• Journal of Chest Surgery
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• 제46권6호
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• pp.391-401
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• 2013

Mechanical circulatory support (MCS) in the pediatric heart failure population has a limited history especially for infants, and neonates. It has been increasingly recognized that there is a rapidly expanding population of children diagnosed and living with heart failure. This expanding population has resulted in increasing numbers of children with medically resistant end-stage heart failure. The traditional therapy for these children has been heart transplantation. However, children with heart failure unlike adults do not have symptoms until they present with end-stage heart failure and therefore, cannot safely wait for transplantation. Many of these children were bridged to heart transplantation utilizing extracorporeal membranous oxygenation as a bridge to transplant which has yielded poor results. As such, industry, clinicians, and the government have refocused interest in developing increasing numbers of MCS options for children living with heart failure as a bridge to transplantation and as a chronic therapy. In this review, we discuss MCS options for short and long-term support that are currently available for infants and children with end-stage heart failure.

• 한국음향학회:학술대회논문집
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• 한국음향학회 1999년도 학술발표대회 논문집 제18권 2호
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• pp.131-134
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• 1999

This paper considers the acoustical characteristics of the mechanical valve employed in the Korean type Artificial Heart. $Bj\"{o}rk-Shiley$ tilting disc valve was chosen for the study and acoustic measurements were performed for the artificial heart operated in a mock circulation system as well as implanted to an animal as a Bi Ventricular Assist Device (BVAD). In the mock system, three different conditions of the valve were examined which were normal, damaged (torn off), pseudothrombus attached. Microphone measurements for the BVAD were carried out at a regular time interval for 5 days after the implantation operation. Of the recorded acoustic emissions from the artificial heart, click sounds mainly originated from the valves were further analyzed using Multiple Signal Classification (MUSIC) for estimating their spectral properties. It was shown that the spectral peaks below 4 kHz and the optimal order number for MUSIC, equivalent to the number of the spectral component, might be the key parameters which were highly correlated to the physiological states of the valve like the mechanical damage of the valve or the formation of thrombus on the valves.

• 한국정밀공학회지
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• 제26권3호
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• pp.40-46
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• 2009

Toroidally-wound brushless direct-current (BLOC) machines are compact, highly efficient, and can work across a large magnetic gap. For these reasons, they have been used in pumps, flywheel energy storage systems and left ventricular assist devices among others. The common feature of these systems is a spinning rotor supported by a set of (either mechanical or magnetic) bearings. From the view point of dynamics, it is desirable to increase the first critical speed of the rotor so that it can run at a higher operating speed. The first critical speed of the rotor is determined by the radial stiffnesses of the bearings and the rotor mass. The motor also affects the first critical speed if the rotor is displaced from the rotating center. In this paper, we analytically derive the flux density distribution in a toroidally-wound BLOC machine and also derive the negative stiffness of the motor, based on the assumption that the rotor displacement perturbs the flux density distribution linearly. The estimated negative stiffness is validated by finite element analyses.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1995년도 추계학술대회
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• pp.211-215
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• 1995

전기유압식 좌심실 보조장치에서 모터 전류 파형을 정보로 하여 작동기의 이완기 속도를 조절함으로써 좌심방으로부터 유입되는 혈류량을 조절하는 알고리즘을 개발하였다. 전기 유압식 좌심실 보조장치에서는 혈액의 유입이 능동적으로 이루어지므로, 좌심방 함몰로 인한 심근 손상 및 외부 공기 유입으로 인한 색전증을 방지하기 위해 유입혈류량을 현재 좌심방 내의 상태에 따라 적절히 조절해 주어야 한다. 좌심방 내의 혈액량 정도는 혈액을 유입해내는 작동기의 이완기 동작 시에 소모되는 에너지 크기에 반영되고, 작동기를 구동하는 모터에 들어가는 전류의 크기는 작동기에 공급되는 에너지에 비례하므로, 이 전류 파형의 정보들을 통해 좌심방 내의 상태를 추정해 볼 수 있다. 본 논문에서는 퍼지로직을 적용하여 모터 전류 파형의 이상 유무를 판단한 뒤 이에 따라 작동기의 이완기 속도를 조절하는 알고리즘을 개발하여 모의순환장치 실험을 통해 그 실효성을 검증한 결과를 정리하였다.

• Journal of Chest Surgery
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• 제35권9호
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• pp.664-667
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• 2002

선천성 심질환에 대한 개심술후 발생한 폐동맥 고혈압 위기증이 혈관확장제 등의 내과적 치료에 반응하지 않는 경우에 체외막 산소화 장치를 사용함으로써, 안정적인 산소공급의 확보를 통한 폐혈관 저항의 상승 방지, 심박출량의 상당 부분의 바이패스를 통한 폐관류압의 감소, 우심실의 용적 부하 감소 및 심실보조 기능을 통한 우심부전 및 저심박출의 예방 등의 치료 효과를 기대할 수 있다. 본 증례의 경우, 동맥관 개존증과 이차성 폐동맥 고혈압이 합병되어 있었던 37세 남자에서 수술후 발생한 폐동맥 고혈압 위기증에 대한 치료시 체외막 산소화 장치를 함께 사용하여 좋은 결과를 얻었기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제35권7호
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• pp.548-552
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• 2002

한국형 인공심장(AnyHeart)은 single moving actuator mechanism을 이용한 일체형 및 이식형 양심실 박동펌프이다. 저자 등은 양심 부전증에 의한 말기 심장병 환자에서 구난의료 차원으로 시도된 한국형 인공심장 (AnyHeart) 이식 1례를 경험하였기에 그 결과를 보고한다.

• 대한의용생체공학회:의공학회지
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• 제19권3호
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• pp.313-320
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• 1998

3상형 박동류는 인체 순환계 혈류의 일반적인 형태이다. 심혈관계의 여러 가지 상황을 모의하려면 이러한 3상형 박동류를 만들어 내는 것이 필수적이다. 본 연구에서는 3상형 박동류를 모의하기 위해서 전기유압식 좌심실보조기를 유리 팬텀과 고무 튜브와 같이 사용하였으며 혈류 모의 시스템의 제어변수를 선정하고 각 변수들의 변화에 대한 영향을 도플러 초음파를 이용하여 관찰하였다. 본 실험의 결과 협착 후위부 탄성과 지연시간이 3상형 혈류를 생성하는 중요한 요인이었다. 본 실험의 결과들은 다양한 혈류 운동을 모의할 수 있게 해 줌으로써 심혈관계의 여러현상을 설명하는 유용한 도구가 될 수 있을 것으로 기대된다.

• 대한의용생체공학회:의공학회지
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• 제18권2호
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• pp.147-156
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• 1997

Various prosthetic heart valves have been developed and used clinically, but they have problems, such as thrombogenecity, hemoltsis, high cost and low durability. New types of trileaflet polymer heart valves have been developed in order to use them as inlet and outlet valves in a ventricular assist device. The aim of this study is to determine the hydrodynamic effectiveness of the newly designed trileaflet polymer valves and their feasibility for temporary use in the blood pumps. Trileaflet polymer valves are made of polyurethane, because of its good blood compatibility, high tonsil strength and good resistance to fatigue. An in vitro experimental investigation was perf'ormed in order to ev91ua1e hydrodynamic performance of the trileaflet polymer valves having different design and fabrication tech- niques. The St. Jude Medical valve (SJMV) and floating-type monoleaflet polymer valve (MLPV) were also tested The pressure drop across the valve, leakage volume, and the flow patterns mere investigated for valves. The result of comparative tests showed that the trileaflet polymer valves had a better hydrodynamic performance than the others. TPV which has two stable membrane shape showed the lowest back flow. The pressure hops of TPVs were lower than that of MLPV, but slightly higher than SJMV. The hydrodynamic performance of valves under the pulastile flow showed the similar results as steady flow. The velocity profiles and turbulent intensities were measured at the distal sites of valves using a hot-film anemometer. Central flow was maintained in trileaflet polymer valves, and the maximum turbulent intensities were lower in TPVs comparing to MLPV.

• 대한의용생체공학회:의공학회지
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• 제17권1호
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• pp.43-48
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• 1996

We investigated the energistics of the physiological heart model by comparing predictive indexes of the myocardial oxygen consumption (MOC), such as tension-time index (R), tension-time or force-time inteual (FTI), rate-pressure product (RPP), pressure-work index, and systolic pressure-volume area (PVA) when using the electro-hydraulic left ventricular device (LVAD). We developed the model of LVAD incorporated the closed-loop cardiovascular system with a baroreceptor which can control heart rate and time-varying elastance of left and right ventricles. On considering the benefit of the LVAD, the effects of various operation modes, especially timing of assistance, were evaluated using this coupled computer model. Overall results of the computer simulation shows that our LVAD can unload the ischemic (less contractile) heart by decreasing the MU and increasing coronary flow. Because the pump ejection at the end diastolic phase of the natural heart may increase the afterload of the left ventricle, the control scheme of our LVAD must prohibit ejecting at this time. Since the increment of coronary flow is proportional to the peak aortic pressure after ventricle contraction, the LVAD must eject immediately following the closure of the aortic valve to increase oxygen availability.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1996년도 춘계학술대회
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• pp.232-234
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• 1996

Cadiac output estimation scheme of LVAD using multi-dimensional interpolation technique was introduced in this paper. This paper also show appropriate input -output data for estimation. Experimental results show our approach is a good one for the estimation of nonlinear hemodynamics.