• 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

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.489-495
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• 2005

In the surgical treatment of aortic dissection, aortic arch replacement under total circulatory arrest is often performed after careful inspection to determine the severity of disease progression. Under circulatory arrest, antegrade or retrograde cerebral perfusion is required for brain protection. Recently, antegrade cerebral perfusion has been used more, because of the limitation of retrograde cerebral perfusion. This study is to compare these two methods especially in the respect to neurological complications. Material and Method: Forty patients with aortic dissection involving aortic arch from May 2000 to May 2004 were enrolled in this study, and the methods of operation, clinical recovery, and neurological complications were retrospectively reviewed. Result: In the ACP (antegrade cerebral perfusion) group, axillary artery cannulation was performed in 10 out of 15 cases. In the RCP (retrograde cerebral perfusion) group, femoral artery Cannulation was performed in 24 out of 25 cases. The average esophageal and rectal temperature under total circulatory arrest was $17.2^{\circ}C\;and\;22.8^{\circ}C$ in the group A, and $16.0^{\circ}C\;and\;19.7^{\circ}C$ in the group B, respectively. Higher temperature in the ACP group may have brought the shorter operation and cardiopulmonary bypass time. However, the length of period for postoperative clinical recovery and admission duration did not show any statistically significant differences. Eleven out of the total 15 cases in the ACP group and thirteen out of the total 25 cases in the RCP group showed neurological complication but did not show statistically significant difference. In each group, there were 5 cases with permanent neurological complications. All 5 cases in the ACP group showed some improvements that enabled routine exercise. However all 5 cases in RCP group did not show significant improvements. Conclusion: The Antegrade, cerebral perfusion, which maintains orthordromic circulation, brings moderate degree of hypothermia and, therefore, shortens the operation time and cardiopulmonary bypass time. We concluded that Antegrade cerebral perfusion is safe and can be used widely under total circulatory arrest.

• Asian-Australasian Journal of Animal Sciences
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• v.27 no.7
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• pp.917-925
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• 2014

An accurate feed formulation is essential for optimizing feed efficiency and minimizing feed cost for swine and poultry production. Because energy and amino acid (AA) account for the major cost of swine and poultry diets, a precise determination of the availability of energy and AA in feedstuffs is essential for accurate diet formulations. Therefore, the methodology for determining the availability of energy and AA should be carefully selected. The total collection and index methods are 2 major procedures for estimating the availability of energy and AA in feedstuffs for swine and poultry diets. The total collection method is based on the laborious production of quantitative records of feed intake and output, whereas the index method can avoid the laborious work, but greatly relies on accurate chemical analysis of index compound. The direct method, in which the test feedstuff in a diet is the sole source of the component of interest, is widely used to determine the digestibility of nutritional components in feedstuffs. In some cases, however, it may be necessary to formulate a basal diet and a test diet in which a portion of the basal diet is replaced by the feed ingredient to be tested because of poor palatability and low level of the interested component in the test ingredients. For the digestibility of AA, due to the confounding effect on AA composition of protein in feces by microorganisms in the hind gut, ileal digestibility rather than fecal digestibility has been preferred as the reliable method for estimating AA digestibility. Depending on the contribution of ileal endogenous AA losses in the ileal digestibility calculation, ileal digestibility estimates can be expressed as apparent, standardized, and true ileal digestibility, and are usually determined using the ileal cannulation method for pigs and the slaughter method for poultry. Among these digestibility estimates, the standardized ileal AA digestibility that corrects apparent ileal digestibility for basal endogenous AA losses, provides appropriate information for the formulation of swine and poultry diets. The total quantity of energy in feedstuffs can be partitioned into different components including gross energy (GE), digestible energy (DE), metabolizable energy (ME), and net energy based on the consideration of sequential energy losses during digestion and metabolism from GE in feeds. For swine, the total collection method is suggested for determining DE and ME in feedstuffs whereas for poultry the classical ME assay and the precision-fed method are applicable. Further investigation for the utilization of ME may be conducted by measuring either heat production or energy retention using indirect calorimetry or comparative slaughter method, respectively. This review provides information on the methodology used to determine accurate estimates of AA and energy availability for formulating swine and poultry diets.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.41-45
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• 2009

Background: Arteriovenous fistula formation is not always easy to perform in hemodialysis patients because of poor preservation of veins due to repeated venipuncture and cannulation. We analyzed the patency rate and complications of prosthetic arteriovenous fistulas using the vena comitantes as a venous outflow in the antecubital fossa, which are protected from venipuncture. Material and Method: Between January 2006 and June 2008, 12 patients underwent prosthetic arteriovenous fistula formation using the vena comitantes as a venous outflow. Arterial inflow was via the brachial artery and the graft was placed in a loop fashion. The male-to-female ratio was 7 : 5 and the mean age was $59{\pm}14$ years. Six patients had diabetes mellitus and 10 patients had hypertension. Result: There were no complications, such as a graft infection or bleeding. Five patients showed postoperative stenosis at an average of 3 months. The primary patency rate was 75.0, 65.6, and 52.2% at 3, 6, and 12 months, respectively. All the patients with stenosis were able to continue hemodialysis after intervention therapy. The secondary patency rate was 100% at 12 months. Conclusion: Creation of a prosthetic arteriovenous fistula using uninjured vena comitantes resulted in a good patency rate and this vein may become a substitute for inappropriate superficial veins.

• Asian-Australasian Journal of Animal Sciences
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• v.7 no.4
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• pp.537-546
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• 1994

This experiment was carried out to compare the effects of six different plant protein sources such as soybean meal, extruded full-fat soybean, canola meal, rapeseed meal, cottonseed meal and perilla meal as a sole protein source of diets on growth performance and amino acid bioavailabilities in growing-finishing pigs. A total of 54 pigs with average 25 kg of body weight were used as experimental subjects for a 65-d feeding trial. Digestion trial was carried out with seven ileal-cannulated pigs. The most rapid rate of weight gain was observed in pigs fed soybean meal and full-fat soybean, the moderate one in pigs fed canola meal and cottonseed meal and the least one in pigs fed rapeseed meal and perilla meal (p<0.005). Feed efficiency was better for groups fed soybean meal and full-fat soybean than other protein meals (p<0.05). The apparent ileal digestibilities of essential amino acids of soybean meal and full-fat soybean (82.5% and 81.6%) were significantly (p<0.05) higher than those of other protein sources (61.2 to 69.4%). Regardless of protein sources, the apparent ileal digestibility of arginine was highest, whereas that of histidine was lowest among essential amino acids. Proline had the lowest digestibility among non-essential amino acids. True amino acid digestibilities tended to be higher than apparent amino acid digestibilities. The differences between true and apparent ileal digestibilities were greater in canola meal, rapeseed meal or cottonseed meal than other protein sources. The differences was greatest in praline except for cottonseed meal. The fecal digestibility appeared to be higher than the ileal digestibility. The differences between fecal and ileal digestibilities were greater in canola meal, rapeseed meal, cottonseed meal and perilla meal than in soybean meal and full-fat soybean. In general, praline was the most disappeared amino acid in the hind gut, while the net synthesis of lysine in the large intestine was observed in all protein sources except perilla meal. It is appropriate that swine feeds should be formulated based on true ileal amino acid digestibility of protein sources for pig's normal growth.

• Asian-Australasian Journal of Animal Sciences
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• v.18 no.3
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• pp.396-402
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• 2005

Three experiments were conducted to determine the effects of dietary arginine concentrations on plasma free amino acid (PAA) concentrations in rainbow trout, Oncorhynchus mykiss (Walbaum). The first experiment was conducted to determine appropriate post-prandial and food deprivation sampling times in dorsal aorta cannulated rainbow trout averaging 519${\pm}$9.5 g (mean${\pm}$SD) at $16^{\circ}C$. Blood samples were taken at 0, 2, 3, 4, 5, 6 and 24 h after feeding (0 and 24 h blood samples were taken from the same group of fish). PAA concentrations increased by 2 h post-feeding and the concentration of all essential amino acids except histidine peaked at 5 h and returned to 0 time values by 24 h. In the second experiment dorsal aorta cannulated rainbow trout averaging 528${\pm}$11.3 g (mean${\pm}$SD) were divided into 6 groups of 4 fish to study the effect of dietary arginine levels on PAA. After 24 h food deprivation, each group of fish was fed one of six L-amino acid diets containing graded levels of arginine (0.48, 1.08, 1.38, 1.68, 1.98 or 2.58%) by intubation. Blood samples were taken at 0, 5 and 24 h after feeding. Post-prandial (5 h after feeding) plasma-free arginine concentrations (PParg) showed a breakpoint at 1.03% arginine in the diet and post-absorptive (24 h after feeding) plasma free-arginine concentrations (PAarg) showed a breakpoint at 1.38% arginine. PAarg increased linearly from fish fed diets containing arginine between 0.48% and 1.38%, and the concentrations remained constant from fish fed diets containing arginine at or above 1.38%, but were all below PParg at all time points. Results of the third experiment confirm the results that PParg concentrations from fish fed arginine deficient diets were higher than PAarg (0 or 24 h values). Thus, in contrast to mammals and birds, the PParg when arginine is present in the diet as the most limiting amino acid such that it severely limits growth, increases in plasma rather than decreases.

• The Korean Journal of Physiology
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• v.23 no.1
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• pp.13-21
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• 1989

The present study was designed to investigate i) the action of various nucleotides on membrane permeability of rat red blood cell and hepatocyte for $Na^{+}$ and $Rb^{+}$ ii) the characteristics of purinoceptors on these cell membranes. Blood from Sprague-Dawley rats was obtained by carotid arterial cannulation. Red blood cells were then washed 3 times with saline at $4{\circ}C$. Hepatic parenchymal cells were isolated from rat livers by using a modification of the Berry and Friend (1969) method. For the $Na^{+}$ influx studies, isolated RBC and hepatocyte were incubated in incubation medium containing $^{22}Na^{+}0.2\;{\mu}Ci/ml$ at $37^{\circ}C$. After various time intervals samples were removed from the incubation flask and washed out 3 times with ice-cold washing solutions. Cells were destroyed by adding Triton X-100 and TCA solution. After centrifugation, the supernatants were assayed for $^{22}Na^{+}$ by gamma counter. $^{86}Rb^{+}$ was used to simulate $K^{+}$ in these $K^{+}efflux$ studies. Isolated hepatocytes were incubated for 60 min in the loading solution containing $^{86}Rb^{+}\;10\;{\mu}Ci/ml$ at $37^{\circ}C$. After loading, the cells washed out 3 times by centrifugation with washing solution. The cells were incubated in buffer solution at $37^{\circ}C$. At intervals thereafter, samples were removed and centrifuged. The supernatants were analyzed for $^{86}Rb^{+}$ by liquid scintillation counter. The main results of the experiments were: 1) ATP and ATPP increased in both $^{22}Na^{+}$ influx and $^{86}Rb^{+}$ efflux in the red blood cell. Although ADP showed a tendency to increase in RBC membrane permeability for $^{22}Na^{+}$ and $^{86}Rb^{+}$, the changes were not significantly different from the control. 2) The Significant changes in $^{22}Na^{+}$ and $^{86}Rb^{+}$ flux by ATP were also demonstrated in hepatocyte. ATPP and ADP showed a tendency to increase in hepatocyte membrane permeability for both ions. 3) Other nucleoside triphosphates-ITP, GTP and CTP-did not change in membrane permeability for $^{22}Na^{+}$ and $^{86}Rb^{+}$ in RBC and hepatocyte. In conclusion, not only ATP but also ATPP activate purinoceptors and change in membrane permeability for $Na^{+}$ and $K^{+}$. In order to activate purinoceptors on the cell membrane, the nucleotides have to possess intact adenine moiety and three phosphates or more in its molecule.

• Journal of Chest Surgery
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• v.53 no.3
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• pp.132-139
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• 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.

• Asian-Australasian Journal of Animal Sciences
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• v.10 no.6
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• pp.643-651
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• 1997

This experiment was conducted to determine apparent ileal and fecal digestibilities of protein sources for young pigs (15.6 kg BW) which were fitted with simple ileal T-cannulas. Experimental diets included one of the followings as a sole protein source: spray-dried plasma protein (SDPP), spray-dried blood meal (SDBM), soybean meal (SBM), isolated soy protein (ISP), dried skim milk (DSM), and fish meal (FM). The digestibilities of dry matter (DM), gross energy (GE) and crude protein (CP) in DSM-based diet were the highest (p < 0.05), and those of SDBM and SBM diets were the lowest at the terminal ileum. The average ileal digestibilities of essential amino acids (AAs) were 88.3, 84.7, 84.6, 83.4, 83.0 and 77.7% for pigs fed the DSM, ISP, SDBM, SBM, SDPP and FM diets, respectively. There were no significant differences in overall apparent ileal AAs digestibilities in DSM and ISP diets. Digestibilities of essential AAs in DSM, however, were significantly higher than those of ISP (p < 0.05). Among the essential AAs, the digestibility of arginine was higher except for SDBM or DSM, than other AAs. The ileal digestibilities of lysine, methionine and threonine were higher (p < 0.05) in pigs fed SDBM or DSM diet than in those fed SBM diet. Digestibilities for SDPP or ISP diet in these AAs were similar except for threonine which was higher (p < 0.05) for SDPP diet. The apparent ileal digestibilities of lysine and methionine ranged from 79.6 (FM) to 92.5 (DSM) and 75.4 (SDPP) to 88.7 (DSM), respectively. The apparent fecal digestibilities of average essential AAs were 90.4, 89.1, 86.0, 84.4, 84.2 and 80.8% in pigs fed the DSM, ISP, SDBM, SDPP, SBM and FM diets, respectively. The fecal digestibilities of essential AAs were higher (p < 0.05) in pigs fed the DSM and ISP. Lysine digestibility in pigs fed the DSM or ISP diet was higher (p < 0.05) than that of pigs fed SBM diet. Apparent essential AAs digestibility was the highest (p < 0.05) in pigs fed DSM diet, and was the lowest (p < 0.05) in pigs fed FM diet. Digestiibilities of essential AAs and nonessential AAs were higher when measured over the total digestive tract than at the end of the small intestine except for several AAs in SDPP, SDBM and SBM diets. In conclusion, whether it is fecal or ileal, the digestibilities of proximate nutrients and AAs in pigs fed DSM and ISP diet were the highest, and those of pigs fed FM was the lowest.

• Asian-Australasian Journal of Animal Sciences
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• v.10 no.6
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• pp.635-642
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• 1997

This experiment was conducted to determine apparent ileal and fecal digestibilities of some grains for young pigs (15.6 kg BW). Ileal and fecal digestibility of corn, milo, wheat, barley, rice and tapioca were measured with pigs fitted with simple ileal T-cannula. Rice was the highest (p < 0.05) and tapioca was the lowest (p < 0.05) in the digestibilities of gross energy. For the crude protein digestibilities, rice, barley and wheat were higher (p < 0.05) than corn, milo and tapioca. The average ileal digestibilities of essential amino acids (AAs) were 89.9, 85.8, 81.5, 80.9, 80.2 and 76.3% for those fed rice, barley, milo, wheat, corn and tapioca diets, respectively. Regardless of the dietary carbohydrate sources, among the dispensable amino acids, glycine had lowest digestibility except for barley and milo. The apparent ileal digestibility of lysine and methionine were 90.7, 94.0% in rice, 88.3, 86.5% in barley and 86.3, 82.3% in wheat. The apparent fecal digestibility of average essential AAs were 90.8, 89.9, 87.7, 85.1, 82.5 and 77.9% in pigs fed the rice, barley, wheat, corn, milo and tapioca diets, respectively. The fecal digestibilities of essential AAs and nonessential AAs, in general, were higher than the ileal digestibilities, which indicating a loss of nitrogenous components in the cecum and colon. For all AAs, differences between ileal and fecal amino acid digestibilities ranged from 0.0 (valine) to 5.8 (threonine) in rice, 0.1 (arginine) to 14.5 (glycine) in barley, 2.8 (lysine) to 12.4 (glycine) in wheat, 1.0 (isoleucine) to 12.9 (glycine) in corn, 0.2 (serine, glutamic acid) to 6.5 (methionine) in milo and 0.5 (valine) to 22.1 (glycine) percentage units in tapioca diets. In conclusion, whether it is ileal or fecal, rice and barley appeared to be excellent alternative carbohydrate sources for young pigs in terms of AAs digestibility. However, energy value and cost for each grain should be considered when formulating diets.