• Journal of Chest Surgery
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• 제49권3호
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• pp.203-206
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• 2016

Patients with venoarterial extracorporeal membrane oxygenation (ECMO) frequently suffer from pulmonary edema due to left ventricular dysfunction that accompanies left heart dilatation, which is caused by left atrial hypertension. The problem can be resolved by left atrium (LA) decompression. We performed a successful percutaneous LA decompression with an atrial septostomy and placement of an LA venting cannula in a 38-month-old child treated with venoarterial ECMO for acute myocarditis.

• 대한골관절종양학회지
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• 제11권1호
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• pp.17-24
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• 2005

의학의 발달과 더불어 종양에 대한 국소치료는 광범위근치술(extended radical surgery) 로부터 기능보존술(function preserving surgery)로 발달하고 이것은 다시 최소침습술(minimal-invasive surgery)로 발전하여 왔다. 그러나 최근 들어서는 기술의 혁신적인 진보로 비침습적수술법(non-invasive surgery)이 개발되어 감마나이프(gamma knife), 사이버나이프(cyber knife), 및 하이푸나이프(HIFU knife) 등이 출현하게 되었다. 본 논문에서는 이들 중 하이푸나이프를 이용한 체외강력집속초음파치료(extracorporeal high intensity focused ultrasound therapy)에 대하여 발달사, 치료기 구조 및 치료과정, 조직학적 변화와 기전, 임상적용, 장단점 및 전망 등을 살펴보고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권1호
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• pp.30-36
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• 2014

There are many treatment options in management of mandibular condylar neck fractures. Closed reduction is the most conservative treatment; however, achievement of anatomic reduction is difficult, and there are some risks of mandibular functional impairment. Open anatomic reduction and internal fixation have some advantages; therefore, many oral and maxillofacial surgeons have attempted to achieve anatomic reduction through the open approach and extracorporeal reduction and fixation. However, when using this method, there is some risk of resorption of the fractured mandibular condylar head. Therefore, we designed a modified extracorporeal reduction technique, without detaching the lateral pterygoid muscle in order to maintain the blood supply to the fractured mandibular condylar head. We believe that this minor modification may minimize the risk of resorption of the fractured mandibular condylar head. In this article, we introduce this technique in detail, and report on two cases.

• 융합신호처리학회논문지
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• 제11권4호
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• pp.298-302
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• 2010

체외 순환 보조 장치는 호흡부전 및 심부전 등에 사용하는 장치이며 세계적으로 많은 연구 개발과 임상에의 사용이 계속되고 있다. 이 장치들을 사용할 때 주의해야할 사항중 하나는 공기 색전증이다. 공기 색전증은 정맥혈내로 공기가 들어갈 수 있는 여러 가지 수술 과정 및 진단 과정의 합병증으로 일어날 수 있으며, 수술부위가 심장보다 위치, 수술 과정 중 체강, 체외 순환 보조 장치를 사용할 때 공기의 유입이 생길 수 있다. 이러한 문제를 해결하기위해 비유전율 상수의 변화를 이용한 공기방울 감지 장치를 개발했다. 모의순환 장치에서 실험해본 결과 튜브 안의 공기 양에 따라 신호의 차를 분명하게 보여주어 공기방울을 감지할 수 있었다.

• 대한방사선기술학회지:방사선기술과학
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• 제21권1호
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• pp.40-45
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• 1998

To determine its usefulness and safety of extracorporeal shock-wave lithotripsy in common bile duct and pancreatic duct stones, we analyzed the results of 13 patients with common bile duct stones and 6 patients with pancreatic duct stones which were removed by endoscopic procedures using the balloon or basket, who was performed the extracorporeal shock-wave lithotripsy using the ultrasonography for stone localization with a spark gap type Lithotriptor(Dernier MPL 9000, Germany). Fragmentation and complete clearance of the common bile duct and pancreatic duct stones were obtained in 19 of 19 patients(100%). Apart from transient attacks of fever in 2 of 13 patients with common bile duct stones(15%) and mild elevation of serum amylase and lipase in 2 of 6 patients with pancreatic duct stones(33%), no other serious side effects were observed. In our experiences, extracorporeal shock-wave lithotripsy is a safe and useful treatment for endoscopically unretrievable common bile duct and pancreatic duct stones.

• Physical Therapy Rehabilitation Science
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• 제3권2호
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• pp.142-147
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• 2014

Objective: This study aims to investigate high energy and low energy extracorporeal shockwave therapy (ESWT) and which one is more effective for shoulder pain. Design: Single blind randomized controlled trial. Methods: Fifty two subjects with upper trapezius (UT) trigger point (TrP) participated in this study. They were allocated to high energy (n=26) and low energy group (n=26). This study applies ESWT and investigates the changes of pressure pain threshold (PPT) and visual analogue scale (VAS). The high and low energy groups received focused piezo electric type ESWT 4 Hz, 1,000 pulses and 0.351 and $0.092mJ/mm^2$ respectively. Outcome measures of PPT and pain was measured by algometer and pain VAS. These measurements were performed before and after treatment. Results: The PPT value was significantly increased in both groups after treatment (p<0.05) and VAS scores were significantly decreased after treatment in both groups (p<0.05). However, there were no significant differences between groups. Conclusions: ESWT is an effective treatment for the application of the UT TrP. Although there were significant effects of extracorporeal shock wave therapy on PPT and VAS scores, there were no signficant differences between high and low energy extracorporeal shock wave therapy.

• Journal of Chest Surgery
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• 제15권1호
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• pp.40-45
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• 1982

A Clinical study was carried out to observe changes in concentration of serum and urinary potassium during and after open-heart surgery under extracorporeal circulation with Heart-Lung-Machine. The patients studied in the present work included eight cases of congenital heart anomalies and seven cases of acquired valvular diseases of the heart. Blood and urine samples were collected at intervals of 30 minutes during open-heart surgery and at intervals of 8 hours until 48 hours after the operation to determine concentration of serum and urinary potassium. 1.While the concentration of urinary potassium was not changed during the operation, the concentration of urinary potassium was rapidly increased after the operation. Eight hours after the operation, the concentration of urinary potassium was increased to the highest value of 86.97±43.96 mEq/L and was gradually decreased thereafter. The concentration of urinary potassium, however, still remained elevated even 48 hours after the operation, the concentration being greater than preoperative state by 19.90 mEq/L. 2.The concentration of urinary potassium after the operation was higher in the group who went through 90 minutes of extracorporeal circulation [$108.71{\pm}94.71mEq/L$] than in the group who went through 60 minutes of extracorporeal circulation [$86.58{\pm}50.87mEq/L$]. The Increased level of urinary potas-sium observed In the group who went through 90 minutes of extracorporeal circulation continued for longer period of time as compared with that in the group who went through 60 minutes of extracorporeal circulation. 3.The increased level of urinary potassium was observed in the both groups of patients with or without diuretics plus digitalis therapy. However, the increased level of urinary potassium appeared to con-tinue for longer period of time in the group of patients receiving diuretics plus digitalis therapy prior to the operation than in the group of patients receiving no diuretics plus digitalis therapy.

• Journal of Chest Surgery
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• 제17권3호
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• pp.402-408
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• 1984

During the period of August 1983 to February 1984 study has been done on the value of serum lactate at regular intervals before, during and after operation on 30 patients who went through open heart surgery with extracorporeal circulation for congenital or acquired heart diseases at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University- The results were as follows: 1.The mean value of serum lactate before the operation was observed to be 28.5 \ulcorner.41 mg/dl. 2.At 10 minutes after the beginning of extracorporeal circulation the mean value of serum lactate showed a rapid increase to 73.24\ulcorner3.61 mg/dl, an increase of 44.74 mg/dl [156.9%] from the pre-operation value. 3.At 40 minutes after the beginning of extracorporeal circulation the mean value of serum lactate was observed to be 78.98\ulcorner1.67 mg/dl which was the highest level. It was an increase of 50.48 mg/dl [177.12%] from the preoperation value. 4.At 70 minutes after the beginning of extracorporeal circulation the mean value of serum lactate was observed to be 64.39\ulcorner9.29 mg/dl, an increase of 35.89 mg/dl [125.9%] from the preoperation value, and at over 100 minutes it was observed to be 68.00\ulcorner5.79 mg/dl, an increase of 39.5 mg/dl [138.5%] from the preoperation value. 5.The mean value of serum lactate immediately after the operation was 61.36\ulcorner6.94 mg/dl, an increase of 32.86 mg/dl [115.2%] from the preoperation value. 7.On the 7th post-operative day the value of serum lactate returned the preoperation value.

• Journal of Chest Surgery
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• 제49권3호
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• pp.151-156
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• 2016

Background: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.

• 대한임상독성학회지
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• 제14권1호
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• pp.1-8
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• 2016

Purpose: Extracorporeal life support (ECLS) is a term used to describe a number of modalities including extracorporeal membrane oxygenation (ECMO) to support cardiac and/or pulmonary systems. The purpose of this study is to review the available evidence regarding the effect of ECLS in patients with acute poisoning. Methods: Electronic literature searches with PubMed, Embase, Cochrane library, and KoreaMed were conducted for identification of relevant studies addressing ECLS in treatment of acute poisoning. The literature search was conducted by two investigators in March, 2016 with publication language restricted to English and Korean. The toxic substance, technique of ECLS, and final outcome of each case were analyzed. Results: The final analysis included 64 articles including 55 case reports. There were no articles classified according to a high level of evidence such as randomized trial and prospective cohort study. ECLS treatment was used in the management of patients poisoned with 36 unique substances. Venovenous ECMO was performed in 4 cases. Among the reported cases, 10 patients died despite treatment with ECLS. Conclusion: Evidence supporting ECLS for patients with acute poisoning is inadequate. However, many case reports suggest that early consideration of ECLS in poisoned patients with refractory cardiac arrest or hemodynamic compromise refractory to standard therapies may be beneficial.