• 멤브레인
• /
• 제15권3호
• /
• pp.233-240
• /
• 2005

유용하고 중요한 의료기기인 폐 보조 장치(LAD)의 혈액 접촉 표면과 인공 폐 막에 사용하기 위한 혈액 적합성 생체 재료를 개발하기 위해 폴리프로필렌 중공사 막의 표면 개질을 수행하였다. 재료의 혈액적합성은 항응고 처리된 혈액을 사용하였고 플라스마 응고 형성, 혈소판 접착 및 플라스마 응고 활성화, 그들의 표면 혈전 형성을 평가하여 결정하였다. 실험 결과는 실리콘 코팅 중공사들에 부착한 혈소판 수가 우수한 혈액 적합성을 나타내는 폴리프로필렌에 부착한 혈소판 수보다도 상당히 더 낮았음이 확인되었다. 또한, 상대적으로 플라스마 표면 처리한 폴리프로필렌 중공사 막이 혈액 적합성 평가에서 보체 활성화 억제를 보였음이 확인되었다.

• Journal of Chest Surgery
• /
• 제53권3호
• /
• pp.132-139
• /
• 2020

Background: The double-lumen cannula (DLC) has begun to be used worldwide for venovenous (VV) extracorporeal membrane oxygenation (ECMO). We aimed to examine whether the DLC could be an effective tool in the treatment of pediatric respiratory failure in Korea. Methods: We reviewed the records of patients weighing under 15 kg who underwent ECMO due to respiratory failure between January 2017 and December 2018. Outcomes of ECMO using a DLC and conventional ECMO using central method or 2 peripheral cannulas were compared. Results: Twelve patients were treated with ECMO for respiratory failure. Among them, a DLC was used in 5 patients, the median age of whom was 3.8 months (interquartile range, 0.1-49.7 months). In these patients, the median values of pH, partial pressure of carbon dioxide, and partial pressure of oxygen were 7.09, 74 mm Hg, and 37 mm Hg before ECMO and corrected to 7.31, 44 mm Hg, and 85 mm Hg, respectively, after ECMO cannulation. Median blood flow rate in the patients treated with ECMO using a DLC was slightly higher than that in the conventional ECMO group, but this difference was not statistically significant (86.1 mL/kg/min and 74.3 mL/kg/min, respectively; p=1.00). One patient from the DLC group and 3 patients from the conventional group were weaned off ECMO. Conclusion: VV ECMO using a DLC provided adequate oxygenation, ventilation, and blood flow rate in Korean pediatric patients with respiratory failure. Further prospective and randomized studies are warranted.

• 한국전기전자재료학회:학술대회논문집
• /
• 한국전기전자재료학회 2001년도 기술교육위원회 창립총회 및 학술대회 의료기기전시회
• /
• pp.13-18
• /
• 2001

The ECMO system, including umbilical cord and membrane type oxygenator was connected with extracorporeal circulation unit, was applied to the fetus growth model of goat. The maximum survival time of goat fetus was 48 hours. Average blood rate for the extracorporeal circulation was $223{\pm}15.2 ml/min.$ The survival time of fetus was deeply related to body temperature, blood circulation and water temperature, anesthetized time, and fetus weights. Extern variables that are composed of anesthetized time, fetus weights, change of hemoglobin, circuit pressure, related to the survival time for fetus corrected the problem of previous ECMO model that is controlled by roller pump. It is directly delivered to heart on load. Applying the results from new ECMO model, further research will provide to the system of ECMO for human.

• Journal of Chest Surgery
• /
• 제51권2호
• /
• pp.114-121
• /
• 2018

Background: Unfractionated heparin is commonly used for anticoagulation in extracorporeal membrane oxygenation (ECMO). Several studies have shown that nafamostat mesilate (NM) has comparable clinical outcomes to unfractionated heparin. This study compared anticoagulation with NM and heparin in a large-animal model. Methods: Beagle dogs (n=8; weight, 6.5-9 kg) were placed on venovenous ECMO. Blood samples were taken every hour and the following parameters were compared: hemoglobin level, activated partial thromboplastin time (aPTT), thromboelastography (TEG) data, platelet function, and inflammatory cytokine levels. Results: In both groups, the aPTT was longer than the baseline value. Although the aPTT in the NM group was shorter than in the heparin group, the TEG parameters were similar between the 2 groups. Hemoglobin levels decreased in both groups, but the decrease was less with NM than with heparin (p=0.049). Interleukin $(IL)-1{\beta}$ levels significantly decreased in the NM group (p=0.01), but there was no difference in the levels of tumor necrosis factor alpha or IL-10 between the 2 groups. Conclusion: NM showed a similar anticoagulant effect to that of unfractionated heparin, with fewer bleeding complications. NM also had anti-inflammatory properties during ECMO. Based on this preclinical study, NM may be a good alternative candidate for anticoagulation in ECMO.

• Parasites, Hosts and Diseases
• /
• 제51권5호
• /
• pp.551-555
• /
• 2013

Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.

• Journal of Trauma and Injury
• /
• 제35권3호
• /
• pp.209-214
• /
• 2022

We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.

• Journal of Chest Surgery
• /
• 제57권3호
• /
• pp.319-322
• /
• 2024

Venovenous extracorporeal membrane oxygenation (VV ECMO) is often used in cases of severe respiratory failure, especially in patients considered for lung transplantation. However, because many lung diseases can ultimately result in right heart failure, the treatment of secondary right heart failure can present a challenge when the patient is already under VV ECMO support. In such cases, an oxygenated-right ventricular assist device (OxyRVAD) can be used. OxyRVAD is designed to maintain anterograde blood flow and prevent right ventricular distension. Moreover, the pulmonary arterial cannula can be inserted percutaneously. We report a case in which percutaneous OxyRVAD was successfully implemented to manage right heart failure in a patient with respiratory failure who was on VV ECMO.

• Clinical and Experimental Pediatrics
• /
• 제57권11호
• /
• pp.489-495
• /
• 2014

Purpose: The aims of this study were to document our single-center experience with pediatric acute fulminant myocarditis (AFM) and to investigate its clinical features and short-term outcomes. Methods: We performed a retrospective chart review of all children <18 years old who were diagnosed with AFM between October 2008 and February 2013. Data about patient demographics, initial symptoms, investigation results, management, and outcomes between survivors and nonsurvivors were collected. Results: Seventeen of 21 patients (80.9%) with myocarditis were diagnosed with AFM. Eleven patients (64.7%) survived to discharge, and 6 (35.3%) died. Electrocardiography on admission revealed dysrhythmia in 10 patients (58.8%); of these, all 7 patients with a complete atrioventricular block survived. Fractional shortening upon admission was significantly different between the survivors (16%) and nonsurvivors (8.5%) (P=0.01). Of the serial biochemical markers, only the initial brain natriuretic peptide (P=0.03) and peak blood urea nitrogen levels (P=0.02) were significantly different. Of 17 patients, 4 (23.5%) required medical treatment only. Extracorporeal membrane oxygenation (ECMO) was performed in 13 patients (76.5%); the survival rate in these patients was 53.8%. ECMO support was initiated >24 hours after admission in 4 of the 13 patients (30.7%), and 3 of those 4 patients (75%) died. Conclusion: AFM outcomes may be associated with complete atrioventricular block upon hospital admission, left ventricular fractional shortening at admission, time from admission to the initiation of ECMO support, initial brain natriuretic peptide level, and peak blood urea nitrogen level.

• Investigative Magnetic Resonance Imaging
• /
• 제1권1호
• /
• pp.66-74
• /
• 1997

혈액의 산소화와 불 산소화에 따른 국부적인 자화율 효과의 변화에 의한 자장의 불 균일성에 민감한 경사 자장 에코 기법은 현재의 뇌기능 MR 영상의 기본이 되고 있다. 일반적으로 이러한 경사 자장 에코기법은 $T2^{*}$ 혹은 BOLD효과에 의한 자장의 불 균일성의 증가가 신호의 감소로 나타난다. BOLD 효과는 주자장에 대한 핏줄의 방향이나 영상 형식, 즉, 횡단면, 관상면, 또는 시상면에 따라 달라진다. 그래서 영상 형식과 영상면에 대한 기울임 각에 따른 신호의 변화와 BOLD 효과의 변화에 대한 정량적인 연구를 하였다. 연구는 자화율 효과에 대해 다른 민감도를 가지는 TRFGE 와 CGE 기법으로 이루어졌다. 컴퓨터 모의 실험과 실험 결과를 본 논문에 나타내었다.

• 성인간호학회지
• /
• 제16권3호
• /
• pp.460-469
• /
• 2004

Purpose: The purpose was to investigate the physiological parameter and physical health status and health perception in the elderly, and to find the correlation between these variables. The subjects were 139 in Kyungi senior center. Method: The instruments for this study were physiological parameters, which were composed of vital capacity, blood pressure, pulse oxygenation, hand grip power, body fat and physical health status scale developed by researcher, and health perception scale developed by Ware(1976). The data were analyzed by the SPSS-PC 11.0 version. Results: 1) 7.9% of subjects were included in abnormal range of vital capacity, 40.3% were systolic hypertension and 11.5% were diastolic hypertension. And 92.1% were included in normal range of pulse oxygenation, 79.8% were weakened hand grip power, and 10.1% of subjects were included in normal range of body fat. 2) The total mean score of the physical health status was 26.34 of a possible maximum score of 45. The physical health status score of women was lower than man's. 3) The mean score of man's health perception was 24.52 and women's was 20.39 of a possible maximum score of 44. 4) There was a significant positive correlation between hand grip power and physical health status(r=.28, p=.001). And a significant correlation between physical health status and health perception was found (r=.24, p=.004). Conclusion: It is concluded that the blood pressure, hand grip power and body fat among the physiological parameters of elderly subjects in Kyungi senior center were included in abnormal range. The factors were related life style. therefore, it is suggested that the health education to change life style for the elderly is needed.