• Title/Summary/Keyword: 인공 혈관

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Thin Micro-Porous Scaffold Layer on Metallic Substrate (금속기질에 앓은 마이크로 다공질 스케폴드 코팅에 관한 연구)

  • Sin, D.C.;Miao, X.;Kim, W.C.
    • Journal of Power System Engineering
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    • v.14 no.5
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    • pp.41-47
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    • 2010
  • 티타늄과 티타늄 합금은 재료적 특이성 때문에 심장 혈관 임플란트에서 일반적으로 사용되어 왔다. 일찍이 적용된 예로는 인공심장판막, 심박조율기의 보호케이스, 혈액 순환 장치 등이 있다. 하지만 물질유도혈전증(Material-induced thrombosis)은 혈전폐색에 의해 기인한 기능 손실로 심장혈관 임플란트 장치의 주된 합병증으로 존재하고 있으며, 심장혈관 임플란트의 혈전유전자는 심장혈관장치의 발달에 주된 난관 중 하나로 남아있다. 그리고 텍스처 혈액 접합 물질(Textured blood-contacting material)은 1960년대 초반 이후부터 혈액순환 보조 장치의 임상실험에 사용되고 있다. 접합 물질에 내장된 텍스처 섬유조직 표면은 형성, 성장, 안정적 부착, 생물학적 내벽(neointimal layer) 등 유도 혈액(entrapping blood) 성분에 의해 형성된다. 공동(cavity) 형상의 용해 가능한 미립자를 사용하는 SCPL법(Solvent casting/particulate leaching method)은 티타늄 기질 이전에 형성된 폴리우레탄 위에 텍스처(texture)를 생성하기 위해 사용되었다. 또한 콜라겐의 부동화(不動化)에 의한 공동(cavity)은 혈액 접합면에 잔존하기 위한 내피세포를 고정할 수 있는 효과가 있다. cpTi로 층화된 PU 기소공성(microporous)은 구조적 특성과 혈전증 감소를 위한 생물학적 내벽 사용의 잠재성을 평가하기 위한 세포 공동체 실험을 통해서 평가되었다.

의료용재료의 최근 개발현황

  • 김영하
    • Journal of Biomedical Engineering Research
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    • v.10 no.2
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    • pp.117-124
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    • 1989
  • The intelligent trajectory control method that controls moving direction and average velocity for a prosthetic arm is proposed by pattern recognition and force estimations using EMG signals. Also, we propose the real time trajectory planning method which generates continuous accelleration paths using 3 stage linear filters to minimize the impact to human body induced by arm motions and to reduce the muscle fatigue. We use combination of MLP and fuzzy filter for pattern recognition to estimate the direction of a muscle and Hogan`s method for the force estimation. EMG signals are acquired by using a amputation simulator and 2 dimensional joystick motion. The simulation results of proposed prosthetic arm control system using the EMf signals show that the arm is effectively followed the desired trajectory depended on estimated force and direction of muscle movements.

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A Clinical Experience of Korean Artificial Heart(AnyHeart) (한국형 인공심장(AnyHeart)의 임상경험)

  • Sun, Kyung;Son, Ho-Sung;Jung, Jae-Seung;Chung, Bong-Kyu;Lee, Sung-Ho;Shin, Jae-Seung;Kim, Kwang-Taik;Lee, Hye-Won;Min, Byoung-Goo;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.548-552
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    • 2002
  • Korean artificial heart(AnyHeart) is a single-pieced and implantable hi-ventricular pulsaile pump adapting a moving actuator mechanism. The authors report a case of clinical application of AnyHeart as a life-saving device for the patients with end-stage heart disease combined with biventricular failure.

Clinical Experiences of Open Heart Surgery (개심술(開心術) 2,000례의 임상적 고찰)

  • 김하늘루;박경택;곽기오;한일용;소영환;최강주;이양행;조광현
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1183-1194
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    • 1998
  • Background: From Sept. 1985 to Sept. 1997, 2,000 cases of open heart surgery(OHS) were performed in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. Material and Method: Among the total of 2,000 cases of OHS, 1532 cases were congenital heart disease(CHD) and 468 cases were acquired heart disease(AHD). The age distribution was 9 days(4.0kg) to 68 years in CHD and 11 to 66 years in AHD. In 1532 cases of CHD, there were 1403 acyanotic cases and 129 cyanotic cases. Result: The CHD cases consisted of 940 ventricular septal defects(61.4%), 324 atrial septal defects(21.1%), 112 tetralogy of Fallot(7.3%), 46 pulmonary stenosis(3%), 38 endocardial cushion defects(2.5%), 15 valsalva sinus ruptures(1%), 4 transposition of great arteries (0.3%), 4 double outlet right ventricles(0.3%), and etc. Corrective operations were applied for congenital heart disease with a result of 3.1% hospital mortality. Of 468 AHD, 381 cases were valvular heart diseases, 48 ischemic heart diseases, 12 cardiac tumors, 8 annuloaortic ectasias, 16 dissecting aortic aneurysms and etc. In the 381 valvular heart diseases, there were 226 single valve replacements(36 aortic valve replacements(AVR), 188 mitral valve replacements(MVR), and 2 tricuspid valve replacements(TVR), among these were 71 cases of double valve replacements(AVR & MVR), 54 cases of MVR with tricuspid valve annuloplasty(TVA), and 18 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 466. In MVR, 123 St. Jude Medical valves, 90 Carpentier-Edwards valves, 65 CarboMedics valves, 42 Sorin valves and 16 other valves were used. In AVR, 68 St. Jude Medical valves, 36 CarboMedics valves, 14 Carpentier-Edwards valves and 9 other valves were used. Coronary Artery Bypass Surgery(CABG) were performed in 48 cases. The patterns of bypass graft were 14 patients of single vessel graft, 21 patients of two vessels graft, 10 patients of three vessels graft and 3 patients of four vessels graft. Conclusion: The hospital operation mortality rate of congenital acyanotic, cyanotic and acquired heart diseases were 2.0%, 15.5%, and 5.1% respectively. The overall mortality rate was 3.6%(72/2,000).

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Pulmonary Artery Intimal Sarcoma with Lung Metastasis (폐 전이를 동반한 주폐동맥의 혈관 내막 육종)

  • 김인섭;정성철;김우식;배윤숙;신용철;정승혁;유환국;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.979-984
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    • 2003
  • Primary pulmonary artery sarcoma is very rare disease. The diagnosis of pulmonary artery sarcoma is frequently confused with pulmonary embolism because its clinical symptom and radiologic findings are similar with pulmonary embolism. It was often diagnosed at autopsy as it progresses rapidly. So Pulmonary artery sarcoma must be suspected if the origin of thrombus is not known and anticoagulation therapy is not effective. In this case, a 57 years old man who has been diagnosed pulmonary embolism was transferred to our department because of ineffective anticoagulant therapy and its worsening lesion despite of 5 month-therapy. In operative findings, it was pulmonary artery sarcoma that invaded to pericardium. There was angiosarcoma in right pulmonary artery, which metastasized to lung parenchyme. Under cardiopulmonary bypass, we resected main pulmonary artery and right lung. The Gore-tex graft was interposed between main pulmonary artery and left pulmonary artery. He was discharged after chemotherapy.

A case of pulmonary vascular air embolism in a very-low-birth-weight infant with massive hydrops (초극소 미숙아에서 발생한 중증 태아 수종을 동반한 폐혈관 공기 색전증 1례)

  • Kim, Myo Jing;Yu, Hee Joon;Lee, Cha Gon;Park, Soo Kyoung;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.52 no.12
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    • pp.1392-1395
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    • 2009
  • Pulmonary vascular air embolism is a rare and, universally, almost a fatal complication of positive pressure ventilation in newborn infants. Here, we report a case of this unusual complication in a very-low-birth-weight infant who showed the clinical and radiological features of this complication along with pulmonary hypoplasia and massive hydrops. The possible pathogenesis has been discussed and a brief review of related literature has been presented.

Pulmonary Infarction of Left Lower Lobe after Left Upper Lobe Lobectomy - 1 case report - (좌 상엽의 폐엽 절제 후 발생한 좌하엽의 폐 경색 치험 1례)

  • 윤용한;강정신;홍윤주;이두연
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.318-321
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    • 1999
  • The remaining lung infarction is a rare but life-threatening complication after a thoracic operation and trauma. We report a case of this rare complication after the left upper lobectomy due to pulmonary aspergilloma. The infarction of the remaining left lower lobe occurred due to kinking of the pulmonary vessels after the left upper lobectomy and the completion pneumonectomy was performed in the post-operative second day. Therefore, prompt diagnosis and treatment may be necessary to prevent morbidity and mortality associated with pulmonary infarction from torsion of pulmonary artery and vein.

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Application of the Total Artificial Heart as an Implantable Biventricular Assist Device by Left Thoracotomy in an Ovine Model (양에서 좌측 개흉술 하에 완전인공심장의 체내이식형 양심실 보조장치로 사용에 관한 연구)

  • 원태희;민병구;김원곤
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.296-304
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    • 2001
  • 배경: 이번 연구의 목적은 체내이식형 양심실 보조장치의 개발을 위한 안전하고 간편한 동물실험 모델을 확립하는 것이며 이동작동형 완전 인공심장의 양심실 보조장치로의 사용 가능성을 알아보는 것이다. 대상 및 방법: 7마리의 Corridale 양을 대상으로 실험하였다. 5번째 늑간극을 통하여 좌측 개흉술을 시행하고 좌측 유출로 캐뉼라는 하행 대동맥에 Dacron graft을 사용하여 연결하였고 유입로 캐뉼라는 좌심방에 삽입하였다. 우측 유출로 캐뉼라는 하행 대동맥과 같은 방법으로 주폐동맥에 연결하였으며 유입로 캐뉼라는 혜동맥을 하방으로 젖혀 우심방이를 노출시킨 다음 우심방이에 삽입하였다. 4마리에 있어서는 양심실 보조장치를 전복막강(preperitoneal space)에 위치시켰으며 2마리에 촤측흉강 내에, 1마리에서는 외부에 위치시켰다. aPTT는 수술전 aPTT의 2∼2.5배로 맞추어 주었다 결과: 수술중 또는 수술직후 사망한 경우는 없었으며 7마리 모두 인공호흡기 이탈이 가능하였고 스스로 기립하고 음식물 섭취도 가능하였다. 1마리는 술후 2일째 혈전 색전증 및 인공호흡기 작동 잘못으로 사망하였으며 2마리의 겨우는 술후 2일째 각각 양심실 보조장치의 작동 잘못 및 호흡부전으로 사망하였고, 3마리의 경우는 술후 4일째 혈전색전증으로 인한 급성신부전 및 호흡부전 등으로 사망하였다. 1마리에 있어서는 28일간 생존하였으며 양심실 보조장치의 구동 장치에 연결된 라인의 마로로 인해 양심실 보조장치의 작동이 정지되었으나 바로 양심실 보조장치를 제거하고 살릴 수 있었다. 모든 경우에 있는 캐뉼라를 삽입하고 양심실 보조장치를 작동시키는데 큰 어려움이 없었다. 7마리 중 4마리에서 혈전이 발견되었으며 특히 판막을 연결한 부위에 혈전생성이 많았다. 그러나 캐뉼라에는 혈전생성이 없었다. 결론: 양에 있어서 좌측 개흉술 및 전복막강 공간에 양심실 보조장치를 위치시키는 이번 동물실험 모델은 체내 이식형 양심실 보조장치 개발을 위한 좋은 동물실험 모델이라고 생각된다. 또한 디동 작동기형 완전 인공심장의 혈전생성을 억제할수 있는 방법들의 연구개발이 지속된다면 장기간의 체내 이식형 양심실 보조장치로 사용할 수 있을 것으로 생각된다.

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A Scanning Electron Microscopic Study on the Sinusoidal Fenestrations in the Hepatic Lobule of Normal Rat (간소엽내 동모양혈관내피창에 관한 주사전자현미경적 연구)

  • Koh, Seong-Eun;Shin, Young-Chul
    • Applied Microscopy
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    • v.25 no.4
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    • pp.62-70
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    • 1995
  • Rat liver sinusoids were observed by scanning electron microscopy. The sinusoids were provided with fenestrations which were divided into three types; small, medium-sized and large. The small fenestrations were usually gathered into clusters. The medium-sized fenestrations were either individually organized or in the cluster of small fenestrations. The large fenestrations were usually accompanied by small or medium-sized fenestrations. The lobule was divided into three zones; peripheral, intermediate and central, according to the distribution pattern of the fenestrations. The sinusoid providing with small fenestrations (type I) were predominant in the peripheral zone. The sinusoid showing medium-sized fenestrations (type II) were frequently observed in the central zone. The sinusoid having large fenestrations (type III) were abundant in the intermediate zone. This evidence indicate that the sinusoidal fenestrations become larger toward the intermediate zone from the peripheral zone of the lobule and progressively smaller toward the central zone. However, the fenestrations observed in the central zone seem to be larger than those seen in the peripheral zone of the lobule.

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A Numerical Analysis on the Motion of Mechanical Heart Valve(MHV) and Characteristics of Blood Flow in an Elastic Blood Vessel (탄성혈관 내 기계식 인공심장판막(MHV)의 거동 및 혈액 유동 특성에 관한 수치해석적 연구)

  • Bang Jin-Seok;Choi Choeng-Ryul;Kim Chang-Nyung
    • Journal of the Korean Society for Precision Engineering
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    • v.22 no.3 s.168
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    • pp.154-161
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    • 2005
  • In this study, the leaflet motion of a mechanical heart valve and the characteristics of two-dimensional transient blood flow in an elastic blood vessel have been numerically investigated by using fluid-structure interaction method. Here, blood has been assumed as a Newtonian, incompressible fluid. Pressure profiles have been used as boundary conditions at the ventricle and the aorta. As a result, closing motion of the leaflet is faster than opening one. While opening angles of leaflet grow up, vortex is detected at the sinus and backward of the leaflets. When the leaflet is fully closed, vortex is detected at the ventricle and at that moment maximum displacement of the elastic blood vessel is observed in the vicinity of the sinus region. Maximum displacement is caused in association with the blood flow that is oriented toward the elastic blood vessel.