Left Ventricular Pacing after Mitral, Tricuspid Valve Replacement without Interruption of Anticoagulation

Yo-Han Ku,Hyung-Wook Park,Seong Ahn,Sang-Yoon Ha,Rim Lee,Ki Hong Lee,Jeong Gwan Cho 순천향대학교 순천향의학연구소 2014 Journal of Soonchunhyang Medical Science Vol.20 No.2

Pacemaker implantation for patients with mechanical tricuspid valve is quite challengeable because lead insertion through prosthetic tricuspid valve may cause valve dysfunction or lead impingement. Also complications due to interrupt of anticoagulation should be considered. A 65 years old woman received AAI (atrium paced, atrium sensed, inhibited) pacemaker for sick sinus syndrome and mechanical mitral valve replacement for severe mitral steno-insufficiency at the same time 16 years before. She needed to undergo mechanical tricuspid valve replacement (TVR) because of severe tricuspid regurgitation despite of medical therapy. Complete atrioventricular block developed during the TVR operation and it was not recovered even after several days of temporary pacing. We decided left ventricular pacing through coronary sinus because ventricular lead could not pass mechanical tricuspid or mitral valve and also planned to continue oral anticoagulation therapy. We could find a place where high pacing output did not pace phrenic nerve with acceptable sensing, pacing threshold. The patient recovered well without any periprocedural complications. Left ventriclcular pacing lead implantation through coronary sinus without interruption of anticoagulation can be an alternative to epicardial pacing for patients with mechanical tricuspid valve.

연하곤란의 드문 원인인 Kommerell 게실

구요한 ( Yo Han Ku ),김계훈 ( Kye Hun Kim ),김형윤 ( Hyung Yoon Kim ),정인석 ( In Seok Jeong ),정명호 ( Myung Ho Jeong ),조정관 ( Jeong Gwan Cho ),박종춘 ( Jong Chun Park ) 대한내과학회 2020 대한내과학회지 Vol.95 No.4

Kommerell 게실은 근위부 하행대동맥의 확장이 특징인 대동맥 궁의 드문 선천성 이상으로 이상적으로 기시하는 쇄골하동맥이 동반된다. 무증상일 수 있으나 식도나 기도 등의 압박으로 인한 증상이 동반될 수 있으며, 대동맥 박리나 게실의 파열로 나타날 수 있다. 저자들은 우측 대동맥 궁에서 동반된 Kommerell 게실이 식도를 압박하여 심한 연하곤란으로 발현한 증례를 경험하였기에 보고하고자 한다. Kommerell diverticulum is a rare congenital anomaly of the aortic arch characterized by dilation at the proximal descending aorta, which gives rise to an aberrant subclavian artery. Kommerell diverticulum is usually asymptomatic, but can also be associated with symptoms due to compression of the esophagus or trachea, and can rarely be fatal due to dissection or rupture of the diverticulum. Here, we report a rare case of dysphagia caused by compression of the esophagus by Kommerell diverticulum originating from the right-sided aortic arch. (Korean J Med 2020;95:287-291)

고용량 항암요법후 말초혈액 자가조혈모세포 이식환자에서의 감염 양상

구성현,최소연,조요한,한동석,마경애,김현수,김효철 대한조혈모세포이식학회 1996 대한조혈모세포이식학회지 Vol.1 No.1

목적: 동종골수이식이나 자가골수이식, 말초혈액 자가조혈모세포이식에서 공통적으로 이병률과 사망률에 관여하는 중요한 인자중의 하나가 항암 치료후 발생하는 감염이다. 감염의 발생빈도 및 정도에 대해서 확실히 알수 있고, 위험인자를 감별해 낼수 있다면 고용량 항암요법 후에 발생하는 이병률과 사망률을 줄여 더 나은 결과를 얻을수 있다고 사료되어 저자 등은 고용량 항암요법을 시행한 환자들을 대상으로 후향적인 연구를 통해 감염 및 그로 인한 합병증을 발생빈도, 정도 및 감염과 관련된 위험인자를 규명하려고 하였다. 방법: 1995년 11월부터 96년 8월까지 아주대학교병원에서 고용량 항암요법후에 말초혈액 자가조혈모 세포이식을 시행한 33명의 환자를 대상으로 하여 나이, 성별, 진단명, 조혈모세포이식 날짜, 사용한 항암제의 종류, 방사선 치료 유무 여부, 호중구 감소증 기간, 사망여부, 사망원인을 분석하였다. 결과 33명의환자에서 37회(4명은 2번 항암치료)의 고용량 항암 요법을 시행한 결과를 분석하였다. 1) 기존에 가지고 잇는 질환을 종류별로 보면, non-Hodgkin's lymphoma(n=13), Hodgkin's disease(n=1), breast cancer(n=5), stomach cancer(n=14)이었으며 모든 환자가 기존의 항암 치료에 불응하는 악성 종양이었다. 2) 대상환자의 평균 연령은 42세이었으며 여자가 18명이었고, 평균 호중구 감소기간은 9.62일 이었다. 3) 37회 고용량 항암 요법후 8회를 제외한 29회 (78.3%)에서 열이 있었으며, 29회의 발열 중 8예(21.6%)에서 감염이 균 검출로 증명되었거나 임상적으로 확실히 의심되었다. 8회의 감염중 Staphylococcus epidermidis가 1예, E coli가 2예, Bacteroides fragilis가 1예 있었다. 4) 33명의 환자중 모두 10명이 현재까지 추적관찰중 사망하였는데 이중 2명이 고용량 항암요법후 호중구가 감소되어있는 기간에 발생한 패혈증으로 사망하여 사망원인이 고용량 항암요법에 의한 합병증과 직접적인 연관이 있었다. 5) 감염에 연관되는 위험인자를 알아보기 위하여 나이, 성별, 방사선치료유부, 호중구 감소증 기간, 악성종양 종류 등을 감염군과 비감염군으로 나누어 비교하였는데 모든 항목에서 감염군과 비감염군 사이에 통계적으로 의미있는 차이를 찾을수 없었다. 결론: 고용량 항암요법후 감염이 가장 중요한 이병률 및 사망률의 원인이 되고 있는데 현재 말초혈액 자가조혈모 세포이식후 조혈촉진인자를 사용하여 감염 발생률을 많이 줄이기는 하였으나 앞으로 좀더 많은 환자를 오랜기간 추적 관찰하여 감염으로 인한 문제점을 찾아 개선해 나가야 하겠다. Objectives: Infection is one of the most important factor in the morbidity and mortality of both allogenic and autologous bone marrow transplantation, and peripheral blood stem cell transplant patients. Therefore, an accurate knowledge of the incidence, severity, and risk factors can lead to reduction in the morbidity and mortality. We performed a retrospective analysis in patients with high dose chemotherapy to clarify these infections and also the incidence of complication, severity and associated risk factors. Methods: The subjects of our study were patients who had been admitted at Ajou University Hospital from November 1995 to August 1996 and received autologous peripheral blood stem cell transplantation(PBSCT) after high dose chemotherapy. There were 33 patients in all and the following were analyzed : age, sex, disease diagnosis, date of PBSCT, the duration of neutropenia, and the cause of death. Results: The results of 37 trials (4 patients had two trials) of high dose chemotherapy in 33patients were analyzed. ① The diagnosis included non-Hodgkin's lymphoma(n=13), Hodgkin's disease(n=1), breast cancer(n=5), stomach cancer(n=14). All of the patients were refractory to the conventional chemotherapy. ② The average age was 42years, 18 of the patients were female and the mean duration of netropenia was 9.62days. ③ 29 out of37trials was associated with fever. In 8 out 29case, infection was diagnosed by detection of bacteria or clinically suspicious. Staphylococcus aureus was detected in 4case, Staphylococcus epidermidis in 1 case, E coli in 2 case, and Bacteroides fragilis 1 case. ④10patients died during follow up. 2 case died of sepsis during the period of neurtropenia. Therefore 2 death were directly related to the complications of high dose chemotherapy. ⑤The following factors were analyzed in both infected and non-infected group to determine if there any significant different: age, sex, radiation therapy, duration of neutropenia, disease. There was no significant different between the 2 groups. Conclusion: Infection is the most important cause of morbidity and mortality in high dose chemotherapy. The rate of infection has been largely reduced as a result of rapid marrow engraftment following autologous PBSCT. A longer duration of follow up must be done on more patients to find and improve the problems after autologous PBSCT.

SVD MIMO Transmission schemes for Time-varying channel

Yo Han Kim,Sang Woon Chun,Eun Jeong Yim,Dong Ku Kim 한국통신학회 2003 한국통신학회 학술대회논문집 Vol.2003 No.11

단일광자방출전산화단층촬영을 이용한 정신분열증 환자의 국소 뇌혈류 변화에 대한 평가

이요왕 ( Yo Wang Lee ),이경한 ( Kyeng Han Lee ),채정호 ( Jung Ho Chai ),한광수 ( Kwang Su Han ),노왕구 ( Wang Ku Rho ),김원길 ( Won Kil Kim ) 국군의무사령부 1993 대한군진의학학술지 Vol.24 No.1

항공 우주 해상 : ADS-B 메시지를 이용한 충돌 경보 알고리즘에 관한 연구

주요한 ( Yo Han Ju ),구성관 ( Sungkwan Ku ),홍교영 ( Gyo Young Hong ) 한국항행학회 2015 韓國航行學會論文誌 Vol.19 No.5

1990년대 말 미국에서는 미래 자유비행 기술개발 및 시험을 추진하였고, 이에 국내에서도 2017년까지 자유비행을 실현 할 계획을 수립하였다. 자유비행 실현을 위해서는 항공기 간 충돌의 예방을 위해 항공기 분리보증 (separation assurance)이 필수적이다. 현대 대형 민간항공기는 분리보증을 위해 충돌회피장치(TCAS; traffic collision avoidance system) 운영 및 회피 기동 규칙이 있지만 경량항공기는 비용과 공간 문제로 TCAS를 적용하기 어렵기 때문에 이에 대한 대안이 필요하다. 이에 본 논문에서는 저비용으로 경량화 및 소형화되어 구성된 ADS-B 환경 하를 가정하여 소형항공기에 적합하도록 수정하였고 LABVIEW 프로그램으로 시뮬레이션하여 시험해보았다. 시뮬레이션은 국제항공민간기구에서 제시한 항공기 충돌상황에 대하여 수행하였고, 그 결과 TCAS 기준에 따라 경보발령을 100% 수행하였음을 확인하였다. In the end of 1990’s, future free flight technology had been developed and tested in America and government established the plan for free flight until 2017. Aircraft separation assurance must be secured essentially to avoid collision between aircrafts before Free Flight comes true. Now, Civil aircraft has rules about avoidance activity with traffic collision avoidance system (TCAS) but it can`t apply to light aircraft. So there is a need about alternative method to apply light-aircraft because it has space and price problem to use TCAS. In this paper, TCAS algorithm has been modified and verified by simulating with LABVIEW program under ADS-B condition to get miniaturization and weight lighting cheaply. By simulating, collision alert algorithm is analyzed and verified with collision situation proposed by ICAO, and 100% checked for performing the alert announciation on all cases by TCAS standards.

Acute Pancreatitis Associated with Pegylated Interferon α-2b and Ribavirin Treatment of Chronic Hepatitis C

Seong Ahn,Yo Han Ku,Sang Yoon Ha,Rim Lee,Cheol Koo 순천향대학교 순천향의학연구소 2014 Journal of Soonchunhyang Medical Science Vol.20 No.2

Acute pancreatitis is an uncommon side effect of pegylated interferon (PEG-IFN) α-2b and ribavirin (RBV) combination therapy. In South Korea, There is a no report of acute pancreatitis associated PEG-IFN α-2b plus RBV combination therapy. Here, acute pancreatitis associated with PEG-IFN α-2b plus RBV treatment is described in two patients with chronic hepatitis C. We started on weekly subcutaneous injection of PEG-IFN α-2b plus daily RBV. During this therapy, acute pancreatitis occurred in these patients without other causes of acute pancreatitis. We thought that the cause of acute pancreatitis in these patients was PEG-IFN α-2b and RBV. We stopped the treatment of PEG-IFN α-2b and RBV, and patients were improved.

소형무인항공기 항법시스템오차 시험평가 방법

구성관 ( Sungkwan Ku ),안효정 ( Hyojung Ahn ),주요한 ( Yo-han Ju ),홍석민 ( Seokmin Hong ) 한국항행학회 2021 韓國航行學會論文誌 Vol.25 No.6

최근 무인항공기의 활용 범위와 수요가 지속적으로 증가하고 있으며, 저고도 무인항공기의 경우 유인항공기와 별개의 관리 체계 개발을 통해 별도의 운영 시스템 구축에 관한 연구가 진행되고 있다. 저고도 무인항공기의 경우도 공역을 비행하는 비행체 이므로 비행체의 운영에 필요한 기술 기준 및 인증 제도의 수립이 필수적이며, 이에 대한 연구도 함께 진행되고 있다. 비행체의 운영기준 및 인증 요건이 제시되는 경우, 이를 확인할 수 있는 시험방법도 함께 제시되어야 한다. 특히, 소형무인항공기의 경우는 비행 중 요구되는 항법의 정확도 수준이 유인항공기 또는 대형 무인항공기 보다 정밀한 비행을 요구하므로, 기존의 비행체 비행에서만 확인할 수 있는 비행 결과 정확도 산출이 아닌 별도의 항법오차의 산출이 필요할 것으로 판단하였다. 본 연구에서는 기존 유인항공기와 다른 장시간의 운영 데이터 획득이 어려운 무인항공기에 적용이 가능한 항법 오차 도출에 관한 시험 방법에 대하여 제시하였고, 실증 시험을 수행하였다. Recently, the range of utilization and demand for unmanned aerial vehicle (UAV) has been continuously increasing, and research on the construction of a separate operating system for low-altitude UAV is underway through the development of a management system separate from manned aircraft. Since low-altitude UAVs also fly in the airspace, it is essential to establish technical standards and certification systems necessary for the operation of the aircraft, and research on this is also in progress. If the operating standards and certification requirements of the aircraft are presented, a test method to confirm this should also be presented. In particular, the accuracy of small UAV’s navigation required during flight is required to be more precise than that of a manned aircraft or a large UAV. It was necessary to calculate a separate navigation error. In this study, we presented a test method for deriving navigation errors that can be applied to UAVs that have difficulty in acquiring long-term operational data, which is different from existing manned aircraft, and conducted verification tests.

Methyl cellulose- and carrageenan-based edible coatings to improve quality and shelf-life of melon cubes

Dan Yeol Ku,Ji Hye An,Dae Beom Yun,Yo Han Song,Hea Joon Kim,Jeong pin Ahn,Hyo Jin Kim,Dong Hwa Chung 한국산업식품공학회 2022 학술대회 및 심포지엄 Vol.2022 No.11

다양한 악성 종양에서의 말초혈액조혈 모세포이식을 통한 고용량 항암치료

김현수,구성현,최소연,조요한,지석배,박준성,박희붕,황성철,유희석,전미선,조용관,김효철 대한조혈모세포이식학회 1996 대한조혈모세포이식학회지 Vol.1 No.1

High dose chemotherapy with autologous stem cell transplantation is a new therapeutic strategy for various malignancy, especially leukemia, lymphoma, breast cancer. Recently, increasing number of trials has been done in solid tumors responsive to conventional chemotherapy using high dose chemotherapy and autologous peripheral blood stem cell transplantation. At Ajou University Hospital, between August 1995 and September 1996, 60 patients received high dose chemotherapy with peripheral blood stem cell transplantation, which in cluded 20 stomach cancers, 16 breast cancers, 15 lymphomas, 4 lung cancers, 3 ovarian cancers, 1 cervix cancer and 1 cancer of unknown primary cancer. Median age of patients was 44 years(range, 19 to 66), and male to female ratio was 0.7:1. The median time to recovery to neutrophil count more than 0.5x109/L was 11 days, and platelet count more than 20x109/L and 50x109/L was 13 and 17 days. With high dose chemotherapy in 41 patients who had relapsed or refractory disease, the complete remission was achieved in 34%(14/41) of patients and overall response rate was 83%(34/41). There was high response rate in spite of various tumor and various status of disease. In with stomach cancer and breast cancer who were given HDCT with adjuvant treatment aim, high dose chemotherapy was well tolerated with minimal non-hematogic toxicity and morbidity. During high dose chemotherapy, there was three transplantation related death, 2 sepsis and 1 veno-occlusive disease. Our experience suggest is well tolerated procedure which confers that high dose chemotherapy with peripheral blood transplantation will be a promising treatment modality for the relapsed and refractory tumors, as well as for patients with high risk for relapse following curative surgical resection.