• Journal of Chest Surgery
• /
• v.40 no.1 s.270
• /
• pp.79-82
• /
• 2007

Tracheobronchial rupture due to blunt chest trauma is an uncommon injury although the incidence is increasing. Early diagnosis and primary repair of tracheobronchial rupture not only restore a normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair We present one case of the tracheal transsection caused by traffic accident. Patient suffered from progressive dyspnea, subcutaneous emphysema on the neck and anterior chest wall and tension pneumothorax at both sides were noted. Although both closed thoracostomy were done, massive air leakage through the chest tube continued and subcutaneous emphysema spread to the anterior abdominal wall and scrotum and the degree of dyspnea aggravated. With the impression of tracheobronchial injury, we performed the emergency operation. Preoperative bronchoscopy at the operation room was proceeded, which revealed the trachea was near totally transsected in transverse direction. Operation was performed through collar incisiion on the anterior neck, and the trachea was anastomosed with 4-0 $Vicryl^{(R)}$ interruptedly. Postoperative course were uneventful and patient discharged without any complications.

• Journal of Chest Surgery
• /
• v.40 no.9
• /
• pp.613-616
• /
• 2007

Background: Spontaneous hemopneumothorax is a rare disease and can be life threatening; it occurs in $1{\sim}12%$ of patients with spontaneous pneumothorax. We analyzed clinical reviews and treatments, as well as complications of spontaneous hemopneumothorax patients that were treated to aid in the optimal management. Material and Method: We studied retrospectively 30 cases with spontaneous hemopneumothorax for 11 years, from 1995 to 2006, at our hospital. Result: All the patients were male and most of the patients were under 30 years. The sides with the disorder were as follows: right in 15 cases and left in 15 cases. Patients showed mostly initial symptoms of chest pain, dyspnea and hypovolemic shock. All patients underwent a closed thoracostomy and 27 patients underwent surgery. Chemical pleurodesis was peformed because of postoperative persistent air leakage and one case was treated in the ICU due to re-expansion pulmonary edema, There were no other complications such as fibrothorax seen during the follow-up periods. Conclusion: The most important finding is proper initial management, as the spontaneous hemopneumothorax can potentially lead to a life-threatening condition. Recently, video assisted thoracoscopic surgery (VATS) is common procedure for general thoracic surgery and overcomes the weak points of performing a thoracotomy. The results of VATS are encouraging.

• Journal of Korean Society of Occupational and Environmental Hygiene
• /
• v.28 no.4
• /
• pp.382-392
• /
• 2018

Objective: Allergic diseases such as asthma due to fungal exposure in houses have increased, and proper management is urgent. Mold can grow in the air, floor, walls, and other areas according to environmental conditions, and there are many limitations to the conventional methodology for examining fungal exposure. For this reason, the degree of fungal contamination is being evaluated by ERMI (Environmental Relative Moldiness Index), a quantitative analysis method proposed by the EPA. In this study, we compared ERMI values between water-damaged dwellings and non-damaged ones to evaluate the effectiveness of Korean ERMI values. We also explored the association of ERMI values with the level of airborne mold and characteristics of dwellings. Methods: Floor dust was collected after installing a Dustream collector on the suction port of a vacuum cleaner. The collected samples were filtered to remove only 5 mg of dust, and DNA was extracted using the FastDNA SPIN KIT protocol. Results: The ERMI values were found to be 19.6 (-6.9-58.8) for flooded houses, 7.5 (-29.2-48.3) for leaks/condensation, and 0.8 (-29.2-37.9) for non-damaged dwellings. The airborne concentration of mold for flooded, leakage or condensed, and non-damaged houses were $684CFU/m^3$, $566CFU/m^3$, and $378CFU/m^3$, respectively. The correlation between ERMI values and the levels of airborne mold was low (R = 0.038), but a weakly significant association of the ERMI values with the concentration of particulate matter ($PM_{10}$) was observed as well(R=0.231,P<0.05). Conclusions: Our findings show that the reference value using ERMI can be used to distinguish water-damaged and non-damaged dwellings. It is believed that ERMI values could be a promising tool for assessing long-term fungal exposure in dwellings.

• Journal of the Korean Institute of Gas
• /
• v.25 no.2
• /
• pp.22-27
• /
• 2021

This paper is a purpose to study the failure examples for LPG vehicle. The first example, the researcher certified the incongruity phenomenon decreased engine power by ignition fire leakage because of spark plug threaded part damage assembling in cylinder head. The second example, the timing mark that accurately adjusting the camshaft and crankshaft position were twisted about 0.5 block each other. Finally, the researcher seeked the disharmony phenomenon as it couldn't set ignition timing. The third example, the researcher knew the failure phenomenon by interrupted the closing period for intake valve moving with air flow in the number 3 port of cylinder head as the foreign substance in cylinder head didn't remove. Therefore, the manager of a car has to thorough going inspect and the manufacture of a car must remove the cause of failure with quality assurance.

• Journal of the Korea institute for structural maintenance and inspection
• /
• v.25 no.4
• /
• pp.56-64
• /
• 2021

Leakage due to deterioration and damage is one of the major causes of volume change by freezing and thawing, and it leads micro-cracking and surface scaling in concrete structures. The deterioration of damaged concrete accelerates with the chloride attack. Thus, in the detailed guidelines for facility performance evaluation (2020), the quality of cover concrete and the freeze-thaw (FT) repetition cycle were newly suggested for concrete durability assessment. The quality of cover concrete should be evaluated by the rebound hammer test and the FT repetition cycle should be also considered in the deterioration environmental assessment. This study suggested the application of fast dynamic based nonlinear ultrasound method to monitor initial micro-scale damage under freezing and thawing environment. Concrete specimens were fabricated with different water-cement ratios (40%, 60%) and air contents (1.5% and 3.0%). The compressive strength, rebound number, relative dynamic modulus, and nonlinear ultrasound were measured with different FT cycles. The scanning electron microscopy was also performed to investigate the micro-scale FT damage. As a result, both the rebound number and the relative dynamic modulus had difficulty to detect early damage but the proposed method showed a potential to detect initial micro-scale damage and predict the FT resistance performance of concrete.

• Journal of Chest Surgery
• /
• v.32 no.5
• /
• pp.448-455
• /
• 1999

Background: Recent developments in techniques of video-assisted thoracic surgery(VATS) and endoscopic equipment has expanded the application of video-assisted surgical procedures in the field of thoracic surgery. Especially, it will probably become the treatment of choice of spontaneous pneumothorax(SP). There is, however, a high recurrence rate, high cost, and paucity of long-term results. We report the results of postoperative follow-up and analyze perioperative parameters affected to recurrence, retrospectively. Material and Method: From march 1992 to march 1997, 276 patients with spontaneous pneumothorax underwent 292 VATS procedures. Conversion to open thoracotomy was necessitated in eight patients, and this patients excluded from the study. Result: The sex distribution was 249 males and 31 females. The mean age was 28.1 12.2 years(range, 15 to 69 years). Primary SP was 237cases(83.5%) and secondary SP was 47cases(16.5%). The major underlying lung diseases associated with secondary SP were tuberculosis 27cases(57.4%) and emphysema 8cases (38.3%). Operative indications included Ipsilateral recurrence 123(43.9%), persistent air-leak 53(18.9%), x-ray visible bleb 40(14.3%), tension 30(10.7%), contralateral recurrence 21(7.5%), uncomplicated first episode 8(2.9%), bilateral 3(1.1%), complicated episode 2(0.7%). Blebs were visualized in 247cases(87%) and 244cases(85.9%) performed stapled blebectomy. Early postoperative complications occurred in 33 cases(11.6%): 16 prolonged air-leak more than 5 days(four of them were required a second operation and found missed blebs); 5 bleeding; 5 empyema; 2 atelectasis; 1 wound infection. No deaths occured. The mean operative time was 52.8 23.1 minutes(range, 20 to 165 minutes). The mean d ration of chest tube drainage was 5.0 4.5 days(range, 2 to 37 days). The mean duration ofhospital stay was 8.2 5.5 days (range, 3 to 43days). At a mean follow-up 22.3 18.4 months(range, 1 to 65 months), 12 patients(4.2%) were lost to follow-up. There were 24 recurrences and seven patients underwent second operation and 6 patients(85.7%) were found the missed blebs. 12 perioperative parameters(age, sex, site, underlying disease, extent of collapse, operative indication, size of bleb, number of bleb, location of bleb, bleb management, pleural procedure, prolonged postoperative air-leak) were analyzed statistically to identify significant predictors of recurrence. The significant predictors of recurrence was the underlying disease[17.0%(8/47): 6.8%(16/237), p=0.038], prolonged postoperative air-leakage[37.5%(6/16): 6.7%(18/268), p=0.001], and pleural procedure [11.4%(19/167): 4.3%(5/117), p=0.034]. Blebectomy has less recurrence rate then non-blebectomy [8.2%(20/244) : 10.0%(4/40), p>0. 5]. However, this difference was not statistically significant(p=0.758). Conclusion: We conclude that it is important that we shoud careful finding of bleb during VATS due to reducing of recurrnece, and cases of no bleb identified and secondary spontaneous pneumothorax were indicated of pleurodectomy. VATS is a valid alternative to open procedure for the treatment of spontaneous pneumothorax with less pain, shorter hospital stay, more rapid return to work, high patient acceptance, less scar and exellent cosmetics. But, there is high recurrence rate and high cost, and than it is necessary to evaluate of long-term results for recurrence and to observate carefully during VATS.

• Journal of Chest Surgery
• /
• v.36 no.7
• /
• pp.497-503
• /
• 2003

Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

• Journal of Chest Surgery
• /
• v.42 no.4
• /
• pp.497-501
• /
• 2009

Background: Prolonged air leakage and pleural fluid drainage from a chest tube may delay removing the chest tube after a patient undergoes video-assisted thoracoscopic wedge resection and the patient is otherwise ready for discharge. We reviewed 37 outpatients patients who were being managed with a postoperative chest tube (a Panda Pneumothorax set with a Heimlich valve). Material and Method: From January 2005 to December 2007, 294 patients underwent video-assisted thoracoscopic wedge resections & pleurodesis. Of them, 37 patients met the criteria for outpatient chest drainage management with using a Panda Pneumothorax set with a Heimlich valve. The patients received written instructions, and they demonstrated competence with using the Panda system. The patients returned for chest tube removal after satisfactory resolution of their air leak and pleural fluid drainage. Result: The patients discharged with a Panda pneumothorax set had a longer duration of hospital stay (mean: 10.3$\pm$1.7 days, range: 11 to 17 days) as compared with the patients without a Panda pneumothorax set (mean: 6.2$\pm$1.5 days, range: 4 to 7 days). The chest tube was removed successfully from the patients with a Panda pneumothorax set at an average of 9.8$\pm$1.6 days (range: 9$\sim$18 days) after discharge. There were no major complications. Four patients experienced minor complications. Thirty six patients (97.3%) experienced uneventful and successful outpatient chest tube management. Conclusion: Successful postoperative outpatient chest tube management with using the Panda set was accomplished in 36 selected patients. This program resulted in a substantially reduced hospital cost and enhanced patient satisfaction by allowing earlier discharge.

• Journal of the Korea Organic Resources Recycling Association
• /
• v.9 no.1
• /
• pp.56-64
• /
• 2001

Composting of livestock feces is economic and safe process to decrease the possibility of direct leakage of organic pollutants to ecosystem from commercial and environmental point of view. This study was conducted with three different experiments related to composting of livestock feces. The purpose of experiment 1 was to investigate changes of characteristic of compost pile during composting period by low temperature in cold season. To compare composting effect of experimental compost pile and control pile exposed in cold air, experimental compost piles were warmed up by hot air until their temperatures were reached at $35^{\circ}C$. Sawdust, Ricehull and Ricestraw were mixed with livestock feces as bulking agent. The highest temperatures of compost pile during composting period were in sawdust, rice hull, rice straw, and control were $75^{\circ}C$, $76^{\circ}C$, $68^{\circ}C$, $45^{\circ}C$ respectively. Moisture content, pH, C/N and volume of compost were decreased during composting period. Experiment 2 was carried out to study utilization effect of compost by plant. A corn was cultivated for 3 years on fertilized land with compost and chemical fertilizer. The amount of harvest and nutrition value of corn were analyzed. In first year of trial, the amount of harvest of corn on land treated with compost was lower by 20% than that of land treated with chemical fertilizer. In second year, there was no difference in yield of com between compost and chemical fertilizer. In third year, the yield of com on land fertilized with compost was much more than that of land fertilized with chemical fertilizer. The purpose of experiment 3 was to estimate the decrease of malodorous gas originating from livestock feces by bio-filter. Four types of bio-filters filled with saw dust, night soil, fermented compost and leaf mold were manufactured and tested. Each bio-filter achieved 87-95% $NH_3$ removal efficiency. This performance was maintained for 10 days. The highest $NH_3$ removal efficiency was achieved by leaf mold on the first day of operation period. It reduced the concentration of $NH_3$ by about 95%. Night soil and fermented compost showed nearly equal performance of 93 to 94% for 10 days from the beginning of operation. The concentration of hydrogen sulfide and methyl mercaptan originating for compost were equal to or less than $3mg/{\ell}$ and $2mg/{\ell}$, respectively. After passing throughout the bio-filter, hydrogen sulfide and methyl mercaptan were not detected.

• Journal of Chest Surgery
• /
• v.32 no.3
• /
• pp.294-298
• /
• 1999

Background: Video-assisted thoracoscopic surgery(VATS) has been established as a new method for treatment of spontaneous pneumothorax. We compared the clinical results of VATS with those of thoracotomy performed during the recent 5 years. Material and Method: We analyzed 126 patients whose medical records were available among the 154 patients who underwent operations for spontaneous pneumothorax from 1992 to 1996. The mean age was 27.1 years(15 to 75 years). 87 patients were operated on by VATS(Group A) and the other 39 by thoracotomy(Group B). The mean follow-up period was 14.7 months. Result: The operation time was shorter in group A than in group B(90.6${\pm}$38.6minutes: 117.2${\pm}$58.9minutes, p<0.05). The duration of postoperative hospital stay was shorter in group A than in group B(6.7${\pm}$4.2: 9.4${\pm}$3.3 days, p<0.05). The amount of analgesics(nalbuphin HCl, ketoprofen) used postoperatively were 2.4${\pm}$2.8 ampules in group A, which is less than the 6.5${\pm}$5.6 ampules in group B(p<0.05). The number of staples used in group A was smaller(2.7${\pm}$1.3 in group A, 1.76${\pm}$1.1 in group B, p<0.05). The duration of chest tube indwelling(4.3${\pm}$4.0 days in group A, and 5.6${\pm}$3.0 days in group B, NS), the recurrence rate(13.8% in group A, 2.6% in group B, NS), and the duration of air leakage(1.3${\pm}$3.3 days in group A, and 1.0${\pm}$2.5days in group B, NS) were not statistically different between the two groups. Conclusion: The application of VATS for the treatment of spontaneous pneumothorax has brought in better clinical results(shorter operation time, shorter hospital stay, less pain, and better cosmetic merits) than the thoracotomy without increasing any morbidity. However no advantages in recurrence rates and duration of postoperative air leakages are revealed.