Gastrointestinal Bleeding in Extracorporeal Membrane Oxygenation Patients: A Comprehensive Analysis of Risk Factors and Clinical Outcomes

Kim Sahri,Lim Jung Hyun,Ko Ho Hyun,Kwon Lyo Min,이홍규,Ra Yong Joon,Kim Kunil,김형수 대한심장혈관흉부외과학회 2024 Journal of Chest Surgery (J Chest Surg) Vol.57 No.2

Background: Extracorporeal membrane oxygenation (ECMO) is an intervention for severe heart and lung failure; however, it poses the risk of complications, including gastrointestinal bleeding (GIB). Comprehensive analyses of GIB in patients undergoing ECMO are limited, and its impact on clinical outcomes remains unclear. Methods: This retrospective study included 484 patients who received venovenous and venoarterial ECMO between January 2015 and December 2022. Data collected included patient characteristics, laboratory results, GIB details, and interventions. Statistical analyses were performed to identify risk factors and assess the outcomes. Results: GIB occurred in 44 of 484 patients (9.1%) who received ECMO. Multivariable analysis revealed that older age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01–1.06; p=0.0130) and need to change the ECMO mode (OR, 3.74; 95% CI, 1.75–7.96; p=0.0006) were significant risk factors for GIB, whereas no association was found with antiplatelet or systemic anticoagulation therapies during ECMO management. Half of the patients with GIB (22/44, 50%) underwent intervention, with endoscopy as the primary modality (19/22, 86.4%). Patients who underwent ECMO and developed GIB had higher rates of mortality (40/44 [90.9%] vs. 262/440 [59.5%]) and ECMO weaning failure (38/44 [86.4%] vs. 208/440 [47.3%]). Conclusion: GIB in patients undergoing ECMO is associated with adverse outcomes, including increased risks of mortality and weaning failure. Even in seemingly uncomplicated cases, it is crucial to avoid underestimating the significance of GIB.

Outcomes of Extracorporeal Membrane Oxygenation in COVID-19: A Single-Center Study

Kim Sahri,Lim Jung Hyun,고호현,이홍규,Ra Yong Joon,김건일,김형수 대한심장혈관흉부외과학회 2024 Journal of Chest Surgery (J Chest Surg) Vol.57 No.1

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

Some Physical Properties of 9-Year-Old Xylia xylocarpa Planted in Malaysia

Mohd. Hamami Sahri,James Josue,Su Kyoung Chun 한국가구학회 2008 한국가구학회지 Vol.19 No.6

Xylia xylocarpa is fast-growing trees that are currently planted on trial basis in Sabah, Malaysia. The wood quality of trees grown in Sabah may differ from those grown in other places due to the environmental factors. Five 9-year-old trees of each species were extracted from their respective plots at Luasong, Tawau. Wood specimens were prepared from three height levels; bottom, middle and top, at the inner and outer radial positions. The within-tree and between-tree variations of physical properties of these species were analyzed. The basic density, oven-dry density and green moisture content (MC) are 0.72 g/㎤, 0.78 g/㎤ and 49.8% respectively. The shrinkage from green to oven-dry conditions for the radial and tangential directions were 3.35% and 5.76%, respectively. The trends of within-tree variations for most properties were more consistent in radial rather than vertical direction. This suggests diameter growth to be a more important factor contributing to the variations compared to height. Samples from the outer part of the stem were found to have higher density, shrinkage and mechanical strengths. The between-trees variations of some wood properties were found to be significantly different, probably due to genetic and micro-environmental factors. Significant correlation was recorded among the physical properties of the species. The true potential of X. xylocarpa for end-uses would be enhanced by further research such as the study on properties of wood from different sites and other properties like durability, seasoning, processing and machining characteristics. The characteristics of X. xylocarpa are comparable to a number of local popular hardwood species, indicating its suitability for heavy construction uses.

Chemical Pleurodesis Using Tetracycline for the Management of Postoperative Pneumothorax Recurrence

양준태,Kim Sahri,김형수,이희성,Ra Yong Joon,이홍규 대한심장혈관흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.4

Background: Although there is no obvious recommendation for the management of pneumothorax recurrence after surgery, chemical pleurodesis with tetracycline has been applied as a significant treatment approach. The objective of this study was to evaluate the effectiveness of chemical pleurodesis with tetracycline for the management of postoperative recurrence of primary spontaneous pneumothorax (PSP). Methods: We retrospectively analyzed patients who underwent video-assisted thoracic surgery (VATS) as therapy for PSP at Hallym University Sacred Heart Hospital from January 2010 to December 2016. Patients who had ipsilateral recurrence after surgery were included in this study. Patients who underwent pleural drainage with chemical pleurodesis were compared with patients who only underwent pleural drainage. Results: In total, 932 patients who underwent VATS for PSP were analyzed, and ipsilateral recurrence after surgery occurred in 67 patients (7.1%). The treatment modalities for recurrence after surgery were observation (n=12), pleural drainage alone (n=16), pleural drainage with chemical pleurodesis (n=34), and repeated VATS (n=5). Eight of the 16 patients (50 %) treated with pleural drainage alone had recurrence again, while 15 of the 34 patients (44.1%) treated with pleural drainage and chemical pleurodesis experienced further recurrence. Chemical pleurodesis with tetracycline did not show a meaningful difference in the re-recurrence rate in comparison with pleural drainage alone (p=0.332). Conclusion: Chemical pleurodesis with tetracycline for the management of postoperative recurrence of PSP was not effective. Further research is required to identify alternative drugs that can significantly decrease the re-recurrence rate.

Wood and Cellular Properties of 4 New Hevea Species

Allwi, Norul Izani Md.,Sahri, Mohd. Hamami,Chun, Su-Kyoung Korea Furniture Society 2008 한국가구학회지 Vol.19 No.4

Increasing demand for timber and the depletion of natural forest have encouraged utilization of many non-popular species. The understanding of wood properties and behavior is important to evaluate the potential of these species to produce high quality end products. This study determines the anatomical and physical properties of Hevea species viz Hevea pauciflora, Hevea guianensis, Hevea spruceana, Hevea benthamiana and Hevea brasiliensis. Each sample tree was cut into three different portions along the height (bottom- B, middle- M and upper -T parts) and two radial samples (outer- O and inner- I parts). H. brasiliensis clone RRIM 912 exhibited the longest fibre with $1214{\mu}m$, followed by H. benthamiana (HB, $1200{\mu}m$), H. pauciflora (HP, $1189{\mu}m$), H. spruceana (HS, $1158{\mu}m$) and H. guianensis (HG, $1145{\mu}m$). Fibre length has a positive correlation with specific gravity. The largest fibre diameter ($24.9{\mu}m$) and lumen diameter ($12.5{\mu}m$) were recorded in H. guianensis. The highest moisture content was obtained from H. spruceana (64.34%) compared to the lowest with 60.01% (Clone RRIM912). The higher moisture content is normally associated with lower strength. Overall, the properties of clone RRIM 912 is found to be comparatively better because of higher strength due to longer fibre length, thicker cell walls and higher specific gravity than the other Hevea species. Therefore, this species can be used as a general utility timber.

Wood and Cellular Properties of 4 New Hevea Species

Norul Izani Md. Allwi,Mohd. Hamami Sahri,Su Kyoung Chun 한국가구학회 2008 한국가구학회지 Vol.19 No.4

Increasing demand for timber and the depletion of natural forest have encouraged utilization of many non-popular species. The understanding of wood properties and behavior is important to evaluate the potential of these species to produce high quality end products. This study determines the anatomical and physical properties of Hevea species viz Hevea pauciflora, Hevea guianensis, Hevea spruceana, Hevea benthamiana and Hevea brasiliensis. Each sample tree was cut into three different portions along the height (bottom- B, middle- M and upper -T parts) and two radial samples (outer- O and inner- I parts). H brasiliensis clone RRIM 912 exhibited the longest fibre with 1214㎛, followed by H. benthamiana (HB, 1200㎛), H.pauciflora (HP, 1189㎛), H. spruceana (HS, 1158㎛) and H. guianensis (HG, 1145㎛). Fibre length has a positive correlation with specific gravity. The largest fibre diameter (24.9㎛) and lumen diameter (12.5㎛) were recorded in H. guianensis. The highest moisture content was obtained from H. spruceana (64.34%) compared to the lowest with 60.01% (Clone RRIM912). The higher moisture content is normally associated with lower strength. Overall, the properties of clone RRIM 912 is found to be comparatively better because of higher strength due to longer fibre length, thicker cell walls and higher specific gravity than the other Hevea species. Therefore, this species can be used as a general utility timber.

A Non-Convex Economic Dispatch Problem with Point-Valve Effect Using a Wind-Driven Optimisation Approach

Ramli Nur Fariza,Kamari Nor Azwan Mohamed,Abd Halim Syahirah,Zulkifley Mohd Asyraf,Sahri Mohd Saiful Mohd,Musirin Ismail 대한전기학회 2022 Journal of Electrical Engineering & Technology Vol.17 No.1

This study presents the effi ciency of the wind-driven optimisation (WDO) approach in solving non-convex economic dispatch problems with point-valve eff ect. The best economic dispatch for a power system is one wherein the system can generate energy at a low cost. The calculation of the generating cost is subject to a number of constraints, such as the power demand for the entire system and the generation limit for each generator unit in the system. In addition, the system should also produce low power loss. The WDO optimisation technique is developed based on the concept of natural wind movement, which serves as a stabiliser to equalise the inequality of air pressure in the atmosphere. One major advantage of WDO over other techniques is its search accuracy. The proposed algorithm has been implemented in two systems, namely, the 10-generator and 40-generator systems. Both systems were tested in a Matlab environment. To highlight the capabilities of WDO, the results using this proposed technique are compared with the results obtained using fl ower pollination algorithm, moth fl ame optimisation, particle swarm optimisation and evolutionary programming techniques to determine the effi ciency of the proposed approach in solving economic dispatch. The simulation results show the capability of WDO in determining the optimal power generation value with minimum generation cost and low rate of power loss.