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Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019: Expert Recommendations from The Korean Society for Thoracic and Cardiovascular Surgery

  • Jeong, In Seok;Kim, Woong-Han;Baek, Jong Hyun;Choi, Chang-Hyu;Choi, Chang Woo;Chung, Euy Suk;Jang, Jae Seok;Jang, Woo Sung;Jung, Hanna;Jung, Jae-Seung;Kang, Pil Je;Kim, Dong Jung;Kim, Do Wan;Kim, Hyoung Soo;Kim, Jae Bum;Kim, Woo-Shik;Kim, Young Sam;Kwak, Jae Gun;Lee, Haeyoung;Lee, Seok In;Lim, Jae Woong;Oh, Se Jin;Oh, Tak-Hyuck;Park, Chun Soo;Ryu, Kyoung Min;Shim, Man-Shik;Son, Joohyung;Son, Kuk Hui;Song, Seunghwan;The Korean Society for Thoracic and Cardiovascular Surgery COVID-19 ECMO Task Force Team
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.2-8
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    • 2021
  • Since the first reported case of coronavirus disease 2019 (COVID-19) in December 2019, the numbers of confirmed cases and deaths have continued to increase exponentially despite multi-factorial efforts. Although various attempts have been made to improve the level of evidence for extracorporeal membrane oxygenation (ECMO) treatment over the past 10 years, most experts still hesitate to take an active position on whether to apply ECMO in COVID-19 patients. Several ECMO management guidelines have been published recently, but they reflect some important differences from the Korean medical system and aspects of real-world medical practice in Korea. We aimed to find evidence on the efficacy of ECMO for COVID-19 patients by reviewing the published literature and to propose expert recommendations by analyzing the Korean COVID-19 ECMO registry data.

Determination of Mycotoxins in Agricultural Products Used for Food and Medicine Using Liquid Chromatography Triple Quadrupole Mass Spectrometry and Their Risk Assessment (LC-MS/MS를 이용한 식·약 공용 농산물의 곰팡이독소 분석 및 위해평가)

  • Choi, Su-Jeong;Ko, Suk-Kyung;Park, Young-Ae;Jung, Sam-Ju;Choi, Eun-Jung;Kim, Hee-sun;Kim, Eun-Jung;Hwang, In-Sook;Shin, Gi-Young;Yu, In-Sil;Shin, Yong-Seung
    • Journal of Food Hygiene and Safety
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    • v.36 no.1
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    • pp.24-33
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    • 2021
  • For this study, we surveyed concentrations of 8 mycotoxins (aflatoxin B1, B2, G1, G2, ochratoxin A, fumonisin B1, B2 and zearalenone) in agricultural products used for food and medicine by liquid chromatography-tandem mass spectrometry and conducted a risk assessment. Samples were collected at the Yangnyeong Market in Seoul, Korea, between January and November 2019. Mycotoxins were extracted from these samples by adding 0.1% formic acid in 50% acetonitrile and cleaned up by using an ISOLUTE Myco cartridge. The method was validated by assessing its matrix effects, linearity, limit of detection (LOD), limit of quantification (LOQ), recovery and precision using four representative matrices. Matrix-matched standard calibration was used for quantification and the calibration curves of all analytes showed good linearity (r2>0.9999). LODs and LOQs were in the range of 0.02-0.11 ㎍/kg and 0.06-0.26 ㎍/kg, respectively. Sample recoveries were from 81.2 to 118.7% and relative standard deviations lower than 8.90%. The method developed in this study was applied to analyze a total of 187 samples, and aflatoxin B1 was detected at the range of 1.18-7.29 ㎍/kg (below the maximum allowable limit set by the Ministry of Food and Drug Safety, MFDS), whereas aflatoxin B2, G1 and G2 were not detected. Mycotoxins that are not regulated presently in Korea were also detected: fumonisin (0.84-14.25 ㎍/kg), ochratoxin A (0.76-17.42 ㎍/kg), and zearalenone (1.73-15.96 ㎍/kg). Risk assessment was evaluated by using estimated daily intake (EDI) and specific guideline values. These results indicate that the overall exposure level of Koreans to mycotoxins due to the intake of agricultural products used for food and medicine is unlikely to be a major risk factor for their health.

Inhibitory Effect of Protaetiamycine 6 on Neuroinflammation in LPS-stimulated BV-2 Microglia (LPS에 의해 활성화된 미세아교세포에서 흰점박이꽃무지 유래 항균 펩타이드 Protaetiamycine 6의 신경염증 억제 효과)

  • Lee, Hwa Jeong;Seo, Minchul;Baek, Minhee;Shin, Yong Pyo;Lee, Joon Ha;Kim, In-Woo;Hwang, Jae-Sam;Kim, Mi-Ae
    • Journal of Life Science
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    • v.30 no.12
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    • pp.1078-1084
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    • 2020
  • Protaetia brevitarsis seulensis is an insect belonging to the order Coleoptera. This insect is reported to contain large amounts of physiologically active substances useful for liver protective effect and improvements in blood circulation as well as a broad source of edible protein. Antimicrobial peptides (AMPs) are found in a variety of species, from microorganisms to mammals, and play an important role in the innate immune systems of living things. Microglia are the main source of proinflammatory cytokines and nitric oxide (NO) in the central nervous system. Activated microglia secrete large amounts of neuroinflammatory mediators (e.g., TNF-α, NO, and ROS), which are the main cause of neuronal cell death. In the present study, we investigated the inhibitory effect of Protaetiamycine 6 (PKARKLQKLSAYKTTLRN-NH2), an AMP derived from Protaetia brevitarsis seulensis, on LPS-induced neuroinflammation in BV-2 microglia. Protaetiamycine 6 significantly inhibited NO production without cytotoxicity and decreased the expression levels of inducible NO synthase and cyclooxygenase-2. In addition, Protaetiamycine 6 also reduced the production of neuroinflammatory cytokines on activated BV-2 microglia. These results suggest that Protaetiamycine 6 could be a good source of functional substance to prevent neuroinflammation and neurodegenerative diseases.

Evaluation of Patient Radiation Doses Using DAP Meter in Interventional Radiology Procedures (인터벤션 시술 시 면적선량계를 이용한 환자 방사선 선량 평가)

  • Kang, Byung-Sam;Yoon, Yong-Su
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.27-34
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    • 2017
  • The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipments in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effectives of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were $237.7Gy{\cdot}cm^2$ in TACE, $17.3Gy{\cdot}cm^2$ in AVF, $114.1Gy{\cdot}cm^2$ in LE PTA & STENT, $188.5Gy{\cdot}cm^2$ in TFCA, $383.5Gy{\cdot}cm^2$ in Aneurysm Coil, $64.6Gy{\cdot}cm^2$ in PTBD, $64.6Gy{\cdot}cm^2$ in Biliary Stent, $22.4Gy{\cdot}cm^2$ in PCN, $4.3Gy{\cdot}cm^2$ in Hickman, $2.8Gy{\cdot}cm^2$ in Chemo-port, $4.4Gy{\cdot}cm^2$ in Perm-Cather, $17.1Gy{\cdot}cm^2$ in PCD, and $357.9Gy{\cdot}cm^2$ in Vis, EMB. Dose referenece level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipments and procedures in the interventional radiology procedures, further studies and monitorings are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

Crystallographic Study on the Selectivity and Distribution of Sr2+ Ions Within Zeolite A In the Presence of Competing Na+ Ions in Aqueous Exchange Solution (Na+ 경쟁이온이 존재하는 수용액에서 Zeolite A 내 Sr2+ 이온의 선택성 및 분포에 관한 결정학적 연구)

  • kim, Hu Sik;Park, Jong Sam;Lim, Woo Taik
    • Korean Journal of Mineralogy and Petrology
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    • v.35 no.1
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    • pp.41-50
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    • 2022
  • To study the properties of Sr2+ exchange into zeolite A with increasing the molar concentration of Na+ in given exchange solution, four single crystals of fully dehydrated Sr2+- and Na+- exchanged zeolite A were prepared by the bath method using mixed ion-exchange solutions. The Sr(NO3)2:NaNO3 molar rations of the ion exchange solution were 1:1(crystal 1), 1:100(crystal 2), 1:250(crystal 3), and 1:500 (crystal 4), respectively, with a total concentration of 0.05 M. The single-crystals were then vacuum dehydration at 623 K and 1×10-4 Pa for 2 days. Their single-crystal structures were determined by single-crystal synchrotron X-ray diffraction techniques in the cubic space group Pm3-m, at 100(1) K, and were then refined to the final error indices of R1/wR2=0.047/0.146, 0.048/0.142, 0.036/0.128, and 0.040/0.156 for crystals 1, 2, 3, and 4, respectively. In crystals 1 and 2, the 6 Sr2+ ions are found at three different crystallographic sites. In crystal 3, 1 Sr2+ and 10 Na+ ions are found in large cavity and sodalite unit. In crystal 4, only 12 Na+ ions occupy three equipoints. The degree of Sr2+ ion-exchange decreased sharply from 100 to 16.7 to 0% as the initial Na+ concentration increase and the Sr2+ concentration decrease. In addition, the unit cell constant of the zeolite framework decreased with this lower level of Sr2+ exchange.

A Study on the aesthetic of Calligraphy by Seok Jeon Hwang Wook (석전(石田) 황욱(黃旭)의 서예미학(書藝美學) 고찰)

  • Kim, Doyoung
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.2
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    • pp.227-234
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    • 2022
  • Seok Jeon Hwang Wook (18913~1999), a descendant of a traditional literary writer in the western part of Honam, did not join the flow of modern and contemporary calligraphy and painting. And throughout his life, he enjoyed himself without losing the appearance of a scholar, immersed himself in traditional calligraphy, and gained spotlight at his late age for his original hand grabbing calligraphy. Immediately after the Korean War, all of his property was lost due to his two sons' left-wing activities, causing great pain at home. Even in the most painful and difficult time in human history, he relied on brushes, poetry, and gayageum to keep his upright scholarly spirit and national love. And beyond the pleasures of the worldly senses, he played with self-satisfaction in the 'true pleasure(大樂)' without greed. In the course of his studies, he focused on honing the fonts of Wang Hui-ji, Gu Yang-sun, An Jin-gyeong, Jo Maeng-bu, and Xin-wi and Lee Sam-man without a special teacher. In particular, he faced a crisis of having to give up his brush due to tremor that came after his 60th birthday, but he showed a strong will. He transformed it into a new style of art, such as developing hand grabbing calligraphy(握筆法) with a strong and strong energy that no one could match. From 1965 to 1983, 'right hand grabbing calligraphy' was used, and from 1984 to 1993, 'left hand grabbing calligraphy' was used. She made her name as a calligrapher widely known in 1973 (age 76) with her first solo exhibition, The Calligraphy Exhibition commemorating her 60th wedding anniversary. His writing method is naturally rough and sloppy by breaking away from the previous calligraphy methods and artificial technique, and is unfamiliar yet full of muscle. And the calm, strong and rough chuhoegsa(錐劃沙) and the heavy yet majestic ininni(印印泥) individual handwriting expressed a strange feeling and achieved original Seokjeon calligraphy that went beyond the existing calligraphy writing methods, and his indomitable calligraphy spirit was As a unique existence in the history of calligraphy, he still remains as a model.

Long-Term Survival Outcomes of Elderly Patients Treated With S-1 or Capecitabine Plus Oxaliplatin for Stage II or III Gastric Cancer: A Multicenter Cohort Study

  • Choi, Seohee;Min, Jae-Seok;Jeong, Sang-Ho;Yoo, Moon-Won;Son, Young-Gil;Oh, Sung Jin;Kim, Jong-Han;Park, Joong-Min;Hur, Hoon;Jee, Ye Seob;Hwang, Sun-Hwi;Jin, Sung-Ho;Lee, Sang Eok;Lee, Young-Joon;Seo, Kyung Won;Park, Sungsoo;Lee, Chang Min;Kim, Chang Hyun;Jeong, In Ho;Lee, Han Hong;Choi, Sung Il;Lee, Sang-Il;Kim, Chan-Young;Chae, Hyundong;Son, Myoung-Won;Pak, Kyung Ho;Kim, Sungsoo;Lee, Moon-Soo;Kim, Hyoung-Il
    • Journal of Gastric Cancer
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    • v.22 no.1
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    • pp.67-77
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    • 2022
  • Purpose: Tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (CAPOX) are standard adjuvant chemotherapies (ACs) administered after gastrectomy to patients with stage II or III gastric cancer. However, the efficacy of AC in elderly patients remains unclear. The objective of this retrospective multicenter cohort study was to compare the efficacies of S-1 and CAPOX AC in patients aged ≥70 years. Materials and Methods: Nine hundred eighty-three patients who were treated with AC using S-1 (768 patients) or CAPOX (215 patients) were enrolled in this study. Each patient underwent AC after curative gastrectomy for stage II or III gastric cancer at one of 27 hospitals in the Republic of Korea between January 2012 and December 2013. Relapse-free survival (RFS) and overall survival (OS) were analyzed according to AC regimen and age group. Results: Of the 983 patients, 254 (25.8%) were elderly. This group had a similar RFS (P=0.099) but significantly poorer OS (p=0.003) compared with the non-elderly group. Subgroup analysis of the non-elderly group revealed no AC-associated differences in survival. Subgroup analysis of the elderly group revealed significantly better survival in the S-1 group than in the CAPOX group (RFS, P<0.001; OS, P<0.001). Multivariate analysis revealed that the CAPOX regimen was an independent poor prognostic factor for RFS (hazard ratio [HR], 1.891; 95% confidence interval [CI], 1.072-3.333; P=0.028) and OS (HR, 2.970; 95% CI, 1.550-5.692; P=0.001). Conclusions: This multicenter observational cohort study found significant differences in RFS and OS between S-1 and CAPOX AC among patients with gastric cancer aged ≥70 years.

Evaluation of the Usefulness of Virtual Reality Equipment for Relieving Patients' Anxiety during Whole-Body Bone Scan (전신 뼈 검사 환자의 불안감 해소를 위한 가상현실 장비의 유용성 평가)

  • Kim, Hae-Rin;Kim, Jung-Yul;Lee, Seung-Jae;Baek, Song-Ee;Kim, Jin-Gu;Kim, Ga-Yoon;Nam-Koong, Hyuk;Kang, Chun-Goo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.1
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    • pp.27-32
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    • 2022
  • Purpose When performing a whole-body bone scan, many patients are experiencing psychological difficulties due to the close distance to the detector. Recently, in the medical field, there is a report that using virtual reality (VR) equipment can give pain relief to pediatric patients with weak concentration or patients receiving severe treatment through a distraction method. Therefore, in this paper, VR equipment was used to provide psychological stability to patients during nuclear medicine tests, and it is intended to evaluate whether it can be used in clinical practice. Materials and Methods As VR equipment, ALLIP Z6 VR (ALLIP, Korea) was used and the experiment was conducted after connecting to a mobile phone. The subjects were 30 patients who underwent whole-body bone examination from September 1, 2021 to September 30, 2021. After intravenous injection of 99mTc-HDP, 3 to 6 hours later, VR equipment was put on and whole body images were obtained. After the test, a survey was conducted, and a Likert scale of 5 points was used for psychological anxiety and satisfaction with VR equipment. Hypothesis verification and reliability of the survey were analyzed using SPSS Statistics 25 (IBM, Corp., Armonk, NY, USA). Results Anxiety about the existing whole-body bone test was 3.03±1.53, whereas that of anxiety after wearing VR equipment was 2.0±1.21, indicating that anxiety decreased to 34%. When regression analysis of the effect of the patient's concentration on VR equipment on anxiety about the test, the B value was 0.750 (P<0.01) and the t value was 6.181 (P<0.01). decreased and showed an influence of 75%. In addition, overall satisfaction with VR equipment was 3.76±1.28, and the intention to reuse was 66%. The Cronbach α value of the reliability coefficient of the questionnaire was 0.901. Conclusion When using VR equipment, patients' attention was dispersed, anxiety was reduced, and psychological stability was found. In the future, as VR equipment technology develops, it is thought that if the equipment can be miniaturized and the resolution of VR content images is increased, it can be used in various clinical settings if it provides more realistic stability to the patient.

Removal Properties of Methylene Blue using Biochar Prepared from Street Tree Pruning Branches and Household Wood Waste (가로수 전정가지 및 생활계 폐목재를 이용하여 제조한 바이오차의 Methylene Blue 흡착특성)

  • Do, Ji-Young;Kim, Dong-Su;Park, Kyung-Chul;Park, Sam-Bae;Chang, Yoon-Young;Yang, Jae-Kyu
    • Journal of the Korea Organic Resources Recycling Association
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    • v.30 no.3
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    • pp.13-22
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    • 2022
  • In order to improve water quality of the water system contaminated with dyes, biochars prepared using discarded waste resources were applied in this study. Biochars with a large specific surface area were manufactured using street tree pruning products or waste wood, and were applied to remove an organic dye in synthetic water. Biochars were made by pyrolysis of typical street tree porch products (Platanas, Ginkgo, Aak) and waste wood under air-controlled conditions. Methylene blue (MB), which is widely used in phosphofibers, paper, leather, and cotton media, was selected in this study. The adsorption capacity of Platanas for MB was the highest and the qmax value obtained using the Langmuir model equation was 78.47 mg/g. In addition, the adsorption energy (E) (kJ/mol) of MB using the Dubinin-Radushkevich (D-R) model equation was 4.891 kJ/mol which was less than 8 kJ/mol (a criteria distinguishing physical adsorption from chemical adsorption). This result suggests a physical adsorption with weak interactions such as van der Waals force between the biochar and MB. In addition, the physical adsorption may resulted from that Platanas-based biohar has the largest specific surface area and pore volume. The ∆G value obtained through the adsorption experiment according to temperature variation was -3.67 to -7.68, which also suggests a physical adsorption. Considering these adsorption results, the adsorption of MB onto Platanas-based biochar seems to occur through physical adsorption. Overall, it was possible to suggest that adsorption capacity of the biochr prepared from this study was equal to or greater than that of commercial activated carbon reported in other studies.

Physicochemical Properties of Protaetia brevitarsis sinulensis Larvae Reared with Feed Including Noni and Nipa Palm (노니와 해죽순 급이가 흰점박이꽃무지 유충에 미치는 물리화학적 특성)

  • Kim, Sam Woong;Je, Kyeong Min;Kim, Dul Nam;Kim, Tae Wan;Bang, Kyu Ho;Chi, Won-Jae;Bang, Woo Young;Kim, Jang Hyeon;Yang, Chul Woong;Kim, Il-Suk
    • Journal of Life Science
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    • v.32 no.10
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    • pp.784-791
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    • 2022
  • This study observed changes in the body composition of Protaetia brevitarsis sinulensis larvae when reared with feed that included noni and nipa palm. Compared to the control group, the death rate and product yield of the treatment group were improved after the larval fasting process. The brightness of the larval powder of the treatment group increased, but the redness decreased. The crude fat content of the treated group was slightly increased according to the assays of the general components, but the mineral content was significantly increased. The total structural amino acids of the treatment group decreased, but the total free amino acids increased. The structural amino acids generally tended to decrease in the treatment group. However, the free amino acids showed no specific differences. Among the free amino acids, tryptophan, phosphoserine, and methylhistidine were highly increased in the treatment group, whereas threonine, methionine, and asparagine showed the opposite results. Among the polyunsaturated fatty acids, eicosapentaenoic acid (C20:5n3) of omega-3 was increased in the treatment group, but the omega-6 series was decreased. Since minerals, total free amino acids, and omega-3 fatty acids in the treatment group were increased compared to the control group, we suggest that noni and nipa palm can potentially be applied to the production of functionally improved substances as additional sources of feed for Protaetia brevitarsis sinulensis larvae.