• Korean Journal of Radiology
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• v.24 no.6
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• pp.512-521
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• 2023

Objective: There is increasing recognition that left atrial (LA) strain can be a prognostic marker of various cardiac diseases. However, its prognostic value in acute myocarditis remains unclear. Therefore, this study aimed to evaluate whether cardiovascular magnetic resonance (CMR)-derived parameters of LA strain can predict outcomes in patients with acute myocarditis. Materials and Methods: We retrospectively analyzed the data of 47 consecutive patients (44.2 ± 18.3 years; 29 males) with acute myocarditis who underwent CMR in 13.5 ± 9.7 days (range, 0-31 days) of symptom onset. Various parameters, including feature-tracked CMR-derived LA strain, were measured using CMR. The composite endpoints included cardiac death, heart transplantation, implantable cardioverter-defibrillator or pacemaker implantation, rehospitalization following a cardiac event, atrial fibrillation, or embolic stroke. The Cox regression analysis was performed to identify associations between the variables derived from CMR and the composite endpoints. Results: After a median follow-up of 37 months, 20 of the 47 (42.6%) patients experienced the composite events. In the multivariable Cox regression analysis, LA reservoir and conduit strains were independent predictors of the composite endpoints, with an adjusted hazard ratio per 1% increase of 0.90 (95% confidence interval [CI], 0.84-0.96; P = 0.002) and 0.91 (95% CI, 0.84-0.98; P = 0.013), respectively. Conclusion: LA reservoir and conduit strains derived from CMR are independent predictors of adverse clinical outcomes in patients with acute myocarditis.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.329-335
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• 2002

Background: The surgical technique for biventricular assist device(BVAD) implantation has mainly consisted of cannulation procedures. A median sternotomy has been the technique of choice as it gives a surgeon an excellent exposure of the heart. However, considering that most patients require a future sternotomy or already have a previous sternotomy, sternotomy-related complication remains a major concern in BVAD implantation. Based on this consideration as well as the clinical experiences of conventional heart surgery, the authors have hypothesized that the cardiac chambers for BVAD cannulation can be approached from the right side of the heart. The purpose of this studs to develop a novel surgical technique of right thoracotomy for BVAD implantation in an animals study. Material and Method: For last two years, 16 (11 calves, 3 canines, and 2 sheep) out of 30 experimental animals with AnyHeart implantation underwent a right thoracotomy. The device was used as an implantable BVAD in 14 animals, a wearable BVAD in 1, and an implantable LVAD in 1. The chest cavity was entered through the 4th intercostal space or the 5th periosteal bed. As for the BVAD use, a right inflow cannula was inserted into the right atrial free wall and a right outflow cannula was grafted onto the main pulmonary artery. A left inflow cannula was inserted into the interatrial groove and a left outflow cannula was grafted on the innominate artery of the ascending aorta. The connecting tubes were brought out through the thoracotomy wound and connected to the pump located in the subcutaneous pocket at the right flank. Result: Except for the 5 animals for a lilting test or during the early learning curve, all recovered smoothly from the procedures. The inflow drainage allowed the pump output 6.5 L/min at the maximum with 3-3.5 L/min in an average. Of the survivors, there noted no procedure-related mortality or morbidity. Necropsy findings demonstrated the well-positioned cannula tips in the each cardiac chamber

• The Korean Society of Law and Medicine
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• v.24 no.2
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• pp.147-196
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• 2023

Advances in brain science have made it possible to stimulate the brain to treat brain disorder or to connect directly between the neuron activity and an external devices. Non-invasive neurotechnologies already exist, but invasive neurotechnologies can provide more precise stimulation or measure brainwaves more precisely. Nowadays deep brain stimulation (DBS) is recognized as an accepted treatment for Parkinson's disease and essential tremor. In addition DBS has shown a certain positive effect in patients with Alzheimer's disease and depression. Brain-computer interfaces (BCI) are in the clinical stage but help patients in vegetative state can communicate or support rehabilitation for nerve-damaged people. The issue is that the people who need these invasive neurotechnologies are those whose capacity to consent is impaired or who are unable to communicate due to disease or nerve damage, while DBS and BCI operations are highly invasive and require informed consent of patients. Especially in areas where neurotechnology is still in clinical trials, the risks are greater and the benefits are uncertain, so more explanation should be provided to let patients make an informed decision. If the patient is under guardianship, the guardian is able to substitute for the patient's consent, if necessary with the authorization of court. If the patient is not under guardianship and the patient's capacity to consent is impaired or he is unable to express the consent, korean healthcare institution tend to rely on the patient's near relative guardian(de facto guardian) to give consent. But the concept of a de facto guardian is not provided by our civil law system. In the long run, it would be more appropriate to provide that a patient's spouse or next of kin may be authorized to give consent for the patient, if he or she is neither under guardianship nor appointed enduring power of attorney. If the patient was not properly informed of the risks involved in the neurosurgery, he or she may be entitled to compensation of intangible damages. If there is a causal relation between the malpractice and the side effects, the patient may also be able to recover damages for those side effects. In addition, both BCI and DBS involve the implantation of electrodes or microchips in the brain, which are controlled by an external devices. Since implantable medical devices are subject to product liability laws, the patient may be able to sue the manufacturer for damages if the defect caused the adverse effects. Recently, Korea's medical device regulation mandated liability insurance system for implantable medical devices to strengthen consumer protection.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.34 no.5
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• pp.619-628
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• 2010

Shape Memory Alloy (SMA) has recently received attention in developing implantable surgical equipments and it is expected to lead the future medical device market by adequately imitating surgeons' flexible and delicate hand movement. However, SMA actuators have not been used widely because of their nonlinear behavior called hysteresis, which makes their control difficult. Hence, we propose a parameter, $t_1$, which is necessary for temperature control, by analyzing the open-loop step response between current and temperature and by comparing it with the values of linear differential equations. $t_1$ is a pole of the transfer function in the invariant linear model in which the input and output are current and temperature, respectively; hence, $t_1$ is found to be related to the state variable used for temperature control. When considering the parameter under heat treatment conditions, $T_{max}$ was found to assume the lowest value, and $t_1$ was irrelevant to the heat treatment.

• Journal of Adhesion and Interface
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• v.10 no.2
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• pp.77-83
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• 2009

PDMS was selected for a coating material of implantable biosensors and the cytotoxicity of extracts released from a polymer was evaluated using ISO 10993-5, Biological evaluation of medical devices-Part 5: Tests for in vitro cytotoxicity. Organo-tin was used as a positive control and a medium without serum was used as a negative control. Materials extract were prepared by incubating specimens in RPMI medium without serum ($125{\mu}L/cm^2$) for 24 h, 1 week and 6 weeks at $38^{\circ}C$. The evaluation of cytotoxicity was performed by two different methods : 1) seeding cells with extracts at the beginning 2) incubating extracts with cell sheets already formed on the plate. Both cell morphology and MTT numerical data were shown for the confirmation of cytotoxicity and cell spreading on the surface of PDMS.

• Journal of Digital Convergence
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• v.13 no.11
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• pp.149-156
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• 2015

Due to a change of food culture, many patients suffering from various diseases such as hypertension, heart disease, stroke, cancer. However, it takes a long time in the hospital for many patients due to the administration before the patient care process. In this paper, we propose a m-Healthcare service model that patients can receive medical services without the inconvenience offers by reducing the administrative hospital treatment that can automatically recognize through the hospital installed RFID readers when the patient patients with various diseases are foreign to the hospital. In particular, the proposed model improves the operational efficiency of the existing healthcare system by shortening the treatment time for medical personnel to help patients in emergency situations can determine automatically the patient's status does not give the disease type and condition of the patient to health care personnel. Test results, service latency, efficiency, etc. patient satisfaction, and evaluate the existing health care system model results, the proposed method was improved service delay existing techniques average 16.5% efficiency was higher 27% of patients service satisfaction was improved by 22.4% on average.

• Journal of the Institute of Electronics and Information Engineers
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• v.53 no.7
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• pp.110-120
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• 2016

A power-efficient neuromodulator is needed for implantable systems. In spite of their stimulation signal's simplicity of wave shape and waiting time of MCU(micro controller unit) much longer than execution time, there is no consideration for low-power design. In this paper, we propose a novel of low-power algorithm based on the characteristics of stimulation signals. Then, we designed and implement a neuromodulation software that we call NMS(neuro modulation simulation). In order to implement low-power algorithm, first, we analyze running time of every function in existing NMS. Then, we calculate execution time and waiting time for these functions. Subsequently, we estimate the transition time between active mode (AM) and low-power mode (LPM). By using these results, we redesign the architecture of NMS in the proposed low-power algorithm: a stimulation signal divided into a number of segments by using characteristics of the signal from which AM or LPM segments are defined for determining the MCU power reduces to turn off or not. Our experimental results indicate that NMS with low-power algorithm reducing current consumption of MCU by 76.31 percent compared to NMS without low-power algorithm.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.99-107
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• 2020

Chronic severe pain results in a detrimental effect on the patient's quality of life. Such patients have to take a large number of medications, including opioids, often without satisfactory effect, sometimes leading to medication abuse and the pain worsening. Spinal cord stimulation (SCS) is one of the most effective technologies that, unlike other interventional pain treatment methods, achieves long-term results in patients suffering from chronic neuropathic pain. The first described mode of SCS was a conventional tonic stimulation, but now the novel modalities (high-frequency and burst), techniques (dorsal root ganglia stimulations), and technical development (wireless and implantable pulse generator-free systems) of SCS are becoming more popular. The improvement of SCS systems, their miniaturization, and the appearance of new mechanisms for anchoring electrodes results in a significant reduction in the rate of complications and revision surgeries, and the appearance of new waves of stimulation allows not only to avoid the phenomenon of addiction, but also to improve the long-term results of chronic SCS. The purpose of this review is to describe the current condition of SCS and up-to-date technical advances.

• Journal of Biomedical Engineering Research
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• v.30 no.2
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• pp.162-168
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• 2009

Implantable middle ear hearing devices (IMEHDs) have been widely studied as an alternative hearing aids to solve the problems of conventional hearing aids. Vibration transducer of middle ear hearing aids is a key component because vibration characteristics of transducer is directly involved performance of hearing aids. So, the study about middle ear hearing aids concentrate on the transducers. A floating mass type transducer is most efficient. In this paper, we suggest a lumped mechanical model of electromagnetic floating mass transducer implanted on human middle ear. The proposed model enables analysis of the vibration characteristics of a floating mass transducer and prediction of the variation after implant on ossicle that offers a simple and easy to analyze. The parameters was drawn based on the components and the structures of transducer. The Lumped mechanical model was converted by the electrical-mechanical equivalent model, and simulated using PSpice. So, we investigated vibration characteristics of transducer influenced it's components. And we predict vibration characteristics of stapes footplate due to implanted transducer's vibration using combining model of transducer and human ear. To prove the feasibility of the suggested model, we fabricated a differential floating mass transducer (DFMT) as one of floating mass transducers and performed experiments using the human temporal bones.

• Journal of Biomedical Engineering Research
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• v.38 no.6
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• pp.277-284
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• 2017

This paper presents an implantable pH measurement electrode for wireless gastroesophageal reflux measurement. Usually, gastroesophageal reflux is diagnosed by a catheter-type wire connection between the esophagus and the diagnostic device which brings many side effects such as restriction of daily living, pain, and discomfort in the nasal cavity and pharynx of patients. In order to solve these issues, researchers have been studied a wireless measurement method and a micro-sized pH electrode for human body insertion is necessary. Commercial glass packaged pH meter is formed by a sensing and a reference electrodes in a KCl solution. However, if the glass meter is inserted into the human body, there are risks of leakage of the solution, breakage of the glass package, injury of the body elements. Therefore, the solution should be solidified on the micro-sized noble metal wire which has a characteristic of biocompatible. After solidified wire fabrication, the designed meter was tested for feasibility of measurement and the result was well agreed with pH values of commercial pH meter. Potentials in pH 1 to 12 solution was measured to obtain the sensitivity of the sensor with linearity. And we have designed a simulation of gastroesophageal reflux with symptom frequency, interval, and duration time in pH 2 solution. The proposed sensor has capable to get the same potential for 24 measurements in 3 days, and it has sensed same pH values of 2 for one hour with every 10 minutes. Furthermore, the sensor was survived for 48 hours with reasonable potentials in the acid solution.