• 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

• JSTS:Journal of Semiconductor Technology and Science
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• v.14 no.5
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• pp.658-665
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• 2014

The neural stimulators have been employed to the visual prostheses system based on the functional electrical stimulation (FES). Due to the size limitation of the implantable device, the smaller area of the unit current driver pixel is highly desired for higher resolution current stimulation system. This paper presents a 16-channel compact current-mode neural stimulator IC with digital to analog converter (DAC) sharing scheme for artificial retinal prostheses. The individual pixel circuits in the stimulator IC share a single 6 bit DAC using the sample-and-hold scheme. The DAC sharing scheme enables the simultaneous stimulation on multiple active pixels with a single DAC while maintaining small size and low power. The layout size of the stimulator circuit with the DAC sharing scheme is reduced to be 51.98 %, compared to the conventional scheme. The stimulator IC is designed using standard $0.18{\mu}m$ 1P6M process. The chip size except the I/O cells is $437{\mu}m{\times}501{\mu}m$.

• Journal of the Microelectronics and Packaging Society
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• v.22 no.2
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• pp.11-19
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• 2015

Since CMOS device scaling has stalled, three-dimensional (3-D) integration allows extending Moore's law to ever high density, higher functionality, higher performance, and more diversed materials and devices to be integrated with lower cost. 3-D integration has many benefits such as increased multi-functionality, increased performance, increased data bandwidth, reduced power, small form factor, reduced packaging volume, because it vertically stacks multiple materials, technologies, and functional components such as processor, memory, sensors, logic, analog, and power ICs into one stacked chip. Anticipated applications start with memory, handheld devices, and high-performance computers and especially extend to multifunctional convengence systems such as cloud networking for internet of things, exascale computing for big data server, electrical vehicle system for future automotive, radioactivity safety system, energy harvesting system and, wireless implantable medical system by flexible heterogeneous integrations involving CMOS, MEMS, sensors and photonic circuits. However, heterogeneous integration of different functional devices has many technical challenges owing to various types of size, thickness, and substrate of different functional devices, because they were fabricated by different technologies. This paper describes new 3-D heterogeneous integration technologies of chip self-assembling stacking and 3-D heterogeneous opto-electronics integration, backside TSV fabrication developed by Tohoku University for multifunctional convergence systems. The paper introduce a high speed sensing, highly parallel processing image sensor system comprising a 3-D stacked image sensor with extremely fast signal sensing and processing speed and a 3-D stacked microprocessor with a self-test and self-repair function for autonomous driving assist fabricated by 3-D heterogeneous integration technologies.

• Polymer(Korea)
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• v.26 no.5
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• pp.691-700
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• 2002

Interstitial therapy using biodegradable polymeric device loaded with anticancer agent can deliver the drug to the tumor site at high concentration, resulting in an increase of therapeutic efficacy. 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU, carmustine) is most commonly used as chemotherapeutic agent for brain tumors. The design of implantable device is regarded as an important factor lot the efficient delivery of antitumor agent to targeting site. In order to control the release profile of drug, the release pattern of BCNU with the changes of various dimension and additives was investigated. The PLGA wafers containing 3.85, 10, 20 and 30% of BCNU were prepared in various shape (diameter of 3, 5 and 10 mm, thickness of 0.5, 1 and 2 mm) by direct compression method. In vitro drug release profile of BCNU-loaded PLGA wafers could be controlled by changing the dimension of wafers such as initial drug content, weight, diameter, thickness, volume and surface area of wafers, as well as PLGA molecular weight and additives. Drug release from BCNU-loaded PLGA wafers was facilitated with an increase of BCNU-loading amount or presence of poly(N-vinylpyrrolidone)(PVP) or sodium chloride (NaCl). The effects of various geometric factors and additives on the BCNU release pattern were confirmed by the investigation of mass loss and morphology of BCNU-loaded PLGA wafers.

• 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 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 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.

• Journal of Chest Surgery
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• v.54 no.2
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• pp.99-105
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• 2021

Background: The number of heart transplantations (HTx) is increasing annually. Due to advances in medical and surgical support, the outcomes of HTx are also improving. Extracorporeal circulatory life support (ECLS) provides patients with decompensated heart failure a chance to undergo HTx. A medical approach involving collaboration among experienced experts in different fields should improve the outcomes and prognosis of ECLS-bridged HTx. Methods: From December 2003 to December 2018, 1,465 patients received ECLS at Samsung Medical Center. We excluded patients who had not undergone HTx or underwent repeated transplantations. Patients younger than 18 years were excluded. We also excluded patients who received an implantable durable left ventricular assist device before HTx. In total, 91 patients were included in this study. A multidisciplinary team approach began in March 2013 at our hospital. We divided the patients into 2 groups depending on whether they were treated before or after implementation of the team approach. Results: The 30-day mortality rate was significantly higher in the pre-ECLS team group than in the post-ECLS team group (n=5, 18.5% vs. n=2, 3.1%; p=0.023). The 1-year survival rate was better in the post-ECLS team group than in the pre-ECLS team group (n=57, 89.1% vs. n=19, 70.4%; p=0.023). Conclusion: We found that implementing a multidisciplinary team approach improved the outcomes of ECLS-bridged HTx. Team-based care should be adapted at HTx centers that perform high-risk HTx.