• Title/Summary/Keyword: 심폐기

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The Wireless Monitoring System of Respiration Signal (호흡신호 무선 통신 시스템 개발)

  • Son, Byoung-Hee;Jang, Jong-Chan;Yang, Hyo-Sik;Cha, Eun-Jong
    • Journal of the Institute of Convergence Signal Processing
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    • v.12 no.3
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    • pp.157-162
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    • 2011
  • This study is about implementing wireless transferring system in pre-hospital cardiopulmonary resuscitation(CPR). Also, this study includes monitoring based feedback between patient and hospital to increase the survival rate of emergency patient by developing the performance of cardiopulmonary resuscitation in pre-hospital. It minimizes the loss of flow rate or gastric inflation through the space between the airway and the esophagus, which enables the inspiration-expiration rate to be measured more precisely. Due to these reasons this study applied ET insertion based respiratory sensor to measure flow rate. The main indices of artificial ventilation are justified from minute respiration(V), end-tidal $CO_2(E_TCO_2)$, and tracheal pressure($P_{tr}$). The simulation is performed to verify the bandwidth and delay time of transport network for in-hospital monitoring even as transporting images and voice information simultaneously. The total bandwidth is 815 kbps, and WLAN (IEEE 802.11x) is used as communication protocol. The network load is under 1.5% and the transmit delay time is measured under 0.3 seconds.

Leukocyte Sequestration and Free Radical-Mediated Lung Injury in Ovine Cardiopulmonary bypass Using Membrane Oxygenator (양에서 막형 산화기를 사용하여 심폐바이패스할 경우 백혈구격리 및 자유라디칼로 중재되는 폐손상)

  • 김원곤;신윤철;서정욱
    • Journal of Chest Surgery
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    • v.32 no.11
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    • pp.978-983
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    • 1999
  • Background: Complement activation with transpulmonary leukocyte sequestration is considered a main mediator leading to ischemia-reperfusion lung(I-R) injury. We studied the role of leukocytes in the formation of I-R injury in ovine cardiopulmonary bypass(CPB) model with a membrane oxygenator. Material and Method: Five sheep were used. CPB circuitry consisted of a roller pump(American Optical Corp., Greenwich, CT, USA) and a membrane oxygenator(UNIVOX-IC, Bentley, Baxter Health Corp, Irvine, CA, USA). The CPB time was fixed at 120 min. Ten minutes after the start of CPB, total CPB was established. Thereafter a total CPB of 100 min was performed, followed by another 10 min of partial CPB. The CPB was discontinued and the animals were fully recovered. For measuring left and right atrial leukocyte counts, blood samples were taken before thoracotomy, 5 min and 109 in after the start of CPB, and 30 min and 120 min after weaning. C3a was measured before thoracotomy, 109 min after the start of CPB, and 30 min and 120 min after weaning. Plasma malondialdehyde(MDA) was checked before thoracotomy, 109 min after the start of CPB, and 30 min after weaning. One to two grams of lung tissue were taken for water content measurement before thoracotomy, 109 min after the start of CPB, and 30 min after weaning. Lung biopsy specimens were examined by light and electron microscopy. Result: Of 5 animals, 4 survived the experimental procedures. Of these, 3 animals survived on a long-term basis. No significant differences in transpulmonary gradients of leukocyte were found and no significant complement activation was expressed by C3a levels. MDA level did not show significant changes related to lung reperfusion despite an increase after the start of CPB. On both light and electron microscopic examinations, mild to moderate acute lung change was observed. Interstitial edema, leakage of erythrocytes into the alveolar space and endothelial cell swelling were the main findings. Water content of the lung showed a slight increase after the start of CPB, but there was no statistical significance. Conclusion: These findings indicate that ischemia-repersusion lung injury may not be from complement activation-leukocyte sequestration but from another source of oxygen free radicals related to CPB.

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Current Status of Cardiopulmonary Perfusionists in the Republic of Korea (한국 체외순환사의 현황과 문제점 - 주요 외국 국가들과의 비교 분석 -)

  • Kim Won Gon
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.1-12
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    • 2005
  • The primary responsibility of a perfusionist is to operate the heart-lung bypass machine during open heart surgery, which is vital for the successful operative outcome. However, despite the perfusionist's crucial role on the cardiac surgical team, no relevant studies have not yet been conducted in our country. In this regard, this study was performed about the current status of perfusionists in Korea with comparative analysis on the certification and education system of perfusionists in foreign countries. Material and Method: We analyzed the demographic data on the Korean perfusionists conducted in 1994 and 2003, with comparison of recent data on the perfusionists of the nineteen foreign countries. Result and Conclusion: Although all agree that professionalism and responsibility of the perfusionist are essential in conducting a cardiac procedure and bringing about successful outcome, the formally approved training and certification system for perfusionists have not yet been established in Korea. Adequate measures should be done as soon as possible in order to try to obtain the adequate recognition of the profession.

Effects of a Rehabilitation Program on Quality of Life, Cardiopulmonary Function and Fatigue During Radiotherapy for Breast Cancer Patients (유방암 환자의 방사선 치료 기간 동안 재활치료 프로그램이 삶의 질, 심폐기능, 피로에 미치는 영향)

  • Do, Jung-Hwa;Seong, Jun-Hyuk;Ahn, Jun-Su;Cho, Young-Ki
    • Physical Therapy Korea
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    • v.19 no.1
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    • pp.56-65
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    • 2012
  • This study examines the effects of a rehabilitation program on quality of life (QOL), cardiopulmonary function and fatigue during radiotherapy for breast cancer patients. The program includes aerobic exercise, stretching and strengthening exercises. Sixty-five women participated in this study and they were asked to perform supervised exercises that last for 60 minutes five times a week for six weeks. The European organization for research and treatment of cancer-cancer (EORTC QLQ-C30) and the breast (EORTC QLQ-BR23), predicted maximal volume of oxygen consumption ($VO_{2max}$) and fatigue severity scale (FSS) were assessed before and after the rehabilitation program. The 60-minute program consisted of a 10-minute warm-up, 30-minute of aerobic exercises, and 15-minute of strengthening exercises, followed by a five-minute cool-down. Heart rates were monitored throughout the exercise class to ensure that patients were exercising at the target heart rate of 40~75% of the age-adjusted heart rate maximum. There were statistically significant differences in the changes of physical function and cancer related symptoms in the EORTC QLQ-C30 and EORTC QLQ-BR23 (p<.05). There was a statistically significant improvement in the predicted $VO_{2max}$ (p<.05), although there were no significant differences in the FSS (p>.05). The results of our study suggest that a supervised rehabilitation program may benefit the physical aspects and QOL of patients receiving radiotherapy for breast cancer.

Two Patients with Atypical Infantile Pompe Disease Presenting with Hypertrophic Cardiomyopathy (비후성 심근병증으로 발현된 비전형적 영아형 폼페병 2례)

  • Kim, Eun-Hee;Ko, Jung-Min;Lee, Beom-Hee;Kim, Gu-Hwan;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.6 no.2
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    • pp.161-165
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    • 2009
  • Pompe disease (glycogen storage disease type II) is an autosomal recessive disorder caused by deficiency of acid-${\alpha}$-glucosidase (GAA) resulting in lysosomal glycogen accumulation in multiple tissue, particularly cardiac and skeletal muscle. The classic infantile form of Pompe disease is characterized by marked cardiomegaly, respiratory failure and severe generalized hypotonia. Most patients die from cardiorespiratory failure or respiratory infection within the first year or two of life without treatment. A "non-classic" phenotype presents with less severe clinical feature and slow progression of disease. We report two patients with non-classic infantile Pompe disease from one family manifested hypertrophic cardiomyopathy and progressive proximal weakness.

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Successful Bilateral Lung Retransplantation in a Patient with Primary Graft Failure Following a Single Lung Transplantation (일측 폐 이식 후 발생한 이식편 부전으로 양측 폐 재이식을 시행한 1예 보고)

  • Hwang Jung-Joo;Joung Eun-Kyu;Kim Jae-Ho;Lee Doo-Yun;Paik Hyo-Chae
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.490-494
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    • 2006
  • Lung transplantation is the choice of treatment for selected patients with end-stage pulmonary disease. However, retransplantation of the lung due to primary graft failure carries a high risk of morbidity and mortality. This is a case of a 52 year old male with emphysema who continuously needed a ventilator care and a tracheostomy. He underwent a left single lung transplantation but were not able to wean from the ventilator due to primary graft failure, and therefore we decided to do a retransplantation. Bilateral sequential single lung transplantation was performed under the cardiopulmonary bypass. The patient recovered quite well and was discharged and fully active with his work. Retransplantation although it carries a high risk, is a very effective treatment in patients with primary graft failure.

Development of Portable Cardiopulmonary Support System (이동형 심폐보조시스템의 개발)

  • Lee, Hyuk-Soo;Min, Byoung-Goo
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.44 no.1
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    • pp.94-99
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    • 2007
  • Many cases of acute cardiac shock and cardiac arrest in emergency room and ICU have been increasing. In this case, ECMO with centrifugal pump has been used generally. However, due to the heavy weight and big size, the system is not adequate for emergency cases. And other defects of this system are that membrane oxygenator's pressure is high and blood are exposed to the air. There was some tries of ECMO using pulsatile pump, but it was found that the weak point of these system is high peak pressure and hemolysis. The mechanism of twin pulsatile pump is that Membrane oxygenator Outlet Pump(MOP) make negative pressure when Membrane oxygenator Inlet Pump(MIP) provides high positive pressure, and the negative pressure will decrease positive pressure of Membrane Oxygenator. Our group analyzed this advantage through In-Vitro and 12 Cases In-Vivo test.

A Cardiac Surgeon from the USA who had Worked in Korea a Half Century Ago - Dr. George Schimert - (반세기 전 한국에서 근무하였던 한 미국흉부외과 의사 - Dr. George Schimert -)

  • Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.189-201
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    • 2008
  • Dr. George Schimert, born in 1918 in Switzerland, received his medical degrees from universities in Hungary and in Germany. After immigration to the United States, he continued medical training at several hospitals. In 1956, for pursuit of cardiac surgery, he had joined the group headed by Dr. Walt Lillehei at the University of Minnesota. During this period, in 1958, he joined Seoul National University Hospital as a overall medical adviser and adviser in surgery for 15 months in partnership with the University of Minnesota Medical School. During his stay in Korea, in addition to the works in the medical administration and education, he contributed to the early establishment of thoracic surgery program. In August 6, 1959, he performed open heart surgery using cardiopulmonary bypass for an ASD patient at Seoul National University Hospital. However, the patient died 6 hours after the operation. In 1960, after returning to the United States, he began his career at Buffalo General Hospital as the first director of its cardiac surgery program. In 1985, the Dr. George Schimert Lectureship and Medical Conference was established to honor his contributions and achievements. He died December 7, 2002.

A Prospective Clinical Study of Crystalloid and Colloid Solutions as Priming Additive Fluids for Cardiopulmonary bypass of the Small Children (소아에서 인공심폐기 충전액의 첨가용액으로서 사용한 crystalloid와 colloid 용액에 관한 임상연구)

  • Han, Jae-Jin;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.469-479
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    • 1992
  • Searching for the clinical effects of colloid solutions that used to increasing the oncotic pressure of priming solutions at the cardiopulmonary bypass, 29 patients [who were diagnosised as simple VSD around 10kg of body weight and scheduled to be operated from June 1990 to December 1990 at Sejong General Hospital] were divided randomly and prospectively to the two groups: A group [15] was received 4gm% albumin as addition to the priming solutions and B Group [14] the same amount of Ringer`s lactated solution. 34 clinical parameters [Body weight, sex, age, body surface area, Qp/Qs, pulmonary arterial pressure, cardiopulmonary bypass time, anesthetic time, intraoperatively infused crystalloid and colloid amount, hemoglobin, hematocrit, serum sodium concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum protein, serum albumin concentration, urine output, central venous pressure, postoperatively infused colloid amount, immedediate post-operative peak inspiratory pressure, cardiac index, blood pressure and pump flow during cardiopulmonary bypass, inotro-pic assist, diuretics, extubation period, total drain amount, duration of ICU] were measured and compaired between the two groups. There were no differences of preoperative and operative clinical parameters. And postoper-atively, practically there were no nearly differences at the clinical outcomes between the two groups, but some parameters [cardiac index, PIP, BP and pumpflow during CPB, etc] contributed to being preferable to the Group A at certain times [P<0.05]. Conclusively, it might be thought that the priming solution of cardiopulmonary bypass added by colloid solution had some beneficial effects on the patients, especially younger and associated with complex anomaly to be expected taken longer time of cardiopulmonary bypass, and more studies about the neonatal and complex anomaly cases were needed in that points.

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Successful Removal of Intravenous Leiomyomatosis with Extension into Inferior Vena Cava and Right Atrium (하대정맥, 우심실에 연장된 정맥내 평활근종증의 성공적 절제)

  • Shin Hong Ju;Song Kwang Jae;Hahm Shee Young;Kim Young Tak;Seo Joon Beom;Song Meong Gun
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.441-444
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    • 2005
  • Abdominal tumors that can grow through vascular lumen and spread to the right heart are rare. Intravenous leiomyomatosis is a rare tumor that originates from the uterus and spreads through the vessels. Although histologically benign, tumor extension with mechanical obstruction of the inferior vena cava, right cardiac cavities, or even the pulmonary artery, may occasionally result in fatal outcome. The best treatment is complete surgical resection of the entire tumor using cardiopulmonary bypass and total circulation arrest, We report a case of intravenous leiomyomatosis of the uterus that showed intravascular growth up to the right atrium. The patient underwent successful resection of the tumor by one-stage cardiotomy with laparotomy.