Accuracy of cardiac output measurements during off-pump coronary artery bypass grafting: according to the vessel anastomosis sites

Sung Yong Park,Dae Hee Kim,Han Bum Joe,Ji Young Yoo,Jin Soo Kim,Min Kang,Yong Woo Hong 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.5

Background: During beating heart surgery, the accuracy of cardiac output (CO) measurement techniques may be influenced by several factors. This study was conducted to analyze the clinical agreement among stat CO mode (SCO), continuous CO mode (CCO), arterial pressure waveform-based CO estimation (APCO), and transesophageal Doppler ultrasound technique (UCCO) according to the vessel anastomosis sites. Methods: This study was prospectively performed in 25 patients who would be undergoing elective OPCAB. Hemodynamic variables were recorded at the following time points: during left anterior descending (LAD) anastomosis at 1 min and 5 min; during obtuse marginal (OM) anastomosis at 1 min and 5 min: and during right coronary artery (RCA) anastomosis at 1 min and 5 min. The variables measured including the SCO, CCO, APCO, and UCCO. Results: CO measurement techniques showed different correlations according to vessel anastomosis site. However, the percent error observed was higher than the value of 30% postulated by the criteria of Critchley and Critchley during all study periods for all CO measurement techniques. Conclusions: In the beating heart procedure, SCO, CCO and APCO showed different correlations according to the vessel anastomosis sites and did not agree with UCCO. CO values from the various measurement techniques should be interpreted with caution during OPCAB. Background: During beating heart surgery, the accuracy of cardiac output (CO) measurement techniques may be influenced by several factors. This study was conducted to analyze the clinical agreement among stat CO mode (SCO), continuous CO mode (CCO), arterial pressure waveform-based CO estimation (APCO), and transesophageal Doppler ultrasound technique (UCCO) according to the vessel anastomosis sites. Methods: This study was prospectively performed in 25 patients who would be undergoing elective OPCAB. Hemodynamic variables were recorded at the following time points: during left anterior descending (LAD) anastomosis at 1 min and 5 min; during obtuse marginal (OM) anastomosis at 1 min and 5 min: and during right coronary artery (RCA) anastomosis at 1 min and 5 min. The variables measured including the SCO, CCO, APCO, and UCCO. Results: CO measurement techniques showed different correlations according to vessel anastomosis site. However, the percent error observed was higher than the value of 30% postulated by the criteria of Critchley and Critchley during all study periods for all CO measurement techniques. Conclusions: In the beating heart procedure, SCO, CCO and APCO showed different correlations according to the vessel anastomosis sites and did not agree with UCCO. CO values from the various measurement techniques should be interpreted with caution during OPCAB.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

Reduction of Bacillus cereus Contamination in Biofilms on Stainless Steel Surfaces by Application of Sanitizers and Commercial Detergent

Lee, Min-Jeong,Ha, Ji-Hyoung,Kim, Yong-Su,Ryu, Jee-Hoon,Ha, Sang-Do The Korean Society for Applied Biological Chemistr 2010 Applied Biological Chemistry (Appl Biol Chem) Vol.53 No.1

We established the effectiveness of a washing, detergent and sanitizer treatments for reducing Bacillus cereus (B. cereus) contamination in biofilms on stainless steel surfaces. A water treatment did not affect biofilms and chlorine treatments at 200 ppm for 10 min and 300 ppm for 5 min, iodophor at 200 ppm for 10 min, and QAC at 400 ppm for 10 min were used to eliminate all B. cereus cells. B. cereus cells after detergent treatment were eliminated by chlorine at 100 ppm for 10 min, 200 ppm for 5 min, and 300 ppm for 3 min, and with iodophor at 100 ppm for 10 min and 200 ppm for 10 min, and QAC at 400 ppm for 10 min.

쿠싱증후군 환자에서 당 대사 이상 정도에 따른 인슐린 감수성과 인슐린 저항성의 변화

정인경,김성훈,정재훈,민용기,이명식,이문규,유형준,안규정,노정현,김동준,김광원 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

연구배경 당질 코르티코이드는 당 대사에 매우 중요한 호르몬으로 내인성 당질 코르티코이드 과다상태인 쿠싱증후군에서는 말초조직에서 인슐린 저항이 증가하고 이를 보상하고자 인슐린 분비의 증가로 고인슐린혈증이 동반된다고 보고되고 있다. 하지만 생체 내에서와 달리 시험관내에서는 췌도세포에 당질 코르티코이드를 장시간 처리하면, 인슐린 분비 및 생합성이직접적으로 억제됨이 확인된 바 있어 쿠싱증후군 환자에서 당뇨병의 원인으로는 아마도 말초조직에서 증가된 인슐린 저항성 뿐 아니라 이를 충분히 보상하지 못하는 췌장에서의 인슐린 분비 저하가 같이 동반되어있지 않을까 하는 가설을 세우게 되었고, 아직까지 당질코르티코이드가 당대사 이상을 일으키는 기전에 대해 쿠싱증후군을 당대사 정도에 따라 인슐린 감수성과 분비능을 분석한 연구는 없었기에 이를 알아보고자 하였다. 방법: 삼성서울병원에서 쿠싱증후군으로 진단 받은 환자 15명을 대상으로 하였다. 이에 대한 대조군으로는 쿠싱증후군 환자와 같은 성별 그리고 체질량지수를 갖은 15명의 건강한 성인을 대상으로 비교 하였다 쿠싱증후군 환자를 대상으로 경구당부하 검사를 통해 당대사 정도를 정상군, 내당능장애군, 그리고 당뇨병군으로 나눈 후 정맥 당부하 검사를 시행하여 각군의 인슐린 저항성과 인슐린 분비능의 지표를 비교하고, 수술 후 쿠싱증후군이 완치된 상태에서 수술 전후의 당대사 지표의 변화를 조사하였다. 결과: 1) 쿠싱증후군 환자 중 정상인은 20%, 내당능 장애는 27%, 그리고 당뇨병은 53%였다. 체질량지수, 나이, 그리고 발병 기간은 세 군간에 의미 있는 차이가 없었으나, 24시간 소변검사의 코르티솔 농도는 당뇨병군에서 의미있게 높았다. 2) 정맥당부하 검사 결과, 인슐린 감수성 지표인 Sl는쿠싱증추린」서 1.58±0.10[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 대조군의 3.37±0.49[×10^(-4)(min^(-1)(μU/mL)^(-1)]에 비해 의미있게 낮았으나(P=0.024), 쿠싱증후군 환자 중 NGT, IGT, DM 군간에 서로 통계적인 차이는 없었다. 3) SG는 정상 대조군과 쿠싱증후군 환자간에는 의미있는 차이가 없었고, 쿠싱 증후군에 있어서 당대사가 악화될수록 감소하는 경향을 보였으나 의미있는 차이는 없었다. 4) 인슐린 분비능의 지표인 AIRg는 정상인에 비해 전체 쿠싱증후군 환자의 경우 증가하는 경향을 보였으나 의미있는 차이는 없었다. 하지만 쿠싱증후군 환자중에서 당대사 상태에 따라 NGT군은 1299 (1297∼1310)(mu/g/min ×10^(-2))로 정상 대조군(368.9±98.6[mu/g/min ×10^(-2)]) 보다도 의미있게 높았고, DM군{202.2 (91.1~371.4) [mu/g/min ×10^(-2)}은 NGT군에 비해 의미있게 낮았다(P=0.0031). 5) 15명중 현재 완치 상태에 있는 6명에 대해 수술전과 후로 비교하였다. 수술 전 당대사 상태가 1명은정상, 1명은 내당능 장애, 그리고 4명은 당뇨병이었으나 수술 후 시행한 경구 당부하 검사상 모두 정상 당대사 상태를 보였다. 6) 수술 후 완치된 환자 6명에 있어 인슐린 감수성지표인 Sl는 수술전에 중앙값이 1.22[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 대조군에 비해 의미있게 감고』어 있었으나(p.0.05), 수술후 10.95 [×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 수준으로 회복되었고(P=0.0022), 인슐린 분비능을 나타내는 AIRg [mu/g/min ×10^(-2)] 값도 정상수준으로 회복되었다. 특히 인슐린 분비능의 회복양상은 혈당농도에 따라 판이하게 나타나서, 정상과 내당능장애 상태에 있던 2명은 수술전에 1201 [mu/g/min ×10^(-2)]로 증가되어 있던 AIRg 값이 수술 후 정상 수준으로 감소하였고, 수술 전에 당뇨병 상태에 있던 4명의 경우 245.9 [mu/g/min ×10^(-2)]로 인슐린 분비능이 감고il어 있었는데 이들은 수술 후 모두 정상 수준으로 증가되었다 (P=0.0286). 결론: 쿠싱증후군 환자에서 당대사 이상은 80%로 높은 유병률을 보였다. 모든 쿠싱증후군환자에서 인슐린 감수성은 정상인에 비해 저하되어 있어 말초조직의 인슐린 저항이 선행됨을 시사하며, 인슐린 분비능은 당대사의 정도에 따라 다르게 나타났는데, 정상 당대사군에서는 인슐린의 저항성을 극복할 만큼 정상 대조군보다 더 많은 양의 인슐린 분비를 하다가 고코르티솔혈증이 심할수록 인슐린 분비능의 감소로 당뇨병으로 진행됨을 확인할 수 있었고, 이런 인슐린 저항성과 인슐린 분비장애는 수술 후 다시 회복되는 가역적인변화를 보였다. Background: Glucocorticoid plays an important role in the control of carbohydrate metabolism. Patients with Cushing's syndrome have been reported to have an increased incidence of carbohydrate intolerance due to peripheral insulin resistance and hyperinsulinemia, although the exact incidence and nature of this disorder have remained unclear. Few results have been published about insulin resistance and insulin secretion according to the level of glucose concentration, or about the reversibility of such defects in patients with Cushing's syndrome. Methods: To assess the effect of glucocorticoid on the insulin sensitivity and insulin secretion in Cushing's syndrome, 15 patients with Cushing's syndrome were classified into 3 groups (normal glucose tolerance: NGT, impaired glucose tolerance: IGT, diabetes: DM) according to the degree of glucose tolerance based on the oral glucose tolerance test (OGTT). Insulin modified, frequently sampled, intravenous glucose tolerance test (FSIGT) was performed before and after curative surgery on these patients and on 15 healthy control subjects. Data were evaluated by non-parametric statistical analysis. Results: 1) Among the 15 patients with Cushing's syndrome, 3 (20%) were NGT, 4 (27%) IGT, and 8 (53%) DM, based on OGTT. Twenty-four hour urinary free cortisol (UFC) was significantly higher in the DM group. 2) Insulin sensitivity index (SI) of Cushing's syndrome was significantly lower than that of the control group p=0.0024), but was not significantly different among the three Cushing's syndrome groups of NGT, IGT and DM. 3) Glucose mediated glucose disposal (SG) (Ed- confirm this abbreviation; it does not seem to match the definition) of Cushing's syndrome was not significantly different from that of the control group. 4) Insulin secretion (AIRg) of Cushing's syndrome tended to be high, but it was not significantly different from that of control. However, according to the level of glucose concentration there was significant difference in AlRg among the three Cushing's syndrome groups p=0.0031); AIRg of DM was significantly lower than that of NGT. 5) After surgical treatment, parameters of insulin sensitivity and insulin secretion were normalized in 6 cured patients; 1 with NGT, 1 with IGT, and 4 with DM, preoperatively. Median SI of all 6 patients was significantly improved up to the normal range postoperatively p=0.0022). Median AIRg of these 6 patients was balanced around that of normal control postoperatively p=0.0286). Conclusion: Eighty percent of patients with Cushing's syndrome had abnormality of carbohydrate metabolism. Insulin sensitivity was significantly decreased in Cushing's syndrome. Insulin secretion was significantly higher only in the NGT and IGT groups of Cushing's syndrome. As the hypercortisolemia is exacerbated, insulin secretion is significantly decreased and causes DM, suggesting that glucocorticoid has a direct or indirect toxic effect on the pancreatic beta cell (J Kor SOC Endocrinol 18:392-403, 2003).

실험적 급성 허혈성 신부전에서 Verapamil 이 혈중 Polyamine 동태에 미치는 영향

원동준(Dong Jun Won),권현민(Hyun Min Kwon),김용섭(Yong Seop Kim),구자룡(Ja Ryong Gu),권영주(Young Ju Kwon),조원용(Won Yong Cho),김형규(Hyung Kyu Kim) 대한내과학회 1991 대한내과학회지 Vol.40 No.6

N/A It has been proposd that calcium entry from an external medium increases intracellular free calcium to toxic levels during ischemic acute renal failure, and verapamil (ARF) has been suggested as the agentblocking calicium entry into renal cells and protecting renal function during ischemic injury. Polyamines, anorganic cations that play various roles in normal cellular proliferation and differentiation, accumulate in renal failare. Alsa it has been suggested tht the synthesis and metabolism of polyamine are influence by acute changes of the general condition, such as acute renal failure, and are mediated by a calcium influx into the cells. The study was designed to study the protective effects of systemic verapamil pretreatment on renal function and the influence on polyamine metabolism in experimental ischemic ARF in cats. For these purpose, the experimental animals were divided into 2 groups. While Group I (n=5) was an ischemic ARF model by renal artery clamping for 60 minutes, Group II (n=5) was ischemic ARF with systemic verapamil (5 ml/min/kg) pretreatment. The creatinine clearance and plasma and urinary polyamine were measured in each group before and after the renal artery clamp. The results were as follows: 1) Creatinine clearance before and after the renal artery clamp were 10.64±7.18 ml/min/kg and 2.09±1. 70 ml/min/kg in Group I, 4.47±3.38 ml min/kg and 0.60±0.79ml/min/kg in Group II, respectively, So creatinine clearance decreased more significantly in Group II campared with Group I. 2) Plasma polyamine increased after ischemia in Group I. In group I, plasma levels of putrescine, spermidine, and spermine before ischemia were 4.75±0.40 nmol/ml, 0.69±0.09 nmol/ml, and 0.83±0.63 nmol/ml, were elevated to 7.17±2.91 nmol/ml, 9.83±1.46 nmol/ ml, and 2.64±1.14nmol/ml after ischemia. But in Group II, the plasma level of polyamine was not changed, and especially, spermine decreased significantly from 0.83±0.27 before ischemia to 0.49±0.23 nmol/ml after ischenmine (p=0.033). 3) Urine polyamine excretion decreased after ischemia in Group I and Group II. In Group II, urinary excretion of spermidine and spermine before ischemia, 0.13±0.10 nmol/min and 0.17±0.13nmol/min, decreased after ischemia to 0.01±0.01nmol/min (p=0.019) and 0.032±0.26 nmol/min (p=0.0257). 4) In renal tissue, spermine content vas highest. In Group II, preischemic spermine were 397.20 nmol/g and increased to 646.66nmol/g after ischema, But there were no significant changes in the polyamine contents in Group II. From these data, it was suggested that systemic verapamil pretreatment exerts no protective effect on ischemic ARF. Plasma polyamines are elevated in ischemic ARF, and verapamil may protect these elevations.

알루미늄 PEO 코팅의 결정상에 미치는 공정 조건에 대한 연구 I. Unipolar 펄스와 코팅시간

김배연,함재호,이득용,김용남,전민석,김기윤,최지원,김성엽,김광엽,Kim, Bae-Yeon,Ham, Jae-Ho,Lee, Deuk Yong,Kim, Yong-Nam,Jeon, Min-Seok,Kim, Kiyoon,Choi, Ji-Won,Kim, Sung Youp,Kim, Kwang Youp 한국결정성장학회 2014 韓國結晶成長學會誌 Vol.24 No.2

전해질로 $Na_2SiO_3$을 사용하여 A1050 알루미늄 판재를 pulse 폭 $ 2000{\mu}sec$, impulse 420 V, 400 ${\mu}$sec의 unipolar pulse로 플라즈마 전해 산화 코팅(plasma electrolytic oxidation coating)을 하여 산화 피막을 2, 5, 15, 30분에 따라 형성시킨 다음 산화피막을 분석하였다. 표면에 형성된 산화물의 결정상은 ${\alpha}-alumina$와 ${\gamma}-Alumina$로서 시간에 따른 변화는 없었다. 반응 초반에는 ${\gamma}-Alumina$가 많이 생성되었지만 시간이 갈수록 ${\gamma}-Alumina$의 양에는 변화 없이 ${\alpha}-alumina$가 많이 생겨남을 알 수 있었다. 이런 결과는 micro plasma에 의해서 ${\gamma}-Alumina$가 우선 생성되고, 이후 계속되는 micro plasma의 열에 의해서 ${\alpha}-alumina$로의 전이가 일어나기 때문으로 판단된다. Crystallographic phases of Plasma electrolytic oxidized Al alloy, A1050, were investigated. The electrolyte of PEO was $Na_2Si_2O_3$ and KOH. Unipolar pulse, $ 2000{\mu}sec$ with $400{\mu}sec+420V$ impulse, were applied for 2 min, 5 min, 15 min, and 30 min. ${\gamma}-Alumina$, as well as ${\alpha}-alumina$, was main crystal phase. ${\gamma}-Alumina$ was appeared in the beginning, then the amount of ${\alpha}-alumina$ was increased with time, but the amount of ${\gamma}-Alumina$ remained constant without any increasing. So, it is concluded that plasma gas produce ${\gamma}-Alumina$ at the first, and then ${\gamma}-Alumina$ transform ${\alpha}-alumina$ finally. During the transformation, high temperature of micro plasma gives transformation energy.

모과내 기능성 유용성분 용매추출공정의 최적화

전주영 ( Ju Yeong Jeon ),조인희 ( In Hee Jo ),경현규 ( Hyun Kyu Kyung ),김현아 ( Hyun A Kim ),이창민 ( Chang Min Lee ),최용희 ( Yong Hee Choi ) 한국산업식품공학회 2010 산업 식품공학 Vol.14 No.2

본 연구에서는 모과내의 여러 가지 기능성 유용성분을 효과적으로 추출하기 위해서, 모과나무의 익은 열매로 만든 약재인 모과를 사용 하였다. 모과의 기능성 유용성분용매 추출 공정의 최적 조건을 확립하고자 하였다. 모과를 에탄올에 추출하여 반응표면 분석법으로 모니터링하여 최적 용매 조건을 설정하였다. 중심합성계획법에 따라 시료에 대한 용매비(X1)와 추출온도(X2), 추출시간(X3)을 요인변수로 하고 추출수율(Y1), 총페놀 함량(Y2), 전자공여능(Y3), 갈색도(Y4), 환원당(Y5)을 종속변수로 하여 시행하였다. 실험 결과 추출수율은 추출 온도와 추출 시간에 유의하게 영향을 받음을 알 수 있었다. 안장점에서 추출조건은 시료에 대한 용매비는 26.38mL/g, 추출온도는 72.82oC, 추출시간은 74.86 min에서 최대값을 나타내었다. 총페놀 함량은 용매비와 시간에 영향을 거의 받지 않았고 추출시간에는 영향을 받았으며, 최대값은 20.70mg/mL 로 나타났다. 이때의 추출조건은 시료에 대한 용매비는 22.61mL/g, 추출온도는 84.49oC, 추출시간은 77.25 min으로 나타났다. 전자공여능은 추출온도에 따라 유의하게 영향을 받은 것으로 나타났다. 안장점에서의 추출조건인 시료에 대한 용매비 10.65mL/g, 추출온도 67.78oC, 추출시간 96.75 min에서 추출수율은 94.12%로 예측되었다. 갈색도에 대한 추출조건은 시료에 대한 용매비 23.77mL/g, 추출온도 87.27oC, 추출시간 96.68 min 일 때 안장점이 나타났다. 환원당은 시료에 대한 용매비 26.83mL/g, 추출온도 82.167oC, 추출시간 81.94 min에서 10.55mg/mL로 최대값을 나타내었고 추출시간에 영향을 받았다. In this study, various active functional components in Chinese Quince were extracted by solvent extraction method. A central composit design for optimization was applied to investigate the effects of independent variables such as solvent to sample ratio (X1), extraction temperature (X2), and extraction time (X3) on the soluble solid contents (Y1), total phenols (Y2), electron donating ability (Y3), browning color (Y4) and reducing sugar contents (Y5). It was found that extraction temperature and extraction time were the main effective factors in this extraction process. The maximum soluble solid contents of 35.77% was obtained at 26.38mL/g (X1), 72.82oC (X2) and 74.86 min (X3) in saddle point. Total phenols were rarely affected by solvent ratio and extraction time, but it was affected by extraction temperature. The maximum total phenols of 20.70% was obtained at 22.61mL/g (X1), 84.49oC (X2), 77.25 min (X3) in saddle point. The electron donating ability was affected by extraction time. The maximum electron donating ability of 94.12% was obtained at 10.65mL/g (X1), 67.78oC (X2), 96.75 min (X3) in saddle point. The maximum browning color of 0.32% was obtained at 23.77mL/g (X1), 87.27oC (X2), 96.68 min (X3) in saddle point. The maximum value of reducing sugar content of 10.55% was obtained at 26.83mL/g (X1), 82.167oC (X2), 81.94 min (X3). Reducing sugar content was affected by extraction time.

정상상피세포(HaCat)와 자궁경부 암세포(SiHa)에서 GeneFishing^(TM) PCR technique을 이용한 유전자 발현의 변화

김병훈,배수미,서민제,김용완,이정웅,김용욱,이준모,남궁성은,김종국,안웅식 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4

목적 : 본 실험의 목적은 정상상피 세포와 자궁경부 암세포 사이에서 유전자의 발현 차이를 조사하였다. 연구 방법 : 정상상피 세포(HaCat)와 자궁암 세포(SiHa)를 사용하였으며, 두 세포 간에 유전자 발현 차이를 GeneFish^(TM) PCR을 이용하여 알아보았으며, BLAST serach를 통해 분석하였다. 결과 : 정상상피 세포와 자궁암 세포 비교 결과, 자궁암 세포에서 S1-2-2와 S5-1을 포함한 25개의 유전자가 발현이 증가하였고, 24개의 유전자가 감소하였다. 결론 : GeneFishing^(TM) PCR기법은 유전자의 발현 변화를 확인하는데 있어서 아주 민감하고 효과적인 방법이다. 우리는 정상상피 세포와 자궁경부 암세포에서 다르게 발현하는 유전자를 찾을 수 있었고, 앞으로는, 종양의 발생과 진행과정에 관여하는 유전자를 더 탐지하고 해당 유전자의 기능을 연구할 필요가 있다고 생각된다. Objective : The purpose of this study is investigated the differentially expressed genes between normal and cervical cancer cell line. Methods : We used normal human keratinocyte (HaCaT) as a control and HPV-16 positive cervical cancer (SiHa) cell line. Two cell lines were studied differential expressed genes by using GeneFishing^(TM) PCR and analyzed with BLAST search. Results : As compared with normal, cervical cancer cell line was showed 25 up-regulated genes including the S1-2-2, S5-1 and 24 down-regulated genes. Conclusion : GeneFish^(TM) PCR test is very sensitive and effective method for detection of changed gene expression. We could search differentially expressed genes between normal and cervical cancer cell line. In the future, we need to research various genes function to participate in the process of tumor development and progression.

Lutembacher 증후군 환자 증례 보고

김성범,서정주,곽철훈,김상민,이보라,민선경,황은구,김용인,조욱현,최석구 인제대학교 2008 仁濟醫學 Vol.29 No.-

Lutembacher's syndrome is rare combination of mitral stenosis (MS) and atrial septal defect (ASD). The hemodynamic interplay between the MS and ASD leads to wide variation of clinical presentation. Here we describe a 43-year-old female with Lutembacher's syndrome and tricuspid regurgitation with pulmonary hypertension, who underwent direct closure of ASD and tricuspid valvuloplasty successfully. We also reviewed other literatures in an effort to increase awareness of this condition.

다단계 임계치를 이용한 패턴 디지털 워터마킹

김현환,김용민,김두영 東亞大學校 附設 情報通信硏究所 1999 情報通信硏究所論文誌 Vol.7 No.1

Digital Watermarking is a research area which aims at hiding secret information in digital multimedia contents such as image, audio, and video. In this paper, we propose a new watermaking method with visually recongnizable pattern into the digital image using wavelet transform, spread spectrum method and multilevel threshold value in considering the wavelet coefficients. The watermark information can be extracted by subtracting wavelet coefficients between the origitnal image and orginal image and the watermarked image. The esperimental results show that the prosposed technique is invisible watermarking and robust to JPEG lossy compression, resizing, masking, and filtering.