• Title/Summary/Keyword: 하행대동맥

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A Study of Optimal Model for the Circuit Configuration of Korean Pulsatile Extracorporeal Life Support System (T-PLS) (한국형 박동식 생명구조장치(T-PLS) 순환회로를 위한 최적화 모델 연구)

  • Lim Choon Hak;Son Ho Sung;Lee Jung Joo;Hwang Znuke;Lee Hye Won;Kim Kwang Taik;Sun Kyung
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.661-668
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    • 2005
  • Background: We have hypothesized that, if a low resistant gravity-flow membrane oxygenator is used, then the twin blood sacs of TPLS can be located at downstream of the membrane oxyenator, which may double the pulse rate at a given pump rate and increase the pump output. The purpose of this study was to determine the optimal configuration for the ECLS circuits by using the concept of pulse energy and pump output. Material and Method: Animals were randomly assigned to 2 groups in a total cardiopulmonary bypass model. In the serial group, a conventional membrane oxygenator was located between the twin blood sacs. In the parallel group, the twin blood sacs were placed downstream of the gravity-flow membrane oxygenator. Energy equivalent pressure (EEP) and pump output were collected at pump-setting rates of 30, 40, and 50 BPM. Result: At the given pump-setting rate, the pulse rate was doubled in the parallel group. Percent changes of mean arterial pressure to EEP were $13.0\pm1.7,\; 12.0\pm1.9\;and\;7.6\pm0.9\%$ in the parallel group, and $22.5\pm2.4,\; 23.2\pm1.9,\;and\;21.8\pm1.4\%$ in the serial group at 30, 40, and 50 BPM of pump-setting rates. Pump output was higher in the parallel circuit at 40 and 50 BPM of pump-setting rates $(3.1\pm0.2,\;3.7\pm0.2L/min\;vs.\;2.2\pm0.1\;and\;2.5\pm0.1L/min,\;respectively,\;p=0.01)$. Conclusion: Either parallel or serial circuit configuration of the ECLS generates effective pulsatility. As for the pump out, the parallel circuit configuration provides higher flow than the serial circuit configuration.

Quality Characteristics of Bread with Dried Persimmons Hot-Water Extracts (곶감 열수추출물을 첨가한 식빵의 품질특성)

  • 문혜경;한진희;김준한;김귀영;강우원;김종국
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.4
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    • pp.723-729
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    • 2004
  • To develop foods using dried persimmon, hot-water extracts of dried persimmons were added into strong wheat flour in the ratio of 10, 20, 30, and 40% and the quality characteristics of baked products were investigated. The proximate compositions of dried persimmons hot-water extracts were 70.37% of moisture, 1.72% of crude protein, 0.18% of crude lipids, 1.99% of crude ash and 4.37% of crude fiber, respectively. With increasing the addition of dried persimmons hot-water extracts, moisture content of the added breads was increased to 47.20% from 41.12% of non-added bread and water activity to 0.576 from 0.495. Water binding capacity of the added dried persimmons hot-water extracts rasied weight of the bread but decreased specific volume. In the hunter's color values the more dried persimmons hot-water extracts was added, the lower L vaules we, and the higher a and b values we. In the texture property, the addition of dried persimmons hot-water extracts increased hardness, gumminess and chewiness, while decreased adhesiveness and fracturability. Judging from texture, taste and overall acceptability of the product, recommended substitution level for hot-water extracts of dried persimmons in bread was 30% or less.

Clinical Application of Stent-graft in Thoracic Aortic Diseases (흉부 대동맥 질환에서 스텐트-그라프트의 임상적 적용)

  • Kim, Kyung-Hwan;Lee, Cheul;Chang, Ji-Min;Chung, Jin-Wook;Ahn, Hyuk;Park, Jae-Hyung
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.698-703
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    • 2001
  • Background: Endovascular stent-graft insertion in aortic diseases is now generally accepted as an attractive alternative treatment modality. We reviewed our clinical experiences of endovascular stent-graft insertion in thoracic aorta. Material and Method: Since 1995, we performed 8 cases of endovasclar stent-graft insertion. Preoperative diagnoses were aortic aneurysms in 4, traumatic aortic ruptures in 3, and ruptured aortic pseudoaneurysm in 1. All procedures were performed in angiography room with the guidance of fluoroscopy. The stent-graft device is a custom-made 0.35mm thickness Z-shaped stainless steel wires, intertwined with each other using polypropylene suture ligation. It is covered with expanded Dacron vascular graft. Result: All procedures were performed successfully. Follow-up studies revealed 2 minimal perigraft leakages. There was no significant leakage or graft migration. 2 patients expired due to multiple organ failure and fungal sepsis. Other survivors(6) are doing well. Conclusion: Endovascular stent-graft insertion is relatively saft and effective treatment modality in the managment of various types of aortic diseases. In may be an effective alternative in aortic diseases of great surgical risk.

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Development of Korean Version of Heparin-Coated Shunt (헤파린 표면처리된 국산화 혈관우회도관의 개발)

  • Sun, Kyung;Park, Ki-Dong;Baik, Kwang-Je;Lee, Hye-Won;Choi, Jong-Won;Kim, Seung-Chol;Kim, Taik-Jin;Lee, Seung-Yeol;Kim, Kwang-Taek;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.97-107
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    • 1999
  • Background: This study was designed to develop a Korean version of the heparin-coated vascular bypass shunt by using a physical dispersing technique. The safety and effectiveness of the thrombo-resistant shunt were tested in experimental animals. Material and Method: A bypass shunt model was constructed on the descending thoracic aorta of 21 adult mongrel dogs(17.5-25 kg). The animals were divided into groups of no-treatment(CONTROL group; n=3), no-treatment with systemic heparinization(HEPARIN group; n=6), Gott heparin shunt (GOTT group; n=6), or Korean heparin shunt(KIST group; n=6). Parameters observed were complete blood cell counts, coagulation profiles, kidney and liver function(BUN/Cr and AST/ ALT), and surface scanning electron microscope(SSEM) findings. Blood was sampled from the aortic blood distal to the shunt and was compared before the bypass and at 2 hours after the bypass. Result: There were no differences between the groups before the bypass. At bypass 2 hours, platelet level increased in the HEPARIN and GOTT groups(p<0.05), but there were no differences between the groups. Changes in other blood cell counts were insignificant between the groups. Activated clotting time, activated partial thromboplastin time, and thrombin time were prolonged in the HEPARIN group(p<0.05) and differences between the groups were significant(p<0.005). Prothrombin time increased in the GOTT group(p<0.05) without having any differences between the groups. Changes in fibrinogen level were insignificant between the groups. Antithrombin III levels were increased in the HEPARIN and KIST groups(p<0.05), and the inter-group differences were also significant(p<0.05). Protein C level decreased in the HEPARIN group(p<0.05) without having any differences between the groups. BUN levels increased in all groups, especially in the HEPARIN and KIST groups(p<0.05), but there were no differences between the groups. Changes of Cr, AST, and ALT levels were insignificant between the groups. SSEM findings revealed severe aggregation of platelets and other cellular elements in the CONTROL group, and the HEPARIN group showed more adherence of the cellular elements than the GOTT or KIST group. Conclusion: Above results show that the heparin-coated bypass shunts(either GOTT or KIST) can suppress thrombus formation on the surface without inducing bleeding tendencies, while systemic heparinization(HEPARIN) may not be able to block activation of the coagulation system on the surface in contact with foreign materials but increases the bleeding tendencies. We also conclude that the thrombo-resistant effects of the Korean version of heparin shunt(KIST) are similar to those of the commercialized heparin shunt(GOTT).

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