• Title/Summary/Keyword: Bypass-circuit

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Evaluation of Biocompatibility of Extracorporeal Circuit - Development of a Quantification Technique using in-vivo Injection of Tc99m Radioactive Platelets - (체외순환도관의 혈액적합성 평가 - 방사선 동위원소(Tc99m) 활성화 혈소판의 생체 내 주입을 이용한 정량분석법의 개발 -)

  • Lee, Sung-Ho;Sun, Kyung;Choi, Jai-Geol;Son, Ho-Sung;Jung, Jae-Seung;Ahn, Sang-Soo;Oh, Hye-Jung;Lee, Whan-Sung;Lee, Hye-Won;Kim, Kwang-Taik;Jeong, Yoon-Seop;Kim, Young-Ha;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.171-176
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    • 2002
  • Background: Blood-foreign interaction cause activation of coagulation and inflammatory process that may lead to multiorgan dysfunction and determine the surgical outcomes. Of the methods for assessing the biocompatibility, the platelet adhesion study is considered as the most valuable evaluation step in blood-foreign interaction. As the most studies have used in-vitro or ex-vivo conditions, we have developed a technique of quantification for platelet adhesion on the blood contact surface by using in-vivo injection of radioactive platelets. Material and Method: A coupled bypass circuit was designed to connect the proximal and descending thoracic aorta in 6 piglets(20∼25 Kg). One side of the circuit tube was consisted of a heparin coated PVC tube(10mm in ID, n=6, Experimental group), and the other, a non-heparin coated PVC tube(10mm in ID, n=6, Control group). After cannulation, the blood was circulated through the circuit for 2 hours. Platelet concentrate was prepared from homologous pig blood 24 hours before the experiment. The platelet concentrate was incubated with Tc-99m-HMPAO for 30 min and then centrifuged for 10 min. The supernatant was discarded and the radio-labeling efficacy was measured. The radio-labeled platelet concentrate was mixed with the autologous plasma to make the volume 5 ml, and the mixture was injected intravenously into the experimental animal. After 2 hour circulation, 5 pieces of the specimen(10mm in length each) were obtained from each PVC tube. The radioisotopes were counted with a gamma counter(Cobra ll, Packard, USA), and the ratio of radioisotope count was compared between the control and experimental group. Result: The radioisotope count number was 537.3221.1 Ci/min in the control group and 311.1 184.5 Ci/min in the experimental group(p=0.0104). The ratio between the groups was 1 to 0.58 (p=0.004). Conclusion: In vivo quantification using technetium-99m-HMPAO labeled platelets is simple and reproducible in evaluating platelet adhesion on a foreign surface. We suggest this technique to be a useful tool for blood compatibility test.

Application of a Single-pulsatile Extracorporeal Life Support System for Extracorporeal Membrane Oxygenation -An experimental study - (단일 박동형 생명구조장치의 인공폐 적용 -실험연구-)

  • Kim, Tae-Sik;Sun, Kyung;Lee, Kyu-Baek;Park, Sung-Young;Hwang, Jae-Joon;Son, Ho-Sung;Kim, Kwang-Taik;Kim. Hyoung-Mook
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.201-209
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    • 2004
  • Extracorporeal life support (ECLS) system is a device for respiratory and/or heart failure treatment, and there have been many trials for development and clinical application in the world. Currently, a non-pulsatile blood pump is a standard for ECLS system. Although a pulsatile blood pump is advantageous in physiologic aspects, high pressure generated in the circuits and resultant blood cell trauma remain major concerns which make one reluctant to use a pulsatile blood pump in artificial lung circuits containing a membrane oxygenator. The study was designed to evaluate the hypothesis that placement of a pressure-relieving compliance chamber between a pulsatile pump and a membrane oxygenator might reduce the above mentioned side effects while providing physiologic pulsatile blood flow. The study was performed in a canine model of oleic acid induced acute lung injury (N=16). The animals were divided into three groups according to the type of pump used and the presence of the compliance chamber, In group 1, a non-pulsatile centrifugal pump was used as a control (n=6). In group 2 (n=4), a single-pulsatile pump was used. In group 3 (n=6), a single-pulsatile pump equipped with a compliance chamber was used. The experimental model was a partial bypass between the right atrium and the aorta at a pump flow of 1.8∼2 L/min for 2 hours. The observed parameters were focused on hemodynamic changes, intra-circuit pressure, laboratory studies for blood profile, and the effect on blood cell trauma. In hemodynamics, the pulsatile group II & III generated higher arterial pulse pressure (47$\pm$ 10 and 41 $\pm$ 9 mmHg) than the nonpulsatile group 1 (17 $\pm$ 7 mmHg, p<0.001). The intra-circuit pressure at membrane oxygenator were 222 $\pm$ 8 mmHg in group 1, 739 $\pm$ 35 mmHg in group 2, and 470 $\pm$ 17 mmHg in group 3 (p<0.001). At 2 hour bypass, arterial oxygen partial pressures were significantly higher in the pulsatile group 2 & 3 than in the non-pulsatile group 1 (77 $\pm$ 41 mmHg in group 1, 96 $\pm$ 48 mmHg in group 2, and 97 $\pm$ 25 mmHg in group 3: p<0.05). The levels of plasma free hemoglobin which was an indicator of blood cell trauma were lowest in group 1, highest in group 2, and significantly decreased in group 3 (55.7 $\pm$ 43.3, 162.8 $\pm$ 113.6, 82.5 $\pm$ 25.1 mg%, respectively; p<0.05). Other laboratory findings for blood profile were not different. The above results imply that the pulsatile blood pump is beneficial in oxygenation while deleterious in the aspects to high pressure generation in the circuits and blood cell trauma. However, when a pressure-relieving compliance chamber is applied between the pulsatile pump and a membrane oxygenator, it can significantly reduce the high circuit pressure and result in low blood cell trauma.

TML 방법에 의한 우주환경에서의 인공위성 부품 탈기체 특성에 관한 연구

  • 정성인;박홍영;유상문;오대수;이현우;임종태
    • Bulletin of the Korean Space Science Society
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    • 2003.10a
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    • pp.62-62
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    • 2003
  • 과학위성 1호에는 위성의 임무를 수행하기 위하여 광학계, 구조부, 및 전자부 등 여러가지 부품들이 실장되는데, 그 중 전자부의 가장 중요한 부품 중의 하나인 인쇄회로기판(Printed Circuit Board, PCB)의 우주환경에서의 특성 대해서 논의하고자 한다. Solder Resistor(Solder Mask)의 화학성분이 위성체가 작동하는 우주환경에서 위성체 임무수행 시 발생할 수 있는 out-gassing으로 인해 위성체가 본연의 임무 실패라는 결과를 초래할 수 있다 NASA 및 ESA의 Out-gassing에 관한 규정과 TRW에 의한 KOMSAT에 사용된 재료의 진공상태의 Outgassing에 관한 내용에 의하면, 재료의 진공상태와 Out-gassing은 America Society for Testing and Materials에서 제시한 ASTM E959 기준에 따라 제작된다. 일반적으로 우주 환경에서 광학계나 전자부의 원활한 동작을 위해서는 인쇄 회로 기판의 총 질량손실(Total Mass Loss, TML)은 1.00%을 넘지 말아야 하며, 휘발성 응축 질량 (Collected Volatile Condensable Mass, CVCM)은 0.1% 미만이어야 한다. Total Mass Loss(TML) 방법은 대기중에서 측정한 질량과 진공 조건에서 변화되는 질량을 측정함으로써 진공조건에서의 탈기체 특성을 측정하는 방법이다. 본 연구에서는 Solder Resistor(Solder Mask)의 탈기체 측정을 위한 진공챔버의 측정방법 및 진공 형성 과정을 기술하고 실제 과학위성1호에 장착될 시료를 예로 들어 인쇄회로기판에 입힌 Solder Resistor(Solder Mask)가 우주환경인 진공상태에서 위성체 부품의 작동 시 발생할 수 있는 탈기체되는 정도를 질량의 변화분으로 측정하여 위성체가 우주 환경에서 본연의 임무를 안전하게 수행할 있는지를 검증하였다.부분이다.다.향을 해석하고 시뮬레이션 하였다.Device Controller)는 ECU로부터 명령어를 받아서 arm 및 safe 상태에 대한 텔리 메트리 데이터를 제공한다 그리고, SAR(Solar Array Regulator)는 ECU로부터 Bypass Relay 및 ARM Relay에 관한 명령어를 받아 수행되며 그에 따른 텔리 메트리 데이터를 제공한다. 마지막으로 EPS 소프트웨어를 검증하는 EPS Software Verification을 수행하였다 전력계 소프트웨어의 설계의 검증 부분은 현재 설계 제작된 전력계 .소프트웨어의 동작 특성 이 위성 의 전체 운용개념과 연계하여 전력계 소프트웨어가 전력계 및 위성체의 요구조건을 만족시키는지를 확인하는데 있다. 전력계 운용 소프트웨어는 배터리의 충ㆍ방전을 효율적으로 관리해 3년의 임무 기간동안 위성체에 전력을 공급할 수 있도록 설계되어 있다this hot-core has a mass of 10sR1 which i:s about an order of magnitude larger those obtained by previous studies.previous studies.업순서들의 상관관계를 고려하여 보다 개선된 해를 구하기 위한 연구가 요구된다. 또한, 준비작업비용을 발생시키는 작업장의 작업순서결정에 대해서도 연구를 행하여, 보완작업비용과 준비비용을 고려한 GMMAL 작업순서문제를 해결하기 위한 연구가 수행되어야 할 것이다.로 이루어 져야 할 것이다.태를 보다 효율적으로 증진시킬 수 있는 대안이 마련되어져야 한다고 사료된다.$\ulcorner$순응$\lrcorner$의 범위를 벗어나지 않는다. 그렇기 때문에도 $\ulcorner$순응$\lrcorner$$\ulcorner$표현$\lrcorner$의 성격과 형태를 외형상으로

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Impact of Pulmonary Vascular Compliance on the Duration of Pleural Effusion Duration after Extracardiac Fontan Procedure (수술 전 폐혈관 유순도가 심장 외 도판을 이용한 Fontan 수술 후 늑막 삼출 기간에 미치는 영향)

  • Yun Tae-Jin;Im Yu-Mi;Song Kwang-Jae;Jung Sung-Ho;Park Jeong-Jun;Seo Dong-Man;Lee Moo-Song
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.579-587
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    • 2006
  • Background: Preoperative risk analysis for Fontan candidates is still less than optimal in that patients with apparently low risks may have poor surgical outcome; prolonged pleural drainage, protein losing enteropathy, pulmonary thromboembolism and death. We hypothesized that low pulmonary vascular compliance (PVC) is a risk factor for prolonged pleural effusion drainage after the Fontan operation. Material and Method: A retrospective review of 96 consecutive patients who underwent the Extracardiac Fontan procedures (median age: 3.9 years) was performed. Fontan risk score (FRS) was calculated from 12 categorized preoperative anatomic and physiologic variables. PVC $(mm^2/m^2{\cdot}mmHg)$ was defined as pulmonary artery index $(mm^2/m^2)$ divided by total pulmonary resistance $(W.U{\cdot}/m^2)$ and pulmonary blood flow $(L/min/m^2)$ based on the electrical circuit analogue of the pulmonary circulation. Chest tube indwelling time was log-transformed (log indwelling time, LIT) to fit normal distribution, and the relationship between preoperative predictors and LIT was analyzed by multiple linear regression. Result: Preoperative PVC, chest tube indwelling time and LIT ranged from 6 to 94.8 $mm^2/mmHg/m^2$ (median: 24.8), 3 to 268 days (median: 20 days), and 1.1 to 5.6 (mean: 2.9, standard deviation: 0.8), respectively. FRS, PVC, cardiopulmonary bypass time (CPB) and central venous pressure at postoperative 12 hours were correlated with LIT by univariable analyses. By multiple linear regression, PVC (p=0.0018) and CPB (p=0.0024) independently predicted LIT, explaining 21.7% of the variation. The regression equation was LIT=2.74-0.0158 PVC+0.00658 CPB. Conclusion: Low pulmonary vascular compliance is an important risk factor for prolonged pleural effusion drainage after the extracardiac Fontan procedure.

Experiences with Emergency Percutaneous Cardiopulmonary Support in In-hospital Cardiac Arrest or Cardiogenic Shock due to the Ischemic Heart Disease (허혈성 심질환으로 인해 병원 내에서 발생한 심정지 혹은 심정지 혹은 심인성 쇼크에 있어서의 경피적 심폐 보조장치의 치료 경험)

  • Rhee Il;Kwon Sung-Uk;Cho Sung Woo;Gwon Hyeon-Cheol;Lee Young Tak;Park Pyo Won;Park Kay-Hyun;Lee Sang Hoon;Sung Kiick
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.201-207
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    • 2006
  • Background: Percutaneous cardiopulmonary support (PCPS) provides passive support of gas exchange and perfusion, allowing the use of other methods of care for organ recovery, and saves lives of patients with severe cardiopulmonary failure in a wide variety of clinical settings with a minimal risk of bleeding and need for chest re~ exploration. We summarized a single center's experiences with PCPS in patients with cardiogenic shock or cardiac arrest due to the ischemic heart disease. Material and Method: Among the 20 consecutive patients with cardiogenic shock or cardiac arrest from May 1999 to June 2005, Biopump (Medtronic, Inc, Minneapolis, MN) was used in 7 patients and the self-priming, heparin-coated circuit of EBS (Terumo, Japan) was applied to remaining 13 patients. Most of cannulations were performed percutaneously via femoral arteries and veins. The long venous cannulas of DLP (Medtronic inc. Minneapolis, MN) or the RMI (Edwards's lifescience LLC, Irvine, CA) were used with the arterial cannulae from 17 Fr to 21 Fr and the venous cannula from 21 Fr to 28 Fr. Result: The 20 consecutive patients who were severely compromised and received PCPS for the purpose of resuscitation were comprised of 13 cardiac arrests and 7 cardiogenic shocks in which by-pass surgery was performed in 11 patients and 9 ongoing PCls under the cardiopulmonary support. The mean support time on the PCPS was 38$\pm$42 hours. Of the 20 patients implanted with PCPS, 11 patients ($55\%$) have had the PCPS removed successfully; overall, 8 of these patients ($40\%$) were discharged from the hospital in an average surviving time for 27$\pm$17 days after removing the PCPS and survived well with 31$\pm$30 months of follow-up after the procedure. Conclusion: The use of PCPS appears to provide the hemodynamic restoration, allowing the survival of patients in cardiac arrest or cardiogenic shock who would otherwise not survive, and patients receiving PCPS had a relatively long-term survival.