관상동맥조영술에 사용된 요골동맥의 우회도관으로서의 적합성에 대한 분석

신윤철,김응중,이동석,지현근 대한흉부외과학회 2004 Journal of Chest Surgery (J Chest Surg) Vol.37 No.11

Background: Although great concerns have been raised regarding the suitability of the use of the radial artery as a bypass conduit after transradial catheterization, there has been no studies that examined this issue in Korea. The purpose of this study was to compare clinical and angiographic results of radial artery grafting between patients with and without previous transradial catheterization. Material and Method: From January 2000 to February 2004, a total of 93 patients underwent coronary artery bypass grafting using the radial artery: 49 patients received preoperative transradial catheterization for coronary angiography (group I) and 44 patients did not (group II). These patients were retrospectively reviewed. Result: There was no significant difference in sex ratio, age, clinical diagnosis, risk factors, ejection fraction and early clinical outcomes between two groups. The graft patency rates in groups I and II were both 100% in the internal thoracic artery and in the radial artery, and 85% and 86% in the saphenous vein. respectively. The stenosis-free graft patency in groups I and II were 93% and 81% in the radial artery respectively but no statistical significance was shown. Conclusion: There was no significant difference in graft patency at postoperative coronary angiography between two groups. Radial artery graft after transradial catherization seems to be suitable for bypass conduit in short-term analysis. 배경: 관상동맥조영술 또는 중재술에 사용된 요골동맥을 관상동맥우회술시 우회도관으로 사용하는 경우가 늘고 있으나 이로 인한 요골동맥도관의 개존성 및 환자의 임상성적에 미치는 영향에 대해 체계적인 연구는 보고되고 있지 않다. 이에 본 저자들은 관상동맥조영술에 사용된 요골동맥을 우회도관으로 사용한 환자들의 임상성적과 술 후 개존도를 그렇지 않은 환자들과 비교 분석하고자 하였다. 대상 및 방법: 2000년 1월 부터 2004년 2월까지 관상동맥조영술에 사용된 요골동맥을 동맥도관으로 사용한 49예를 I군으로, 관상동맥조영술에 쓰이지 않은 요골동맥을 동맥도관으로 사용한 44예를 II군으로 정하여 두 군간에 성비, 나이, 술 전 위험인자, 과거력, 임상진단, 수술방법, 수술성적, 우회도관의 개존도 등을 후향적으로 비교 분석하였다. 결과: 두 군 간 남녀비, 연령, 진단명, 수술 위험인자, 심박출률 등의 유의한 차이는 없었다. 술 전 관상동맥조영술은 I군에서는 전예에서 좌측 요골동맥을 이용하였고 II군에서는 대퇴동맥 혹은 우측 요골동맥을 이용하였다. 수술은 전예에서 인공심폐기를 이용한 관상동맥우회술을 시행하였으며 수술사망은 양군에서 모두 없었고 주요합병증은 I군은 5예(10%), II군은 3예(7%) 있었다. 수술에 이용된 우회도관으로는 양군에서 내흉동맥, 요골동맥, 대복재정맥을 주로 이용하였고 I군은 환자당 평균 3.7 1.1원위부문합, II군은 3.7 0.9원위부문합을 시행하였고 요골동맥절편은 I군에서 환자당 평균 1.2 0.4원위부문합, II군에서 1.3 0.5원위부문합을 시행하였다. 요골동맥의 원위부문합은 양 군에서 회선지 부위가 가장 많았고 근위부문합은 두군에서 모두 상행대동맥, 내흉동맥, 대복재정맥 후드 순이었다. 수술 후 관상동맥조영술상 양군에서 내흉동맥과 요골동맥은 모두 100%의 개존도를 보였으며 대복재정맥은 I군 85%, II군 86%의 개존도를 보였다. 요골동맥절편에서 완전개존이 I군에서 93%로 II군의 81%보다 오히려 높게 나왔으나 유의하지는 않았다. 결론: 술 후 시행한 관상동맥조영술에서 양군에 개존율에 큰 차이는 없었으며 수술 전 관상동맥조영술에 사용된 요골동맥도 비교적 안전하게 관상동맥우회술의 우회도관으로 사용할 수 있다고 판단된다.

寄宿舍生의 個人 및 學業生活의 適應度에 關한 調査硏究

申允澈 진주교육대학교 1980 論文集 Vol.21 No.-

셀룰라 신경회로망의 연상메모리를 이용한 영상 패턴의 분류 및 인식방법

신윤철,박용훈,강훈 한국지능시스템학회 2003 한국지능시스템학회논문지 Vol.11 No.3

셀룰라 신경회로망의 연상 메모리를 이용하여 시각적인 입력 데이터의 연산을 통하여 영상 패턴의 분류와 인식을 수행한다. 셀룰라 신경회로망은 일반적인 신경회로망과 같이 비선형 데이터의 실시간 처리가 가능하고, 세포자동자와 같이 이 격자구조의 셀로 이루어져 인접한 셀과 직접 정보를 주고받는다. 응용 분야로는 최적화, 선형/비선형화, 연상 메모리, 패턴인식, 컴퓨터 비전 등에 적용할 수 있다. 영상의 이미지 픽셀을 셀룰라 신경회로망의 셀에 대응하여 전체 이미지 영상을 모든 셀룰라 신경회로망의 셀에서 동시에 병렬로 처리할 수 있어 2-D 이미지 처리에 적합하다. 본 논문은 셀룰라 신경회로망에 의한 연상 메모리 구조를 설계하고, 학습된 하중값 메모리에서 가장 적당한 하중값을 선택하여 학습된 영상과 정확히 일치하는 출력을 얻는 방법을 제시한다. 학습을 통한 연상 메모리 구현에는 각각의 뉴런에서 일정하지 않은 다른 템플릿을 사용한다. 각각의 템플릿은 뉴런들 간의 연결 하중값을 나타내고 학습에 따라 갱신된다. 학습방법으로는 템플릿 하중값 학습에 뉴런들 간의 연결 하중값을 조정하는 가장 단순한 규칙인 Hebb의 학습방법이 사용되었고 분류값 학습에 LMS 알고리즘이 사용되었다. In this paper, Associative Memory with Cellular Neural Networks classifies and recognizes image patterns as an operator applied to image process. CNN processes nonlinear data in real-time like neural networks, and made by cell which communicates with each other directly through its neighbor cells as the Cellular Automata does. It is applied to the optimization problem, associative memory, pattern recognition, and computer vision. Image processing with CNN is appropriate to 2-D images, because each cell which corresponds to each pixel in the image is simultaneously processed in parallel. This paper shows the method for designing the structure of associative memory based on CNN and getting output image by choosing the most appropriate weight pattern among the whole learned weight pattern memories. Each template represents weight values between cells and updates them by learning. Hebbian rule is used for learning template weights and LMS algorithm is used for classification.

農工團地의 工業構造와 立地特性에 관한 硏究 : 忠淸南道를 中心으로

申尹撤 公州大學校 産業開發硏究所 1994 産業開發硏究 Vol.2 No.-

The development project of rural-industrial complex aims to verify income source and to activate regional economic in the rural area b introducing industry. Ultimately, its aim was to accomplish the balanced regional development between urban and rural. The objectives of the study were 1) to measure the industrial structure and the locational characteristics of the rural-industrial complex in Chung-chong Namdo, 2) to draw implications for the development directions of rural-industrial complex. The major findings of this study were as follows; 1) Chung-chong Namdo area was the most active area on the development of rural-industrial complex in korea. The 603 enterprises of 49 complexes were ranged over 20 cities and Guns in Chung-chong Namdo in the present. 2) The type of industry of the occupant enterprises, the machinery and metal industry was highest with 24.9%, but the food industry was lowest with 6.5%. 3) The size of rural-industrial complex's enterprises, the number of employee were below 50 person(69.8%) and the size of estate was below a billion won(68.1%). 4) The characteristics of occupant enterprises in the complex, the newly established enterprises(52.9%) were more than the removal enterprises(47.1%). And the types of enterprises were divided into (1) a branch factory(46%), (2) a newly established factory(30.2%), (3) a removal factory(16.9%). And the major occupant factors in the rural-industrial complex were (1) the cheep land price(45.3%), (2) the support to tax and finance(21.7%).

農工團地의 開發實態와 發展方向

申尹澈 公州大學校 地域開發硏究所 1992 地域開發硏究論叢 Vol.1 No.1

The objectives of the study were 1) to review the present situation and problems and 2) to search further development directions in the development work of Rural-industrial district. This study was carried out through literature review. The major findings of this study were as follows; 1) In order to develop and activate continually the Rural-industrial district, the manpower supply-demand relaction and the rural manpower utilization must be achived. In point of the rural manpower utilization, it is important not only growing the factory working ratio for the enterprises in rural-industrial district but also growing technical skilled manpower for the qualitive supplement of rural manpower. 2) Rural-industrial district development work must be carried out in terms of a link a chain of intergrated community development programs. So, rural area can be activated a settlement living area and a base of economic activity. And the shortage of manpower of rural-industrial enterprises can be solved basically. 3) In order to cope with the radical changes of industrial environment by the open-door policy and internationalization, rural-industrial district development stratigies must be changed. In the beginning, rural-industrial district development work was set out from farming income increasing. Now we must have aims to leaving out from petty farming and employment promoting of rural living. And rural-industrial district must be become a main location source of small and medium enterprises in rural-industrial district. So, we can achived macro goals by means of a balanced community development.

소아개심술시 아프로티닌이 술후 출혈 및 혈액응고계에 미치는 영향

신윤철,전태국 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.3

1994년 12월부터 1995년 4월까지 서울대학교병원 소아흉부외과에서 개심술을 시행받는 95명의 환아 들을 무작위로 아프로티닌을 쓴 환아군(n=47)과 쓰지않은 환아군(n=48)으로 분류하여 아프로티닌의 효과에 대하여 연구하였다. 아프로티닌은 50,000K/U/kg를 인공심폐기의 충전용액에 단일 투여하였다. 술전, 마취후 5분, 심폐기 관류 5분후, 심폐기 관류 35분후, 재관류 5분후, 재관류 3시간후 및 24시간후에 혈액을 채 취하여 헤모글로빈, 헤마토크릿, BUW, creatinine, 섬유소원, 전해질 농도, 활성 응고시간, 프 로트롬빈 시간, 제3항 트롬빈 등을 측정하였다. 또한 술후 24시간 동안 흥관을 통한 배액 양, 수혈 혈액의 양을 체중으로 나누어 비교하였다. 두 환자군간에 술후 24시간 동안 수혈한 충전 적혈구 양을 제외한 다른 모든 검사에서 통계 학적 의의는 없었으나 아프로티닌의 부작용은 발견되지 않았고 출혈로 인한 재수술도 없었다. From December of 1994 to April of 1995, we, SHUH Department of Pediatric Thoracic and Cardiovascular Surgery, studied effects of aprotinin. 95 patients were randomly divided into two groups : group I (n=47) with aprotinin and group ll (n=48) without aprotinin. Aprotinin was given as one shot injection to cardiopulmonary bypass perfusion solution with dose of 50,000 KIUikg. Laboratory data such as hemoglobin, hematocrit, BUH, creatinine, fibrinogen, electrolyte concentration, aPTT, PT, and AT R was checked preoperatively, 5 minutes after anesthesia, 5 minutes and 35 minutes after CPB circulation, and 5 minutes, 3 hours, and 24 hours after reperfusion. Also, chest-tube drainage, transfused amount of RBC, platelet concentrate, and fresh frozen plasma within first 24 hours postoperatively were checked and analyzed after transition nn body weight demension. Only RBC transfused postoperatively had statistical significance with P value of less than 0.001. Others had no difference statistical wise. Postoperative side effects of aprotinin was not detected weeks after the surgery and there was no reoperated patient due to postoperative bleeding.

初等敎育의 當面課題와 改善方向

申允澈 진주교육대학교 1981 論文集 Vol.1981 No.23

영아 및 소아에서의 대동맥궁의 형성부전을 포함한 대동맥 교약증의 수술요법 -21년간의 수술 경험-

신윤철,이정렬,김용진,노준량,Sin, Yun-Cheol,Lee, Jeong-Ryeol,Kim, Yong-Jin,No, Jun-Ryang 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.3

1973년 3월부터 1994년 12월까지 수술을 시행한 영아 및 소아 연령의 대동맥 교약증 157례를분석하 였다. 남아가 93명 여아가 64명 이 었고 연령은 1개 월부터 15세까지로 평균 23.8 $\pm$ 41.6개월이 었다. 영아 기의 주증상은 심부전이 었고(781113) 그 이상의 연령 에서 무증상이 빈번하였다(15/44). 단독 대동맥 교약증은 31례의 환아에서 있었고, 9례의 환아에서 심방중격결손이 있었으며(I군), 73명 의 환아에서 심실중격결손이 동반됐고(ll군), 44명의 환아에서 복잡 심기형이 있었다(III군).대동맥궁 의 형 성 부전은 17례의 환아에서 발견되었다. 수술은 71례의 환아에서 쇄골하동맥 편 성형술이 시행됐고, 단순 단단문합술이 32례, 조직편 대동맥 성형술이 26례, 확장 단단문합술이 27례, 기타 1례가 있었다, 전체 수술사망률은 17.2% (27/157)이었고, 재 협착률은 18.0% (28/157)이 었다. 수술합병증은 영아기에 서는 호흡기질환이, 그 이상의 연령 에서는 고혈압이 가장 많았다. We have reviewed 157 cases of coarctation of aorta in the age of infancy and children from March 1973 to december 1994. Patients were 9) males and 64 females, and their age ranged from one month to fifteen years (23.8 $\pm$ 41.6months) with 113 infant cases. In the infantile age, congestive heart failure was the most common chief complaint (781113), and above that age, asymptom was most common (15/44). Isolated coarctation was present in 31 patients, and 9 patients had additional atrial septal defect (group I), 73 patients had associated ventricular septal defect (group II), and 44 patients had associated complex intracardiac lesions(group III). Aortic arch hypoplasia was present in 17 patients. , The operations perf'ormed were subclavian flap angioplasty in 71 patients, resection and anastomosis in 32 patients, patch aortoplasty in 26 patients, resd extended end-!o-end anastomosis in 27 patients, and direct angioplasty with resection of web in 1 patient. The early mortality was 17.2% (27/157) and re-coarctation rate was 18.0% (281157). The most common complication was respiratory problem in infants and postoperative hypertension in children.

初等敎員 養成制度와 敎育課程改編에 관한 硏究

申允澈 진주교육대학교 1978 論文集 Vol.16 No.1

1. Object There are colleges of education as institution of cultivating elementary in Korea. It is more of less insufficient to cultivate the excellent elementary teachers in the current system of colleges of educations and curriculum. In this research, the main point is as follows: I suggest the developed model of the educated reform which is essential to the elementary teacher training system and curriculum in order to accomplish the elementary education correctly. 2. The Context of Research: We consider the specialty of the teaching profession with respect to the theoretical background and describe the quality of teachers and the peculiarity of elementary teacher. We clarify the direction of the teacher's education. We research the difference between our country and other country(America, England, France, Germany Japan etc) to the system of cultivating elementary teachers and curriculum. Also we analyze all the problems of Elementary-teacher-training system and the public opinion to the system of college of education in our country. Therefore the main subjects are the reformed model of the elementary teacher training system and curriculum. 3. The Method of Research In this paper, we analyze references and preceding researchs and as a tentative plan suggest the model of the developed reform informations which is given to during disscussions. 4. Result 1. It is desirable to cultivate elementary teacher at Universities when we consider the specialty of teaching profession and peculiarity of Elementary education. 2. In the advanced nations, Elementary teachers are cultivated at Universities. 3. We all agree to reform the system of the college of Education because it is insufficient to cultivate the excellent elementary teacher under current condition of the college of Education. 5. Conclusion It is desirable to train elementary teachers at educational University (four-year-Education) and we need the credits are 140 or 160.

셀룰라 신경회로망 기반의 연상메모리를 이용한 영상패턴의 분류 및 인식에 대한 연구

신윤철,조용군,박용훈,강훈 중앙대학교정보통신연구소 2001 정보통신연구소논문집 Vol.3 No.1

셀룰라 신경회로망은 실시간의 비선형 데이터를 처리하는 신경회로망의 기능과 이웃하는 셀과 직접 통신하는 세포자동차의 구조를 갖고 있다. 각각의 셀들이 영상의 화소와 대응하여 동시에 병렬적인 처리가 가능하기 때문에 영상 처리 문제에 셀룰라 신경회로망이 적합하다. 본 논문에서는 셀룰라 신경회로망에 기반한 연상 메모리의 구조를 디자인하고 학습된 전체 패턴에서 최적의 하중 패턴을 선택하여 출력 영상을 얻는 방법을 제안한다. 이 때 사용되는 템플릿 패턴을 학습하기 위해 Hebbian 학습법을, 영상을 분류하기 위해 LMS 알고리듬을 사용하였다. Cellular Neural Networks process nonlinear data in real-time like neural networks, and consist of cells which communicate with each other directly through their neighbor cells as the Cellular Automata does. Image processing with CNN is appropriate to 2-D images, because each cell which corresponds to each pixel in the image is simultaneously processed in parallel. This paper suggests the method for designing the structure of associative memory based on CNN and getting output image by choosing the most appropriate weight pattern among the whole learned weight pattern memories. Hebbian rule is used for learning template weights and LMS algorithm is used for classification.