1.00), 67.2% (p=0.03) on a patient basis and 78.8% (p<0.01), 64.1% (p=1.00), 72.5% (p=0.02) on a lesion basis, respectively. The sensitivity, specificity, accuracy of neck US was 71.1% (p=0.07), 52.2% (p=0.75), 63.9% (p=0.05) on a patient basis and 71.2% (p<0.01), 61.5% (p=1.00), 67.0% (p=0.06) on a lesion basis, respectively. Combined 18F-FDG PET/CT with neck US improved the sensitivity, specificity, accuracy to 94.7% (p=0.50), 82.6% (p=0.13), 90.2% (p=0.03) on a patient basis and 96.2% (p=0.50), 89.7% (p<0.01), 93.4% (p<0.01) on a lesion basis, respectively. Conclusion: 18F-FDG PET/CT demonstrated significantly higher sensitivity than neck US for the detection of recurred papillary thyroid cancer lesions. Furthermore, combined 18F-FDG PET/CT with neck US showed more improved sensitivity, specificity, accuracy for diagnosis of recurrent papillary thyroid cancer. (Nucl Med Mol Imaging 2009;43(5):411-420)

膿胸의 外科的治療와 肺剝皮術의 臨床的 評價

金近鎬(Kun Ho Kim) 대한외과학회 1966 Annals of Surgical Treatment and Research(ASRT) Vol.8 No.2

텍스트와 이미지 유사도 융합을 이용한 사람 재인식 기술

김근호(Kun-Ho Kim),김민재(Min-jae Kim),김형태(Hyungtae Kim),박석목(Seokmok Park),백준기(Joonki Paik) 대한전자공학회 2022 대한전자공학회 학술대회 Vol.2022 No.6

Pancoast’s Syndrome를 隨倂한 肺尖部腫痬 5例의 手術治驗

金近鎬(Kun Ho Kim),李東俊(Dong Jun Lee),文瑛植(Yung Sik Moon),魚秀元(Soo Won Eo) 대한외과학회 1967 Annals of Surgical Treatment and Research(ASRT) Vol.9 No.8

객체 검출 성능 향상을 위한 RepPoints 기반 IoU Supervision

김근호(Kun-Ho Kim),김민재(Min-jae Kim),김형태(Hyungtae Kim),박석목(Seokmok Park),박혁진(Hyeokjin Park),성현오(Hyunoh Sung),백준기(JoonKi Paik) 대한전자공학회 2021 대한전자공학회 학술대회 Vol.2021 No.6

RepPoints (Representative Points) recently showed that the anchor-free object detector could achieve competitive performance due to the adaptive representation. In this paper, we improve the representation power of RepPoints through the Intersection-over-Union (IoU) supervision. By adding the IoU estimation branch and loss, the network can learn to move the RepPoints toward more semantic locations. After training, the estimated IoU value is also used as the localization confidence in the Non-Maximum-Suppression (NMS) stage. Experimental results show that the proposed method is more accurate than the existing methods.

The effect of Nafion^(R) ionomer content/distribution and relative humidities on PEMFC performances of MEAs prepared by a CCM spraying method

김근호(Kim, Kun-Ho),전유택(Jeon, Yoo-Taek) 한국신재생에너지학회 2011 한국신재생에너지학회 학술대회논문집 Vol.2011 No.11

For commercial applications, MEA development must be optimized in order to achieve high performance and low cost. There are many factors that affect the performance of MEA. Especially, the optimization of the method for preparing catalyst layer has great effect on the performance of MEA. Various methods have been used to prepare the catalyst layer of MEA. Among them, spraying method has a merit in that catalysis lay can be prepared with very flexible changes in catalyst layer as well as in the solvent composition of catalyst ink. In addition, in order to reduce the time required for manufacturing catalyst layer, an effort has been made to change the nozzle size and injection pressure of spray system. Further, the operation condition of spray system was changed in various ways in an effort to prepare optimum catalyst layer of MEA. Having optimized the operation condition of spraying system, comprehensive and diverse experiments were carried out concerning various factors that affect the performance of MEA. The present research report describes the results of more sub-categorized and more detailed experiments about the important factors (Nafion^(R) ionomer, Relative humidity) which have been shown in previous experiments to exert greater effect on the performance of MEA.

胃腐蝕의 病理解剖學的 所見에 대한 考察

金近鎬(Kun Ho Kim),池幸玉(Heng Ok Jee) 대한외과학회 1972 Annals of Surgical Treatment and Research Vol.14 No.12

肺發育不全 及 囊腫을 隨伴한 外傷性 橫隔膜 Hermia 1例

金近鎬(Kun Ho Kim),李建祐(Keun Wo Lee) 대한외과학회 1970 Annals of Surgical Treatment and Research Vol.12 No.2