• Journal of Chest Surgery
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• v.45 no.2
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• pp.91-94
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• 2012

Background: Despite improved managements for acute respiratory distress syndrome (ARDS), its mortality remains high. Extracorporeal membrane oxygenation (ECMO) has emerged as the final option for the treatment of ARDS unresponsive to conventional measures. This study describes our experiences of venovenous ECMO support for the treatment of ARDS. Materials and Methods: Between 2007 and 2010, 56 patients (aged $56.6{\pm}13.4$ years, 43 males) received venovenous ECMO for the treatment of ARDS. The detailed clinical records were retrospectively reviewed. Results: Before the institution of ECMO support, 35 patients (55.4%) required nitric oxide inhalation, 35 patients (55.4%) received continuous renal replacement therapy, and 20 patients (35.7%) were in shock status. The median duration of ECMO support was 164 hours (range, 5 to 1,413 hours). 27 (48%) patients could be successfully weaned from ECMO. Of them, 7 (13%) survived to discharge. On logistic regression analysis, a requirement for higher inspiratory pressure before ECMO support was the only significant factor that could predict ECMO weaning failure. Conclusion: The outcome of venovenous ECMO support for the treatment of ARDS was suboptimal. Further improvements in outcomes should be made through the accumulation of experience and establishment of a standardized protocol for the management of ECMO.

• Journal of the Korean Chemical Society
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• v.38 no.2
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• pp.122-128
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• 1994

Macrocyclic ligand has been known to selectively bind with metal ions so that ability applied for the transport of metal ions across the emulsion liquid membrane in this study. The metal ions are transproted from the source phase to the receiving phase by the carrier of the organic phase. Several factors involved in the transport of metal ions acrose the emulsion membrane we reported here and these factors provided the informations for the selective seperation of some metal ion. Stability constants for cation-macrocyclic ligand and metal ion-anion receiving phase interaction are examined as parameters for the prediction of metal ion transport selectivities. $Pb^{2+}$ was transported higher rates than the other metal ions in the mixture solution. The interaction of metal ion to anion in receiving phase is important. $S_2O_3^{2-}$- in replacement of $NO_3^-$ in the receiving phase enhances the transport of $Pb^{2-}$since $Pb^{2-}-S_2O_3^{2-}$interaction is greater than $Pb^{2+}-NO_3^-$ interaction.

• Journal of the Korean Electrochemical Society
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• v.14 no.1
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• pp.9-15
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• 2011

The composite membranes comprising of sulfonated polymers as matrix and ionic liquids as ion-conducting medium in replacement of water are studied to investigate the effect of annealing of the sulfonated polymers. The polymeric membranes are prepared on recast Nafion containing the ionic liquid, 1-ethyl-3-methylimidazolium tetrafluoroborate ($EMIBF_4$). The composite membranes are characterized by thermogravitational analyses, ion conductivity and small-angle X-ray scattering. The composite membranes annealed at $190^{\circ}C$ for 2 h after the fixed drying step showed better ionic conductivity, but no significant increase in thermal stability. The mean Bragg distance between the ionic clusters, which is reflected in the position of the ionomer peak (small-angle scattering maximum), is larger in the annealed composite membranes containing $EMIBF_4$ than the non-annealed ones. It might have been explained to be due to the different level of ion-clustering ability of the hydrophilic parts (i.e., sulfonic acid groups) in the non- and annealed polymer matrix. In addition, the ionic conductivity of the membranes shows higher for the annealed composite membranes containing $EMIBF_4$. It can be concluded that the annealing of the composite membranes containing ionic liquids due to an increase in ion-clustering ability is able to bring about the enhancement of ionic conductivity suitable for potential use in proton exchange membrane fuel cells (PEMFCs) at medium temperatures ($150-200^{\circ}C$) in the absence of external humidification.

• Journal of Chest Surgery
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• v.55 no.2
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• pp.158-167
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• 2022

Background: This study investigated mortality and morbidity in patients requiring postcardiotomy extracorporeal membrane oxygenation (ECMO) support after operations for congenital heart disease (CHD). Methods: CHD patients requiring postoperative ECMO support between May 2011 and May 2021 were retrospectively reviewed. Patients were divided into non-survivors and survivors to hospital discharge. Survival outcomes and associations of various factors with in-hospital death were analyzed. Results: Fifty patients required postoperative ECMO support. Patients' median age and weight at the time of ECMO insertion were 1.85 months (interquartile range [IQR], 0.23-14.5 months) and 3.84 kg (IQR, 3.08-7.88 kg), respectively. Twenty-nine patients (58%) were male. The median duration of ECMO support was 6 days (IQR, 3-12 days). Twenty-nine patients (58%) died on ECMO support or after ECMO weaning, and 21 (42%) survived to hospital discharge. Postoperative complications included renal failure (n=33, 66%), bleeding (n=11, 22%), and sepsis (n=15, 30%). Prolonged ECMO support (p=0.017), renal failure (p=0.005), continuous renal replacement therapy (CRRT) application (p=0.001), sepsis (p=0.012), bleeding (p=0.032), and high serum lactate (p=0.002) and total bilirubin (p=0.017) levels during ECMO support were associated with higher mortality risk in a univariate analysis. A multivariable analysis identified CRRT application (p=0.013) and a high serum total bilirubin level (p=0.001) as independent risk factors for death. Conclusion: Postcardiotomy ECMO should be considered as an important therapeutic modality for patients unresponsive to conventional management. ECMO implementation strategies and management in appropriate patients without severe complications, particularly renal failure and/or liver failure, are crucial for achieving positive outcomes.

• Journal of Chest Surgery
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• v.57 no.1
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• pp.36-43
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• 2024

Background: Coronavirus disease 2019 (COVID-19) can lead to acute respiratory failure, which frequently necessitates invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, the limited availability of ECMO resources poses challenges to patient selection and associated decision-making. Consequently, this retrospective single-center study was undertaken to evaluate the characteristics and clinical outcomes of patients with COVID-19 receiving ECMO. Methods: Between March 2020 and July 2022, 65 patients with COVID-19 were treated with ECMO and were subsequently reviewed. Patient demographics, laboratory data, and clinical outcomes were examined, and statistical analyses were performed to identify risk factors associated with mortality. Results: Of the patients studied, 15 (23.1%) survived and were discharged from the hospital, while 50 (76.9%) died during their hospitalization. The survival group had a significantly lower median age, at 52 years (interquartile range [IQR], 47.5-61.5 years), compared to 64 years (IQR, 60.0-68.0 years) among mortality group (p=0.016). However, no significant differences were observed in other underlying conditions or in factors related to intervention timing. Multivariable analysis revealed that the requirement of a change in ECMO mode (odds ratio [OR], 366.77; 95% confidence interval [CI], 1.92-69911.92; p=0.0275) and the initiation of continuous renal replacement therapy (CRRT) (OR, 139.15; 95% CI, 1.95-9,910.14; p=0.0233) were independent predictors of mortality. Conclusion: Changes in ECMO mode and the initiation of CRRT during management were associated with mortality in patients with COVID-19 who were supported by ECMO. Patients exhibiting these factors require careful monitoring due to the potential for adverse outcomes.

• Proceedings of the Korean Society of Toxicology Conference
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• 2001.05a
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• pp.117-117
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• 2001

The aim of this study was to assess a possible alternative method as replacement for in vivo phototoxicity test. The 3T3 mouse fibroblast neutral red uptake phototoxicity assay (3T3 NRU PT assay) is a screening method for studying DNA or cellular damage. Photohemolysis assay is a mechanistic study for investigating oxygen-dependent membrane damage.(omitted)

• Computers and Concrete
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• v.8 no.5
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• pp.541-561
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• 2011

The Finite Element Method (FEM) was employed to demonstrate that accurate simulations of seismically repaired and retrofitted reinforced concrete shear walls can be achieved provided a good analysis program with comprehensive models for material and structural behaviour is used. Furthermore, the analysis tool should have the capability to retain residual damage experienced by the original structure and carry it forward in the repaired and retrofitted structure. The focus herein is to provide quick, simple, but reliable modelling procedures for repair and retrofitting strategies such as concrete replacement, addition of diagonal reinforcing bars, bolting of external steel plates, and bonding of external steel plates and fibre reinforced polymer sheets, thus illustrating versatility in the modelling. Slender, squat, and slender-squat shear walls were investigated. The modelling utilized simple rectangular membrane elements for the concrete, truss bar elements for the steel and FRP retrofitting materials, and bond-link elements for the bonding interface between steel or FRP to concrete. The analyses satisfactorily simulated seismic behaviour, including lateral load capacity, displacement capacity, energy dissipation, hysteretic response, and failure mode.

• Clinical and Experimental Pediatrics
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• v.54 no.8
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• pp.317-321
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• 2011

Children who suffer from steroid-resistant nephrotic syndrome (SRNS) require aggressive treatment to achieve remission. When intravenous high-dose methylprednisolone fails, calcineurin inhibitors, such as cyclosporine and tacrolimus, are used as the first line of treatment. A significant number of patients with SRNS progress to end-stage renal disease if remission is not achieved. For these children, renal replacement therapy can also be problematic; peritoneal dialysis may be accompanied by significant protein loss through the peritoneal membrane, and kidney allograft transplantation may be complicated by recurrence of SRNS. Plasmapheresis and rituximab were initially used for treatment of recurrent SRNS after transplantation; these are now under consideration as rescue therapies for refractory SRNS. Although the prognosis of SRNS is complicated and unfavorable, intensive treatment in the early stages of the disease may achieve remission in more than half of the patients. Therefore, timely referral of pediatric SRNS patients to pediatric nephrology specialists for histological and genetic diagnosis and treatment is highly recommended.

• Applied Biological Chemistry
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• v.37 no.2
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• pp.130-141
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• 1994

A continuous two-stage membrane (1st-SCMR, MWCO 10,000; 2nd-SCMR, MWCO 5,000) reactor was developed and optimized for the production of fish skin gelatin hydrolysate with different molecular size distribution profiles using trypsin and pronase E. The optimum operating conditions in the 1st-step membrane reactor using trypsin were: temperature, $55^{\circ}C$ ; pH 9.0; enzyme concentration, 0.1 mg/ml; flux, 6.14 ml/min; reaction volume, 600 ml; and the ratio of substrate to trypsin, 100 (w/w). After operating for 1 hr under the above conditions, 79% of total amount of initial gelatin was hydrolysed. In the 2nd-step using pronase E under optimum operating conditions[temperature, $50^{\circ}C$ ; pH 8.0; enzyme concentration, 0.3 mg/ml; flux, 6.14 ml/min; reaction volume, 600 ml; and the ratio of substrate to pronase E, 33 (w/w)], the 1st-step hydrolysate was hydrolysed above 80%. Total enzyme leakages in the 1st-step and 2nd-step membrane reactors were about 11.5% at $55^{\circ}C$ for 5hrs and 9.0% at $50^{\circ}C$ for 4 hrs, respectively. However, there was no apparent correlation between enzyme leakage and substrate hydrolysis. The membrane has a significant effect on activity lose of trypsin and pronase E activity for 1 hr of the membrane reactors operation. The loss of initial activity of enzymes were 34% and 18% in the 1st-step and 2nd-step membrane reactor, whereas were 23% and 10% after operating time 3 hr in the 1st-step and 2nd-step membrane reactor lacking the membrane, respectively. The productivities of 1st-step and 2nd-step membrane reactor for 8 times of volume replacement were 334 mg and 250 mg per mg enzyme, respectively.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.18-29
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• 2021

Purpose: Patients with hematologic malignancy (HM) typically have a high mortality rate when their condition deteriorates. The chronic progressive course of the disease makes it difficult to assess the effect of intervention on acute events. We investigated the effectiveness of a rapid response team (RRT) on in-hospital mortality in patients with HM. Methods: We retrospectively analyzed the data of patients with HM who admitted to the medical intensive care unit between 2006 and 2015. Clinical outcomes before and after RRT implementation were evaluated. Results: A total of 228 patients in the pre-RRT period and 781 patients in the post-RRT period were included. The overall in-hospital mortality was 55.4%. Patients in the post-RRT period had improved survival; however, they required more vasopressor therapy, continuous renal replacement therapy, and extracorporeal membrane oxygenation. Multivariate analysis revealed that in-hospital mortality was associated with RRT activation (hazard ratio [HR], 0.634; 95% confidence interval [CI], 0.498-0.807; p < .001), neurological disease (HR, 2.007; 95% CI, 1.439-2.800; p < .001), sequential organ failure assessment score (HR, 1.085; 95% CI, 1.057-1.112; p < .001), need for continuous renal replacement therapy (HR, 1.608; 95% CI, 1.206-1.895; p< .001), mechanical ventilation (HR, 1.512; 95% CI, 1.206-1.895; p< .001), vasopressor (HR, 1.598; 95% CI, 1.105-2.311; p = .013), and extracorporeal membrane oxygenation (HR, 1.728; 95% CI, 1.105-2.311; p = .030). Conclusion: RRT activation may be associated with improved survival in patients with HM.