• Title/Summary/Keyword: bypass flow

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Noninvasive Evaluation of Coronary Artery Bypass Graft Patency by Electron Beam Tomography (전자선 단층 촬영을 이용한 관상동맥 우회로 개존의 비침습적 평가)

  • 최규옥;김호석;조범구
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.693-701
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    • 1999
  • Recently non-invasive diagnostic imaging replaced the invasive catheter angiography in the diagnosis of vascular disease. Catheter methods are now almost confined to the purpose of intervention. Coronary artery or coronary artery bypass graft still needs catheter technique because of small diameter and the cardiac motion. The last challenge for radiologists in this domain is to obtain a non-invasive imaging. Electron beam tomography(EBT) for high temporal resolution is able to obtain a coronary arteriogram or coronary artery bypass graft (CABG), of which CABG imaging is quite useful for the evaluation of patency. In our experience as well as others, the accuracy of EBT angiogram in evaluating CABG patency revealed that the accuracy of patency of saphenous vein grafts(SVG) is high due to relatively wide lumen, short and straight course and less influence from cardiac motion. The sensitivity and specificity of patency of SVGs were 92%, 97% respectively in the prospective evaluat on and 100% each in the retrospective evaluation. A false positive and a false negative case are rudimentary errors in the initial learing period. In contrast the analysis of left internal mammary artery(LIMA) graft was difficult due to the inherent small size and the adjacent surgical clips provoking beam-hardening artifact; therefore, the method of combining 3 dimensional reconstruction and flow mode study was important in improving the accuracy of LIMA patency. The sensitivity and specificity of LIMA patency were 100% and 80% in both prospective and retrospective evaluation. Therefore, EBT angiography is an accurate non-invasive diagnostic modality for evaluating the patency of CABG, particularly in SVGs. The accuracy can be improved with the improvement of the EBT and the development of the image reconstruction software.

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Dynamic Service Chaining Method Considering Performance of Middlebox Over SDN (소프트웨어 정의 네트워크상의 미들박스 성능을 고려한 동적 서비스 체이닝 방안)

  • Oh, Hyeongseok;Kim, Namgi;Choi, Yoon-Ho
    • Journal of Internet Computing and Services
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    • v.16 no.6
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    • pp.47-55
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    • 2015
  • The conventional dynamic routing methods in Software Defined Networks (SDN) set the optimal routing path based on the minimum link cost, and thereby transmits the incoming or outgoing flows to the terminal. However, in this case, flows can bypass the middlebox that is responsible for security service and thus, thus the network can face a threat. That is, while determining the best route for each flow, it is necessary to consider a dynamic service chaining, which routes a flow via a security middlebox. Therefore, int this paper, we propose a new dynamic routing method that considers the dynamic flow routing method combined with the security service functions over the SDN.

Ideal Internal Carotid Artery Trapping Technique without Bypass in a Patient with Insufficient Collateral Flow

  • Chung, Joon-Ho;Shin, Yong-Sam;Lim, Yong-Cheol;Park, Min-Jung
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.260-263
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    • 2009
  • Internal carotid artery (ICA) trapping can be used for treating intracranial giant aneurysm, blood blister-like aneurysms and ICA rupture during the surgery. We present a novel ICA trapping technique which can be used with insufficient collaterals flow via anterior communicating artery (AcoA) and posterior communicating artery (PcoA). A patient was admitted with severe headache and the cerebral angiography demonstrated a typical blood blister-like aneurysm at the contralateral side of PcoA. For trapping the aneurysm, the first clip was placed at the ICA just proximal to the aneurysm whereas the distal clip was placed obliquely proximal to the origin of the PcoA to preserve blood flow from the PcoA to the distal ICA. The patient was completely recovered with good collaterals filling to the right ICA territories via AcoA and PcoA. This technique may be an effective treatment option for trapping the aneurysm, especially when the PcoA preservation is mandatory.

Clinical Application of OXYREX Hollow Fiber Membrane Oxygenator (국산 막형 산화기 (OXYREX)의 체외순환 임상 성적 - 개심수술 40례 적용 -)

  • 김형묵
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1049-1056
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    • 1990
  • The OXYREX hollow fiber membrane oxygenator developed by joint work of KIST and Green Cross Medical company has been evaluated by experimental investigation and clinical application, In this oxygenator gas exchanges occur through small pores of 0.1pm size which are distributed on 70% of surface of polypropylene hollow fiber. The Oxyrex membrane oxygenator consists of 36 thousand hollow fibers and it has 3.3m2 of gas exchange surface. The Oxyrex membrane oxygenator has unique blood flow path: blood enters the oxygenator passes between the hollow fibers and exits through outlet ports, that provides low transmembrane pressure drop. In the animal experiment and in vitro investigations of Oxyrex oxygenator, it showed low transmembrane pressure difference, effective heat exchanger performance, stable gas transfer function and less blood trauma. The Oxyrex oxygenator been used from March, 1990, to October, 1990, in 40 patients undergoing open heart operations. In the clinical applications of Oxyrex, adequate oxygenation[PaO2, 283$\pm$70mmHg] and carbon dioxide removal[PaCO2, 27\ulcorner6mmHg]were maintained under the condition of FiO2: below 0.6, Hct; 25%, perfusion flow; 2.4 L/min, gas flow: 2.1 L/min. During maximum 365 minutes of cardiopulmonary bypass[CPB] time period, the Oxyrex oxygenator maintained stable condition of PaO2, PaCO2 respectively and it also kept low plasma hemoglobin level. The complement proteins C3 and CH50 were not significantly changed pre to post CPB. There were no complications related to the oxygenator during and after the CPB.

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A Study for Flow-rate Balancing when the System Resistance Changes in the Control of the Radiant Floor Heating System (온돌난방제어 시 시스템저항 변화에 따른 유량 밸런싱에 관한 연구)

  • Choi, Jeong-Min;Lee, Kyu-Nam;Ryu, Seong-Ryong;Kim, Kwang-Woo;Yeo, Myoung-Souk
    • Proceedings of the SAREK Conference
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    • 2005.11a
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    • pp.129-134
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    • 2005
  • The behavior of whole system is affected by a minor change of system in the hydronic radiant floor heating system. Under partial load condition, the change of system resistance causes overflow of supply water. This unexpected effect is the cause of several problems in the heating system. In this study, we find some factors were validated with several computer simulations. After validation of this result, several conceptual solutions are evaluated to prevent overflow.

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A study on Stage-Based Flow Graph Model for Expressing Cyber Attack Train Scenarios (사이버 공격 훈련 시나리오 표현을 위한 Stage 기반 플로우 그래프 모델 연구)

  • Kim, Moon-Sun;Lee, Man-Hee
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.31 no.5
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    • pp.1021-1030
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    • 2021
  • This paper proposes S-CAFG(Stage-based Cyber Attack Flow Graph), a model for effectively describing training scenarios that simulate modern complex cyber attacks. On top of existing graph and tree models, we add a stage node to model more complex scenarios. In order to evaluate the proposed model, we create a complicated scenario and compare how the previous models and S-CAFG express the scenario. As a result, we confirm that S-CAFG can effectively describe various attack scenarios such as simultaneous attacks, additional attacks, and bypass path selection.

Energy Efficient Control of Onboard Hydraulic Power Unit for Hydraulic Bipedal Robots (유압 구동식 이족 로봇의 구동을 위한 탑재식 유압 파워 유닛의 에너지 효율적 제어)

  • Cho, Buyoun;Kim, Sung-Woo;Shin, Seunghoon;Kim, Min-Su;Oh, Jun-Ho;Park, Hae-Won
    • The Journal of Korea Robotics Society
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    • v.16 no.2
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    • pp.86-93
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    • 2021
  • This paper proposes a controller to regulate the supply pressure of the hydraulic power unit (HPU) for driving a bipedal robot. We establish flow rate models for charging accumulator, actuating joints and leaking from actuators and spool valves. This determines the pump driving motor speed to satisfy the demanded flow rate for operating the bipedal robot without the energy loss caused by the bypass through a pressure regulating valve. We apply proposed controller to an onboard HPU mounted on top of bipedal robot platform with twelve degrees of freedom. We implement air-walking motion and squat motion which require variable flow rate to the bipedal robot. Through this experiment, the energy efficiency of proposed controller was verified by comparing the electric energy consumed when the controller was applied and when the pump operated at constant speed. We also shows the capability of the HPU's control performance to regulate supply pressure.

Restoring blood flow to the lateral plantar artery after elevation of an instep flap or medialis pedis flap

  • Velazquez-Mujica, Jonathan;Amendola, Francesco;Spadoni, Davide;Chen, Hung-Chi
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.80-85
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    • 2022
  • The instep flap and medialis pedis flap are both originate based on the medial plantar artery. The medialis pedis flap is based from the deep branch and the instep flap is based from the superficial branch. To increase the axial rotation, it is acceptable to ligate the lateral plantar artery. However, this can partially affect the blood supply of the plantar metatarsal arch. We restored the blood flow with a vein graft between the posterior tibial artery and the ligated stump. From 2012 to 2020, 12 cases of heel reconstruction, including seven instep flaps and five medialis pedis flaps, were performed with ligation of the lateral plantar artery. The stump of the lateral plantar artery was restored with a vein graft and between the posterior tibial artery and the ligated stump. Patients were followed for 18 months. Long-term results showed the vascular restoration of the lateral plantar artery remained patent demonstrated by doppler ultrasonography. Restoring blood flow to the lateral plantar artery maintains good blood supply to the toes. If the patient in the future develops a chronic degenerative disease, with microvascular complications, bypass surgery can still be performed because of the patency of both branches.

The Comparative Study of on Pump CABG during Pulsatile $(T-PLS^{TM})$ and Nonpulsatile $(Bio-pump^{TM})$ Perfusion (관상동맥우회술 시 사용된 박동성펌프$(T-PLS^{TM})$와 비박동성펌프$(Bio-pump^{TM})$의 비교연구)

  • Park Young-Woo;Her Keun;Lim Jae-Ung;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.354-358
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    • 2006
  • Background: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of $T-PLS^{TM}$ through the comparison of clinical effects of $T-PLS^{TM}$ (pulsatile pump) and $Bio-pump^{TM}$ (non-pulsatile pump) used for coronary bypass surgery. Material and Method: The comparison was made on 40 patients who had coronary bypass using $T-PLS^{TM}\;and\;Bio-pump^{TM}$ (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. Result: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with $T-PLS^{TM}\;(46{\pm}15\;mmHg\;in\;T-PLS^{TM}\;vs\;35{\pm}13\;mmHg\;in\;Bio-pump^{TM},\;p<0.05)$. The $T-PLS^{TM}$-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant $(9.7{\pm}3.9\;cc/min\;in\;T-PLS^{TM}\;vs\;8.9{\pm}3.6\;cc/min\;in\;Bio-pump^{TM},\;p=0.20)$. There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with $T-PLS^{TM}\;(24.5{\pm}21.7\;mg/dL\;in\;T-PLS^{TM}\;versus\;46.8{\pm}23.0mg/dL\;in\;Bio-pump^{TM},\;p<0.05)$. There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with $T-PLS^{TM}$, but the death rate was not statistically significant. Conclusion: Coronary bypass was operated with $T-PLS^{TM}$ (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which $Bio-pump^{TM}$ was used. In addition, $T-PLS^{TM}$ used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of $T-PLS^{TM}$.

Early Results of Coronary Artery Bypass Graft with Purely Bilateral Internal Thoracic Arteries Using Y-anastomosis in Multiple Coronary Artery Disease Patients: Coronary Angiographic Analysis (다중혈관 관상동맥 환자에서 Y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적: 관상동맥 조영술 분석)

  • 성기익;이영탁;박계현;전태국;박표원;한일용;장윤희
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.142-149
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    • 2003
  • To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. Material and Method: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively The mean age of these patients was $61.2{\pm}8.5$ (range: 30 ~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. Result: The mean number of distal anastomoses was $3.1{\pm}0.9$ (range: 2~6), the mean duration of hospital stay was $8.4{\pm}4.5$ days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean $4.1{\pm}0.8$/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. Conclusion: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.