• Journal of Chest Surgery
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• 제44권2호
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• pp.193-196
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• 2011

Bronchogenic carcinoma involving the carina has remained a challenging problem for thoracic surgeons. Carinal resection and reconstruction is limitedly indicated because this aggressive surgical approach has been reported to be associated with significant morbidity and mortality while long-term outcome has not been determined. Wesuccessfully performed carinal reconstruction and sleeve right upper lobectomy assisted with ECMO for a 60-year-old male with squamous cell carcinoma in the right upper lobe extending to the carina.

• 고신대학교 의과대학 학술지
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• 제33권2호
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• pp.215-222
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• 2018

An incidentaloma is a tumor found incidentally without clinical symptoms or suspicion; the lesion may be adrenal, pituitary, or thyroidal. We report the case of an asymptomatic individual with preoperatively undiagnosed pheochromocytoma (size: 4.86 cm) that was revealed using elective nonadrenal surgical procedures. The patient demonstrated peri- and post-operative hypertensive crisis and tachycardia. Three days after the dramatic onset of symptoms, the patient expired due to pulmonary edema, multiple organ failure, and terminal sepsis, despite administration of extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation. A left medial kidney mass obtained at autopsy confirmed pheochromocytoma.

• 대한의용생체공학회:의공학회지
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• 제42권4호
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• pp.193-200
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• 2021

Flowmeter and oxygen sensors are listed in COVID-19 essential medical devices. This article reports a Teensy microcontroller-based Oxygen mass flow controller (MFC), core part of the oxygen respirator or extracorporeal membrane oxygenation (ECMO). The developed MFC consisting of the microcontroller, MEMS flow sensor, and solenoid valve was able to accurately control 0 to 100 sccm of oxygen flow rate. The pressure of vacuum chamber increased proportionally to the flow rate (0.998 of Pearson correlation coefficient). The experimental results proved that the developed MFC exhibits comparable performance to a commercial MFC in accuracy, settling time, linearity with pressure, and repeatability of oxygen mass flow control. It is expected that this simple and cheap MFC is utilized for oxygen therapy against the severe acute respiratory syndrome coronavirus 2.

• 멤브레인
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• 제15권3호
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• pp.224-232
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• 2005

생체 폐를 대신해서 임시적으로 제공하는 폐 보조 장치(LAD)의 사용은 기계 환기술의 단순화와 체외순환 막형 인공폐의 기능을 결합하여 급성호흡부전 환자에 적합하다. 본 연구에서의 주 관심은 폐 보조 장치에서의 막 진동 효율에 있었으며 정량적인 실험 측정은 혈액 용혈에 대한 막 진동 의존을 확인하기 위하여 실행하였다. 또, 혈액 용혈은 막 진동이 이루어질 때 한계 용혈의 가진 주파수 대에서 결정하였다. 최대 기체 전달율을 보이는 675의 중공사 막으로 이루어져 있는 유형 5의 가진 주파수에서 최대 진폭의 발생 및 중공사에 진동의 전달에 의해 최대 산소 전달율이 일어났다. 이 주파수가 혈류량에 가동 가능했던 제 2 형태의 공진 주파수가 되어 높은 각 혈류량 비에서 $25{\pm}5$ 헤르쯔까지 가진이 되었으며, 혈액 용혈은 $25{\pm}5$ 헤르쯔의 가진 주파수에서 상대적으로 낮았다. 따라서 우리는 이 폐 보조 장치의 한계 용혈 주파수가 $25{\pm}5$ 헤르쯔인 것으로 결정했다.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.328-334
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• 2019

Background: Although the frequency of respiratory viral infection in patients with pulmonary acute respiratory distress syndrome (ARDS) is not uncommon, clinical significance of the condition remains to be further elucidated. The purpose of this study was to compare characteristics and outcomes of patients with pulmonary ARDS infected with influenza and other respiratory viruses. Methods: Clinical data of patients with pulmonary ARDS infected with respiratory viruses January 2014-June 2018 were reviewed. Respiratory viral infection was identified by multiplex reverse transcription-polymerase chain reaction (RT-PCR). Results: Among 126 patients who underwent multiplex RT-PCR, respiratory viral infection was identified in 46% (58/126): 28 patients with influenza and 30 patients with other respiratory viruses. There was no significant difference in baseline and clinical characteristics between patients with influenza and those with other respiratory viruses. The use of extracorporeal membrane oxygenation (ECMO) was more frequent in patients with influenza than in those with other respiratory viruses (32.1% vs 3.3%, p=0.006). Co-bacterial pathogens were more frequently isolated from respiratory samples of patients with pulmonary ARDS infected with influenza virus than those with other respiratory viruses. (53.6% vs 26.7%, p=0.036). There were no significant differences regarding clinical outcomes. In multivariate analysis, acute physiology and chronic health evaluation II was associated with 30-mortality (odds ratio, 1.158; 95% confidence interval, 1.022-1.312; p=0.022). Conclusion: Respiratory viral infection was not uncommon in patients with pulmonary ARDS. Influenza virus was most commonly identified and was associated with more co-bacterial infection and ECMO therapy.

• 중환자간호학회지
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• 제3권2호
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• pp.49-59
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• 2010

Purpose: The purpose of this study was to investigate in-service education needs in order to develop clinical competence of critical care nurses', and to identify contents which have to include in-service education according to nurses' characteristics. Methods: Data was collected using Critical Care Nurse Job Analysis Tool that was modified by professional team. Collected data was analyzed using the SPSS program. Results: Total 148 critical care nurses, who had worked at adult intensive care unit of one tertiary hospital in Seoul, filled out questionnaire. The results showed the participants highly needed education about cardiological nursing practices such as ECMO, pacemaker, cardiac tamponade. And there were significant correlations among in-service educational needs and ICU careers, preceptors experience, and charge nurse experience. Conclusion: It will be necessary for better nursing to develop in-service education is based on critical care nurse's need and their characteristics. Especially, it is important to develop and provide in-service education programs, which consider ICU nurse's differences for their career ladder and nursing preceptors.

• International Journal of Fluid Machinery and Systems
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• 제8권1호
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• pp.1-12
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• 2015

In cardiopulmonary support systems with a membrane oxygenation such as a percutaneous cardiopulmonary support (PCPS) or an extracorporeal membrane oxygenation (ECMO), blood pumps need to generate the pressure rise of approximately 200mmHg or higher, due to the high hydraulic resistances of the membrane oxygenation and of the cannula tubing. In order to realize the blood pump with higher pressure rise, higher anti-hemolysis and thrombosis performances, the development of novel centrifugal blood pump composed of two-stage has been conducted by the authors. In the present paper, effective attempts to decrease the wall shear stress and to suppress the stagnation are introduced for the prevention of hemolysis and thrombosis in blood pumps. The hemolysis test was also carried out and it was clarified that the decrease of wall shear stress is effective as a guideline of design of blood pumps for improving the anti-hemolysis performance.

• 한국전산유체공학회지
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• 제20권3호
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• pp.79-86
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• 2015

A blood pump is an important part of a cardiac assist device. Since the shear rate in blood is known to be a primary factor on hemolysis generation, it has been very important to evaluate hemolysis inside blood pumps for understanding performance and reliability of cardiac assist devices. In this study, hemolysis generation inside blood pumps is analyzed using CFD with power-law based models for the blood damage index(BDI), in order to overcome difficulties in measuring hemolysis by experiment. The BDI values in blood pumps can be evaluated using Lagrangian or Eulerian approaches. In this study, several Lagrangian and Eulerian approaches are compared to estimate the efficiency of the numerical methods in a practice sense. It is found that the Eulerian approaches are advantageous in terms of the efficiency and robustness. Two different Eulerian approaches are used to evaluate the BDI values of a few commercial blood pumps. For the conditions of extracorporeal membrane oxygenator(ECMO) and ventricular assist device(VAD), local generation of hemolysis is analyzed using divided regions of blood pumps, in order to investigate the effects of the pump geometry.

• Journal of Chest Surgery
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• 제24권11호
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• pp.1045-1057
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• 1991

Over the past four decades after World War II a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of cardiovascular diseases in Korea. Clinical data after the first open heart surgery by Professor Yung Kyoon Lee on August 7, 1959 up to 1984 revealed the total number of cardiovascular surgery in Korea as 13,100 cases performed in 22 institutes with overall hospital mortality of 7.7%[Cardiovascular Surgery in Korea 1985], Publishing committee of the Korean Thoracic and Cardiovascular Surgical Society collected the data of cardiovascular surgical cases in Korea again in between 1985 and 1990 from 38 institutes out of total 42 institutes of open heart centers in Korea. The results are: 1. The survey reply ratio was 90.5%[38 out of 42 institutes]. 2. Of the total 30,061 cases of cardiovascular surgery reported from 38 institutes 1,402 cases were failed as hospital mortality of 4.7%[4.5% of the 21,761 operations for congenital, and 5.2% of the 8,300 operations for acquired heart diseases]. Out of the total congenital cases, 17,303 cases were acyanotic group with a operative mortality as 2.0%, and 4,458 cases were cyanotic group with a hospital mortality as 14.le The incidence of corrective operations for complex congenital cardiac anomalies were increasing recently with decreasing age group. 3. During the year in 1990, 38 institutes performed 5,427 cardiovascular surgery with a hospital mortality of 3.4%. 4. Of the total cumulative 6,458 cases for cardiac valve surgery more than 90% cases were put to prosthetic valve replacement with hospital mortality as 4.8%. And the incidence of re-Do valve surgery was increasing recently as 13.1% in 1990. 5. Coronary artery bypass graft was increasing recently with 7.9% of hospital mortality in total 440 cases. Intracardiac operation for intractable arrhythmia was started since 1987 as 49 cases in total. Experiences on VAD and ECMO were also reported sporadically in recent year. 6. Home made oxygenator[OXYREX] is now in clinical use, and under animal experiment for clinical trial in near future.

• Journal of Chest Surgery
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• 제51권1호
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• pp.22-28
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• 2018

Background: Lung transplantation is a life-saving procedure in patients with end-stage lung disease, and is increasingly performed in Korea. Methods: We retrospectively evaluated the outcomes of patients who received a lung transplant at Asan Medical Center between January 2008 and December 2016. Thirteen of 54 patients experienced multiorgan transplantation; the remaining 41 who received only lung grafts were included. Results: The mean age of the lung transplant recipients was 44.6 years; 27 were men and 14 were women. The most frequent reasons were idiopathic interstitial pneumonia (21 of 41 patients, 51.2%), interstitial lung disease (9 of 41, 22.0%), and bronchiolitis obliterans after bone marrow transplantation (7 of 41, 17.1%). The median waiting time was 47 days, and many patients received preoperative intensive care (27 of 41, 65.9%), ventilator support (26 of 41, 63.4%), or extracorporeal life support (19 of 41, 46.3%). All 41 patients received bilateral lung grafts. Ten deaths occurred (24.3%), including 5 cases of early mortality (12.2%) and 5 cases of late mortality (12.2%). The 1-, 3-, and 5-year survival rates were 78.9%, 74.2%, and 69.3%, respectively. Conclusion: Despite a high percentage of patients who required preoperative intensive care, the transplantation outcomes were acceptable.