• Title/Summary/Keyword: Air-leakage rate

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Risk Factors for Recurrent Pneumothorax after Primary Spontaneous Pneumothorax (원발 기흉 수술 후 재발의 위험인자)

  • Yu, Jai-Kun;Lee, Seong-Ki;Seo, Hong-Joo;Seo, Min-Bum
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.724-728
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    • 2008
  • Background: The purpose of this study was to identify factors associated with recurrent pneumothorax after wedge resection in primary spontaneous pneumothorax in our hospital. Material and Method: Two hundred thirty-five consecutive patient (98% males; mean age, $23.9{\pm}4.5$ years) who had undergone video-assisted thoracoscopic surgery (VATS) were reviewed retrospectively. The two groups were divided as follows: group A, non-recurrent patients (225 patients [96%]); and group B, recurrent group (10 patients [4%]); the risk factors were compared between the two groups. The single and multiple factors that influenced the recurrence rate were analyzed using Cox's proportional hazard model. Result: There were no significant differences between the recurrent and non-recurrent groups in terms of gender, smoking, site of recurrence, degree of collapse, operative time, and number or weight of resected bullae. The recurrence rate was significantly more common in the following: younger ages, increased height/weight ratio, longer initial air leakage period, and shorter duration of chest drainage. Early aggressive exercise (<30 days) of patients after wedge resection increased the tendency for recurrence. Conclusion: Thoracoscopic wedge resection does not have a higher recurrence rate than open thoracotomy. However, young age, height/weight ratio, continuous air, and duration of chest tube placement were risk factors for a recurrent pneumothorax.

Staple Line Coverage with a Polyglycolic Acid Patch and Fibrin Glue without Pleural Abrasion after Thoracoscopic Bullectomy for Primary Spontaneous Pneumothorax

  • Hong, Ki Pyo;Kim, Do Kyun;Kang, Kyung Hoon
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.85-91
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    • 2016
  • Background: This study was conducted to determine the efficacy of staple line coverage using a polyglycolic acid patch and fibrin glue without pleural abrasion to prevent recurrent postoperative pneumothorax. Methods: A retrospective analysis was carried out of 116 operations performed between January 2011 and April 2013. During this period, staple lines were covered with a polyglycolic acid patch and fibrin glue in 58 cases (group A), while 58 cases underwent thoracoscopic bullectomy only (group B). Results: The median follow-up period was 33 months (range, 22 to 55 months). The duration of chest tube drainage was shorter in group A (group A $2.7{\pm}1.2day$ vs. group B $3.9{\pm}2.3day$, p=0.001). Prolonged postoperative air leakage occurred more frequently in group B than in group A (43% vs. 19%, p=0.005). The postoperative recurrence rate of pneumothorax was significantly lower in group A (8.6%) than in group B (24.1%) (p=0.043). The total cost of treatment during the follow-up period, including the cost for the treatment of postoperative recurrent pneumothorax, was not significantly different between the two groups (p=0.43). Conclusion: Without pleural abrasion, staple line coverage with a medium-sized polyglycolic acid patch and fibrin glue after thoracoscopic bullectomy for primary spontaneous pneumothorax is a useful technique that can reduce the duration of postoperative pleural drainage and the postoperative recurrence rate of pneumothorax.

Clinical Evaluation of Spontaneous Pneumothorax - A Review of 830 Cases - (자연기흉의 임상적 고찰)

  • Gwon, U-Seok;Kim, Hak-Je;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.299-306
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    • 1988
  • We have reviewed 330 cases of spontaneous pneumothorax from Jan. 1980 to Jul. 1987 at the department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University. The ratio of male to female was 8.4:1, predominant in male. The incidence according to the age group was highest as 32% in the adolescence between 21 and 30 years old. The site of pneumothorax was right in 48%, left in 45% and bilateral in 7%. The initial symptoms were frequently dyspnea in 85%, chest pain in 63%. The etiologic factors were as follows; bleb origin in 31%, tuberculous origin in 30%, COPD in 3.3%, lung cancer in 1.5%, unknown in 29%. There was no significant difference in seasonal incidence irrespective of tuberculous or sex. The employed managements were as follows; bed rest with oxygen inhalation in 4 cases, closed thoracostomy in 326 cases, open thoracotomy in 122 cases, median sternotomy in 23 cases. The operative procedures at thoracotomy were as follows; simple pleurodesis in 5 cases, bleb excision or wedge resection in 113 cases, segmentectomy or lobectomy in 17 cases, decortication in 42 cases. Recurrence rate of each treatment was as follow; 50% in conservative treatment, 19% in closed thoracostomy, 2% in open thoracotomy, 4% in median sternotomy. Therefore overall recurrence rate was 12%. Open thoracotomy was the most effective procedure in recurrent pneumothorax, previous contralateral pneumothorax, bilateral simultaneous pneumothorax, visible bleb or bullae on the chest x-ray and persistent air leakage. 23 cases of unilateral spontaneous pneumothorax was examined whether or not underlying pathology of pneumothorax at opposite lung. 18 cases[78%] were positive findings. Therefore, bilateral thoracotomy by median sternotomy was a good operative method preventing contralateral pneumothorax.

Numerical Study on the Effect of Heat Release Rate and Interior Opening on Fire Flow Velocity in the Case of Interior Fire in an Apartment Building (공동주택 화재 시 화재크기 및 실내 개구부 크기가 화재풍속에 미치는 영향에 관한 수치해석적 연구)

  • Seo, Chanwon;Shin, Weon Gyu
    • Fire Science and Engineering
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    • v.28 no.5
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    • pp.37-43
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    • 2014
  • In the case of interior fire in an apartment building, contamination of vestibule area by fire smoke before air fan operating when fire doors are open makes the evacuation of people very difficult. In order to investigate the effect of heat release rate (HRR) and interior opening on fire flow velocity, numerical simulations using Fire Dynamics Simulator were carried out. In simulations, actual dimensions and configuration of an apartment building were considered and interior leakage and HRR were varied. From simulation results, it was found that fire flow velocity distribution is significantly influenced by HRR and interior opening resulting in the change of the location of a neutral plane. Also, it is shown that there is a larger difference of the fire flow velocity between upper and lower part of the fire door when the neutral plane becomes closer to the ceiling.

Video-assisted Thoracic Surgery [VATS] in Diagnosis and Treatment of Thoracic Diaseas; Report of 90 Cases (비디오 흉강경: 흉부질환의 진단과 치료;90례 보고)

  • 백만종
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.475-482
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    • 1993
  • 90 patients[75 men and 15 women] with the thoracic disease underwent video-assisted thoracic surgery[VATS] during the period March 1992 to February 1993. The thoracic diseases were classified into two groups of spontaneous pneumothorax and general thoracic patients and they were 66 and 24, respectively.The mean size of the tumor resected was 4.3 $\pm$ 2.0 cm x 3.3 $\pm$ 1.1 cm x 2.7 $\pm$ 1.0 cm. The mean time of anesthesia and operation were 90.0 $\pm$ 19.9 min and 43.7 $\pm$ 13.1 min in spontaneous pneumothorax group and 123.3 $\pm$ 40.3 min and 62.8 $\pm$ 32.2 min in general thoracic group. The mean period of postoperative chest tube drainage and hospital stay were 5.0$\pm$ 5.5 days and 6.6 $\pm$ 7.4 days in spontaneous pneumothorax group and 3.5$\pm$ 1.6 days and 9.5 $\pm$ 6.1 days in general thoracic group. The indications of VATS were 71 pleural disease[78.9%: 66 spontaneous pneumothorax; 3 pleural effusions ; 1 pleural paragonimus westermanii cyst; 1 malignant pleural tumor with metastasis to the lung], 9 mediastinal disease[10.0%: 5 benign neurogenic tumor; 2 pericardial cyst; 1 benign cystic teratoma; 1 undifferentiated carcinoma], 8 pulmonary parenchymal disease[8.9%: 3 infectious disease ; 3 interstitial disease ; 2 malignant tumor ], and 2 traumatic cases of exploration and removal of hematoma[2.2%]. The applicated objectives of VATS were diagnostic[ 7 ], therapeutic[ 67 ] and both[ 16 ] and the performed procedures were pleurodesis[ 66 ], wedge resection of lung[ 59 ], parietal pleurectomy[ 11 ], removal of benign tumor[ 9 ], excision and/or biopsy of tumor[ 4 ], pleural biopsy and aspiration of pleural fluid[ 3 ] and exploration of hemothorax and removal of hematoma in traumatic 2 patients. The complication rate was 24.2%[ 16/66 ] in the spontaneous pneumothorax group and 8.3%[ 2/24 ] in the general thoracic group and so overally 20.0%[ 18/90 ]. The mortality within postoperative 30 days was 2.2%[ 2/90 ], including 1 acute renal failure and 1 respiratory failure due to rapid progression of pneumonia. The conversion rate to open thoracotomy during VATS was 5.6%[ 5/90 ], including 2 immediate postoperative massive air leakage, 1 giant bullae, 1 malignant pleural tumor with metastasis to lung and 1 pulmonary malignancy. The successful cure rate of VATS was 75.8%[ 50/66 ] in the spontaneous pneumothorax group and 76.5%[ 13/17 ] in the general thoracic group and the successful diagnostic rate was 100%[ 7/7 ]. In conclusion, although prospective trials should be progressed to define the precise role of VATS, the VATS carries a low morbidity and mortality and high diagnostic and therapeutic success rate and now can be effectively applicated to the surgical treatment of the extensive thoracic disease.

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A Wireless Video Streaming System for TV White Space Applications (TV 유휴대역 응용을 위한 무선 영상전송 시스템)

  • Park, Hyeongyeol;Ko, Inchang;Park, Hyungchul;Shin, Hyunchol
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.26 no.4
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    • pp.381-388
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    • 2015
  • In this paper, a wireless video streaming system is designed and implemented for TV white space applications. It consists of a RF transceiver module, a digital modem, a camera, and a LCD screen. A VGA resolution video is captured by a camera, modulated by modem, and transmitted by RF transceiver module, and finally displayed at a destination 2.6-inch LCD screen. The RF transceiver is based on direct-conversion architecture. Image leakage is improved by low pass filtering LO, which successfully covers the TVWS. Also, DC offset problem is solved by current steering techniques which control common mode level at DAC output node. The output power of the transmitter and the minimum sensitivity of the receiver is +10 dBm and -82 dBm, respectively. The channel bandwidth is tunable among 6, 7 and 8 MHz according to regulations and standards. Digital modem is realized in Kintex-7 FPGA. Data rate is 9 Mbps based on QPSK and 512ch OFDM. A VGA video is successfully streamed through the air by using the developed TV white-space RF communication module.

Outcomes of the Tower Crane Technique with a 15-mm Trocar in Primary Spontaneous Pneumothorax

  • Chong, Yooyoung;Cho, Hyun Jin;Kang, Shin Kwang;Na, Myung Hoon;Yu, Jae Hyeon;Lim, Seung Pyung;Kang, Min-Woong
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.80-84
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    • 2016
  • Background: Video-assisted thoracoscopic surgery (VATS) pulmonary wedge resection has emerged as the standard treatment for primary spontaneous pneumothorax. Recently, single-port VATS has been introduced and is now widely performed. This study aimed to evaluate the outcomes of the Tower crane technique as novel technique using a 15-mm trocar and anchoring suture in primary spontaneous pneumothorax. Methods: Patients who underwent single-port VATS wedge resection in Chungnam National University Hospital from April 2012 to March 2014 were enrolled. The medical records of the enrolled patients were reviewed retrospectively. Results: A total of 1,251 patients were diagnosed with pneumothorax during this period, 270 of whom underwent VATS wedge resection. Fifty-two of those operations were single-port VATS wedge resections for primary spontaneous pneumothorax performed by a single surgeon. The median age of the patients was $19.3{\pm}11.5$ years old, and 43 of the patients were male. The median duration of chest tube drainage following the operation was $2.3{\pm}1.3days$, and mean post-operative hospital stay was $3.2{\pm}1.3days$. Prolonged air leakage for more than three days following the operation was observed in one patient. The mean duration of follow-up was $18.7{\pm}6.1months$, with a recurrence rate of 3.8%. Conclusion: The tower crane technique with a 15-mm trocar may be a promising treatment modality for patients presenting with primary spontaneous pneumothorax.

Comparison of Maximum Phonation Time Associated with the Changes in Vocal Intensity in Patients with Unilateral Vocal Fold Palsy and Sulcus Vocalis (성대마비와 성대구증의 강도 변화에 따른 최대발성지속시간 비교)

  • Choi, Se-Jin;Choi, Hong-Shik;Kim, Jae-Ock;Choi, Yae-Lin
    • Phonetics and Speech Sciences
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    • v.4 no.1
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    • pp.125-131
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    • 2012
  • The patients with incomplete glottic closure have an important feature decreasing the maximum phonation time (MPT) because airflow rate or air leakage is greater than people without voice disorders. Also they can appear a problem in the intensity regulation. This study analyzed MPT difference based on the comfortable intensity and louder intensity and the correlation between MPT and respiration volume of unilateral vocal fold palsy (UVFP) and sulcus vocalis (SV) group. The twenty with UVFP, the 21 with SV, the 21 normal subjects measured MPT in /a/ vowel prolongation task with comfortable intensity and louder intensity and compared analysis by measuring FVC, $FEV_1$, $FEV_1/FVC$ to analyze the correlation between MPT and respiration volume. First, a comparison of MPT according to the intensity between groups is that MPT of the normal group was statistically significant long compared to the patient group in comfortable intensity, but MPT between groups was not statistically significant difference in the louder intensity. Second, an analysis of the correlation between MPT and respiration volume is that this was statistically significant correlation between MPT in comfortable intensity and MPT in louder intensity. But this did not show statistically significant correlation between intensity and respiration volume. This study can be supported the preceding study results deduced that shorting MPT of the patient group compared to the normal group was originated in the problem of laryngeal valving mechanism at the level of vocal folds rather than a problem of respiratory function. Also at the phonation by varying the intensity, the result can deduce that in the case of patient group, the length of MPT had been improved by increasing the glottal closure ratio in the louder intensity. These results can support the theoretical basis that should be applied to the clinicians by varying the intensity at the voice evaluation and voice therapy for the patients with the glottis incompetence.

The Evaluation of Video-Assisted Thoracic Surgery (비디오 흉부수술의 평가)

  • Seong, Suk-Hwan;Kim, Hyeon-Jo;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1015-1022
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    • 1994
  • Over the past few years, video-assisted thoracic surgery [VATS] has been used increasingly for intrathoracic pathologic problems as a less invasive operative techniques. Today it is viewed as a sparing and safe alternative to thoracotomy for a wide spectrum of indications. Using video-assisted operative thoracoscopy, we performed consecutive 150 operations on 148 patients during the initial 2 years of our experience from July 1992 with the following indications: pneumothorax [n=53], hyperhidrosis [n=29], mediastinal mass [n=23], pleural disease [n=13], diffuse parenchymal or interstitial lung disease [n=12], benign pulmonary nodule [n=7], metastatic lung mass [n=3], primary lung cancer [n=3], bronchiectasis [n=2], malignant pericardial effusion [n=2], endobronchial tuberculosis [n=1], esophageal achalasia [n=1], and pulmonary parenchymal foreign body [n=1]. There were no death, and overall complicaton rate was 24.0%[n=36]. The most prevalent complication was persistent air leakage [longer than 5 days] in 14 cases [9.3%]. Persistent pleural effusion [longer than 5 days] occurred in 6 cases [4.0%]. Six patients were converted to an open thoracotomy because of inability to control the operative bleeding [n=3], failed adhesiolysis in bronchiectasis [n=2], and radical excision of an lung cancer [n=1]. Pneumothorax recurred in 3 cases[2.0%]. Other complications were Horner`s syndrome, diaphragm tears, temporary phrenic nerve palsy, hoarseness, subsegmental atelectasis, transient respiratory difficulty, and esophageal mucosal tear. The advantages of this minimally traumatizing operative technique lie in improved visualization, decreased pain, shortened hospital stay, and less postoperative morbidity. The indications of VATS has been extended increasingly to intrathoracic pathologies, but its role in the managements of primary lung cancer and esophageal disease remains to be defined.

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Construction of the Heat Pump System Using Thermal Effluents for Greenhouse Facilities in Jeju and Evaluation of Cooling Performance (제주 시설온실 냉난방을 위한 발전소 온배수 활용 열펌프 시스템 구축 및 냉방성능 평가)

  • Lee, Yeon-Gun;Heo, Jaehyeok;Lee, Dong-Won;Hyun, Myung-Taek
    • Journal of Energy Engineering
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    • v.27 no.4
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    • pp.70-79
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    • 2018
  • A heat pump system using the thermal effluent from the Jeju thermal power plant of KOMIPO was constructed with the capacity of 300 RT to supply cool or hot water to greenhouse facilities located 3 km from the power station. The way of transporting heat from the thermal effluent to greenhouses at a long distance was optimized, and a monitoring system to measure the water temperature and detect a leakage in a pipe conduit was also installed. This paper presents the system configuration of the constructed heat pump system for air conditioning and heating of greenhouse facilities in Jeju, and the characteristics of major components deployed in the system. The preoperational tests of the heat pump system were conducted during the summer season in 2018 for evaluation of its cooling performance. The operational stability and cooling performance of the heat pump system were confirmed by investigating the measured fluid temperature and flow rate, and COP of the heat pump in a cooling mode.