• Journal of Chest Surgery
• /
• v.57 no.3
• /
• pp.312-314
• /
• 2024

A 3-year-old boy with Glenn physiology exhibited refractory heart failure with reduced ejection fraction. To improve the patient's oxygen saturation, he underwent ventricular assist device (VAD) implantation with concomitant Fontan completion. The extracardiac conduit Fontan operation was performed with a 4-mm fenestration. For VAD implantation, Berlin Heart cannulas were positioned at the left ventricular apex and the neo-aorta. Following weaning from cardiopulmonary bypass, a temporary continuous-flow VAD, equipped with an oxygenator, was utilized for support. After a stabilization period of 1 week, the continuous-flow VAD was replaced with a durable pulsatile-flow device. Following 3 months of support, the patient underwent transplantation without complications. The completion of the Fontan procedure at the time of VAD implantation, along with the use of a temporary continuous-flow device with an oxygenator, may aid in stabilizing postoperative hemodynamics. This approach could contribute to a safe transition to a durable pulsatile VAD in patients with Glenn physiology.

• Journal of Chest Surgery
• /
• v.53 no.6
• /
• pp.368-374
• /
• 2020

Background: The extracorporeal ventricular assist device (e-VAD) system is designed for left ventricular support using a permanent life support console. This study aimed to determine the impact of temporary e-VAD implantation bridging on posttransplant outcomes. Methods: We reviewed the clinical records of 6 patients with the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1, awaiting heart transplantation, who were provided with temporary e-VAD from 2018 to 2019. The circuit comprised a single centrifugal pump without an oxygenator. The e-VAD inflow cannula was inserted into the apex of the left ventricle, and the outflow cannula was positioned in the ascending aorta. The median follow-up duration was 8.4±6.9 months. Results: After e-VAD implantation, lactate dehydrogenase levels significantly decreased, and Sequential Organ Failure Assessment scores significantly improved. Bedside rehabilitation was possible in 5 patients. After a mean e-VAD support duration of 14.5±17.3 days, all patients were successfully bridged to transplantation. After transplantation, 5 patients survived for at least 6 months. Conclusion: e-VAD may reverse end-organ dysfunction and improve outcomes in INTERMACS I heart transplant patients.

• Proceedings of the KSME Conference
• /
• 2008.11a
• /
• pp.1419-1426
• /
• 2008

Fulminant hepatic failure is a clinical syndrome associated with a high mortality rate. Orthotopic liver transplantation is the only clinically proven effective treatment for patients with end-stage liver disease who do not respond to medical management. A major limitation of this treatment modality is the scarcity of donor organs available, resulting in patients dying while waiting for a donor liver. An extracorporeal bioartificial liver (BAL) device containing viable hepatocytes has the potential to provide temporary hepatic support to liver failure patients, serving as a bridge to transplantation while awaiting a suitable donor. In some patients, providing temporary hepatic support may be sufficient to allow adequate regeneration of the host liver, thereby eliminating the need for a liver transplant. Although the BAL device is a promising technology for the treatment of liver failure, there are several technical challenges that must be overcome in order to develop systems with sufficient processing capacity and of manageable size. In this overview, the authors describe the critical issues involved in developing a BAL device. They also discuss their experiences in hepatocyte culture optimization within the context of a microchannel flat-plate BAL device.

• Korean Journal of Environmental Biology
• /
• v.41 no.1
• /
• pp.18-30
• /
• 2023

Forest destruction is an inevitable result of the development processes. According to the environmental impact assessment, over 10% of the destroyed trees need to be recycled and transplanted to minimize the impact of forest destruction. However, the rate of successful transplantation is low, leading to a high rate of tree death. This is attributable to a lack of consideration for environmental factors when choosing a temporary site for transplantation and inadequate management. To monitor transplanted trees, a field survey is essential; however, the spatio-temporal aspect is limited. This study evaluated the applicability of remote sensing for the effective monitoring of transplanted trees. Vegetation indices based on satellite remote sensing were derived to detect time-series changes in the status of the transplanted trees at three temporary transplantation sites. The mortality rate and vitality of transplanted trees before and after the transplant have a similar tendency to the changes in the vegetation indicators. The findings of this study showed that vegetation indices increased after transplantation of trees and decreased as the death rate increased and vitality decreased over time. This study presents a method for assessing newly transplanted trees using satellite images. The approach of utilizing satellite photos and the vegetation index is expected to detect changes in trees that have been transplanted across the country and help to manage tree transplantation for the environmental impact assessment.

• Journal of Chest Surgery
• /
• v.51 no.5
• /
• pp.328-332
• /
• 2018

Background: Extracorporeal life support (ECLS) can be applied in brain-dead donors for organ perfusion before donation, thereby expanding the donor pool. The aim of this study was to examine the benefits and early clinical outcomes of ECLS for organ preservation. Methods: Between June 2012 and April 2017, 9 patients received ECLS with therapeutic intent or for organ preservation. The following data were collected: demographics, purpose and duration of ECLS, cause of death, dose of vasoactive drugs, and need for temporary dialysis before organ retrieval. The early clinical outcomes of recipients were studied, as well as survival and graft function at 1 month. Results: ECLS was initiated for extracorporeal cardiopulmonary resuscitation in 5 patients. The other patients needed ECLS due to hemodynamic deterioration during the assessment of brain death. We successfully retrieved 18 kidneys, 7 livers, and 1 heart from 9 donors. All organs were transplanted and none were discarded. Only 1 case of delayed kidney graft function was noted, and all 26 recipients were discharged without any significant complications. Conclusion: The benefits of protecting the vital organs of donors is significant, and ECLS for organ preservation can be widely used in the transplantation field.

• Journal of Chest Surgery
• /
• v.33 no.4
• /
• pp.338-341
• /
• 2000

Renal transplant recipients who received immunosuporessive agent are in high risk of development Kaposi's sarcoma. In Korea a few report of Kaposi's sarcoma has been pubilshed but any report of intrathoracic Kaposi's sarcoma provedn by open lung biopsy has not been pulbilshed until now. We report a case of intrathoracic Kaposi's sarcoma developed in a 25 year old Korean man, who had been operated renal transplantation due to end stage renal disease and received cyclosporine and prednisolone as immunosuppessive agent, without any other organ involvment and was proven by open lung biopsy. Although discontinuation of immunosuppressive agent, temporary symptomatic and radilolgic improvement were observed, he died 11 days later after open lung biopsy because of intractable resiratory failure.

• Journal of Environmental Impact Assessment
• /
• v.30 no.6
• /
• pp.361-379
• /
• 2021

About 10% of trees damaged by the development projects are to be transplanted when conducting the Environmental Impact Assessment. However, various problems have been raised during transplantation. In this study, we confirm the stakeholder's perceptions of the problems that occur during transplantation. The survey was conducted from October 9 to 25, 2020. Among the stakeholder groups, 36 respondents participated in the consulting institute group, 44 from the review institute group, and 83 from the developer·agency group (total of 163). All three groups responded that it was necessary to transplant some of the damaged trees even if the development charge increased because the damage caused by the development project was serious. The most serious problem was 'high mortality'. The response rate was high that all three groups should plant the same species with the same quantity as an alternative method in case of withering. In order to reduce the mortality rate, small-sized trees were transplanted and transplanted trees were expanded to include planted species and landscape trees. In addition, the number of transplanted trees was high in response to calculating the transplantratio to the number of native tree damaged. The percentage of respondents who said that it was necessary to allocate a separate manager was also high. The results will be used as basic data to improve problems that occur during transplantation of damaged trees.

• Journal of Environmental Impact Assessment
• /
• v.31 no.6
• /
• pp.423-437
• /
• 2022

Parts of damaged trees are being transplanted in accordance with the Environmental Impact Assessment Manual. Problems such as death or poor growth are constantly being addressed in the process of transplanting trees from the forest they originally inhabited to temporary and final transplant sites. The purpose of this study is to analyze the differences in soil properties in the surrounding forest, the temporary transplant site, and the construction site and to suggest methods for improving the soil to make it suitable for the growth of transplanted trees. For 10 development projects, 2 soil samples were sampled from the surrounding forest, temporary transplant site, and construction site. A total of 60 soil samples were analyzed for physical and chemical properties. Among the physical properties such as coefficient of permeability, available moisture, and hardness, and chemical properties such as acidity, organic matter content, total nitrogen, and available P showed significant differences among groups. The soil of the construction site is harder than the surrounding forest because of construction equipments, the coefficient of permeability is higherthan the surrounding forest because of high sand content, and the available moisture was low. It does not retain the moisture necessary for plants in the soil and drains immediately. It is necessary to implement tillage to improve the physical properties and structure of the soil. In addition, it is necessary to cover the surface with wood chips or fallen leaves after adding mature organic matter to improve the physical and chemical properties of the soil together.

• The Journal of the Korean bone and joint tumor society
• /
• v.5 no.1
• /
• pp.9-16
• /
• 1999

A new method of limb sparing by resection, extracorporeal irradiation and reimplantation has several theoretical advantages. This method preserves the mobility of a joint and avoids the problem of loosening or breakage of tumor prosthesis. This study involved using extracorporeal irradiated autogenous joint transplantation for reconstruction after en bloc resection, and observed the periods of functional union and histological changes in irradiated tissue of the knee joint. This study also aimed to clarify whether the degeneration of articular cartilage is induced in rabbits by a single 50Gy dose of irradiation at the knee joint. Twenty New Zealand rabbits about three kilograms were randomized into two groups of 10 rabbits each. In group 1, as control, we resected the knee joint followed by reimplantation without irradiation. Group 2 received extracorporeal irradiation on the resected knee joint followed by reimplantation. Following are the results of these observations. The osteotomy site showed external callus formation in the roentgenographic finding eight weeks after reimplantation. There was marked degenerative changes in the collagen fiber of the irradiated anterior cruciate ligament and meniscus during the fourth week, but new blood-vessel formation was observed in the vicinity. There was degenerative changes in the collagen fiber of articular cartilage treated extracorporeal irradiation at four and eight weeks in the scanning electron micrographic findings. These findings was in contrast to those of subchondral bone which showed decreased cellularity and empty lacuna at four and eight weeks. Autoradiography demonstrated active [$^3H$]uridine incorporation by irradiated chondrocyte at eight weeks after reimplantation. These results indicate that when destruction of the articular cartilage and soft tissue of the knee joint is not severe, extracorporeal irradiation and reimplantation can be used with several advantage in maintaining movement of the joint while avoiding problems of tumor prosthesis and rejection, and therefore extracorporeal irradiated autogenous joint transplantation can be used as a limb-sparing procedure for temporary biological spacer in the childhood bone tumor around the knee.

• Journal of Chest Surgery
• /
• v.29 no.12
• /
• pp.1392-1397
• /
• 1996

Over the past two years the free jejunal transfer have been used in 7 consecutive patients to restore alimentary tract continuity artier the resection of esophagus. Six patients had squamous cell carcinomas and one had esophageal stricture . The patients underwent partial esophagectomy with modified radicAl neck dissection or mediastinal Iymph node dissection. The microvascular anastomosis was performed to the neck vessels in 4 patients and to the in ercostal vessels in 3 patients. Postoperative complications were graft necrosis in one patient, and a temporary anastomotic leakage with spontaneous closure in one patient. Reconstruction of the esophagus was successful in 6 of 7 patients. We emphasize that esophagectomy followed by transplantation of a free jejunal transfer is suitable for esophageal carcinoma or intractable esophageal stricture, and involvement of the midesophagus is not a contraindication to the use of the free Jejunal transfer.