• Journal of Chest Surgery
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• 제37권3호
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• pp.201-209
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• 2004

생명구조장치(ECLS)는 호흡부전 및 심부전에 적용하는 장치로 세계적으로 많은 연구개발과 임상시도가 계속되고 있다. 현재까지 생명구조장치의 혈류펌프로는 비박동형 구동장치가 표준으로 사용되고 있으며, 박동형 구동장치는 생리적인 측면에서 유리하지만 급격한 회로압 상승과 그에 따른 혈구손상에 대한 우려가 있고 특히 막형산화기를 사용하는 인공폐 회로에서 기피되어 왔다. 본 연구는 인공폐 실험모델에서 단일 박동형 구동펌프와 막형 산화기 사이에 압력완충장치를 설치함으로써 언급한 부작용을 최소화시키면서 생리적인 박동혈류를 유도할 수 있을 것이라는 가능성을 검증하였다. 실험대상은 올레익산으로 급성 호흡부전증이 유발된 잡견(N=16)을 사용하였다. 실험군은 사용된 구동펌프의 종류와 압력완충장치의 유무에 따라 3개 군으로 분류하였다. 제1군(n=6)은 대조군으로 원심펌프를 이용하였고, 제2군(n=4)은 단일 박동형 구동펌프를 사용하였으며, 제3군(n=6)은 단일 박동형 구동펌프에 압력완충장치를 설치하였다. 실험모델은 흉강 절개 후 우심방-대동맥을 우회시키는 부분 체외순환 형태로, 1.8～2 L/min의 펌프박출량에서 2시간을 구동하였다. 관찰지표는 주로 혈역학 변화, 회로압, 혈액검사 및 혈구세포에 미치는 영향 등에 한정하였다. 맥동압(pulse pressure)은 박동형 구동펌프를 이용한 2군(47$\pm$10 mmHg)과 3군(41$\pm$9 mmHg)에서 비박동형 원심펌프를 이용한 1군(17$\pm$7 mmHg)에 비해 유의하게 높았다(p<0.001). 막형산화기에 걸리는 회로압은 1 군의 경우 222$\pm$8mmHg, 2군의 경우 739 $\pm$ 35 mmHg, 3군의 경우 470$\pm$ 17 mmHg였다(p<0.001). 순환 2시간째의 동맥혈 산소분압은 1군에 비해 박동혈류를 사용하는 2군과 3군에서 현저하게 높았다(77$\pm$41, 96$\pm$48, 97$\pm$25 mmHg; p<0.05). 혈구손상지표인 혈장 유리 헤모글로빈치는 1군에서 가장 낮았고, 2군에서 가장 높았으며, 3군에서 유의하게 감소하였다(55.7$\pm$43.3, 162.8$\pm$113.6, 82.5$\pm$25.1 mg%; p<0.05). 기타 혈액검사치는 특별한 차이가 없었다. 이상의 결과에서 단일 박동형 구동펌프는 비박동형 원심펌프에 비해 막형산화기의 산소교환에 유리한 반면, 회로압과 혈구세포 손상 측면에서 불리하다는 것을 알 수 있었다. 그러나 단일 박동형 구동펌프와 막형 산화기 사이에 압력완충장치를 설치하는 경우, 회로압 상승과 혈구세포손상을 유의하게 감소시킬 수 있었다.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1996년도 춘계학술대회
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• pp.199-202
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• 1996

Artificial hearts are intended for use in patients with severe forms of heart disease for which no surgical repair is possible. The moving-actuator pump was developed to decrease the overall volume size of the electromechanical total artificial heart (TAH) by eliminating the occupied space of the fixed-actuator in the conventional pusher-plate type pump. In our pump, the actuator moves back and forth for alternative ejections of left and right ventricles. The problem of fitting the TAH to atrial remnants and arterial vessels could also be improved by circular or penduluous mot ion of the actuator instead of linear mot ion of the pusher-plate in the conventional pumps. We have evaluated two types of moving- actuator pump; one is a rolling cylinder type, and the other a pendulum type pump. In the rolling cylinder pump, frictional energy loss exists between the pump housing's guide bars and the actuator's end caps, while the bottom rack under the cylindrical actuator increases the height of the pump, the pump is therefor not implantable inside the small chest of human-sized animals with a body weight of less than 70kg. The new human type pump has a penduluous mot ion actuator to correct the above problems while maintaining the advantage of the moving- actuator's small total volume. The totally implantable TAH is composed of a blood pump, a control system and pheriperal equipments. The blood pump, which is constructed by a moving actuator, a right and left blood sac, and four artificial valves, is implanted in the thoracic. In 1988, the first implantation of the rolling cylinder TAH was performed into a female calf weighing 100kg, and the cal f recovered to the degree of voluntary standing and eat ing and survived to 100 hrs. We then survived two female sheep weighing about 63kg with the new human type TAH for three days.

• 센서학회지
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• 제9권1호
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• pp.51-60
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• 2000

본 논문에서는 정상류형 혈액 펌프의 일종인 축류형 혈액 펌프를 이용하여 혈액 펌프 시스템을 설계하였다. 이 시스템은 혈액 펌프, 신호 획득부, 인터페이스부, 신호 처리부로 구성되어 있고, 혈압과 심박수를 이용하여 혈압과 혈류량을 적절히 제어함으로써 좌심실의 기능을 보조할 목적으로 연구되었다. 전동 펌프가 회전할 때 생체내의 순환조건에 알맞도록 혈액 펌프의 회전수, 혈액 펌프에 걸리는 부하와 압력 정보를 적용하여 실험식을 만들어 제어에 이용하였으며 설계 제작된 모의 순환장치로써 실험한 결과 모의 혈관 내에서 적절한 혈압과 혈류의 제어가 가능하였고, 혈구의 변화량 실험 결과는 임시의 목적으로 사용가능 함을 알 수 있었다.

• BMB Reports
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• 제39권4호
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• pp.377-382
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• 2006

Oxidative stress occurs in patients undergoing coronary artery bypass operation. The aim of this study was to investigate the difference in oxidative stress in off-pump versus on-pump coronary artery bypass surgery. In the present study, in serial blood samples, plasma malondialdehyde (MDA) as index of lipid peroxidation, red blood cells glutathione peroxidase (GPx) and superoxide dismutase (SOD) were measured to compare the extent of oxidative stress in 30 patients undergoing OPCAB (off-pump coronary artery bypass grafting), 12 patients undergoing CABG (on-pump coronary artery bypass grafting) and 18 healthy controls. In CABG group, MDA levels increased significantly from $2.87{\pm}0.62\;nmol/mL$ before anesthesia and $2.87{\pm}0.65\;nmol/mL$ after anesthesia to $3.05{\pm}0.66\;nmol/mL$ after ischemia (p < 0.05). Similarly, SOD levels also elevated significantly from $661.58{\pm}78.70\;U/g$ Hb before anesthesia and $659.42{\pm}81.21\;U/g$ Hb anesthesia induction to $678.08{\pm}75.80\;U/g$ Hb after ischemia (p < 0.01, p < 0.01, respectively). In OPCAB group, only SOD levels increased from $581.73{\pm}86.24\;U/g$ Hb anesthesia induction to $590.90{\pm}88.90\;U/g$ Hb after reperfusion (p < 0.05). Glutathione peroxidase levels were not changed according to blood collection times in both of CABG group or OPCAB group (p > 0.05). Our results show that only mild signs of oxidative stress is found after reperfusion in OPCAB operation compared with CABG operation. Further studies are needed in order to confirm this hypothesis.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1079-1095
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• 1995

Recently endogenous digitalis-like substances were found in the blood of various cardiovascular diseases and they have been considered one of the causes of evoking hypertension. However, the mechanism of endogenous digitalis-like substances-induced hypertension is not clarified yet. Therefore, the effects of Na-K pump inhibition on the contractility of vascular smooth muscle[conduit and resistant artery were investigated, using organ bath and bioassay experiment. Aortic and carotid arterial rings[conduit artery and the branches of brachial and superior mesenteric artery[resistant artery were used to find the effect of Na-K pump inhibition. The results obtained were as followes;The magnitudes of contractions induced by norepinephrine, serotonin, or acetylcholine in all these arteries were significantly increased by the inhibition of Na-K pump. The increased contractile responses to these agonists, especially to serotonin, were much more prominant in resistant arteries. Nitroprusside-induced relaxations were attenuated by Na-K pump inhibition and there were no significant differences in the effects of Na-K pump inhibition on nitroprusside-induced relaxations of these blood vessels. Endothelium-dependent relaxation was suppressed by the inhibition of Na-K pump, especially by the administration of ouabain, and this inhibitory effect was much more prominent in the branches of superior mesenteric artery, compared with other arteries. In the branches of superior mesenteric arteries, endothelium-dependent relaxation was completely blocked by ouabain. The release of EDRF was partially suppressed by Na-K pump inhibition.From the above results, it is suggested that the hypertension due to the increase in vascular resistance can be evoked by the inhibition of Na-K pump and endogenous digitalis-like substances induce hypertension through this mechanism.

• Parasites, Hosts and Diseases
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• 제22권2호
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• pp.203-208
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• 1984

만손주혈흠충 충란의 soluble eff antigen (SEA)을 mini-pump를 이용하여 마우스, 복강내에 지속적으로 주입시키면서 말초혈액내의 호산구수 변동, delayed hypersensitivity인 ear swelling test, 간조직병변, 효소 표식면역법을 이용한 혈청내 항체가를 경시적으로 관찰한 결과 다음 성적을 얻었다. 1. 말초혈액 호산구수는 SEA투여후 2~3주후에 최고에 달하였고 그후 서서히 감소하였다. 2. Ear swelling test 실시에서 SEA투여 2주후에 종창이 최고에 달하고 그후 서서히 감소하였다. 3. 간조직병변은 SEA투여후 4주에 육아종형성을 관찰하였고 그후 조직손상이 복귀하였다. 4. 현청에서의 항체가는 SEA투여후 4주후에 양성대조군보다 높았으며 시간이 경과함에 따라 항채가가 증가하였다.

• 한국전산유체공학회:학술대회논문집
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• 한국전산유체공학회 2008년도 춘계학술대회논문집
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• pp.105-106
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• 2008

As a carrier of malaria and sneak of blood, mosquitoes are an unpleasant insect. However, there are several unknown natural secretes related with mosquitoes. Among them, we focused on the blood sucking process of a female mosquito. The main objective of this study is to understand the mosquito's blood sucking mechanism that can be used to resolve the problem encountered in the injection or transport of infinitesimal biological fluids in a micro-chip. At first, the velocity fields of blood-sucking flow in a proboscis were measured using a micro-particle image velocimetry (PIV) technique. The velocity signals of flow in the proboscis show periodic variation. This seems to be resulted from the beating of the pharyngeal pump which works as driving power. To analyze the pumping mechanism, the temporal variation of the pharyngeal pump was visualized using the synchrotron X-ray micro-imaging technique. The volume variation was estimated by the help of digital image processing techniques. Once the main mechanism of blood sucking process was found, a effective micro-pumping system with high efficiency would be developed in near future.

• International Journal of Fluid Machinery and Systems
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• 제7권1호
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• pp.34-41
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• 2014

Computational fluid dynamics (CFD) and particle image velocimetry (PIV) are commonly used techniques to evaluate the flow characteristics in the development stage of blood pumps. CFD technique allows rapid change to pump parameters to optimize the pump performance without having to construct a costly prototype model. These techniques are used in the construction of a bi-ventricular assist device (BVAD) which combines the functions of LVAD and RVAD in a compact unit. The BVAD construction consists of two separate chambers with similar impellers, volutes, inlet and output sections. To achieve the required flow characteristics of an average flow rate of 5 l/min and different pressure heads (left - 100mmHg and right - 20mmHg), the impellers were set at different rotating speeds. From the CFD results, a six-blade impeller design was adopted for the development of the BVAD. It was also observed that the fluid can flow smoothly through the pump with minimum shear stress and area of stagnation which are related to haemolysis and thrombosis. Based on the compatible Reynolds number the flow through the model was calculated for the left and the right pumps. As it was not possible to have both the left and right chambers in the experimental model, the left and right pumps were tested separately.

• Advances in biomechanics and applications
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• 제1권2호
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• pp.127-141
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• 2014

A preliminary study of a new pulsatile pump that will work to a frequency greater than 1 Hz, is presented. The fluid-structure interaction between a Newtonian blood flow and a piston drive that moves with periodic speed is simulated. The mechanism is of double effect and has four valves, two at the input flow and two at the output flow; the valves are simulated with specified velocity of closing and reopening. The simulation is made with finite elements software named COMSOL Multiphysics 3.3 to resolve the flow in a preliminary planar configuration. The geometry is 2D to determine areas of high speeds and high shear stresses that can cause hemolysis and platelet aggregation. The opening and closing valves are modelled by solid structure interacting with flow, the rhythmic opening and closing are synchronized with the piston harmonic movement. The boundary conditions at the input and output areas are only normal traction with reference pressure. On the other hand, the fluid structure interactions are manifested due to the non-slip boundary conditions over the piston moving surfaces, moving valve contours and fix pump walls. The non-physiologic frequency pulsatile pump, from the viewpoint of fluid flow analysis, is predicted feasible and with characteristic of low hemolysis and low thrombogenesis, because the stress tension and resident time are smaller than the limit and the vortices are destroyed for the periodic flow.

• Journal of Chest Surgery
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• 제47권4호
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• pp.350-357
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• 2014

Background: Conservation of blood during cardiac surgery is important because of the shortage of donor blood, risks associated with transfusion, and the costs of allogeneic blood products. This retrospective study explored the feasibility of off-pump coronary artery bypass (OPCAB) without transfusion. Methods: One hundred and two consecutive patients underwent OPCAB from January 2007 to June 2012 at Hallym University Sacred Heart Hospital. Excluding 10 chronic renal failures patients, 102 patients were enrolled. Their characteristics, clinical data, and laboratory data were analyzed. We investigated the success rate of OPCAB without transfusion according to preoperative hemoglobin (Hb), and the cutoff point of the Hb level and the risk factors for transfusion. We implemented multidisciplinary blood-saving protocols. Results: The overall operative mortality and the success rate of OPCAB without transfusion were 2.9% (3/102) and 73.5% (75/102). The success rates in patients with Hb<11, 11 70 years, diagnosis of acute myocardial infarction, preoperative Hb and creatinine levels, and operation time. The events precipitating the need for transfusion were low Hb level in 9 patients and hypotension or excessive bleeding in 18 patients. Conclusion: The preoperative Hb level of >11 facilitates OPCAB without transfusion. These results suggest that transfusion-free OPCAB can be performed by modifying the risk factors and correctable causes of transfusion and improving various blood salvage methods.