• Journal of Chest Surgery
• /
• v.44 no.5
• /
• pp.338-342
• /
• 2011

Background: The axillary artery is frequently used for cardiopulmonary bypass, especially in acute aortic dissection. We have cannulated the axillary artery using a side graft or by directly using Seldinger's technique. The purpose of this study was to assess the technical problems and complications of both cannulation techniques. Materials and Methods: From January 2003 to December 2009, 53 patients underwent operations using the axillary artery for arterial cannulation. The axillary artery was cannulated with a side graft in 35 patients (side graft group) and directly using Seldinger's technique in 18 patients (direct group). Results: The results were compared between two groups, focusing on cannulation-related morbidities including neurologic morbidity. Arterial damage or dissection of the axillary artery occurred in 1 (2.9%) patient in the side graft group and in 1 (5.6%) patient in the direct group. Malperfusion and insufficient flow did not occur in either group. There were no postoperative complications related to axillary cannulation, such as brachial plexus injury, compartment syndrome, or local wound infection, in either group. Conclusion: Technical problems and complications of the axillary arterial cannulation in both techniques were rare. Direct arterial cannulation using Seldinger's technique was done safely and more simply than the previous technique. It was concluded that both axillary arterial cannulation techniques are acceptable and it remains the surgeon's preference which technique should be used.

• Journal of Chest Surgery
• /
• v.42 no.6
• /
• pp.774-776
• /
• 2009

A 57-year-old man with dyspnea was transferred to our institution. Echocardiography demonstrated grade III aortic valve regurgitation with a bicuspid aortic valve. The preoperative coronary angiography showed a left single nary artery. Replacement of the aortic valve was performed. Ventricular fibrillation developed during weaning patient of cardiopulmonary bypass after aortotomy repair. An anomalous origin of the coronary arteries is an incidental finding. However, in patients who are undergoing aortic valve replacement, a can significantly complicate the procedure. If this is present, then it is imperative that the clearly identified and the required procedure should be modified to avoid injury to these.

• Journal of Chest Surgery
• /
• v.54 no.5
• /
• pp.383-388
• /
• 2021

Background: Achieving external access to and manual occlusion of the left atrial appendage (LAA) during minimally invasive mitral valve surgery (MIMVS) through a small right thoracotomy is difficult. Occlusion of the LAA using an epicardial closure device seems quite useful compared to other surgical techniques. Methods: Fourteen patients with atrial fibrillation underwent MIMVS with concomitant surgical occlusion of the LAA using double-layered endocardial closure stitches (n=6, endocardial suture group) or the AtriClip Pro closure device (n=8, AtriClip group) at our institution. The primary safety endpoint was any device-related adverse event, and the primary efficacy endpoint was successful complete occlusion of blood flow into the LAA as assessed by transthoracic echocardiography at hospital discharge. The primary efficacy endpoint for stroke reduction was the occurrence of ischemic or hemorrhagic neurologic events. Results: All patients underwent LAA occlusion as scheduled. The cardiopulmonary bypass and aortic cross-clamp times in the endocardial suture group and the AtriClip group were 202±39 and 128±41 minutes, and 213±53 and 136±44 minutes, respectively (p=0.68, p=0.73). No patients in either group experienced any device-related serious adverse events, incomplete LAA occlusion, early postoperative stroke, or neurologic complication. Conclusion: Epicardial LAA occlusion using the AtriClip Pro during MIMVS in patients with mitral valve disease and atrial fibrillation is a simple, safe, and effective adjunctive procedure.

• Journal of the Korea Institute of Information Security & Cryptology
• /
• v.29 no.1
• /
• pp.105-115
• /
• 2019

Recently, intelligent Android malicious codes have become difficult to detect malicious behavior by static analysis alone. Malicious code with SO file, dynamic loading, and string obfuscation are difficult to extract information about original code even with various tools for static analysis. There are many dynamic analysis methods to solve this problem, but dynamic analysis requires rooting or emulator environment. However, in the case of dynamic analysis, malicious code performs the rooting and the emulator detection to bypass the analysis environment. To solve this problem, this paper investigates a variety of root detection schemes and builds an environment for bypassing the rooting detection in real devices. In addition, SDK code hooking module for Android malicious code analysis is designed using Xposed, and intent tracking for code flow, dynamic loading file information, and various API information extraction are implemented. This work will contribute to the analysis of obfuscated information and behavior of Android Malware.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.49 no.2
• /
• pp.228-233
• /
• 2022

Arteriovenous malformations (AVMs) are rare congenital anomalies characterized by direct communication between arteries and veins that bypass the capillary bed. AVMs may not manifest clinically until late infancy or childhood. In particular, facial AVMs can cause urgent life-threatening dental events. A 5-year-old girl without a medical history visited the hospital because of spontaneous gingival bleeding around the posterior gingival area of the lower left 2nd primary molar. Angiography through the femoral approach under general anesthesia was performed for differential diagnosis and therapeutic option. The blood flow was effectively reduced after arterial embolization alone, and there was no evidence of recurrence at the 5-month follow-up. The present study reports that embolization of the affected vessels can be a more effective and safe method than surgical resection for the treatment of AVM during the growth period.

• Journal of Chest Surgery
• /
• v.31 no.6
• /
• pp.553-559
• /
• 1998

Introduction: The most dramatic application of hypothermia in cardiac surgery is in deep hypothermic circulatory arrest(DHCA). Because man in natural circumstances is never exposed to this extreme hypothermic condition, one of the controversial aspects of clinical hypothermia is appropriate acid-base management($\alpha$-stat versus pH-stat). This study aims to compare $\alpha$-stat with pH-stat for: (1) brain cooling and re-warming speed during hypothermia induction and re-warming by cardiopulmonary bypass (CPB); (2) cerebral perfusion, metabolism, and their coupling; and (3) the extent of development of cerebral edema after circulatory arrest, in young pigs. Materials & Methods: Fourteen young pigs were assigned to one of two strategies of gas manipulation. Cerebral blood flow was measured with a cerebral venous outflow technique. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopHaryngeal temperature fell below $20^{\circ}C$. The flow rate was set at 2,500 ml/min. Once their temperatures were below $20^{\circ}C$, the animals were subjected to DHCA for 40 mins. During cooling, acid-base balance was maintained according to either $\alpha$-STAT or pH-STAT strategies. After DHCA, the body was re-warmed to normal body temperature. The animals were then sacrificed, and their brains measured for edema. Cerebral perfusion and metabolism were measured before the onset of CPB, before cooling, before DHCA, 15 mins after re-warming, and upon completion of re-warming. Results & Conclusion: Cooling time was significantly shorter with $\alpha$-stat than with pH-stat strategy, while there were no significant differences in rewarming time between the two groups. Nosignificant differences were found in cerebral blood flow, metabolic rate, or flow/ metabolic rate ratio between two groups. Temperature-related differences were significant in cerebral blood flow, metabolic rate, and flow/metabolic rate ratio within each group. Brain water content showed no significant differences between two groups.

• Clinical and Experimental Pediatrics
• /
• v.48 no.3
• /
• pp.321-326
• /
• 2005

Kawasaki disease is an acute systemic vasculitis of unknown origin. Giant coronary aneurysm is one of the most serious complications, although peripheral artery vasculitis can produce life-threatening events. Myocardial ischemia and infarction can be caused by coronary artery stenosis, aneurysm, and stagnation of blood flow in coronary arteries which triggers thromboembolism. Atypical presentation in young infants often interferes with prompt diagnosis and timely treatment, resulting in poor outcomes. We describe a 3-month-old infant with multiple giant coronary aneurysms with flow stagnation, stenosis and large mural thrombus due to Kawasaki disease. He presented with a prolonged course of severe coronary involvement in spite of all measures to reduce coronary complications. Finally, surgical intervention was tried because of the worsening coronary artery abnormalities. The patient died of acute cardiorespiratory failure shortly after weaning from cardiopulmonary bypass.

• Journal of Chest Surgery
• /
• v.8 no.2
• /
• pp.135-142
• /
• 1975

Total body perfusion using Sarns Heart-Lung-Machine, five head pump motor system with Travenol disposable bubble oxygenator was attempted in the dogs by the hemodilution method with total prime of buffered Hartman`s solution under moderate hypothermia. The first of all, the functions of Sarns Heart-Lung-Machine and effects of the hemodilution perfusion by buffered Hartman`s solution was studied. At the same time the changes of pressure of artery and vein, gas contents of the blood, and influence on the blood pictures were observed before, during, and after perfusion in 1-2 days. Hemodilution rates were the ranges of 85.0ml/kg to 97.3ml/kg and perfusion flow rates were maintained with the average 80. 5ml/kg/min [the ranges of 73.3ml/kg/min to 92.8ml/kg/min]. Hypothermia was employed between $35^{\circ}C$ and $31^{\circ} of the esophageal temperature. The total body perfusion was continued for 50-60 minutes. In the total cardiopulmonary bypass, atriotomy, ventriculotomy, and atrioventriculotomy were performed respectively. Arterial pressure was ranged approximately between 50 mmHg and 140 mmHg, but generally, it was maintained over 75 mmHg. Venous pressure was measured between 3.8 cm$H_2O$ and 16.0 cm$H_2O$. Optimum oxygenation could be achieved when oxygen flow into the oxygenator was maintained approximately at 5. 5L/min. In this way, the $pO_2$, $pCO_2$, and oxygen saturation were measured before, during, and afterperfusion in 1-2 days. The $pCO_2$ ranged approximately between 26.0 mmHg and 38.5 mmHg, but generally, it was maintained in the average 30.9-32.5mmHg. The $pO_2$ was ranged between 73.0mmHg and 332.2 mmHg, but it was maintained in the average 103.0-219.0 mmHg. Oxygen saturation was measured over 95. 0% during and after extracorporeal circulation respectively. Erythrocyte count, hemoglobin, hematocrit, and leucocyte count were decreased to 49.2%, 49.0%, 49.4%, and 21. 1% of the preoperative value during extracorporeal circulation respectively and these reductions were not recovered until 1-2 days after perfusion. These. resulted from relatively high degree of hemodilution rate and operative bleeding during these experimental studies. The platelets count was also decreased about to 71% during perfusion, on the contrary, it was increased progressively after perfusion and in 1-21 days after perfusion, the value was returned to preoperative contro1 level. Three dogs were all recovered after extracorporeal circulation.

• Journal of Animal Science and Technology
• /
• v.45 no.4
• /
• pp.617-626
• /
• 2003

This experiment employed a rumen simulated continuous culture system to examine the possibility of improving the rumen bypass of polyunsaturated fatty acids (PUFA) by using a high proportion of concentrate in the feed, and compared soya and linseed in terms of conjugated linoleic acid (CLA) production. No effect of type of fat source was observed on ruminal fermentation. A high proportion of concentrate (80%) in the feed decreased (P<0.001) vessel pH but increased (P<0.01) ammonia nitrogen, total VFA, acetate, butyrate and valerate concentrations compared with a low proportion (40%). Fat sources (soya vs. linseed) and concentrate ratio in the feed did not affect digestibilities of organic matter (OM), total nitrogen, neutral detergent fiber (NDF) and acid detergent fiber (ADF). Soya increased the flows of trans C18:1, C18:2 n-6 and C18:3 n-3 compared with linseed. The difference in fat source alone did not affect the flow of CLA but this was increased when high levels of soya and linseed were associated with a high proportion of concentrate in the feed. There was no effect of fat source on biohydrogenation of C18:1 n-9 and C18:2 n-6, but biohydrogenation of C18:3 n-3 and total C18 PUFA was higher with the linseed than with the soya treatment. A high proportion of concentrate decreased biohydrogenation of C18:2 n-6, C18:3 n-3 and total C18 PUFA compared with a low proportion.

• Journal of the Korean Society of Propulsion Engineers
• /
• v.19 no.5
• /
• pp.1-14
• /
• 2015

In case of a gas turbine engine for supersonic operation, the engine have a wide range of operating inlet mass flow rate and required high performance such as thrust and fuel consumption. Therefore, variable system and its optimal control logic are essentially needed. In this work, a method for performance prediction of a gas turbine engine with variable system compressor and its control scheme were developed. Conceptual design of compact acuation system for the operation of the variable system was also conducted. The performance of a low-bypass ratio mixed flow turbofan engine was analyzed, and it was observed that the surge margin of the engine is improved at off-design condition by applying the control scheme.