• 제목/요약/키워드: Extracorporeal

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Extracorporeal Shock Wave Therapy: Its Acoustical Aspects

  • Choi, Min-Joo;Cho, Sung-Chan;Paeng, Dong-Guk;Lee, Kang-Il
    • The Journal of the Acoustical Society of Korea
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    • 제29권3E호
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    • pp.119-130
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    • 2010
  • Extracorporeal shock wave therapy (ESWT) is simply evolved from extracorporeal shock wave lithotripsy known as a revolutionary non-invasive technique for treating kidney stone diseases. Since ESWT was approved for treating plantar fasciitis by FDA in 2000, it has been rapidly accepted into various clinical practices. Its indication includes chronic tendinitis and pseudoarthrosis, and has been widened to various applications other than orthopeadics. Little has been reported on their acoustic properties, yet, even if a number of clinical ESWT systems are readily available. This article reviews the acoustical aspects of ESWT and discusses critical issues towards acoustic exposure optimization and shock wave dosimetry.

Extracorporeal Membrane Oxygenation Support in a Patient with Status Asthmaticus

  • Ju, Min-Ho;Park, Jeong-Jun;Jhang, Won-Kyoung;Park, Seong-Jong;Shin, Hong-Ju
    • Journal of Chest Surgery
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    • 제45권3호
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    • pp.186-188
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    • 2012
  • Status asthmaticus is a rare, fatal condition, especially in children. Sometimes respiratory support is insufficient with a mechanical ventilator or medical therapy for patients with status asthmaticus. In such situations, early extracorporeal membrane oxygenation application is a useful method for treating refractory respiratory failure. We report on a case of a six-year-old, male child who underwent venovenous extracorporeal membrane oxygenation support for refractory status asthmaticus.

A follow-up study on extracorporeal fixation of condylar fractures using vertical ramus osteotomy

  • Park, Sung Yong;Im, Jae Hyoung;Yoon, Seong Hoe;Lee, Dong Kun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권2호
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    • pp.76-82
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    • 2014
  • Objectives: The aim of this study is to report the results of extracorporeal fixation in patients with mandibular condylar fractures and compare them with the clinical results of conservative treatment. Materials and Methods: The medical records of 92 patients (73 male [M] : 19 female [F], age 13-69 years, mean 33.1 years) treated for condylar fractures at the Department of Oral and Maxillofacial Surgery in Sun Dental Hospital (Daejeon, Korea) from 2007 to 2012 were reviewed. Patients were divided into three groups: group A (23 patients; M : F=18 : 5, age 21-69 years, mean 32.6 years), treated with extracorporeal fixation; group B (30 patients; M : F=24 : 6, age 16-57 years, mean 21.1 years), treated by conventional open reduction; and group C (39 patients; M : F=31 : 8, age 16-63 years, mean 34.4 years), treated with the conservative method ('closed' reduction). Clinical and radiographic findings were evaluated and analyzed statistically. Results: Occurrence of postoperative condylar resorption correlated with certain locations and types of fracture. In this study, patients in group A (treated with extracorporeal fixation) did not demonstrate significant postoperative complications such as malocclusion, mandibular hypomobility, temporomandibular disorder, or complete resorption of condyle fragments. Conclusion: In superiorly located mandibular condyle fractures, exact reconstruction of condylar structure with the conventional open reduction technique can be difficult due to the limited surgical and visual fields. In such cases, extracorporeal fixation of the condyle using vertical ramus osteotomy may be a better choice of treatment because it results in anatomically accurate reconstruction and low risk of complications.

하악 과두골절에 관한 임상적 연구: 효과적인 체외고정법 (A CLINICAL STUDY ON FRACTURES OF THE MANDIBULAR CONDYLES: EFFECTIVE EXTRACORPOREAL FIXATION TECHNIQUE)

  • 권광준;정지훈;김지혁;박영욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권4호
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    • pp.359-369
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    • 2008
  • Purpose: Fractures of the mandibular condyle accounts for 15% to 30% of all the mandibular fractures and lots of complications are reported. Among these complications, condylar resorption is the most important one to be taken into account. The purpose of this study is evaluating condylar resorption pattern in relation to extracorporeal fixation technique. Patients & methods: Thirty four patients with 42 mandibular condylar fractures were retrospectively examined with an average follow-up of 18.5 months (6-66 months). Male/female ratio is 27 males (7 bilateral cases) and 7 females (1 bilateral case). Applicated surgical techniques were extracorporeal fixation via submandibular approach and extracorporeal fixation via intraoral approach. We compared radiographic views of post-operative periods with that of most long term follow up in 34 operated sites respectively. Result: There were 2 generalized condylar resorption sites and 3 partial resorption sites with clinical implications. Others (29 joints) showed good healing or satisfactory adaptive state of temporomandibular joints clinically. Radiologically, signs of partial condylar resorption and/or osteoarthrosis were diagnosed in 11 patients. But, 8 out of the 11 patients didn't show significant clinical symptoms, which means successful adaptive remodeling of the surgically located condylar head. Conclusion: From the above results, intentional ramal osteotomy, temporary detachment of the fractured condyle and extracorporeal fixation technique seems to be effective and useful in those cases of condylar fractures in which reduction of the dislocated condyle is very difficult or virtually impossible.

경혈 경락 이론에 근거하여 사용된 체외 충격파 문헌 검색 및 활용 가능성 연구 (Literature Review and Applicability of Extracorporeal Shock Wave with Meridian and Acupoint Theory)

  • 정종혁;김윤아;이상현;김병준;황의형
    • 동의생리병리학회지
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    • 제36권6호
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    • pp.213-220
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    • 2022
  • We investigated the current status of research using extracorporeal shock waves on the basis of meridian and acupoint theory. By March 2022, five foreign databases (CAJ, Pubmed, Web of Science, EMBASE, Cochrane Library) and six Korean databases (Dbpia, RISS, KMBASE, scienceON, KISS, NDSL) were searched with the terms using 'Extracorporeal shock wave' and '(Acupoint or Acupuncture point)'. The search terms were adapted according to the language of the database. There were no restrictions on the study design. As a result of the search, twenty-seven papers were selected for analysis. One study was searched in English database, and the remaining twenty-six studies were searched in Chinese database. There were nineteen pain-related diseases, four obsterics and gynecology diseases, two bone-related diseases, and two other diseases. The most frequently used acupoints were GB34, ST36, and KI3. A total of six adverse events were reported in five papers. The use of extracorporeal shock wave on the basis of meridian and acupoint theory is considered to have sufficient meaning in Korean Medicine. It is expected to use extracorporeal shock wave as a new treatment method for Korean Medicine doctors in the near future.

가토에서 체외 방사선 조사후 재이식한 자가관절의 조직학적 변화 (Histologic Change of Extracorporeal Irradiated Autogenous Joint Transplantation in Rabbit's Knee)

  • 김재도;조명래;유경식;김영창
    • 대한골관절종양학회지
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    • 제5권1호
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    • pp.9-16
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    • 1999
  • A new method of limb sparing by resection, extracorporeal irradiation and reimplantation has several theoretical advantages. This method preserves the mobility of a joint and avoids the problem of loosening or breakage of tumor prosthesis. This study involved using extracorporeal irradiated autogenous joint transplantation for reconstruction after en bloc resection, and observed the periods of functional union and histological changes in irradiated tissue of the knee joint. This study also aimed to clarify whether the degeneration of articular cartilage is induced in rabbits by a single 50Gy dose of irradiation at the knee joint. Twenty New Zealand rabbits about three kilograms were randomized into two groups of 10 rabbits each. In group 1, as control, we resected the knee joint followed by reimplantation without irradiation. Group 2 received extracorporeal irradiation on the resected knee joint followed by reimplantation. Following are the results of these observations. The osteotomy site showed external callus formation in the roentgenographic finding eight weeks after reimplantation. There was marked degenerative changes in the collagen fiber of the irradiated anterior cruciate ligament and meniscus during the fourth week, but new blood-vessel formation was observed in the vicinity. There was degenerative changes in the collagen fiber of articular cartilage treated extracorporeal irradiation at four and eight weeks in the scanning electron micrographic findings. These findings was in contrast to those of subchondral bone which showed decreased cellularity and empty lacuna at four and eight weeks. Autoradiography demonstrated active [$^3H$]uridine incorporation by irradiated chondrocyte at eight weeks after reimplantation. These results indicate that when destruction of the articular cartilage and soft tissue of the knee joint is not severe, extracorporeal irradiation and reimplantation can be used with several advantage in maintaining movement of the joint while avoiding problems of tumor prosthesis and rejection, and therefore extracorporeal irradiated autogenous joint transplantation can be used as a limb-sparing procedure for temporary biological spacer in the childhood bone tumor around the knee.

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CFD 해석을 이용한 Balloon형 인공심폐기 설계를 위한 구조적 해석 (Structural Analysis for Constructing a Balloon Type Extracoporeal Membrane Oxygenator using CFD Analysis)

  • 박영란;심정연;김기범;김상진;강형섭;김진상;김민호;홍철운;김성종
    • Korean Chemical Engineering Research
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    • 제49권2호
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    • pp.238-243
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    • 2011
  • 본 연구는 기존의 인공심폐기의 단점을 보완하기 위하여 혈액펌프를 사용하지 않고 혈류의 흐름을 유도할 수 있는 기구(balloon)형 인공심폐기 설계를 위한 구조적 해석을 시도하였다. 가상의 모형 인공심폐기 내에서의 혈류의 흐름패턴을 분석하기 위하여 CFD 모델링 방법을 사용하였다. 이 시스템의 작동원리는 막 산화기 주위를 기구를 사용하여 압력하중을 인가하여 주기적으로 수축.이완되도록 하였으며, 시간에 따라 변화하는 시간 함수 값은 sine 반주기와 sine 주기를 계산하여 적용하였다. 이와 같은 방법으로 기구형 인공심폐기를 설계할 경우 한 방향에 대한 혈류의 움직임을 유도할 수 있다는 가정 하에 구조적 해석을 하였다. 실험결과 CFD 시뮬레이션을 통하여 인공심폐기의 입구와 출구에 서의 혈류의 속도와 압력을 측정하여 분석한 결과 한 방향에 대한 혈류의 유동이 발생하는 것을 확인하였다. 이와 같은 CFD 시뮬레이션은 혈류의 흐름특성을 미리 예측할 수 있어 인공심폐기 설계에 있어서 최적화된 디자인을 제공할 수 있을 것이라 판단된다.

Extracorporeal Life Support in Organ Transplant Donors

  • Chang, Wonho
    • Journal of Chest Surgery
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    • 제51권5호
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    • pp.328-332
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    • 2018
  • Background: Extracorporeal life support (ECLS) can be applied in brain-dead donors for organ perfusion before donation, thereby expanding the donor pool. The aim of this study was to examine the benefits and early clinical outcomes of ECLS for organ preservation. Methods: Between June 2012 and April 2017, 9 patients received ECLS with therapeutic intent or for organ preservation. The following data were collected: demographics, purpose and duration of ECLS, cause of death, dose of vasoactive drugs, and need for temporary dialysis before organ retrieval. The early clinical outcomes of recipients were studied, as well as survival and graft function at 1 month. Results: ECLS was initiated for extracorporeal cardiopulmonary resuscitation in 5 patients. The other patients needed ECLS due to hemodynamic deterioration during the assessment of brain death. We successfully retrieved 18 kidneys, 7 livers, and 1 heart from 9 donors. All organs were transplanted and none were discarded. Only 1 case of delayed kidney graft function was noted, and all 26 recipients were discharged without any significant complications. Conclusion: The benefits of protecting the vital organs of donors is significant, and ECLS for organ preservation can be widely used in the transplantation field.

Delayed Repair of Ventricular Septal Rupture Following Preoperative Awake Extracorporeal Membrane Oxygenation Support

  • Park, Bong Suk;Lee, Weon Yong;Lim, Jung Hyeon;Ra, Yong Joon;Kim, Yong Han;Kim, Hyoung Soo
    • Journal of Chest Surgery
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    • 제50권3호
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    • pp.211-214
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    • 2017
  • Outcomes of ventricular septal rupture (VSR) as a complication of acute myocardial infarction are extremely poor, with an in-hospital mortality rate of 45% in surgically treated patients and 90% in patients managed with medication. Delaying surgery for VSR is a strategy for reducing mortality. However, hemodynamic instability is the main problem with this strategy. In the present case, venoarterial extracorporeal membrane oxygenation (ECMO) was used to provide stable hemodynamic support before the delayed surgery. Awake ECMO was also used to avoiding the complications of sedatives and mechanical ventilation. Here, we describe a successful operation using awake ECMO as a bridge to surgery.

Cytomegalovirus Myocarditis Required Extracorporeal Membrane Oxygenation Support Followed by Ganciclovir Treatment in Infant

  • Kim, Bong Jun;Jung, Jo Won;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan;Shin, Hong Ju
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.199-202
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    • 2016
  • A 7-month-old girl with no medical history was treated with mechanical circulatory support due to myocarditis. Her cardiac contractility did not improve despite more than one week of extracorporeal membrane oxygenation treatment. Thus, we planned a heart transplant. However, a high level of cytomegalovirus was found in blood laboratory results by quantitative polymerase chain reaction. The patient's heart contractility recovered to normal range four days after ganciclovir treatment. She was discharged with slightly decreased cardiac contractility with a left ventricular ejection fraction of 45%.