• 대한전기학회:학술대회논문집
• /
• 대한전기학회 2004년도 학술대회 논문집 정보 및 제어부문
• /
• pp.322-324
• /
• 2004

Up to the present, digital replantation patients has appealed different symptoms due to blood circulatory failure. But, the level of blood circulatory failure has been evaluated only by clinical symptoms, or angiography. According to the cases of digit replantation is increasing, then objective evaluation methods of the level of blood circulation failure is needed other than patient's subjective symptoms and complaints. Although angiography, doppler, electromagnetic flowmeter, laser blood flowmeter, mechanical blood flowmeter has been used for the evaluation of the blood circulatory failure, the result was affected by time, place, surrounding temperature, patient's body temperature, and even emotion. Therefore, it is pointed out with lack of availability, feasibility and reproducibility. Thus, we compared digital blood flow of dominant hand to non dominant hand, and replanted fingers to opposite normal fingers from developed photo-plethysmography. The average digital blood flow showed no difference in normal digits each other, but, replanted digits showed average of 53% (9 - 100 %) compare to opposit normal digits. As it measure relative blood flow for circulatory failure of tissue such as fingers and toes more sensitively, reliably. In conclusion, it is expected that photo- plethysmography will be very useful for diagnosis, curative effect, prognosis of blood circulatory failure in digital replantation patient.

• 대한의용생체공학회:의공학회지
• /
• 제22권4호
• /
• pp.349-358
• /
• 2001

A novel electro-mechanical implantable ventricular assist system is developed as a bridge to transplantation or recovery for patients with end-stage heart failure. The developed system is composed of an implanted blood pump, an external monitoring system which stores data, and a wearable system including a portable external driver and a portable power supply system. The blood pump is designed to be implanted into the left upper abdominal space and provides blood flow from the left ventricular apex to the aorta. The pulsatile blood flow is generated by a double cylindrical cam. There was mo excessive heat emission from the blood pump into the temperature-controlled chamber in the heat test and no stagnated flow within the blood sac by the observation in the flow visualization test. Animal experiments were performed using sheep and calves. The maximum assist flow rate reached 7.85L/min in the animal experiment. The evaluation results showed that the developed system was feasible for the implantable ventricular assist system. The long-term in vitro durability test and mid-term in vivo experiments are in progress and mow the modified next model is under development.

• 대한전기학회:학술대회논문집
• /
• 대한전기학회 2006년도 심포지엄 논문집 정보 및 제어부문
• /
• pp.42-44
• /
• 2006

Up to the present, finger replantation patients have complained about various symptoms because of blood circulatory failure. Objective evaluation methods for the level of the blood circulatory failures in fingers were needed other than patient's subjective symptoms and complaints. Photoplethysmogram(PPG) measured from fingers is very useful for evaluation of vascular aging and sclerosis level since the PPG signal represents characteristics of peripheral vascular. Several researchers have reported that second derivative of the finger PPG waveform was useful to evaluate vascular compliance and developed various analysis methods for vascular compliance. However, vascular compliance study for finger replantation patient was never evaluated by using second derivative of PPG. Therefore, we aimed to objectively compare and to assess normal and replanted finger vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a represents vascular compliance. Study found out that when vascular compliance is decreased, b/a is increased, the absolute value of b/a is decreased. For 43 finger replantation patients, the average vascular compliance of replanted finger is lower than the normal finger statistically(p=0.001). we suggested an objective evaluation of finger vascular compliance for finger replantation patients and effect of surgical operation.

• 동의생리병리학회지
• /
• 제16권3호
• /
• pp.588-593
• /
• 2002

Paraquat, one of the potent herbicides, causes fatal damage to many vital organs, when orally ingested, resulting in circulatory failure, respiratory distress syndrome, and a few other serious problems, but there is no known specific antidote against it. Of the possible problems related to paraquat intoxication, oliguric acute renal failure, which has been known to develop within 24 or 48 hours after intoxication, are notoriously life-threatening. So we attempted to investigate the clinical characteristics and progress of paraquat-induced acute renal failure and the therapeutic possibilities of herbal medicines. All of the fifteen subjects were treated with intravenous fluid injection of 5% dextrose saline or 10% dextrose water in conjunction with herbal medicines which were used for oral administration or gargling. Gamdutang, a decoction of Semen Glycin(黑豆 200g) and Radix Glycyrrhizae(甘草 100g) with addition of other herbs when necessary, was administered orally. At the same time, gargling fluid, consisted of Chinese ink(墨汁), char-frying powder of Rhei Rhizoma(大黃炒炭末), Succus phyllostachyos(竹瀝), was used to detoxify the oral cavity. Serum levels of Blood Urea Nitrogen(BUN) and Creatinine reached its peak on the third day of hospitalization, but then decreased and fell within the normal range on the 7th day and remained there. Serum levels of Na+ and K+ decreased down below the lower limits of normal range on the 7th day and on the 3rd day, respectively. Then they returned back within normal limits. Mean urine output on the 1st day of hospitalization was 1,050ml and it continuously increased to reach more than 2,000ml on the 14th day. From that day on, it stayed over 2,000ml. Fifteen cases of acute renal failure caused by paraquat intoxication were treated with combined treatments of oriental and western medicine in our hospital. However, we think that it is necessary to study further about the way to combine oriental and western medicine, to find out a more effective treatment method.

• Journal of Chest Surgery
• /
• 제30권3호
• /
• pp.247-252
• /
• 1997

심장이식시에 가교 역할을 담당하거나 수술 후 심부전에 빠진 심장을 보조할 공압식 심실보조장치를 개발하여 동물실험을 시행하였다. 실험 에 이용한 심실보조장치는 소아용과 성 인용의 두 가지 종류로서 박동장이 각각 34cc와 70cc이다. 심실 재료는 폴리우레탄으로 제작하여 항혈전성을 높였다. 총 10마리의 동물실험을 시행하였다. 심실보조장치의 혈액펌프는 좌심방과 대동맥에 연결관을 이용하여 이식하였다. 심실보조장치의 평균 박출량은 펌프 박동수가 60회일 때 성 인의 경우 2.38 L/min였고 소아용의 경우 0.41 L/min였다. 생존시간은 최고 26시간이었다. 가장 큰 합병증은 출혈이었고 주 사망원인은 심부전 및 폐부전이었다. 심실보조장치 자체 에 대한 결함때문에 일어난 실패는 없었다. 현재까지의 실험 결과를 토대로 심실보조장치를 발전시키면 임상에서도 사용 가능할 것으로 보인다.

• Archives of Pharmacal Research
• /
• 제27권1호
• /
• pp.111-117
• /
• 2004

Hepatic microcirculatory failure is a major component of reperfusion injury in the liver. Recent data provided some evidence that endothelium-derived vasoconstrictors and vasodilators may be functionally important to the control of the total hepatic blood flow under these conditions of circulatory failure. Since Kupffer cells provide signals that regulate the hepatic response in ischemia/reperfusion (I/R), the aim of this study was to investigate the role of Kupffer cells in the I/R-induced imbalance of vasoregulatory gene expression. Rats were subjected to 60 min hepatic ischemia, followed by 5 h of reperfusion. The Kupffer cells were inactivated by gadolinium chloride ($GdCl_3$, 7.5 mg/kg body weight, intravenously) 1 day prior to ischemia. Liver samples were obtained 5 hrs after reperfusion for RT-PCR analysis of the mRNA for genes of interest: endothelin-1 (ET-1), its receptors $ET_A and ET_B$, endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS) and heme oxygenase-1 (HO-1). ET-1 mRNA expression was increased by I/R. mRNA levels for $ET_A$ receptors showed no change, whereas $ET_B$ receptor transcripts increased in the I/R group. The increases in ET-1 and $ET_B$ mRNA were not prevented by the $GdCI_3$ pretreatment. The mRNA levels for iNOS and eNOS significantly increased within the I/R group with no significant difference between the I/R group and the $GdCl_3$-treated I/R group. HO-1 mRNA expression significantly increased in the I/R group and this increase was attenuated by $GdCI_3$. In conclusion, we have demonstrated that an imbalance in hepatic vasoregulatory gene expression occurs during I/R. Our findings suggest that the activation of Kupffer cells is not required for I/R-induced hepatic microvascular dysfunction.

• Journal of Chest Surgery
• /
• 제12권3호
• /
• pp.207-214
• /
• 1979

This 3-year-old girl was observed frequent exertional dyspnea and cyanosis at crying since birth. She was not premature baby and delivered at full term normally. On physical examination, she was underdeveloped-body weight 13.5 kg, height 99 cm.- and cyanotic. There was severe clubbing on fingers. There was grade II/VI ejection systolic murmur on left lateral border of the sternum. The preoperative examinations [EKG, echocardiogram, cardiac catheterization and biventriculogram] showed that complicated T.G.A. combined vena cava[S.D.D.]. Preoperatively, we decided the corrective surgery of Rastelli operation using a. pulmonary valved conduit. The operation was performed under total circulatory arrest using deep profound hypothermia combining with extracorporeal circulation. On operation, the anatomy of the heart showed that, 1. The subaortic conus was seen and subaortic muscles were hypertrophied. 2. The VSD[type II], behind the subaortic conus-about 1 cm. in diameter, was visible only through LV cavity and, 3. The pulmonary valve ring was hypoplastic and pulmonary valvular stenosis was seen also. The subpulmonic area [LV outflow tract] was obstructed with hypertrophied muscle and mitral valve. 4. Left superior vena cava was drained to RA via coronary sinus. 5. LAD coronary artery was originated from right coronary artery and ran anterior to the pulmonary artery. According to above anatomy, we performed the VSD closure with Teflon patch, and Mustard operation combined with LV-to-pulmonary artery bypass graft using the valve contained [Hancock 16 mm] conduit. Postoperatively, adequate blood pressure could be maintained under the state of using inotropic agent [epinephrine]. On the second postoperative day, the patient died of cardiac arrest due to low cardiac output syndrome, acute renal failure and pulmonary edema.

• Journal of Chest Surgery
• /
• 제45권5호
• /
• pp.295-300
• /
• 2012

Background: With growing attention to the aortopathy associated with aortic valve diseases, the number of candidates for accompanying ascending aorta and/or root replacement is increasing among the patients who require aortic valve replacement (AVR). However, such procedures have been considered more risky than AVR alone. This study aimed to compare the surgical outcome of isolated AVR and AVR combined with aortic procedures. Materials and Methods: A total of 86 patients who underwent elective AVR between 2004 and June 2010 were divided into two groups: complex AVR (n=50, AVR with ascending aorta replacement in 24 and the Bentall procedure in 26) and simple AVR (n=36). Preoperative characteristics, surgical data, intra- and postoperative allogenic blood transfusion requirement, the postoperative clinical course, and major complications were retrospectively reviewed and compared. Results: The preoperative mean logistic European System for Cardiac Operative Risk Evaluation (%) did not differ between the groups: $11.0{\pm}7.8%$ in the complex AVR group and $12.3{\pm}8.0%$ in the simple AVR group. Although complex AVR required longer cardiopulmonary bypass ($152.4{\pm}52.6$ minutes vs. $109.7{\pm}22.7$ minutes, p=0.001), the quantity of allogenic blood products did not differ ($13.4{\pm}14.7$ units vs. $13.9{\pm}11.2$ units). There was no mortality, mechanical circulatory support, stroke, or renal failure requiring hemodialysis/filtration. No difference was found in the incidence of bleeding (40% vs. 33.3%) which was defined as red blood cell transfusion ${\geq}5$ units, reoperation, or intentional delayed closure. The incidence of mediastinitis (2.0% vs. 0%), ventilator ${\geq}24$ hours (4.0% vs. 2.8%), atrial fibrillation (18.0% vs. 25.0%), mean intensive care unit stay (34.5 hours vs. 38.8 hours), and median hospital stay (8 days vs. 7 days) did not differ, either. Conclusion: AVR combined with additional aortic or root replacement showed an excellent outcome and recovery course equivalent to that after isolated AVR.

• Journal of Chest Surgery
• /
• 제32권11호
• /
• pp.989-997
• /
• 1999

Background: Calcific degeneration is the major cause of clinical failure of glutaraldehyde (GA) crosslinked bioprosthetic tissues implanted in the body and necessitates the reoperation or causes death. Surface modification of biologic tissues using sulfonated polyethyleneoixde (PEO-SO3) has been suggested to significantly enhance blood compatibility, biostability and calcification-resistance by means of the synergistic effect of highly mobile and hydrophilic PEO chains and electrical repulsion of negatively charged sulfonate groups. This study was designed to evaluate the anticalcification effect of surface-modification of biologic arteries by direct coupling of PEO-SO3 after GA fixation and changes of calcification according to the implantation period through the quantitative investigation of the deposited calcium and phosphorous contents of the biologic arterial tissues in the canine circulatory implantation model. Material and Method: Total of 16 fresh canine carotid arteries were harvested from eight adult dogs and divided in to GA group(n =8) and PEO-SO3 group(n=8). Sulfonation of diamino-terminated PEO was performed using propane sultone. Canine carotid arteries were only crosslinked with 0.65% GA solution in GA group and modified by direct coupling 5% PEO-SO3 solution after GA crosslinkage for 2 days and stabilized by NaBH4 solution for 16 hours in PEO-SO3 group. In both groups the resected segment of bilateral carotid arteries were reconstructed. Reconstructed segments of the two groups were analysed the quantities of calcium and phosphorous contents after 3(n=4) and 6(n=4) weeks in vivo. Result: After implantation of 3 seeks, PEO-SO3 group showed significantly less depositions.

• Journal of Chest Surgery
• /
• 제43권3호
• /
• pp.254-259
• /
• 2010

배경: 만성 폐색전증은 초기에 비특이적인 증상으로 인해 진단이 쉽지 않을 뿐만 아니라 국내에서도 흔한 질환이 아니므로 보고된 예도 적다. 본 연구에서는 만성 폐색전증 환자에서 폐동맥 내막절제술의 수술결과를 후향적인 방법으로 분석해보았다. 대상 및 방법: 1996년부터 2008년까지 만성 폐색전증으로 본원에서 수술받았던 환자를 대상으로 하였다. 만성적인 호흡곤란을 주소로 내원한 환자들은 심초음파, 흉부 전산화 촬영, 폐 관류스캔을 이용하여 진단하였다. 결과: 7예의 환자에서는 정중흉골 절개술로, 1예는 좌측 후측방 절개술을 통해 접근하였다. 4예에서는 극저체온 순환 정지하에, 3예는 심실 세동하에, 1예는 심정지하에 폐동맥 내막절제술을 시행하였다. 술후 평균 폐동맥 수축기 혈압은 술 전 $78.9{\pm}14.5\;mmHg$에서 $45.6{\pm}17.6\;mmHg$로 의미 있게 감소하였고(p=0.000) 삼첨판 부전증 정도는 Grade II 이하였다. 조기사망은 2예가 있었으며 그 중 1예는 폐동맥 고혈압이 지속되면서 우 심부전이 호전되지 않아 결국 사망한 경우였다. 결론: 만성 폐색전증의 예후는 아주 불량한 것으로 알려져 있다. 그러나 조기에 적절한 진단과 우 심부전이 심해지기 전에 적절한 수술적인 치료를 한다면 향후 환자의 삶의 질을 향상시킬 수 있을 것으로 보인다.