• Tuberculosis and Respiratory Diseases
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• v.79 no.4
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• pp.214-233
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• 2016

There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.182-192
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• 1985

[here are so many reports that pulsatile blood flow provides physiologic organ perfusions during cardiopulmonary bypass. So, we compared the recent 30 cases undergoing cardiac surgery by Cobe-Stckert pulsatile roller pump with another 30 cases by Polystan nonpulsatile roller pump. Pulsatile flow was applied during aortic-cross clamping period when synchronized to internal EKG simulator, and perfusion mode was changed to continuous nonpulsatile flow after declamping of aorta. Age, sex, weight, and disease entities were comparable and operative techniques were similar between two groups. 1. There were no differences in average ACC time, ECC time, and Operation time. 2. Postoperative artificial respiration time was 6hrs 30mins in nonpulsatile group and 4hrs 48mins in pulsatile group, and detubation time after ventilator weaning was 2hrs 44mins in nonpulsatile group and 1hrs 43mins in pulsatile group. 3. Average pulse pressure was 8mmHg in nonpulsatile group and 55mmHg in pulsatile group, and a mean arterial pressure was 66.0mmHg in nonpulsatile group and 60.7mmHg in pulsatile group. 4. Mean urine-output during ACC;ECC period was 9.717.3;9.913.2ml/kg/hr in nonpulsatile group and 14.215.0;15.817.5 in pulsatile group [p<0, 05], and thereafter progressive decrease of differences in urine output between two groups until POD 2, and lesser amounts of diuretics was needed in pulsatile group during same postoperative period. Serum BUN/Cr level showed no specific difference and urine concentration power was well preserved in both groups. 5. Plasma proteins and other Enzymes showed no differences between two groups, but serum GOT/GPT level was higher in nonpulsatile group till POD 2. 6. Serum Electrolytes showed no differences between two groups. 7. WBC, RBC, Platelet counts, Hgb and Hct were not different and Coagulogram was well preserved in both groups. 8. Plasma free Hgb level was 7.09mg% in pulsatile group compared with 3.48mg% in pulsatile group on POD 1 but was normalized on POD 2. Gross hemoglobinuria after ECC was noted in 6 cases [20%] of pulsatile group and 4 cases [13%] of nonpulsatile group. 9. In both groups, most patients were included in NYHA class III to IV [28 cases;93% in nonpulsatile group, 22 cases;73% in pulsatile group] preoperatively, and well improved to class I to 11[22 cases; 73% in nonpulsatile group, 30 cases; 100% in pulsatile group] postoperatively. There were 7 operative mortalities in nonpulsatile group only, which were 5 cases of TOF with hepatic failure, 1 case of multiple VSDs with low out-put syndrome, and 1 case of mitral valvular heart disease with cardiomyopathy. We concluded that the new, commercially available Cobe-Stckert pulsatile roller pump device was safe, simple, and reliable.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.499-503
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• 2004

Background: We investigated the longevity, thresholds of epicardial pacemaker and causes of reoperation in the pediatric patients who underwent epicardial pacemaker implantation performed during the last 13 years Material and Method: 121 operations were performed in 83 patients from January 1989 to July 2002. We analyzed the stimulation threshold, resistance, R-wave and P-wave, and sensitivity of pacemaker lead at initial implantation. Longevity and causes of reoperations were investigated. Result At implantation, epicardial ventricular mean stimula-tion threshold was 1.2$\pm$0.1 (0.1∼5) mV, mean resistance was 519.1$\pm$18.1 (319∼778) Ohm, and mean R-wave sensitivity was 8.9$\pm$0.7 (4∼20) mV, and mean P wave sensivity was 2.5$\pm$0.7 (0.4∼12) mV. The mean longe-vity of pacemaker generator was 64.7$\pm$3.7 (2∼196) months. The reoperation free rate was 94.6% for 1 year, 93.6% for 2 years, 80.8% for 5years, 63.7% for 7 years, and 45.5% for 10 years. The causes of reoperation were battery waste in 26 cases and lead malfunction in 9 cases. There was no postoperative death related to pacemaker malfunction. Conclusion: in the childrens, average longevity of epicardial pacemaker was within accep-table range. 19.1% of the patients required pacemaker related reoperation. However, recent developments, including steroid eluting lead, 6.7% of the patients required pacemaker related reoperation, look promising in expansion of pacemaker life span.

• Journal of Biomedical Engineering Research
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• v.28 no.3
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• pp.387-391
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• 2007

An oxygenator is a very important artificial organ and widely used for patients with lung failure or during open heart surgery. Although an oxygenator has been widely studied worldwide to enhance its efficiency, studies on oxygenators, in particular when using a pulsatile blood flow, are domestically limited. Therefore, a new oxygenator was developed in the lab and animal experimental results are described in the paper. The oxygenator is composed of polycarbonate housing and polypropylene hollow fibers. It has a total length of 400 mm and a surface area of $1.7 m^2$. The animal experiment lasted for 4 hours. The blood flow rate was set to 2 L/min and a pulsatile blood pump, T-PLS (Twin-Pulse Life Support), was used. Samples were drawn at the oxygenator's inlet and outlet. The total hemoglobin (Hb), saturation oxygen ($sO_2$), and partial oxygen pressure ($pO_2$), partial $CO_2$ pressure ($pCO_2$), and plasma bicarbonate ion concentration ($HCO_3^-$) were measured. The oxygen and carbon dioxide transfer rates were also calculated based on the experimental data in order to estimate the oxygenator's gas transfer efficiency. The oxygen and carbon dioxide transfer rates were $16.4{\pm}1.58$ and $165.7{\pm}10.96 mL/min$, respectively. The results showed a higher carbon dioxide transfer rate was achieved with the oxygenator. Also, the mean inlet and outlet blood pressures were 162.79 and 137.92 mmHg, respectively. The oxygenator has a low pressure drop between its inlet and outlet. The aim of own preliminary study was to make a new oxygenator and review its performance when applying a pulsatile blood pump thus, confirming the possibility of a new oxygenator suitable for pulsatile flow.

• KIPS Transactions on Software and Data Engineering
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• v.8 no.12
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• pp.491-498
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• 2019

Digital twin is a technology that virtualizes physical objects of the real world on a computer. It is used by collecting sensor data through IoT, and using the collected data to connect physical objects and virtual objects in both directions. It has an advantage of minimizing risk by tuning an operation of virtual model through simulation and responding to varying environment by exploiting experiments in advance. Recently, artificial intelligence and machine learning technologies have been attracting attention, so that tendency to virtualize a behavior of physical objects, observe virtual models, and apply various scenarios is increasing. In particular, recognition of each robot's motion is needed to build digital twin for co-robot which is a heart of industry 4.0 factory automation. Compared with modeling based research for recognizing motion of co-robot, there are few attempts to predict motion based on sensor data. Therefore, in this paper, an experimental environment for collecting current and inertia data in co-robot to detect the motion of the robot is built, and a motion prediction model based on the collected sensor data is proposed. The proposed method classifies the co-robot's motion commands into 9 types based on joint position and uses current and inertial sensor values to predict them by accumulated learning. The data used for accumulating learning is the sensor values that are collected when the co-robot operates with margin in input parameters of the motion commands. Through this, the model is constructed to predict not only the nine movements along the same path but also the movements along the similar path. As a result of learning using SVM, the accuracy, precision, and recall factors of the model were evaluated as 97% on average.

• Journal of Biomedical Engineering Research
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• v.25 no.1
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• pp.57-64
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• 2004

The non pulsation blood pump is divided into axial flow and centrifugal style according to the direction of inlet and outlet flow. An axial flow blood pump can be made smaller than a centrifugal blood pump because centrifugal pump's rpm is fewer than axial flow pump. Hemolysis is an important factor for the development of an axial flow blood pump. It is difficult to identify the areas where hemolysis occurs. Evaluation of hemolysis both in in-vitro and in-vivo test requires a long-time and more expensive. Computational fluid dynamics(CFD) analysis enables the engineer to predict hemolysis on a computer which just can get not only amount of htmolysis but also location of hemolysis. It takes shorter time and less expensive than in-vitro test. The purpose of this study is to git Computational fluid dynamics in axial flow pump and to verify the accuracy of prediction by the possibility of design comparing CFD results with in-vitro experimental results. Also, wish to figure out the correction method that can bring improvement in shape of axial flow blood pump using CFD analysis.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.336-340
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• 2015

Background: Potentially harmful unplanned extubation (UE) may occur in patients on mechanical ventilation (MV) in an intensive care unit (ICU) setting. This study aimed to evaluate the clinical characteristics of UE and its impact on clinical outcomes in patients with MV in a medical ICU (MICU). Methods: We retrospectively evaluated MICU data prospectively collected between December 2011 and May 2014. Results: A total of 468 patients were admitted to the MICU, of whom 450 were on MV. Of the patients on MV, 30 (6.7%) experienced UE; 13 (43.3%) required reintubation after UE, whereas 17 (56.7%) did not require reintubation. Patients who required reintubation had a significantly longer MV duration and ICU stay than did those not requiring reintubation ($19.4{\pm}15.1days$ vs. $5.9{\pm}5.9days$ days and $18.1{\pm}14.2days$ vs. $7.1{\pm}6.5days$, respectively; p<0.05). In addition, mortality rate was significantly higher among patients requiring reintubation than among those not requiring reintubation (54.5% vs. 5.9%; p=0.007). These two groups of patients exhibited no significant differences, within 2 hours after UE, in the fraction of inspired oxygen, blood pressure, heart rate, respiratory rate, and pH. Conclusion: Although reintubation may not always be required in patients with UE, it is associated with a poor outcome after UE.

• Journal of Haehwa Medicine
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• v.12 no.1
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• pp.103-121
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• 2003

Human being can't live without nature, then the changes of nature affect human body. It means that human body has corresponding changes to the KI(vital energy) of nature. There is a stream of changes in human body which circulate mysteriously and punctually by the laws of nature. If this stream of changes fits into human's life style, it would be most effective. It has a certain mode continuously. So if a person has a habit fitting into it, he will get the healthiest body. Then the researcher tries to explain the changes in human body by the time, mainly focused on within 24 hours. it is showing not only the oriental view, but also the western's. The researcher can find the coincidence as followings. At In-Si(3-5 am), the body function and the body temperature get to the bottom, therefore it's good for him to wake up and to run the vital energy. At Sa-Si(9-11 am), the patience on pain anxiety and the psychic concentration get to the top, he'd better start the work. At O-Si(11am-1pm), the heart energy has a vital move, then the blood concentration of Hb(hemoglobin) gets to the top. At Mi-Si(1-3 pm), the muscle strength, the squeeze, and the breathing rate increase. The reflex nerve sensitivity gets to the top. Creativity, observation, and working efficiency go high, so it's time to work hard. At Hae-Si(9pm-1am), the body function falls, sleeping is needed. At Chuck-Si(1-3 am), the cell spontaneity gets to the top, immune lymphocyte moves actively, and the blood concentration of growth hormone gets to the top. These are liver's work. In west, there has been active studies on how to reduce the side effect by using a person's bio-rhythm based on the 'time treatment', and how to reorganize the bio-rhythm by using the machine and the age resistance based on the 'bio-watch'. Though the 'time treatment' means something, the artificial resistance on bio-rhythm seems to give bad effects to human body. If a person lives by regimen of oriental medicine, he will maintain the healthiest body. Regimen is that human body follows the laws of nature, and moves its mysterious, Punctual and periodical changes.

• Journal of Hospice and Palliative Care
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• v.18 no.3
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• pp.179-187
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• 2015

For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.

• Korean Journal of Food Science and Technology
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• v.34 no.3
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• pp.487-492
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• 2002

Low-fat and sugar-free (LFSF) cookies were developed for patients with metabolic syndrome X, such as obesity, diabetes, coronary heart disease, and hypertention, using artificial sweeteners (mixture of aspartame and saccharin), pectin and herb extracts such as Polygonatum Odoratum (Mill) Druce, Schizandrae Fructus and Lycii Fructus, without sugar and fats. LFSF cookies were composed of 7.5 : 1 of aspartame and saccharin, 5% pectin, 49% protein, and 5% herb extracts, with reduced fat level. The values for area under the curve in oral glucose tolerance tests were significantly lower in 90% pancreatomized-(Px, n = 8) and sham - operated (Sham, n = 8) rats which consumed LFSF cookies, than the control, which consumed regular cookies. Blood glucose levels were higher and the peak levels were significantly lower in the LFSF cookies group than the control group of Px and Sham rats. Blood glucose levels of healthy female college students (n = 10) at 30 and 60 min after the consumption of 30 g LFSF and regular cookies were not different, but they were significantly lower in the LFSF-cookies group in diabetes patients (n = 10). In conclusions, LFSF cookies was considered as a good snack for diabetic patients.