• 제목/요약/키워드: Assisted circulation

검색결과 15건 처리시간 0.024초

Endovascular Treatment of Wide-Necked Intracranial Aneurysms Using Balloon-Assisted Technique with HyperForm Balloon

  • Youn, Sang-O;Lee, Jae-Il;Ko, Jun-Kyung;Lee, Tae-Hong;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
    • /
    • 제48권3호
    • /
    • pp.207-212
    • /
    • 2010
  • Objective : To assess the feasibility, safety, and effectiveness of the balloon-assisted technique with HyperForm balloon in the endovascular treatment of wide-necked intracranial aneurysms. Methods : A total of 34 patients with 34 wide-necked intracranial aneurysms were treated with endovascular coil embolization using balloon-assisted technique with Hyperform balloon. Twenty-nine aneurysms (85.3%) were located in the anterior circulation. The group of patients was comprised of 16 men and 18 women, aged 33 to 72 years (mean : 60.6 years). The size of aneurysms was in the range of 2.0 to 22.0 mm (mean 5.5 mm) and one of neck was 2.0 to 11.9 mm (mean 3.8 mm). The dome to neck ratio was ranged from 0.83 to 1.43 (1.15). Sixteen patients were treated for unruptured aneurysms and the remaining 18 presented with a subarachnoid hemorrhage. Results : In the 34 aneurysms treated by the remodeling technique with HyperForm balloon, immediate angiographic results consisted of total occlusion in 31 cases (91.2%) and partial occlusion in three cases (8.8%). There were five procedure-related complications (14.7%), including two coil protrusions and three thromboembolisms; Except one patient, all were successfully resolved without permanent neurologic deficit. No new bleeding occurred during the follow-up. Twenty patients (59%) underwent angiographic follow-up from 2 to 33 months (mean 9.2 months) after treatment. Focal recanalization with coil compaction of the neck portion was observed in 5 cases (25%). Only one case showed major recanalization and underwent stent-assisted coil embolization. Conclusion : The balloon-assisted technique with Hyperform balloon is a feasible, safe, and effective endovascular treatment of wide-necked cerebral aneurysms.

Experiences of Tracheal Procedure Assisted by Extracorporeal Membrane Oxygenator

  • Kim, Ji Eon;Jung, Sung-Ho;Ma, Dae Sung
    • Journal of Chest Surgery
    • /
    • 제46권1호
    • /
    • pp.80-83
    • /
    • 2013
  • We report on the application of a venovenous type extracorporeal membrane oxygenator (ECMO) in high-risk tracheal procedures in six cases consisting of five patients with tracheal stenosis. An ECMO should be helpful for preventing respiratory emergency during a tracheal procedure.

태양열 보조열원을 이용한 흡수식 시스템의 동적 시뮬레이션에 의한 과도운전 특성 평가 (Dynamic Simulation of Transient Operations of a Solar Power-Assisted Absorption Chiller)

  • 신영기;서정아;우성민
    • 설비공학논문집
    • /
    • 제22권2호
    • /
    • pp.78-85
    • /
    • 2010
  • A dynamic model has been developed to investigate the operability of a single and double-effect solar energy assisted parallel type absorption chiller. In the study, main components and fluid transport mechanism were modeled. And solar radiation and the solar collector were also modeled along with its control design. The model was run for the single mode with solar energy supply only and the solar/gas driving double effect mode. From the simulation results, it was found that the present configuration of the chiller is not capable of regulating solution flow rates according to variable solar energy input. And the issues of the excessive circulation flow rate and the mismatch between available solar power and cooling load discourages the use of the single mode, but the dual use of gas and solar power is recommendable in view of controllability and enhanced COP.

좌심실 이중유출로를 동반한 교정형 대혈관전위증 -1예보고- (Double-Outlet of Left Ventricle in Corrected Transposition of Great Arteries -One case report-)

  • 권중혁
    • Journal of Chest Surgery
    • /
    • 제12권2호
    • /
    • pp.119-126
    • /
    • 1979
  • This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

  • PDF

Usefulness of Silent MRA for Evaluation of Aneurysm after Stent-Assisted Coil Embolization

  • You Na Kim;Jin Wook Choi;Yong Cheol Lim;Jihye Song;Ji Hyun Park;Woo Sang Jung
    • Korean Journal of Radiology
    • /
    • 제23권2호
    • /
    • pp.246-255
    • /
    • 2022
  • Objective: To determine the usefulness of Silent MR angiography (MRA) for evaluating intracranial aneurysms treated with stent-assisted coil embolization. Materials and Methods: Ninety-nine patients (101 aneurysms) treated with stent-assisted coil embolization (Neuroform atlas, 71 cases; Enterprise, 17; LVIS Jr, 9; and Solitaire AB, 4 cases) underwent time-of-flight (TOF) MRA and Silent MRA in the same session using a 3T MRI system within 24 hours of embolization. Two radiologists independently interpreted both MRA images retrospectively and rated the image quality using a 5-point Likert scale. The image quality and diagnostic accuracy of the two modalities in the detection of aneurysm occlusion were further compared based on the stent design and the site of aneurysm. Results: The average image quality scores of the Silent MRA and TOF MRA were 4.38 ± 0.83 and 2.78 ± 1.04, respectively (p < 0.001), with an almost perfect interobserver agreement. Silent MRA had a significantly higher image quality score than TOF MRA at the distal internal carotid artery (n = 57, 4.25 ± 0.91 vs. 3.05 ± 1.16, p < 0.001), middle cerebral artery (n = 21, 4.57 ± 0.75 vs. 2.19 ± 0.68, p < 0.001), anterior cerebral artery (n = 13, 4.54 ± 0.66 vs. 2.46 ± 0.66, p < 0.001), and posterior circulation artery (n = 10, 4.50 ± 0.71 vs. 2.90 ± 0.74, p = 0.013). Silent MRA had superior image quality score to TOF MRA in the stented arteries when using Neuroform atlas (4.66 ± 0.53 vs. 3.21 ± 0.84, p < 0.001), Enterprise (3.29 ± 1.59 vs. 1.59 ± 0.51, p = 0.003), LVIS Jr (4.33 ± 1.89 vs. 1.89 ± 0.78, p = 0.033), and Solitaire AB stents (4.00 ± 2.25 vs. 2.25 ± 0.96, p = 0.356). The interpretation of the status of aneurysm occlusion exhibited significantly higher sensitivity with Silent MRA than with TOF MRA when using the Neuroform Atlas stent (96.4% vs. 14.3%, respectively, p < 0.001) and LVIS Jr stent (100% vs. 20%, respectively, p = 0.046). Conclusion: Silent MRA can be useful to evaluate aneurysms treated with stent-assisted coil embolization, regardless of the aneurysm location and type of stent used.

응급의료전화상담원의 도움에 의해 교육 받지 않은 목격자의 제세동 시행 후 생존한 병원 전 심정지 1례 (A Pre-Hospital Cardiac Arrest Patient Surviving after Dispather-Assisted Defibrillation by an Untrained Witness)

  • 김종호;문준동
    • 한국산학기술학회논문지
    • /
    • 제19권4호
    • /
    • pp.239-244
    • /
    • 2018
  • 59세의 기왕력 및 가족력에 특이사항이 없는 남자가 가슴통증을 호소하다 의식을 잃고 쓰러지자 이를 목격한 가족이 119에 신고하였다. 응급의료상담원의 도움에 의해 목격자가 심폐소생술을 시행하였고 거주 중인 아파트에 설치된 자동심장충격기를 이용하여 제세동 1회를 시행하였다. 이후 도착한 119구급대에 의해 제세동 2회 실시 후 자발순환회복되어 인근 응급의료센터로 이송되었으며, 저체온 치료 15일 후 대퇴수행분류 1점으로 퇴원하였다. 현재 우리나라의 응급의료전환상담원 도움에 의한 목격자 심폐소생술 및 제세동의 시행은 시작 단계이지만 본 증례를 통해 충분한 효과를 볼 수 있다고 판단되며, 이에 따라 응급의료전화상담원의 적극적인 자동심장충격기 사용 안내와 그에 맞는 체계적인 교육이 필요하다. 특히 훈련받지 않는 목격자의 자동심장충격기의 사용을 도울 수 있고, 119구급대가 현장까지의 반응시간이 지연되는 원거리 지역에서 중요한 의미를 가질 것으로 사료된다. 또한 우리나라 PAD 프로그램의 양적인 보급뿐만 아니라 목격자의 접근성을 높일 수 있는 방안이 될 것이다.

태양열을 이용한 일이중 겸용 흡수식 냉온수기 동적성능 모사연구 (A Study of Dynamic Simulation of a Hybrid Absorption Chiller Utilizing Solar Power)

  • 신영기;서정아;우성민;김효상
    • 대한설비공학회:학술대회논문집
    • /
    • 대한설비공학회 2009년도 하계학술발표대회 논문집
    • /
    • pp.967-972
    • /
    • 2009
  • A dynamic model has been developed to investigate the operability of a single and double-effect solar energy assisted parallel type absorption chiller. In the study, main components and fluid transport mechanism were modeled. And solar radiation and the solar collector also were also modeled along with its control design. The model was run for the single mode with solar energy supply only and the solar/gas driving double effect mode. From the simulation results, it was found that the present configuration of the chiller is not capable of regulating solution flow rates according to variable solar energy input. And the issues of the excessive circulation flowrate and the mismatch between available solar power and cooling load discourages the use of the single mode, but the dual use of gas and solar power is recommendable in view of controllability and enhanced COP.

  • PDF

생체실험을 통한 좌심실보조기의 평가 (Evaluation of Left Ventricular Assist Device through In Vivo Experiments)

  • 박성근;원용순;정필섭;최진욱;김인영;이규백;민병구
    • 대한의용생체공학회:학술대회논문집
    • /
    • 대한의용생체공학회 1993년도 추계학술대회
    • /
    • pp.89-92
    • /
    • 1993
  • In this article, we present and analyze the results of the three consecutive in vivo experiments of the LVAD to evaluate the function of the LVAD and the adverse effects on living animals. We applied the LVAD consecutively to three mongrel dogs and the circulation of the blood was assisted under the anesthesia. We used in general both the asynchronous mode and the synchronous mode to drive the LVAD. During the experiments we monitored the dogs with a polygraph to evaluate the function of the LVAD and the additional effects on the natural hearts. We also examined several clinical pathologic tests in order to see the effects of the LVAD to the red blood cells and the other internal organs. The dogs survived for two to there days. The LVAD assisted the circulatory system at the maximum assist flow rate of 3.0 1/min. Although the red blood cells of the dogs had mechanical damages by the LVAD to result in the hemolysis, the degree of the hemolysis was not so high and the damages caused by the hemolysis on the dogs were not serious. The myocardium of the first dog was gradually worsened and eventually failed. The damage of the myocardium was due to the asynchronous driving mode of the LVAD. The other organs did not have serious damages due to the application of the LVAD. The main purpose of this paper is to evaluate the results of the in vivo experiments of the LVAD and to find better ways to the application of the LVAD to human beings.

  • PDF

개심술후 폐기능 -수술직후 및 장기간의 추이에 대하여- (Pulmonary Function Following Open Heart Surgery -early and late postoperative changes-)

  • 이성행
    • Journal of Chest Surgery
    • /
    • 제13권4호
    • /
    • pp.364-374
    • /
    • 1980
  • Twenty-two patients were selected for evaluation of pre-and postoperative pulmonary function. These patients were performed open cardiac surgery with the extracorporeal circulation from March 1979 to July 1980 at the Department of Thoracic and Cardiovascular Surgery, Kyungbook National University Hospital. Patients were classified with ventricular septal defect 5 cases, atrial septal defect 5 cases, tetralogy of Fallot 5 cases, mitral stenosis 4 cases, rupture of aneurysm of sinus Valsalva 1 case, left atrial myxoma I case, and aortic insufficiency 1 case. The pulmonary function tests were performed and listed: [1] respiratory rate, tidal volume [TV], and minute volume[MV], [2] forced vital capacity [FVC] and forced expiratory volume[FEV 0.5 & FEV 1.0], [3] forced expiratory flow [FEF 200-1200 ml & FEF 25-75%]. [4] Maximal voluntary ventilation [MVV], [5] residual volume [RV] and functional residual capacity[FRC], measured by a helium dilution technique. Respiratory rate increased during the early postoperative days and tidal volume decreased significantly. These values returned to the preoperative levels after postoperative 5-6 days. Minute volume decreased slightly, but essentially unchanged. Preoperative mean values of the forced vital capacity, functional residual capacity and total lung capacity decreased [63.2%, 87.2% & 77.3% predicted, respectively], and early postoperatively these values decreased further [19.6%, 76.0% & 38.0% predicted], but later progressively increased to the preoperative levels. In residual volume, there was no decline in the preoperative mean values [100.9% predicted] and postoperatively the value rather increased [106.3-161.7% predicted]. Forced expiratory volume [FEV 0.5 & FEV 1.0] and forced expiratory flow [FEF 200-1200 ml & FEF 25-75%] also revealed significant declines in the early postoperative period. There was no significant difference in values of the spirometric pulmonary function tests, such as FEF 1.O and FEF 25-75% between successful weaning group [17 cases] extubated within 24 hrs post-operatively and unsuccessful weaning group [5 cases] extubated beyond 24 hrs. Static compliance and airway resistance measured for the two cases during assisted ventilation, however, any information was not obtained. Long term follow-up pulmonary function studies were carried out for 8 cases in 9 months post-operatively. All of the results returned to the pre-operative or to normal predicted levels except FVC, FEV 1.0, and FEF 25-75% those showed minimal declines compared to the pre-operative figures.

  • PDF

태양열이용 하이브리드 열펌프시스템의 성능특성에 관한 연구 (A Study of Performance Characteristics on Hybrid Heat Pump System with Solar Energy as Heat Source)

  • 박윤철;김지영;고광수
    • 한국태양에너지학회 논문집
    • /
    • 제27권1호
    • /
    • pp.47-54
    • /
    • 2007
  • Interests on renewable energy are increased due to oil price and environmental problems aroused from the fossil energy usage. In this study, performances of a solar assisted hybrid heat pump system are analyzed by experimental method. The developed system could runs at two types of operating mode. When the storage temperature is higher than the set temperature, the stored hot water in storage tank is supplied to the load directly. On the other hand, when the storage temperature lower than the set temperature, the water inside of the storage tank is used as heat source of the heat pump. In this study, the system control temperature for the alternation of the operating mode is set to $40^{\circ}C$ of the storage tank outlet. As results, it is founded that the COP of the developed heat pump system shows between 3.0 and 3.5. It is resonable performance for the heating system with a renewable energy as secondary heat source. The solar collect used in this study could supplies heat to the storage tank at over 400 W/m2 solar intensity. If the irradiation is lower than the 400 W/m2, the circulation pump stored and it could not supply heat to the storage tank. It is found that the difference temperature between the outlet of the storage tank and collector is $3^{\circ}C$. Even though, the extended study should be conducted to get a optimum performance of the developed system with various operating condition and control strategies.