• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
• /
• v.28 no.1
• /
• pp.1-18
• /
• 2023

The East Sea, one of the regions where the most rapid warming is occurring, is known to have important implications for the response of the ocean to future climate changes because it not only reacts sensitively to climate change but also has a much shorter turnover time (hundreds of years) than the ocean (thousands of years). However, the processes underlying changes in seawater characteristics at the sea's deep and abyssal layers, and meridional overturning circulation have recently been examined only after international cooperative observation programs for the entire sea allowed in-situ data in a necessary resolution and accuracy along with recent improvement in numerical modeling. In this review, previous studies on the physical characteristics of seawater at deeper parts of the East Sea, and meridional overturning circulation are summarized to identify any remaining issues. The seawater below a depth of several hundreds of meters in the East Sea has been identified as the Japan Sea Proper Water (East Sea Proper Water) due to its homogeneous physical properties of a water temperature below 1℃ and practical salinity values ranging from 34.0 to 34.1. However, vertically high-resolution salinity and dissolved oxygen observations since the 1990s enabled us to separate the water into at least three different water masses (central water, CW; deep water, DW; bottom water, BW). Recent studies have shown that the physical characteristics and boundaries between the three water masses are not constant over time, but have significantly varied over the last few decades in association with time-varying water formation processes, such as convection processes (deep slope convection and open-ocean deep convection) that are linked to the re-circulation of the Tsushima Warm Current, ocean-atmosphere heat and freshwater exchanges, and sea-ice formation in the northern part of the East Sea. The CW, DW, and BW were found to be transported horizontally from the Japan Basin to the Ulleung Basin, from the Ulleung Basin to the Yamato Basin, and from the Yamato Basin to the Japan Basin, respectively, rotating counterclockwise with a shallow depth on the right of its path (consistent with the bottom topographic control of fluid in a rotating Earth). This horizontal deep circulation is a part of the sea's meridional overturning circulation that has undergone changes in the path and intensity. Yet, the linkages between upper and deeper circulation and between the horizontal and meridional overturning circulation are not well understood. Through this review, the remaining issues to be addressed in the future were identified. These issues included a connection between the changing properties of CW, DW, and BW, and their horizontal and overturning circulations; the linkage of deep and abyssal circulations to the upper circulation, including upper water transport from and into the Western Pacific Ocean; and processes underlying the temporal variability in the path and intensity of CW, DW, and BW.

• Journal of Chest Surgery
• /
• v.41 no.3
• /
• pp.329-334
• /
• 2008

Background: Percutaneous cardiopulmonary support. (PCPS) has the potential to rescue patients in cardiogenic shock who might otherwise die. PCPS has been a therapeutic option in a variety of the clinical settings such as for patients with myocardial Infarction, high-risk coronary intervention and postcardiotomy cardiogenic shock, and the PCPS device is easy to install. We report our early experience with PCPS as a life saving procedure in cardiogenic shock patients due to acute myocardial infarction. Material and Method: From January 2005 to December 2006, eight patients in cardiogenic shock with acute myocardial infarction underwent PCPS using the CAPIOX emergency bypass system($EBS^{(R)}$, Terumo, Tokyo, Japan). Uptake cannulae were inserted deep into the femoral vein up to the right atrium and return cannulae were inserted into the femoral artery with Seldinger techniques using 20 and 16-French cannulae, respectively. Simultaneously, autopriming was performed at the $EBS^{(R)}$ circuit. The $EBS^{(R)}$ flow rate was maintained between $2.5{\sim}3.0L/min/m^2$ and anticoagulation was performed using intravenous heparin with an ACT level above 200 seconds. Result: The mean age of patients was $61.1{\pm}14.2$ years (range, 39 to 77 years). Three patients were under control of the $EBS^{(R)}$ before percutaneous coronary intervention (PCI), three patients were under control of the $EBS^{(R)}$ during PCI, one patient was under control of the $EBS^{(R)}$ after PCI, and one patient was under control of the $EBS^{(R)}$ after coronary bypass surgery. The mean support time was $47.5{\pm}27.9$ hours (range, 8 to 76 hours). Five patients (62.5%) could be weaned from the $EBS^{(R)}$ after $53.6{\pm}27.2$ hours. (range, 12 to 68 hours) of support. All of the patients who could successfully be weaned from support were discharged from the hospital. There were three complications: one case of gastrointestinal bleeding and two cases of acute renal failure. Two of the three mortality cases were under cardiac arrest before $EBS^{(R)}$ support, and one patient had an intractable ventricular arrhythmia during the support. All of the discharged patients are still surviving at $16.8{\pm}3.1$ months (range, 12 to 20 months) of follow-up. Conclusion: The use of $EBS^{(R)}$ for cardiogenic shock caused by an acute myocardial infarction could rescue patients who might otherwise have died. Successfully recovered patients after $EBS^{(R)}$ treatment have survived without severe complications. More experience and additional clinical investigations are necessary to elucidate the proper installation timing and management protocol of the $EBS^{(R)}$ in the future.