• Title/Summary/Keyword: Assisted circulation

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Endovascular Treatment of Wide-Necked Intracranial Aneurysms Using Balloon-Assisted Technique with HyperForm Balloon

  • Youn, Sang-O;Lee, Jae-Il;Ko, Jun-Kyung;Lee, Tae-Hong;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.207-212
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    • 2010
  • Objective : To assess the feasibility, safety, and effectiveness of the balloon-assisted technique with HyperForm balloon in the endovascular treatment of wide-necked intracranial aneurysms. Methods : A total of 34 patients with 34 wide-necked intracranial aneurysms were treated with endovascular coil embolization using balloon-assisted technique with Hyperform balloon. Twenty-nine aneurysms (85.3%) were located in the anterior circulation. The group of patients was comprised of 16 men and 18 women, aged 33 to 72 years (mean : 60.6 years). The size of aneurysms was in the range of 2.0 to 22.0 mm (mean 5.5 mm) and one of neck was 2.0 to 11.9 mm (mean 3.8 mm). The dome to neck ratio was ranged from 0.83 to 1.43 (1.15). Sixteen patients were treated for unruptured aneurysms and the remaining 18 presented with a subarachnoid hemorrhage. Results : In the 34 aneurysms treated by the remodeling technique with HyperForm balloon, immediate angiographic results consisted of total occlusion in 31 cases (91.2%) and partial occlusion in three cases (8.8%). There were five procedure-related complications (14.7%), including two coil protrusions and three thromboembolisms; Except one patient, all were successfully resolved without permanent neurologic deficit. No new bleeding occurred during the follow-up. Twenty patients (59%) underwent angiographic follow-up from 2 to 33 months (mean 9.2 months) after treatment. Focal recanalization with coil compaction of the neck portion was observed in 5 cases (25%). Only one case showed major recanalization and underwent stent-assisted coil embolization. Conclusion : The balloon-assisted technique with Hyperform balloon is a feasible, safe, and effective endovascular treatment of wide-necked cerebral aneurysms.

Experiences of Tracheal Procedure Assisted by Extracorporeal Membrane Oxygenator

  • Kim, Ji Eon;Jung, Sung-Ho;Ma, Dae Sung
    • Journal of Chest Surgery
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    • v.46 no.1
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    • pp.80-83
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    • 2013
  • We report on the application of a venovenous type extracorporeal membrane oxygenator (ECMO) in high-risk tracheal procedures in six cases consisting of five patients with tracheal stenosis. An ECMO should be helpful for preventing respiratory emergency during a tracheal procedure.

Dynamic Simulation of Transient Operations of a Solar Power-Assisted Absorption Chiller (태양열 보조열원을 이용한 흡수식 시스템의 동적 시뮬레이션에 의한 과도운전 특성 평가)

  • Shin, Young-Gy;Seo, Jung-A;Woo, Sung-Min
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.22 no.2
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    • pp.78-85
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    • 2010
  • A dynamic model has been developed to investigate the operability of a single and double-effect solar energy assisted parallel type absorption chiller. In the study, main components and fluid transport mechanism were modeled. And solar radiation and the solar collector were also modeled along with its control design. The model was run for the single mode with solar energy supply only and the solar/gas driving double effect mode. From the simulation results, it was found that the present configuration of the chiller is not capable of regulating solution flow rates according to variable solar energy input. And the issues of the excessive circulation flow rate and the mismatch between available solar power and cooling load discourages the use of the single mode, but the dual use of gas and solar power is recommendable in view of controllability and enhanced COP.

Double-Outlet of Left Ventricle in Corrected Transposition of Great Arteries -One case report- (좌심실 이중유출로를 동반한 교정형 대혈관전위증 -1예보고-)

  • 권중혁
    • Journal of Chest Surgery
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    • v.12 no.2
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    • pp.119-126
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    • 1979
  • This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

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Usefulness of Silent MRA for Evaluation of Aneurysm after Stent-Assisted Coil Embolization

  • You Na Kim;Jin Wook Choi;Yong Cheol Lim;Jihye Song;Ji Hyun Park;Woo Sang Jung
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.246-255
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    • 2022
  • Objective: To determine the usefulness of Silent MR angiography (MRA) for evaluating intracranial aneurysms treated with stent-assisted coil embolization. Materials and Methods: Ninety-nine patients (101 aneurysms) treated with stent-assisted coil embolization (Neuroform atlas, 71 cases; Enterprise, 17; LVIS Jr, 9; and Solitaire AB, 4 cases) underwent time-of-flight (TOF) MRA and Silent MRA in the same session using a 3T MRI system within 24 hours of embolization. Two radiologists independently interpreted both MRA images retrospectively and rated the image quality using a 5-point Likert scale. The image quality and diagnostic accuracy of the two modalities in the detection of aneurysm occlusion were further compared based on the stent design and the site of aneurysm. Results: The average image quality scores of the Silent MRA and TOF MRA were 4.38 ± 0.83 and 2.78 ± 1.04, respectively (p < 0.001), with an almost perfect interobserver agreement. Silent MRA had a significantly higher image quality score than TOF MRA at the distal internal carotid artery (n = 57, 4.25 ± 0.91 vs. 3.05 ± 1.16, p < 0.001), middle cerebral artery (n = 21, 4.57 ± 0.75 vs. 2.19 ± 0.68, p < 0.001), anterior cerebral artery (n = 13, 4.54 ± 0.66 vs. 2.46 ± 0.66, p < 0.001), and posterior circulation artery (n = 10, 4.50 ± 0.71 vs. 2.90 ± 0.74, p = 0.013). Silent MRA had superior image quality score to TOF MRA in the stented arteries when using Neuroform atlas (4.66 ± 0.53 vs. 3.21 ± 0.84, p < 0.001), Enterprise (3.29 ± 1.59 vs. 1.59 ± 0.51, p = 0.003), LVIS Jr (4.33 ± 1.89 vs. 1.89 ± 0.78, p = 0.033), and Solitaire AB stents (4.00 ± 2.25 vs. 2.25 ± 0.96, p = 0.356). The interpretation of the status of aneurysm occlusion exhibited significantly higher sensitivity with Silent MRA than with TOF MRA when using the Neuroform Atlas stent (96.4% vs. 14.3%, respectively, p < 0.001) and LVIS Jr stent (100% vs. 20%, respectively, p = 0.046). Conclusion: Silent MRA can be useful to evaluate aneurysms treated with stent-assisted coil embolization, regardless of the aneurysm location and type of stent used.

A Pre-Hospital Cardiac Arrest Patient Surviving after Dispather-Assisted Defibrillation by an Untrained Witness (응급의료전화상담원의 도움에 의해 교육 받지 않은 목격자의 제세동 시행 후 생존한 병원 전 심정지 1례)

  • Kim, Jong-Ho;Moon, Jun-Dong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.239-244
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    • 2018
  • A 59-year-old man with no specific medical or family history complained of chest pain and became unconscious. A member of his family, who was a witness, called 119 and gave him dispatcher-assisted cardiopulmonary resuscitation, followed by defibrillation using an automated external defibrillator placed in his apartment. Afterward, he was given two sessions of defibrillation by the 119 emergency squad, then transferred to an emergency medical center with the return of spontaneous circulation. The patient was discharged with cerebral performance category (CPC) 1 15 days later. While dispatcher-assisted cardiopulmonary resuscitation and defibrillation is at its beginning stage in South Korea, this case seems to demonstrate its effectiveness. Moreover, this case suggests it can be particularly useful for helping untrained witnesses use an automated external defibrillator, which may have important implications in regions in which there are delayed responses of the 119 emergency squad to the site. It is also important to develop a plan for improving witness access to and quantitative supply of the South Korean public access defibrillation (PAD) program.

A Study of Dynamic Simulation of a Hybrid Absorption Chiller Utilizing Solar Power (태양열을 이용한 일이중 겸용 흡수식 냉온수기 동적성능 모사연구)

  • Shin, Young-Gy;Seo, Jung-A;Woo, Sung-Min;Kim, Hyo-Sang
    • Proceedings of the SAREK Conference
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    • 2009.06a
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    • pp.967-972
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    • 2009
  • A dynamic model has been developed to investigate the operability of a single and double-effect solar energy assisted parallel type absorption chiller. In the study, main components and fluid transport mechanism were modeled. And solar radiation and the solar collector also were also modeled along with its control design. The model was run for the single mode with solar energy supply only and the solar/gas driving double effect mode. From the simulation results, it was found that the present configuration of the chiller is not capable of regulating solution flow rates according to variable solar energy input. And the issues of the excessive circulation flowrate and the mismatch between available solar power and cooling load discourages the use of the single mode, but the dual use of gas and solar power is recommendable in view of controllability and enhanced COP.

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Evaluation of Left Ventricular Assist Device through In Vivo Experiments (생체실험을 통한 좌심실보조기의 평가)

  • Park, Seong-Keun;Won, Yong-Soon;Jung, Pil-Sup;Choi, Jin-Wook;Kim, In-Young;Lee, Kyu-Baek;Min, Byoung-Goo
    • Proceedings of the KOSOMBE Conference
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    • v.1993 no.11
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    • pp.89-92
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    • 1993
  • In this article, we present and analyze the results of the three consecutive in vivo experiments of the LVAD to evaluate the function of the LVAD and the adverse effects on living animals. We applied the LVAD consecutively to three mongrel dogs and the circulation of the blood was assisted under the anesthesia. We used in general both the asynchronous mode and the synchronous mode to drive the LVAD. During the experiments we monitored the dogs with a polygraph to evaluate the function of the LVAD and the additional effects on the natural hearts. We also examined several clinical pathologic tests in order to see the effects of the LVAD to the red blood cells and the other internal organs. The dogs survived for two to there days. The LVAD assisted the circulatory system at the maximum assist flow rate of 3.0 1/min. Although the red blood cells of the dogs had mechanical damages by the LVAD to result in the hemolysis, the degree of the hemolysis was not so high and the damages caused by the hemolysis on the dogs were not serious. The myocardium of the first dog was gradually worsened and eventually failed. The damage of the myocardium was due to the asynchronous driving mode of the LVAD. The other organs did not have serious damages due to the application of the LVAD. The main purpose of this paper is to evaluate the results of the in vivo experiments of the LVAD and to find better ways to the application of the LVAD to human beings.

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Pulmonary Function Following Open Heart Surgery -early and late postoperative changes- (개심술후 폐기능 -수술직후 및 장기간의 추이에 대하여-)

  • 이성행
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.364-374
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    • 1980
  • Twenty-two patients were selected for evaluation of pre-and postoperative pulmonary function. These patients were performed open cardiac surgery with the extracorporeal circulation from March 1979 to July 1980 at the Department of Thoracic and Cardiovascular Surgery, Kyungbook National University Hospital. Patients were classified with ventricular septal defect 5 cases, atrial septal defect 5 cases, tetralogy of Fallot 5 cases, mitral stenosis 4 cases, rupture of aneurysm of sinus Valsalva 1 case, left atrial myxoma I case, and aortic insufficiency 1 case. The pulmonary function tests were performed and listed: [1] respiratory rate, tidal volume [TV], and minute volume[MV], [2] forced vital capacity [FVC] and forced expiratory volume[FEV 0.5 & FEV 1.0], [3] forced expiratory flow [FEF 200-1200 ml & FEF 25-75%]. [4] Maximal voluntary ventilation [MVV], [5] residual volume [RV] and functional residual capacity[FRC], measured by a helium dilution technique. Respiratory rate increased during the early postoperative days and tidal volume decreased significantly. These values returned to the preoperative levels after postoperative 5-6 days. Minute volume decreased slightly, but essentially unchanged. Preoperative mean values of the forced vital capacity, functional residual capacity and total lung capacity decreased [63.2%, 87.2% & 77.3% predicted, respectively], and early postoperatively these values decreased further [19.6%, 76.0% & 38.0% predicted], but later progressively increased to the preoperative levels. In residual volume, there was no decline in the preoperative mean values [100.9% predicted] and postoperatively the value rather increased [106.3-161.7% predicted]. Forced expiratory volume [FEV 0.5 & FEV 1.0] and forced expiratory flow [FEF 200-1200 ml & FEF 25-75%] also revealed significant declines in the early postoperative period. There was no significant difference in values of the spirometric pulmonary function tests, such as FEF 1.O and FEF 25-75% between successful weaning group [17 cases] extubated within 24 hrs post-operatively and unsuccessful weaning group [5 cases] extubated beyond 24 hrs. Static compliance and airway resistance measured for the two cases during assisted ventilation, however, any information was not obtained. Long term follow-up pulmonary function studies were carried out for 8 cases in 9 months post-operatively. All of the results returned to the pre-operative or to normal predicted levels except FVC, FEV 1.0, and FEF 25-75% those showed minimal declines compared to the pre-operative figures.

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A Study of Performance Characteristics on Hybrid Heat Pump System with Solar Energy as Heat Source (태양열이용 하이브리드 열펌프시스템의 성능특성에 관한 연구)

  • Park, Youn-Cheol;Kim, Ji-Young;Ko, Gwan-Soo
    • Journal of the Korean Solar Energy Society
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    • v.27 no.1
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    • pp.47-54
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    • 2007
  • Interests on renewable energy are increased due to oil price and environmental problems aroused from the fossil energy usage. In this study, performances of a solar assisted hybrid heat pump system are analyzed by experimental method. The developed system could runs at two types of operating mode. When the storage temperature is higher than the set temperature, the stored hot water in storage tank is supplied to the load directly. On the other hand, when the storage temperature lower than the set temperature, the water inside of the storage tank is used as heat source of the heat pump. In this study, the system control temperature for the alternation of the operating mode is set to $40^{\circ}C$ of the storage tank outlet. As results, it is founded that the COP of the developed heat pump system shows between 3.0 and 3.5. It is resonable performance for the heating system with a renewable energy as secondary heat source. The solar collect used in this study could supplies heat to the storage tank at over 400 W/m2 solar intensity. If the irradiation is lower than the 400 W/m2, the circulation pump stored and it could not supply heat to the storage tank. It is found that the difference temperature between the outlet of the storage tank and collector is $3^{\circ}C$. Even though, the extended study should be conducted to get a optimum performance of the developed system with various operating condition and control strategies.