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Lee DU, Kayumov M, Park J, Park SK, Kang Y, Ahn Y, Kim W, Yoo SH, Park JK, Kim BG, Oh YS, Jeong IS, Choi DY. Antibiofilm and antithrombotic hydrogel coating based on superhydrophilic zwitterionic carboxymethyl chitosan for blood-contacting devices. Bioact Mater 2024; 34:112-124. [PMID: 38204564 PMCID: PMC10777421 DOI: 10.1016/j.bioactmat.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024] Open
Abstract
Blood-contacting devices must be designed to minimize the risk of bloodstream-associated infections, thrombosis, and intimal lesions caused by surface friction. However, achieving effective prevention of both bloodstream-associated infections and thrombosis poses a challenge due to the conflicting nature of antibacterial and antithrombotic activities, specifically regarding electrostatic interactions. This study introduced a novel biocompatible hydrogel of sodium alginate and zwitterionic carboxymethyl chitosan (ZW@CMC) with antibacterial and antithrombotic activities for use in catheters. The ZW@CMC hydrogel demonstrates a superhydrophilic surface and good hygroscopic properties, which facilitate the formation of a stable hydration layer with low friction. The zwitterionic-functionalized CMC incorporates an additional negative sulfone group and increased negative charge density in the carboxyl group. This augmentation enhances electrostatic repulsion and facilitates the formation of hydration layer. This leads to exceptional prevention of blood clotting factor adhesion and inhibition of biofilm formation. Subsequently, the ZW@CMC hydrogel exhibited biocompatibility with tests of in vitro cytotoxicity, hemolysis, and catheter friction. Furthermore, in vivo tests of antithrombotic and systemic inflammation models with catheterization indicated that ZW@CMC has significant advantages for practical applications in cardiovascular-related and sepsis treatment. This study opens a new avenue for the development of chitosan-based multifunctional hydrogel for applications in blood-contacting devices.
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Affiliation(s)
- Dong Uk Lee
- Biomedical Manufacturing Technology Center, Korea Institute of Industrial Technology, Yeongcheon, 38822, Republic of Korea
| | - Mukhammad Kayumov
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, 61469, Republic of Korea
| | - Junghun Park
- Biomedical Manufacturing Technology Center, Korea Institute of Industrial Technology, Yeongcheon, 38822, Republic of Korea
| | - Se Kye Park
- Biomedical Manufacturing Technology Center, Korea Institute of Industrial Technology, Yeongcheon, 38822, Republic of Korea
| | - Yeongkwon Kang
- Research Institute of Advanced Materials, Seoul National University, Seoul, 08826, Republic of Korea
| | - Yejin Ahn
- Department of Organic and Nano System Engineering, Konkuk University, Seoul, 05029, Republic of Korea
| | - Woojin Kim
- Biomedical Manufacturing Technology Center, Korea Institute of Industrial Technology, Yeongcheon, 38822, Republic of Korea
| | - Seung Hwa Yoo
- Department of Quantum System Engineering, Jeonbuk National University, Jeonju-si, 54896, Republic of Korea
| | | | - Bong-Gi Kim
- Department of Organic and Nano System Engineering, Konkuk University, Seoul, 05029, Republic of Korea
| | - Yong Suk Oh
- Department of Mechanical Engineering, Changwon National University, Changwon, 51140, Republic of Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, 61469, Republic of Korea
| | - Dong Yun Choi
- Biomedical Manufacturing Technology Center, Korea Institute of Industrial Technology, Yeongcheon, 38822, Republic of Korea
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Kim MC, Lim Y, Lee SH, Shin Y, Ahn JH, Hyun DY, Cho KH, Sim DS, Hong YJ, Kim JH, Jeong MH, Jung YH, Jeong IS, Ahn Y. Early Left Ventricular Unloading or Conventional Approach After Venoarterial Extracorporeal Membrane Oxygenation: The EARLY-UNLOAD Randomized Clinical Trial. Circulation 2023; 148:1570-1581. [PMID: 37850383 DOI: 10.1161/circulationaha.123.066179] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/29/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Although venoarterial extracorporeal membrane oxygenation (VA-ECMO) is beneficial for the treatment of profound cardiogenic shock, peripheral VA-ECMO cannulation can increase left ventricular afterload, thus compromising myocardial recovery. We investigated whether early routine left ventricular unloading can reduce 30-day mortality compared with the conventional approach in patients with cardiogenic shock undergoing VA-ECMO. METHODS This randomized clinical trial involved 116 patients with cardiogenic shock undergoing VA-ECMO from March 2021 to September 2022 at Chonnam National University Hospital, Gwangju, South Korea. The patients were randomly assigned to undergo either early routine left ventricular unloading with transseptal left atrial cannulation within 12 hours after randomization (n=58) or the conventional approach, which permitted rescue transseptal left atrial cannulation in case of an increased left ventricular afterload (n=58). The primary outcome was all-cause mortality within 30 days. RESULTS All 116 randomized patients (mean age, 67.6±13.5 years; 34 [29.3%] women) completed the trial. At 30 days, all-cause death had occurred in 27 (46.6%) patients in the early group and 26 (44.8%) patients in the conventional group (hazard ratio, 1.02 [95% CI, 0.59-1.74]; P=0.942). Crossover to rescue transseptal left atrial cannulation occurred in 29 patients (50%) in the conventional group according to a clear indication. Time to rescue transseptal cannulation in the conventional group was a median of 21.8 (interquartile range, 12.4-52.2) hours after randomization. There were no significant differences in other secondary outcomes between the 2 groups except for a shorter time to disappearance of pulmonary congestion in the early group (median, 3 [interquartile range, 2-6] versus 5 [interquartile range, 3-7] days; P=0.027). CONCLUSIONS Among patients with cardiogenic shock undergoing VA-ECMO, early routine left ventricular unloading with transseptal left atrial cannulation did not reduce 30-day mortality compared with the conventional strategy, which permitted rescue transseptal left atrial cannulation. These findings should be cautiously interpreted until the results of multicenter trials using other unloading modalities become available. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT04775472.
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Affiliation(s)
- Min Chul Kim
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Yongwhan Lim
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Seung Hun Lee
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Yoonmin Shin
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Joon Ho Ahn
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Dae Young Hyun
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Kyung Hoon Cho
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Doo Sun Sim
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Young Joon Hong
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju Han Kim
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Myung Ho Jeong
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Yong Hun Jung
- Department of Emergency Medicine (Y.H.J.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery (I.-S.J.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Youngkeun Ahn
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
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Kim MC, Lim Y, Lee SH, Shin Y, Ahn JH, Hyun DY, Cho KH, Sim DS, Hong YJ, Kim JH, Jeong MH, Jung YH, Jeong IS, Ahn Y. Early left ventricular unloading after extracorporeal membrane oxygenation: rationale and design of EARLY-UNLOAD trial. ESC Heart Fail 2023. [PMID: 37415397 PMCID: PMC10375154 DOI: 10.1002/ehf2.14450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 05/09/2023] [Accepted: 06/21/2023] [Indexed: 07/08/2023] Open
Abstract
AIMS The clinical benefits of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for profound cardiogenic shock are well known. However, peripheral VA-ECMO increases the left ventricular afterload, thus compromising myocardial recovery. Recent studies have revealed the benefit of left ventricular unloading using various methods applied at different times. The EARLY-UNLOAD trial compares the clinical outcomes of early left ventricular unloading and conventional approach after VA-ECMO. METHODS AND RESULTS The EARLY-UNLOAD trial is a single-centre, open-label, randomized trial that recruited 116 patients with cardiogenic shock undergoing VA-ECMO. Patients meeting the inclusion criteria were randomized in a 1:1 ratio to two groups: routine left ventricular unloading via intracardiac echocardiography-guided transseptal left atrial cannulation within 12 h of VA-ECMO initiation or conventional approach that indicates rescue left ventricular unloading if clinical signs of an increased left ventricular afterload are present. The primary endpoint is the cumulative incidence of all-cause death within 30 days, and patients will be followed-up for 12 months. A key secondary endpoint is a composite measure of all-cause death and rescue transseptal left atrial cannulation in the conventional group (suggestive of VA-ECMO treatment failure) within 30 days. The enrolment of patients was finished in September 2022. CONCLUSIONS The EARLY-UNLOAD trial is the first randomized controlled trial to compare early left ventricular unloading and conventional approach after VA-ECMO using the same unloading modality. The results could impact clinical practice to overcome the haemodynamic issues associated with VA-ECMO.
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Affiliation(s)
- Min Chul Kim
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Yongwhan Lim
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Seung Hun Lee
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Yoonmin Shin
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Joon Ho Ahn
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Dae Young Hyun
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Kyung Hoon Cho
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Doo Sun Sim
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Young Joon Hong
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Ju Han Kim
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Myung Ho Jeong
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Yong Hun Jung
- Department of Emergency Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Youngkeun Ahn
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
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Choi M, Lee HJ, Yu SY, Kim J, Park J, Ryoo S, Kim I, Park DA, Yoon YK, Joh JS, Park S, Yun KW, Choi CH, Kim JS, Shin S, Kim H, Huh K, Jeong IS, Choi SH, Hwang SH, Lee H, Lee DK, Yong HS, Yum HK. Two Years of Experience and Methodology of Korean COVID-19 Living Clinical Practice Guideline Development. J Korean Med Sci 2023; 38:e195. [PMID: 37309700 DOI: 10.3346/jkms.2023.38.e195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/11/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND In Korea, during the early phase of the coronavirus disease 2019 (COVID-19) pandemic, we responded to the uncertainty of treatments under various conditions, consistently playing catch up with the speed of evidence updates. Therefore, there was high demand for national-level evidence-based clinical practice guidelines for clinicians in a timely manner. We developed evidence-based and updated living recommendations for clinicians through a transparent development process and multidisciplinary expert collaboration. METHODS The National Evidence-based Healthcare Collaborating Agency (NECA) and the Korean Academy of Medical Sciences (KAMS) collaborated to develop trustworthy Korean living guidelines. The NECA-supported methodological sections and 8 professional medical societies of the KAMS worked with clinical experts, and 31 clinicians were involved annually. We developed a total of 35 clinical questions, including medications, respiratory/critical care, pediatric care, emergency care, diagnostic tests, and radiological examinations. RESULTS An evidence-based search for treatments began in March 2021 and monthly updates were performed. It was expanded to other areas, and the search interval was organized by a steering committee owing to priority changes. Evidence synthesis and recommendation review was performed by researchers, and living recommendations were updated within 3-4 months. CONCLUSION We provided timely recommendations on living schemes and disseminated them to the public, policymakers and various stakeholders using webpages and social media. Although the output was successful, there were some limitations. The rigor of development issues, urgent timelines for public dissemination, education for new developers, and spread of several new COVID-19 variants have worked as barriers. Therefore, we must prepare systematic processes and funding for future pandemics.
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Affiliation(s)
- Miyoung Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Hyeon-Jeong Lee
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Su-Yeon Yu
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
- Department of Medical Information, College of Nursing and Health, Kongju National University, Gongju, Korea
| | - Jimin Kim
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Jungeun Park
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Seungeun Ryoo
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Inho Kim
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Dong Ah Park
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Young Kyung Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon-Sung Joh
- Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Sunghoon Park
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Ki Wook Yun
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Chi-Hoon Choi
- Department of Radiology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Jae-Seok Kim
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sue Shin
- Department of Laboratory Medicine, Seoul National University-Seoul Metropolitan Government Boramae Hospital, Seoul, Korea
| | - Hyun Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Soo-Han Choi
- Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Sung Ho Hwang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Keon Lee
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
| | - Ho Kee Yum
- Department of Respiratory and Critical Care Medicine, Inje University Seoul Paik Hospital, Seoul, Korea.
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Koh J, Chee HK, Kim KH, Jeong IS, Kim JS, Lee CH, Seo JW. Historical Review and Future of Cardiac Xenotransplantation. Korean Circ J 2023; 53:351-366. [PMID: 37271743 DOI: 10.4070/kcj.2022.0351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/14/2023] [Accepted: 04/05/2023] [Indexed: 06/06/2023] Open
Abstract
Along with the development of immunosuppressive drugs, major advances on xenotransplantation were achieved by understanding the immunobiology of xenograft rejection. Most importantly, three predominant carbohydrate antigens on porcine endothelial cells were key elements provoking hyperacute rejection: α1,3-galactose, SDa blood group antigen, and N-glycolylneuraminic acid. Preformed antibodies binding to the porcine major xenoantigen causes complement activation and endothelial cell activation, leading to xenograft injury and intravascular thrombosis. Recent advances in genetic engineering enabled knock-outs of these major xenoantigens, thus producing xenografts with less hyperacute rejection rates. Another milestone in the history of xenotransplantation was the development of co-stimulation blockaded strategy. Unlike allotransplantation, xenotransplantation requires blockade of CD40-CD40L pathway to prevent T-cell dependent B-cell activation and antibody production. In 2010s, advanced genetic engineering of xenograft by inducing the expression of multiple human transgenes became available. So-called 'multi-gene' xenografts expressing human transgenes such as thrombomodulin and endothelial protein C receptor were introduced, which resulted in the reduction of thrombotic events and improvement of xenograft survival. Still, there are many limitations to clinical translation of cardiac xenotransplantation. Along with technical challenges, zoonotic infection and physiological discordances are major obstacles. Social barriers including healthcare costs also need to be addressed. Although there are several remaining obstacles to overcome, xenotransplantation would surely become the novel option for millions of patients with end-stage heart failure who have limited options to traditional therapeutics.
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Affiliation(s)
- Jiwon Koh
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Kyung-Hee Kim
- Division of Cardiology, Incheon Sejong Hospital, Incheon, Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Jung-Sun Kim
- Department of Pathology and Translational Genomics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Chang-Ha Lee
- Department of Thoracic and Cardiovascular Surgery, Bucheon Sejong Hospital, Bucheon, Korea
| | - Jeong-Wook Seo
- Department of Pathology, Incheon Sejong Hospital, Incheon, Korea.
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Di Nardo M, MacLaren G, Schellongowski P, Azoulay E, DeZern AE, Gutierrez C, Antonelli M, Antonini MV, Beutel G, Combes A, Diaz R, Fawzy Hassan I, Fowles JA, Jeong IS, Kochanek M, Liebregts T, Lueck C, Moody K, Moore JA, Munshi L, Paden M, Pène F, Puxty K, Schmidt M, Staudacher D, Staudinger T, Stemmler J, Stephens RS, Vande Vusse L, Wohlfarth P, Lorusso R, Amodeo A, Mahadeo KM, Brodie D. Extracorporeal membrane oxygenation in adults receiving haematopoietic cell transplantation: an international expert statement. Lancet Respir Med 2023; 11:477-492. [PMID: 36924784 DOI: 10.1016/s2213-2600(22)00535-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 03/16/2023]
Abstract
Combined advances in haematopoietic cell transplantation (HCT) and intensive care management have improved the survival of patients with haematological malignancies admitted to the intensive care unit. In cases of refractory respiratory failure or refractory cardiac failure, these advances have led to a renewed interest in advanced life support therapies, such as extracorporeal membrane oxygenation (ECMO), previously considered inappropriate for these patients due to their poor prognosis. Given the scarcity of evidence-based guidelines on the use of ECMO in patients receiving HCT and the need to provide equitable and sustainable access to ECMO, the European Society of Intensive Care Medicine, the Extracorporeal Life Support Organization, and the International ECMO Network aimed to develop an expert consensus statement on the use of ECMO in adult patients receiving HCT. A steering committee with expertise in ECMO and HCT searched the literature for relevant articles on ECMO, HCT, and immune effector cell therapy, and developed opinion statements through discussions following a Quaker-based consensus approach. An international panel of experts was convened to vote on these expert opinion statements following the Research and Development/University of California, Los Angeles Appropriateness Method. The Appraisal of Guidelines for Research and Evaluation statement was followed to prepare this Position Paper. 36 statements were drafted by the steering committee, 33 of which reached strong agreement after the first voting round. The remaining three statements were discussed by all members of the steering committee and expert panel, and rephrased before an additional round of voting. At the conclusion of the process, 33 statements received strong agreement and three weak agreement. This Position Paper could help to guide intensivists and haematologists during the difficult decision-making process regarding ECMO candidacy in adult patients receiving HCT. The statements could also serve as a basis for future research focused on ECMO selection criteria and bedside management.
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Affiliation(s)
- Matteo Di Nardo
- Paediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Graeme MacLaren
- Cardiothoracic Intensive Care Unit, National University Health System, Singapore
| | - Peter Schellongowski
- Intensive Care Unit 13i2, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Elie Azoulay
- Médecine Intensive et Réanimation, APHP, Saint-Louis Hospital, University of Paris, Paris, France
| | - Amy E DeZern
- Division of Hematologic Malignancies, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Cristina Gutierrez
- Department of Critical Care Medicine, Division of Anesthesiology, Critical Care and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Massimo Antonelli
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Marta V Antonini
- Anaesthesia and Intensive Care Unit, Bufalini Hospital, AUSL della Romagna, Cesena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Gernot Beutel
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Alain Combes
- Institute of Cardiometabolism and Nutrition, INSERM, UMRS_1166-ICAN, Sorbonne Université, Paris, France; Service de médecine intensive-réanimation, Institut de Cardiologie, APHP Sorbonne Université Hôpital Pitié-Salpêtrière, Paris, France
| | | | | | - Jo-Anne Fowles
- Division of Surgery, Transplant and Anaesthetics, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Matthias Kochanek
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center of Integrated Oncology, Aachen-Bonn-Cologne-Dusseldorf, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Tobias Liebregts
- Department of Hematology and Stem Cell Transplantation, West-German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Catherina Lueck
- Department of Hematology and Stem Cell Transplantation, West-German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karen Moody
- Division of Pediatrics, Palliative and Supportive Care Section, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jessica A Moore
- Section of Integrated Ethics in Cancer Care, Department of Critical Care and Respiratory Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Laveena Munshi
- Interdepartmental Division of Critical Care Medicine, Sinai Health System/University Health Network, University of Toronto, Toronto, ON, Canada
| | - Matthew Paden
- Division of Critical Care, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Frédéric Pène
- Service de Médecine Intensive-Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre & Université Paris Cité, Paris, France
| | - Kathryn Puxty
- Department of Critical Care, NHS Greater Glasgow and Clyde, Glasgow, UK; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Matthieu Schmidt
- Institute of Cardiometabolism and Nutrition, INSERM, UMRS_1166-ICAN, Sorbonne Université, Paris, France; Service de médecine intensive-réanimation, Institut de Cardiologie, APHP Sorbonne Université Hôpital Pitié-Salpêtrière, Paris, France
| | - Dawid Staudacher
- Interdisciplinary Medical Intensive Care (IMIT), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Staudinger
- Intensive Care Unit 13i2, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Joachim Stemmler
- Department of Hematology and Oncology, University Hospital, LMU Munich, Munich, Germany
| | - R Scott Stephens
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and Department of Oncology, Johns Hopkins University, Baltimore, MD, USA
| | - Lisa Vande Vusse
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Philipp Wohlfarth
- Stem Cell Transplantation Unit, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands; Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | - Antonio Amodeo
- Cardiac Surgery Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Kris M Mahadeo
- Pediatric Transplant and Cellular Therapy, Duke University, Durham, NC, USA
| | - Daniel Brodie
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MA, USA
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7
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Obiweluozor FO, Kayumov M, Kwak Y, Cho HJ, Park CH, Park JK, Jeong YJ, Lee DW, Kim DW, Jeong IS. Rapid remodeling observed at mid-term in-vivo study of a smart reinforced acellular vascular graft implanted on a rat model. J Biol Eng 2023; 17:1. [PMID: 36597162 PMCID: PMC9810246 DOI: 10.1186/s13036-022-00313-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/21/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The poor performance of conventional techniques used in cardiovascular disease patients requiring hemodialysis or arterial bypass grafting has prompted tissue engineers to search for clinically appropriate off-the-shelf vascular grafts. Most patients with cardiovascular disease lack suitable autologous tissue because of age or previous surgery. Commercially available vascular grafts with diameters of < 5 mm often fail because of thrombosis and intimal hyperplasia. RESULT Here, we tested tubular biodegradable poly-e-caprolactone/polydioxanone (PCL/PDO) electrospun vascular grafts in a rat model of aortic interposition for up to 12 weeks. The grafts demonstrated excellent patency (100%) confirmed by Doppler Ultrasound, resisted aneurysmal dilation and intimal hyperplasia, and yielded neoarteries largely free of foreign materials. At 12 weeks, the grafts resembled native arteries with confluent endothelium, synchronous pulsation, a contractile smooth muscle layer, and co-expression of various extracellular matrix components (elastin, collagen, and glycosaminoglycan). CONCLUSIONS The structural and functional properties comparable to native vessels observed in the neoartery indicate their potential application as an alternative for the replacement of damaged small-diameter grafts. This synthetic off-the-shelf device may be suitable for patients without autologous vessels. However, for clinical application of these grafts, long-term studies (> 1.5 years) in large animals with a vasculature similar to humans are needed.
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Affiliation(s)
- Francis O. Obiweluozor
- grid.14005.300000 0001 0356 9399Research and Business Development foundation, Chonnam National University, 77 Yongbong-ro, Yongbong-dong, Buk-gu, Gwangju, 61186 Republic of Korea
| | - Mukhammad Kayumov
- grid.411597.f0000 0004 0647 2471Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469 Republic of Korea
| | - Yujin Kwak
- grid.411597.f0000 0004 0647 2471Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469 Republic of Korea
| | - Hwa-Jin Cho
- grid.14005.300000 0001 0356 9399Department of Pediatrics, Chonnam National University Children’s Hospital and Medical School, Gwangju, 61469 Republic of Korea
| | - Chan-Hee Park
- grid.411545.00000 0004 0470 4320Department of Mechanical Engineering Graduate School, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, 54896 Republic of Korea
| | - Jun-kyu Park
- grid.454173.00000 0004 0647 1903CGBio Co. Ltd., 244 Galmachi-ro, Jungwon-u, Seongnam, 13211 Republic of Korea
| | - Yun-Jin Jeong
- grid.14005.300000 0001 0356 9399School of Mechanical Engineering Chonnam National University, Repubic of, Gwangju, 61469 South Korea
| | - Dong-Weon Lee
- grid.14005.300000 0001 0356 9399School of Mechanical Engineering Chonnam National University, Repubic of, Gwangju, 61469 South Korea
| | - Do-Wan Kim
- grid.411597.f0000 0004 0647 2471Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469 Republic of Korea
| | - In-Seok Jeong
- grid.411597.f0000 0004 0647 2471Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469 Republic of Korea
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8
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Kayumov M, Kim DW, Cho HJ, Lee KS, Jeong IS. Comparison of hypothermic static and normothermic ex situ donor heart preservation in heterotopic heart transplantation with the murine model. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-3157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mukhammad Kayumov
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - Do-Wan Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - Hwa-Jin Cho
- Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea
| | - Kyo Seon Lee
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea
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9
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Son KH, Kim WH, Kwak JG, Choi CH, Lee SI, Ko UW, Kim HS, Lee H, Chung ES, Kim JB, Jang WS, Jung JS, Kim J, Yoon YK, Song S, Sung M, Jang MH, Kim YS, Jeong IS, Kim DW, Kim TY, Kim SJ, Kim SW, Hong J, An H. Hyperglycemia and Hypoglycemia Are Associated with In-Hospital Mortality among Patients with Coronavirus Disease 2019 Supported with Extracorporeal Membrane Oxygenation. J Clin Med 2022; 11:jcm11175106. [PMID: 36079032 PMCID: PMC9457381 DOI: 10.3390/jcm11175106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
Metabolic abnormalities, such as preexisting diabetes or hyperglycemia or hypoglycemia during hospitalization aggravated the severity of COVID-19. We evaluated whether diabetes history, hyperglycemia before and during extracorporeal membrane oxygenation (ECMO) support, and hypoglycemia were risk factors for mortality in patients with COVID-19. This study included data on 195 patients with COVID-19, who were aged ≥19 years and were treated with ECMO. The proportion of patients with diabetes history among nonsurvivors was higher than that among survivors. Univariate Cox regression analysis showed that in-hospital mortality after ECMO support was associated with diabetes history, renal replacement therapy (RRT), and body mass index (BMI) < 18.5 kg/m2. Glucose at admission >200 mg/dL and glucose levels before ventilator >200 mg/dL were not associated with in-hospital mortality. However, glucose levels before ECMO >200 mg/dL and minimal glucose levels during hospitalization <70 mg/dL were associated with in-hospital mortality. Multivariable Cox regression analysis showed that glucose >200 mg/dL before ECMO and minimal glucose <70 mg/dL during hospitalization remained risk factors for in-hospital mortality after adjustment for age, BMI, and RRT. In conclusion, glucose >200 mg/dL before ECMO and minimal glucose level <70 mg/dL during hospitalization were risk factors for in-hospital mortality among COVID-19 patients who underwent ECMO.
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Affiliation(s)
- Kuk Hui Son
- Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea
| | - Woong-Han Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-2072-3637
| | - Jae Gun Kwak
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Chang-Hyu Choi
- Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea
| | - Seok In Lee
- Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea
| | - Ui Won Ko
- Pulmonary and Allergy Division, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea
| | - Hyoung Soo Kim
- Department of Thoracic and Cardiovascular Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24252, Korea
| | - Haeyoung Lee
- Department of Thoracic and Cardiovascular Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
| | - Euy Suk Chung
- Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul 03181, Korea
| | - Jae-Bum Kim
- Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Korea
| | - Woo Sung Jang
- Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Korea
| | - Jae Seung Jung
- Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, Seoul 02841, Korea
| | - Jieon Kim
- Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, Seoul 02841, Korea
| | - Young Kyung Yoon
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Korea
| | - Seunghwan Song
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Biomedical Research Institute, Pusan National University School of Medicine, Busan 49241, Korea
| | - Minji Sung
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea
| | - Myung Hun Jang
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea
| | - Young Sam Kim
- Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61649, Korea
| | - Do Wan Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61649, Korea
| | - Tae Yun Kim
- Department of Thoracic and Cardiovascular Surgery, Jeonbuk National University Hospital, Jeonju 54907, Korea
| | - Soon Jin Kim
- Department of Thoracic and Cardiovascular Surgery, Jeonbuk National University Hospital, Jeonju 54907, Korea
| | - Su Wan Kim
- Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju 63241, Korea
| | - Joonhwa Hong
- Department of Thoracic and Cardiovascular Surgery, Chung-Ang University Hospital, Seoul 06973, Korea
| | - Hyungmi An
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea
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10
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Park H, Lim Y, Kim MC, Kim SE, Jeong IS, Choi YD, Kim DM. Case Report: Fulminant Myocarditis Successfully Treated With Extracorporeal Membrane Oxygenation in Ikeda Strain Orientia tsutsugamushi Infection. Front Cardiovasc Med 2022; 8:795249. [PMID: 35004906 PMCID: PMC8727758 DOI: 10.3389/fcvm.2021.795249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Scrub typhus is an acute zoonotic febrile illness caused by Orientia tsutsugamushi having a specific geographic endemic area. This infection could be complicated with multi-organ involvement including myocarditis with variable severity. Here, we report a rare case of scrub typhus with biopsy-proven acute fulminant myocarditis which progressed very rapidly to cardiac arrest and was treated successfully with extracorporeal cardiopulmonary resuscitation. Clinicians should be alert to possible rapid progression of scrub typhus myocarditis to fulminant form and be prepared for close monitoring and temporary mechanical support if indicated.
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Affiliation(s)
- Hyejin Park
- Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Medical Hospital, Gwangju, South Korea
| | - Yongwhan Lim
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Chonnam National University Medical Hospital, Gwangju, South Korea
| | - Min Chul Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Chonnam National University Medical Hospital, Gwangju, South Korea
| | - Seong Eun Kim
- Division of Infectious Disease, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Medical Hospital, Gwangju, South Korea
| | - In-Seok Jeong
- Department of Cardiothoracic Surgery, Chonnam National University Medical School, Chonnam National University Medical Hospital, Gwangju, South Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
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11
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Cho HJ, Choi I, Kwak Y, Kim DW, Habimana R, Jeong IS. The Outcome of Post-cardiotomy Extracorporeal Membrane Oxygenation in Neonates and Pediatric Patients: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:869283. [PMID: 35547551 PMCID: PMC9083359 DOI: 10.3389/fped.2022.869283] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO) is a known rescue therapy for neonates and pediatric patients who failed to wean from cardiopulmonary bypass (CPB) or who deteriorate in intensive care unit (ICU) due to various reasons such as low cardiac output syndrome (LCOS), cardiac arrest and respiratory failure. We conducted a systematic review and meta-analysis to assess the survival in neonates and pediatric patients who require PC-ECMO and sought the difference in survivals by each indication for PC-ECMO. DESIGN Systematic review and meta-analysis. SETTING Multi-institutional analysis. PARTICIPANTS Neonates and pediatric patients who requires PC- ECMO. INTERVENTIONS ECMO after open-heart surgery. RESULTS Twenty-six studies were included in the analysis with a total of 186,648 patients and the proportion of the population who underwent PC-ECMO was 2.5% (2,683 patients). The overall pooled proportion of survival in this population was 43.3% [95% Confidence interval (CI): 41.3-45.3%; I 2: 1%]. The survival by indications of PC-ECMO were 44.6% (95% CI: 42.6-46.6; I 2: 0%) for CPB weaning failure, 47.3% (95% CI: 39.9-54.7%; I 2: 5%) for LCOS, 37.6% (95% CI: 31.0-44.3%; I 2: 32%) for cardiac arrest and 47.7% (95% CI: 32.5-63.1%; I 2: 0%) for respiratory failure. Survival from PC-ECMO for single ventricle or biventricular physiology, was reported by 12 studies. The risk ratio (RR) was 0.74 for survival in patients with single ventricle physiology (95% CI: 0.63-0.86; I 2: 40%, P < 0.001). Eight studies reported on the survival after PC-ECMO for genetic conditions. The RR was 0.93 for survival in patients with genetic condition (95% CI: 0.52-1.65; I 2: 65%, P = 0.812). CONCLUSIONS PC-ECMO is an effective modality to support neonates and pediatric patients in case of failed CPB weaning and deterioration in ICU. Even though ECMO seems to improve survival, mortality and morbidity remain high, especially in neonates and pediatric patients with single ventricle physiology. Most genetic conditions alone should not be considered a contraindication to ECMO support, further studies are needed to determine which genetic abnormalities are associated with favorable outcome.
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Affiliation(s)
- Hwa Jin Cho
- Division of Pediatric Cardiology and Cardiac Critical Care, Department of Pediatrics, Chonnam National University Children's Hospital and Medical School, Gwangju, South Korea.,Cardiovascular and Respiratory Research Team, Chonnam National University Hospital, Gwangju, South Korea
| | - Insu Choi
- Division of Pediatric Cardiology and Cardiac Critical Care, Department of Pediatrics, Chonnam National University Children's Hospital and Medical School, Gwangju, South Korea
| | - Yujin Kwak
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, South Korea
| | - Do Wan Kim
- Cardiovascular and Respiratory Research Team, Chonnam National University Hospital, Gwangju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, South Korea
| | - Reverien Habimana
- Cardiovascular and Respiratory Research Team, Chonnam National University Hospital, Gwangju, South Korea.,Department of Biomedical Sciences, College of Medicine, Chonnam National University Graduate School, Gwangju, South Korea
| | - In-Seok Jeong
- Cardiovascular and Respiratory Research Team, Chonnam National University Hospital, Gwangju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, South Korea
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12
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Lim Y, Kim MC, Kim KH, Jeong IS, Cho YS, Choi YD, Lee JE. Case Report: Acute Fulminant Myocarditis and Cardiogenic Shock After Messenger RNA Coronavirus Disease 2019 Vaccination Requiring Extracorporeal Cardiopulmonary Resuscitation. Front Cardiovasc Med 2021; 8:758996. [PMID: 34778411 PMCID: PMC8586196 DOI: 10.3389/fcvm.2021.758996] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 09/28/2021] [Indexed: 12/30/2022] Open
Abstract
Recently, myocarditis following messenger RNA (mRNA) coronavirus disease 2019 (COVID-19) vaccination has become an important social issue worldwide. According to the reports so far, myocarditis related to mRNA COVID-19 vaccination is rare and usually associated with a benign clinical course without intensive care or any sequelae of fulminant myocarditis. Here, we report a case of acute fulminant myocarditis and cardiogenic shock after the mRNA COVID-19 vaccination, requiring extracorporeal cardiopulmonary resuscitation. Clinicians should keep in mind the possibility of progression to fulminant myocarditis in patients who presented with suggestive symptoms or signs of myocarditis after the COVID-19 vaccination.
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Affiliation(s)
- Yongwhan Lim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Min Chul Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Kye Hun Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - In-Seok Jeong
- Department of Cardiothoracic Surgery, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Yong Soo Cho
- Department of Emergent Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea
| | - Jong Eun Lee
- Department of Radiology, Chonnam National University Hospital, Gwangju, South Korea
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13
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Kim MC, Jeong IS, Ahn JH, Hyun DY, Kim D, Lee K, Ahn Y, Jeong MH. Bi-Caval Dual Lumen Catheter for Pediatric Patients Undergoing Venovenous Extracorporeal Membrane Oxygenation. Chonnam Med J 2021; 57:219-220. [PMID: 34621643 PMCID: PMC8485090 DOI: 10.4068/cmj.2021.57.3.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Min Chul Kim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Ho Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Dae Young Hyun
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Dowan Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Kyoseon Lee
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Ho Jeong
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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14
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Cho HJ, Kayumov M, Kim D, Lee K, Onyekachi FO, Jeung KW, Kim Y, Suen JY, Fraser JF, Jeong IS. Acute Immune Response in Venoarterial and Venovenous Extracorporeal Membrane Oxygenation Models of Rats. ASAIO J 2021; 67:546-553. [PMID: 32826395 DOI: 10.1097/mat.0000000000001265] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Although experimental extracorporeal membrane oxygenation (ECMO) animal models have been reported, there are few studies on the immune response to ECMO. We developed the venoarterial (VA) and venovenous (VV) model in rats and serially investigated the changes in the distribution of immune cells. Forty rats underwent both VA and VV modes of ECMO, and blood samples were collected at 1 day before ECMO (D-1), at the end of ECMO run (D+0), and 3 days after the ECMO (D+3). Flow cytometry was used to characterize surface marker expression (CD3, CD4, CD8, CD43, CD45, CD45R, CD161, and His48) on immune cells. Granulocytes were initially activated in both ECMO types and were further reduced but not normalized until 3 days of decannulation. Monocyte and natural killer cells were decreased initially in VA mode. B lymphocytes, helper T lymphocytes, and cytotoxic T lymphocytes also significantly decreased in VA modes after ECMO, but this phenomenon was not prominent in the VV modes. Overall immune cells proportion changed after ECMO run in both modes, and the immunologic balance altered significantly in the VA than in VV mode. Our ECMO model is feasible for the hemodynamic and immunologic research, and further long-term evaluation is needed.
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Affiliation(s)
- Hwa-Jin Cho
- From the Department of Pediatrics, Chonnam National University Children's Hospital and Medical School, Gwangju, Republic of Korea
- Critical Care Research Group, The Prince Charles Hospital, Chermside, QLD, Australia
- Faculty of Medicine, University of Queensland, St Lucia, QLD, Australia
| | - Mukhammad Kayumov
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
| | - Dowan Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
| | - Kyoseon Lee
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
| | - Francis Obiweluozor Onyekachi
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
| | - Kyung-Woon Jeung
- Department of Emergency Medicine, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
| | - Yongsook Kim
- Biomedical Research Institute, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jacky Y Suen
- Critical Care Research Group, The Prince Charles Hospital, Chermside, QLD, Australia
- Faculty of Medicine, University of Queensland, St Lucia, QLD, Australia
| | - John F Fraser
- Critical Care Research Group, The Prince Charles Hospital, Chermside, QLD, Australia
- Faculty of Medicine, University of Queensland, St Lucia, QLD, Australia
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
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15
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Cho HJ, Ogino MT, Jeong IS, Paden ML, Antonini VM, Marwali EM, Fraser JF, MacLaren G, Belohlavek J, Di Nardo M. Pediatric intensive care preparedness and ECMO availability in children with COVID-19: An international survey. Perfusion 2020; 36:637-639. [PMID: 33342366 DOI: 10.1177/0267659120981810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Hwa-Jin Cho
- Department of Pediatrics, Chonnam National University Children's Hospital, and Medical School, Gwangju, South Korea.,Critical Care Research Group, The Prince Charles Hospital and Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Mark T Ogino
- Division of Neonatology, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, South Korea
| | | | | | - Eva M Marwali
- Pediatric Cardiac ICU, National Cardiovascular Harapan Kita, Jakarta, Indonesia
| | - John F Fraser
- Critical Care Research Group, The Prince Charles Hospital and Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Graeme MacLaren
- Cardiothoracic Intensive Care Unit, National University Health System, Singapore.,Paediatric Intensive Care Unit, Department of Paediatrics, The Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Jan Belohlavek
- Internal Medicine and Cardiology Unit, Charles University Prague, Praha, Czech Republic
| | - Matteo Di Nardo
- Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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16
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Kayumov M, Cho HJ, Kim DW, Lee KS, Jeong IS. Rat model of heterotopic heart transplantation to investigate relevant donor heart harvesting method. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.op-1137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mukhammad Kayumov
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Hwa-Jin Cho
- Division of Cardiology, Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea
| | - Do-Wan Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - Kyo-Seon Lee
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea
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Cho SK, Kim DH, Jeong IS, Shin HS, Oh SE. Application of low-strength ultrasonication to the continuous anaerobic digestion processes: UASBr and dry digester. Bioresour Technol 2013; 141:167-173. [PMID: 23582223 DOI: 10.1016/j.biortech.2013.03.116] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 03/16/2013] [Accepted: 03/16/2013] [Indexed: 06/02/2023]
Abstract
In this study, the positive effects of low-strength ultrasonication (LS-ultrasonication) on the anaerobic digestion (AD) performance were investigated by continuously operating an upflow anaerobic sludge blanket reactor (UASBr) and a dry digester. In the ultrasonicated UASBr system (1 s per min, 0.05 W/mL), ultrasonication enhanced the CH₄ production by 38% and 19% in an ambient and a mesophilic condition, respectively. In addition, a different sludge yield and a changed electron flow were observed after ultrasonication. In the ultrasonicated dry digestion system (2 s per 30 s, 0.0025 W/mL), a 40% increase in the production of CH₄ was observed after lowering the total solid content of the reactor from 12% to 10%, implying that a high solid content diminished the ultrasonic stimulation effect. Moreover, the ultrasonication strength itself appeared to be a more crucial factor than the ultrasonication density during the application of LS-ultrasonication in the AD system.
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Affiliation(s)
- Si-Kyung Cho
- Department of Civil and Environmental Engineering, KAIST, 373-1, Guseong-dong, Yuseong-gu, Daejeon, Republic of Korea
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Cho SK, Hwang YH, Kim DH, Jeong IS, Shin HS, Oh SE. Low strength ultrasonication positively affects the methanogenic granules toward higher AD performance. Part I: physico-chemical characteristics. Bioresour Technol 2013; 136:66-72. [PMID: 23563439 DOI: 10.1016/j.biortech.2013.02.111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 02/22/2013] [Accepted: 02/27/2013] [Indexed: 06/02/2023]
Abstract
To elucidate the correlation between enhanced biogas production and changed physico-chemical properties of methanogenic granules after low strength ultrasonication, in this study, the effects of low strength ultrasonication on the settling velocity, permeability, porosity, and fluid collection efficiency of the methanogenic granules were investigated. In addition, their morphological changes were visualized using a scanning electron microscopic technique. The experimental results indicate that low strength ultrasonication increased both the permeability (37%) and specific surface area (230%) of the granules through the generation of greater craters and cracks on the granular surface compared to the control granules. The penetration of nutrients and substrate into the granules was thereby enhanced, and more favorable conditions for achieving higher anaerobic performance were provided to the ultrasonicated granules. The microbial community shift caused by the changed physico-chemical properties of the methanogenic granules will be further analyzed in part II of this study.
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Affiliation(s)
- Si-Kyung Cho
- Department of Civil and Environmental Engineering, KAIST, 291 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea
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Ahn JK, Chebotaryov S, Choi JH, Choi S, Choi W, Choi Y, Jang HI, Jang JS, Jeon EJ, Jeong IS, Joo KK, Kim BR, Kim BC, Kim HS, Kim JY, Kim SB, Kim SH, Kim SY, Kim W, Kim YD, Lee J, Lee JK, Lim IT, Ma KJ, Pac MY, Park IG, Park JS, Park KS, Shin JW, Siyeon K, Yang BS, Yeo IS, Yi SH, Yu I. Observation of reactor electron antineutrinos disappearance in the RENO experiment. Phys Rev Lett 2012; 108:191802. [PMID: 23003027 DOI: 10.1103/physrevlett.108.191802] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Indexed: 06/01/2023]
Abstract
The RENO experiment has observed the disappearance of reactor electron antineutrinos, consistent with neutrino oscillations, with a significance of 4.9 standard deviations. Antineutrinos from six 2.8 GW(th) reactors at the Yonggwang Nuclear Power Plant in Korea, are detected by two identical detectors located at 294 and 1383 m, respectively, from the reactor array center. In the 229 d data-taking period between 11 August 2011 and 26 March 2012, the far (near) detector observed 17102 (154088) electron antineutrino candidate events with a background fraction of 5.5% (2.7%). The ratio of observed to expected numbers of antineutrinos in the far detector is 0.920±0.009(stat)±0.014(syst). From this deficit, we determine sin(2)2θ(13)=0.113±0.013(stat)±0.019(syst) based on a rate-only analysis.
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Affiliation(s)
- J K Ahn
- Department of Physics, Pusan National University, Busan, 609-735, Korea
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20
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Jeong IS, Oh BS, Kim SJ, Yun CH, Beom MS, Kim DW. Pilomatrix Carcinoma in the Chest Wall Around an Eloesser Open Window - A case report -. Korean J Thorac Cardiovasc Surg 2011; 44:269-71. [PMID: 22263167 PMCID: PMC3249318 DOI: 10.5090/kjtcs.2011.44.3.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 10/17/2010] [Accepted: 05/11/2011] [Indexed: 11/16/2022]
Abstract
Pilomatrix carcinoma originates in the matrix cell and is marked by exophytic growing and common local recurrence. There is no established treatment for wide local invasion and metastasis of the pilomatrix besides wide surgical resection. We report a case of rapidly progressive pilomatrix carcinoma, which arose around an Eloesser open window with direct invasion to the adjacent tissue.
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Affiliation(s)
- In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University, Korea
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Jeong IS, Ahn BH, Kim SJ, Oh SG, Oh BS, Kim SH. Mid- to Long-term Results of Surgical Treatment of ASD in Patients over 60 Years Old. Korean J Thorac Cardiovasc Surg 2011; 44:137-41. [PMID: 22263140 PMCID: PMC3249289 DOI: 10.5090/kjtcs.2011.44.2.137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 09/27/2010] [Accepted: 11/15/2010] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is controversy about the benefit of surgical correction of an atrial septal defect (ASD) in patients over 60 years old. The purpose of this study was to determine whether surgical treatment is beneficial in those 60 years of age or older. MATERIALS AND METHODS We reviewed the clinical course of 57 patients (mean age: 63.54±5.59 years) diagnosed with an isolated secundum ASD after the age of 60. The 24 patients (group A) who underwent surgical repair were compared with the 33 patients (group B) who were treated non-surgically. The mean follow-up period was 6.8±4.5 years. RESULTS One operative death, 5 late deaths (20.8%) in group A, and 9 deaths (27.3%) in group B occurred in the study period. Symptomatic improvement was noted in 18 patients (75%) of group A after surgery. However 13 patients (39.4%) of group B showed symptomatic improvement during the follow-up period (p=0.012). The incidence of new atrial arrhythmia of the two groups was significantly different (16.7% vs 36.7%, p=0.038). The actuarial 10 year survival rate was 79% in group A and 73% in group B. CONCLUSION Although surgical correction of ASD did not increase survival in patients over 60 years old, the surgical outcomes of ASD showed low operative mortality and resulted in symptomatic improvement in the majority of these patients. This study has shown the benefits of surgical closure of ASD even in advanced age in comparison to medical treatment.
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Affiliation(s)
- In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University, Korea
| | - Byoung-Hee Ahn
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University, Korea
| | - Soon-Jin Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University, Korea
| | - Sang-Gi Oh
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University, Korea
| | - Bong-Suk Oh
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University, Korea
| | - Sang-Hyung Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University, Korea
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Yun CH, Oh SG, Kim SJ, Jeong IS, Ahn BH, Kim SH. Aortic Thrombus with Myocardial Infarction. Korean J Thorac Cardiovasc Surg 2010. [DOI: 10.5090/kjtcs.2010.43.3.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Chi-Hyeong Yun
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University
| | - Sang-Gi Oh
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University
| | - Soon-Jin Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University
| | - Byoung-Hee Ahn
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University
| | - Sang-Hyung Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, College of Medicine, Chonnam National University
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Chekar JK, Ahn BH, Oh SG, Jeong IS, Yun CH, Kim SH. Papillary Fibroelastoma of Pulmonary Valve with Congestive Heart Failure -A case report-. Korean J Thorac Cardiovasc Surg 2010. [DOI: 10.5090/kjtcs.2010.43.2.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jay-Key Chekar
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School
| | - Byoung-Hee Ahn
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School
| | - Sang-Gi Oh
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School
| | - Chi-Hyeong Yun
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School
| | - Sang-Hyung Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School
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Yun J, Na KJ, Chekar JK, Jeong IS, Song SY, Oh SG. The Clinical Effects of Surgical Treatment for Hemoptysis due to Inflammatory Lung Disease. Korean J Thorac Cardiovasc Surg 2010. [DOI: 10.5090/kjtcs.2010.43.2.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jusik Yun
- Department of Thoracic and Cardiovascular Surgery, Mokpo National Hospital
| | - Kook-Joo Na
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School
| | - Jay-Key Chekar
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School
| | - Sang-Yun Song
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital
| | - Sang-Gi Oh
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School
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Chekar JK, Song SY, Na KJ, Ahn BH, Oh SG, Jeong IS, Park MH. Occult Papillary Thyroid Carcinoma Presenting as a Huge Mediastinal Cystic Metastasis. Korean J Thorac Cardiovasc Surg 2010. [DOI: 10.5090/kjtcs.2010.43.1.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jay Key Chekar
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital
| | - Sang-Yun Song
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital
| | - Kook-Ju Na
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital
| | - Byoung-Hee Ahn
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital
| | - Sang-Gi Oh
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital
| | - Min-Ho Park
- Department of Surgery, Chonnam National University Hwasun Hospital
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Baeck JH, Park SA, Lee WJ, Jeong IS, Jeong K, Cho MH, Kim YK, Min BG, Ko DH. Electronic and structural characteristics of Zr-incorporated Gd2O3 films on strained SiGe substrates. J Chem Phys 2009; 130:204510. [PMID: 19485460 DOI: 10.1063/1.3140203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Zr-incorporated Gd(2)O(3) films were grown on various substrates as a function of Zr content. The extent of interfacial reactions was found to be critically dependent on both the incorporated Zr content and the substrate type. Specifically, the silicide layer was suppressed and the Gd(2)O(3) phase was changed to ZrO(2) on a Si substrate with increasing Zr content. Crystalline Gd(2)Ge(2)O(7) was grown on a Ge substrate, as the result of interfacial reactions between Gd-oxide and the Ge substrate. However, interfacial reactions were not affected by the amount of Zr incorporated. On the SiGe/Si substrate, reactions between Gd-oxide and Si could be controlled effectively by the incorporation of Zr, while the extent of reactions with Ge was significantly enhanced as the Zr content increased. The formation of an interfacial layer between the film and the SiGe substrate resulted in a textured crystalline growth.
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Affiliation(s)
- J H Baeck
- Department of Physics, Yonsei University, Seoul 120-749, Korea
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27
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Yamamoto S, Zalipska J, Aliu E, Andringa S, Aoki S, Argyriades J, Asakura K, Ashie R, Berghaus F, Berns H, Bhang H, Blondel A, Borghi S, Bouchez J, Burguet-Castell J, Casper D, Catala J, Cavata C, Cervera A, Chen SM, Cho KO, Choi JH, Dore U, Espinal X, Fechner M, Fernandez E, Fukuda Y, Gomez-Cadenas J, Gran R, Hara T, Hasegawa M, Hasegawa T, Hayashi K, Hayato Y, Helmer RL, Hiraide K, Hosaka J, Ichikawa AK, Iinuma M, Ikeda A, Inagaki T, Ishida T, Ishihara K, Ishii T, Ishitsuka M, Itow Y, Iwashita T, Jang HI, Jeon EJ, Jeong IS, Joo KK, Jover G, Jung CK, Kajita T, Kameda J, Kaneyuki K, Kato I, Kearns E, Kerr D, Kim CO, Khabibullin M, Khotjantsev A, Kielczewska D, Kim JY, Kim SB, Kitching P, Kobayashi K, Kobayashi T, Konaka A, Koshio Y, Kropp W, Kubota J, Kudenko Y, Kuno Y, Kurimoto Y, Kutter T, Learned J, Likhoded S, Lim IT, Loverre PF, Ludovici L, Maesaka H, Mallet J, Mariani C, Matsuno S, Matveev V, McConnel K, McGrew C, Mikheyev S, Minamino A, Mine S, Mineev O, Mitsuda C, Miura M, Moriguchi Y, Morita T, Moriyama S, Nakadaira T, Nakahata M, Nakamura K, Nakano I, Nakaya T, Nakayama S, Namba T, Nambu R, Nawang S, Nishikawa K, Nitta K, Nova F, Novella P, Obayashi Y, Okada A, Okumura K, Oser SM, Oyama Y, Pac MY, Pierre F, Rodriguez A, Saji C, Sakuda M, Sanchez F, Sarrat A, Sasaki T, Sato H, Scholberg K, Schroeter R, Sekiguchi M, Shiozawa M, Shiraishi K, Sitjes G, Smy M, Sobel H, Sorel M, Stone J, Sulak L, Suzuki A, Suzuki Y, Takahashi T, Takenaga Y, Takeuchi Y, Taki K, Takubo Y, Tamura N, Tanaka M, Terri R, T'jampens S, Tornero-Lopez A, Totsuka Y, Ueda S, Vagins M, Whitehead L, Walter CW, Wang W, Wilkes RJ, Yamada S, Yanagisawa C, Yershov N, Yokoyama H, Yokoyama M, Yoo J, Yoshida M. Improved search for nu(mu) --> nu(e) oscillation in a long-baseline accelerator experiment. Phys Rev Lett 2006; 96:181801. [PMID: 16712358 DOI: 10.1103/physrevlett.96.181801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2006] [Indexed: 05/09/2023]
Abstract
We performed an improved search for nu(mu) --> nu(e) oscillation with the KEK to Kamioka (K2K) long-baseline neutrino oscillation experiment, using the full data sample of 9.2 x 10(19) protons on target. No evidence for a nu(e) appearance signal was found, and we set bounds on the nu(mu) --> nu(e) oscillation parameters. At Deltam(2)=2.8 x 10(-3) eV(2), the best-fit value of the K2Knu(mu) disappearance analysis, we set an upper limit of sin(2)2theta(mue) < 0.13 at a 90% confidence level.
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Affiliation(s)
- S Yamamoto
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
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Hasegawa M, Aliu E, Andringa S, Aoki S, Argyriades J, Asakura K, Ashie R, Berns H, Bhang H, Blondel A, Borghi S, Bouchez J, Burguet-Castell J, Casper D, Cavata C, Cervera A, Chen SM, Cho KO, Choi JH, Dore U, Espinal X, Fechner M, Fernandez E, Fukuda Y, Gomez-Cadenas J, Gran R, Hara T, Hasegawa T, Hayashi K, Hayato Y, Helmer RL, Hill J, Hiraide K, Hosaka J, Ichikawa AK, Iinuma M, Ikeda A, Inagaki T, Ishida T, Ishihara K, Ishii T, Ishitsuka M, Itow Y, Iwashita T, Jang HI, Jeon EJ, Jeong IS, Joo KK, Jover G, Jung CK, Kajita T, Kameda J, Kaneyuki K, Kato I, Kearns E, Kerr D, Kim CO, Khabibullin M, Khotjantsev A, Kielczewska D, Kim JY, Kim SB, Kitching P, Kobayashi K, Kobayashi T, Konaka A, Koshio Y, Kropp W, Kubota J, Kudenko Y, Kuno Y, Kutter T, Learned J, Likhoded S, Lim IT, Loverre PF, Ludovici L, Maesaka H, Mallet J, Mariani C, Maruyama T, Matsuno S, Matveev V, Mauger C, McConnel K, McGrew C, Mikheyev S, Minamino A, Mine S, Mineev O, Mitsuda C, Miura M, Moriguchi Y, Morita T, Moriyama S, Nakadaira T, Nakahata M, Nakamura K, Nakano I, Nakaya T, Nakayama S, Namba T, Nambu R, Nawang S, Nishikawa K, Nitta K, Nova F, Novella P, Obayashi Y, Okada A, Okumura K, Oser SM, Oyama Y, Pac MY, Pierre F, Rodriguez A, Saji C, Sakuda M, Sanchez F, Sarrat A, Sasaki T, Sato H, Scholberg K, Schroeter R, Sekiguchi M, Sharkey E, Shiozawa M, Shiraishi K, Sitjes G, Smy M, Sobel H, Stone J, Sulak L, Suzuki A, Suzuki Y, Takahashi T, Takenaga Y, Takeuchi Y, Taki K, Takubo Y, Tamura N, Tanaka M, Terri R, T'jampens S, Tornero-Lopez A, Totsuka Y, Ueda S, Vagins M, Whitehead L, Walter CW, Wang W, Wilkes RJ, Yamada S, Yamamoto S, Yanagisawa C, Yershov N, Yokoyama H, Yokoyama M, Yoo J, Yoshida M, Zalipska J. Search for coherent charged pion production in neutrino-carbon interactions. Phys Rev Lett 2005; 95:252301. [PMID: 16384451 DOI: 10.1103/physrevlett.95.252301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2005] [Indexed: 05/05/2023]
Abstract
We report the result from a search for charged-current coherent pion production induced by muon neutrinos with a mean energy of 1.3 GeV. The data are collected with a fully active scintillator detector in the K2K long-baseline neutrino oscillation experiment. No evidence for coherent pion production is observed, and an upper limit of is set on the cross section ratio of coherent pion production to the total charged-current interaction at 90% confidence level. This is the first experimental limit for coherent charged pion production in the energy region of a few GeV.
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Affiliation(s)
- M Hasegawa
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
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Aliu E, Andringa S, Aoki S, Argyriades J, Asakura K, Ashie R, Berns H, Bhang H, Blondel A, Borghi S, Bouchez J, Burguet-Castell J, Casper D, Cavata C, Cervera A, Cho KO, Choi JH, Dore U, Espinal X, Fechner M, Fernandez E, Fukuda Y, Gomez-Cadenas J, Gran R, Hara T, Hasegawa M, Hasegawa T, Hayashi K, Hayato Y, Helmer RL, Hill J, Hiraide K, Hosaka J, Ichikawa AK, Iinuma M, Ikeda A, Inagaki T, Ishida T, Ishihara K, Ishii T, Ishitsuka M, Itow Y, Iwashita T, Jang HI, Jeon EJ, Jeong IS, Joo K, Jover G, Jung CK, Kajita T, Kameda J, Kaneyuki K, Kato I, Kearns E, Kerr D, Kim CO, Khabibullin M, Khotjantsev A, Kielczewska D, Kim JY, Kim S, Kitching P, Kobayashi K, Kobayashi T, Konaka A, Koshio Y, Kropp W, Kubota J, Kudenko Y, Kuno Y, Kutter T, Learned J, Likhoded S, Lim IT, Loverre PF, Ludovici L, Maesaka H, Mallet J, Mariani C, Maruyama T, Matsuno S, Matveev V, Mauger C, McConnel K, McGrew C, Mikheyev S, Minamino A, Mine S, Mineev O, Mitsuda C, Miura M, Moriguchi Y, Morita T, Moriyama S, Nakadaira T, Nakahata M, Nakamura K, Nakano I, Nakaya T, Nakayama S, Namba T, Nambu R, Nawang S, Nishikawa K, Nitta K, Nova F, Novella P, Obayashi Y, Okada A, Okumura K, Oser SM, Oyama Y, Pac MY, Pierre F, Rodriguez A, Saji C, Sakuda M, Sanchez F, Sarrat A, Sasaki T, Scholberg K, Schroeter R, Sekiguchi M, Sharkey E, Shiozawa M, Shiraishi K, Sitjes G, Smy M, Sobel H, Stone J, Sulak L, Suzuki A, Suzuki Y, Takahashi T, Takenaga Y, Takeuchi Y, Taki K, Takubo Y, Tamura N, Tanaka M, Terri R, T'Jampens S, Tornero-Lopez A, Totsuka Y, Ueda S, Vagins M, Walter CW, Wang W, Wilkes RJ, Yamada S, Yamamoto S, Yanagisawa C, Yershov N, Yokoyama H, Yokoyama M, Yoo J, Yoshida M, Zalipska J. Evidence for muon neutrino oscillation in an accelerator-based experiment. Phys Rev Lett 2005; 94:081802. [PMID: 15783876 DOI: 10.1103/physrevlett.94.081802] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Indexed: 05/24/2023]
Abstract
We present results for nu(mu) oscillation in the KEK to Kamioka (K2K) long-baseline neutrino oscillation experiment. K2K uses an accelerator-produced nu(mu) beam with a mean energy of 1.3 GeV directed at the Super-Kamiokande detector. We observed the energy-dependent disappearance of nu(mu), which we presume have oscillated to nu(tau). The probability that we would observe these results if there is no neutrino oscillation is 0.0050% (4.0 sigma).
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Affiliation(s)
- E Aliu
- Institut de Fisica d'Altes Energies, Universitat Autonoma de Barcelona, E-08193 Bellaterra (Barcelona), Spain
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Chung HS, Jeong HJ, Hong SH, Kim MS, Kim SJ, Song BK, Jeong IS, Lee EJ, Ahn JW, Baek SH, Kim HM. Induction of nitric oxide synthase by Oldenlandia diffusa in mouse peritoneal macrophages. Biol Pharm Bull 2002; 25:1142-6. [PMID: 12230105 DOI: 10.1248/bpb.25.1142] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Oldenlandia diffusa (OD) has been used to treat malignant tumors. In this study using mouse peritoneal macrophages, we have examined the mechanism by which OD regulates nitric oxide (NO) production. When OD (1 mg/ml) was used in combination with 10 U/ml of recombinant interferon-gamma (rIFN-gamma), there was a marked cooperative induction of NO production (36.13+/-7.12 microM) by the Griess method (nitrite). Treatment of macrophages with rIFN-gamma plus OD (1 mg/ml) caused a significant increase in tumor necrosis factor-alpha (TNF-alpha) production (4.49+/-1.43 ng/ml) by enzyme-linked immunosorbent assay. The increased production of NO and TNF-alpha from rIFN-gamma-plus OD-stimulated cells was almost completely inhibited by pretreatment with 100 microM of pyrrolidine dithiocarbamate (PDTC), an inhibitor of nuclear factor kappa B (NF-kappaB). PDTC also inhibited phosphorylation of IkappaB in rIFN-gamma-plus OD-stimulated cells. These findings demonstrate that OD increases the production of NO and TNF-alpha by rIFN-gamma-primed macrophages and suggest that NF-kappaB plays a critical role in mediating these effects of OD.
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Affiliation(s)
- Hwan-Suck Chung
- Department of Oriental Pharmacy, College of Pharmacy, Wonkwang University, Iksan, Chonbuk, South Korea.
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