• Journal of Chest Surgery
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• 제32권12호
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• pp.1135-1139
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• 1999

Multistage unifocalization and complete repair have been performed for pulmonary atresia ventricular septal defect and major aortopulmonary collateral arteries. We reported a case that divided major aortopulmonary collateral artery was changed into an aneurysm that compressed the left main bronchus. A 1-year-8-month old boy was operated. The Rastelli operation with left pulmonary artery reconstructuion ligation of patent ductus arteriosus and take-down of right Blalock-Taussing shunt was performed on the patient who had pulmonary atreisia ventricular septal defect patent ductus arteriosus and MAPCA at 1 year and 8 months of his age. He previously underwent the unifocalization and right B-T shunt at 9 months of age,. He repeatedly had difficulty in weaning from the mechanical ventilator, After removing the aneurysm from the divided MAPCA that compressed the left main bronchus externally it was possible to wean him from the mechanical ventilator.

• 한국산학기술학회논문지
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• 제18권7호
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• pp.579-588
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• 2017

본 연구는 1급 응급구조사들을 대상으로 제세동 유형에 따른 제세동 효율성을 비교하기 위해 시뮬레이션 교육을 적용하여 가슴압박 중단시간, 제세동 효율성을 비교 분석하여 제세동 효율성을 알아보고자 함이다. 이를 위해 2016년 3월 2일부터 8월 31일까지 K도에 소재하고 있는 소방서 구급대원 중 1급 응급구조사 15명을 대상으로 단일군의 교육 전 후 설계 실험연구이다. 수집된 자료는 Windows용 SPSS Win 21.0을 사용하였다. 연구 결과는 다음과 같다. 첫째, 시뮬레이션 교육 후 심폐소생술 과정 중 가슴압박 중단시간은 반자동제세동기의 수동패들과 수동패드를 사용했을 때 유의미하게 시간이 감소하였다. 둘째, 제세동 수행시간은 반자동제세동기의 수동패들과 수동패드를 사용할 때 통계적으로 유의미하게 시간이 감소하였다. 이러한 결과로 보아 시뮬레이션 교육을 통해 1급 응급구조사의 반자동 제세동기의 수동모드를 이용한 신속한 심전도 판독 및 제세동을 통해 환자 소생률을 높이며 응급구조사 업무확대를 할 수 있는 기초자료로 제시하고자 한다.

• 한국응급구조학회지
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• 제13권2호
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• pp.87-98
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• 2009

Purpose : This study set out to compare the educational effects of a video self-instruction program for child CPR education on childcare teachers by applying the 2006 KACPR Guideline. By adopting the nonequivalent control group posttest quasi-experimental design, the study examined the educational effects on a group that did not receive instructions from the instructor, another group that received his instructions, and the other group that received an extra three-minute practice training session in addition to instructions. Methods : Data were gathered from August 6 to 18, 2008. As for research tools, the Knowledge Instrument of CPR by Connolly (2006) was used along with the National Practice Test Protocol for C1ass 1 Emergency Medical Technicians (2007) and Common Protocol for CPR (2006) to examine the performance of child CPR. By shooting the guide screen of $Resusci^{(R)}$ Junior CPR Manikin of Leardal with a video camera and using the Skill Guide Checklist of the Common Protocol for CPR (2006), the subjects' technical accuracy of chi1d CPR was evaluated. There were three subject groups: 29 childcare teachers randomly assigned to received the video self-instruction program training for chi1d CPR and no instructions from the instructor made up the control group; 22 childcare teachers randomly assigned to received the program training and instructions from the instructor made up experiment group I; 23 childcare teachers randomly assigned to received an extra three-minute practice training session in addition to the program training and the instructions made up experiment group II. The gathered data were analyzed with SPSS/PC+ (Version 14.0) in frequency, percentage, $X^2$-test, ANOVA, Scheffe test. Results : 1) There were no statistically significant differences (F=1.030, p=.362) among the groups in terms of knowledge scores after the child CPR education. 2) There were statistically significant differences (F=13.625, p=.000) among the groups in terms of performance abilities after the child CPR education. 3) There were no statistically significant differences (F=1.610, p=.207) among the groups in terms of technical accuracy of mouth-to-mouth resuscitation after the child CPR education 4) There were no statistically significant differences (F=1.484, p=.234) among the groups in terms of technical accuracy of chest compression after the child CPR education. Conclusion : The results indicate that childcare teachers can improve their performance abilities in child CPR when the instructors are active with their instructions and extra practice hours are secured through a VSI program. It's also needed to provide education with increasing concentration ratio about the items of lower knowledge points in order to help the teachers learn the accurate theory of child CPR. And there should be VSI programs of diverse conditions to increase the effects of child CPR training among childcare teachers.

• 한국응급구조학회지
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• 제11권2호
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• pp.51-66
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• 2007

Purpose: With a view to providing basic data to develop cardiopulmonary resuscitation education suitable for elementary students, the cardiopulmonary resuscitation education was conducted to grasp students' knowledge, skills accuracy and the attitude change before and after the education. Methods: Convenience sampling was made on fourth and fifth graders(total-35 students) of S elementary school located in K city, Chungcheongnam-do, and this was a pre-experiment research designed before and after choosing a single group. In terms of methods, specifically we, researchers ; 1) Handed out questionnaires to students directly to make them fill in firsthand and collected the questionnaires. 2) Utilized PPT materials based on 2005 AHA guideline and DVD materials of AHA, to give students theoretical education of cardiopulmonary resuscitation. We used Anne/SkillReporter$^{(R)}$ torso produced by Leardal Inc, and Little Anne to conduct practical education individually. 3) Asked students to give Anne/SkillReporter$^{(R)}$ torso cardiopulmonary resuscitation five times with the ratio of 30 : 2, and then one of researchers filled in the evaluation sheet individually. 4) Evaluated the accuracy of students' ability to perform the resuscitation based on the record of Anne/SkillReporter$^{(R)}$ integrated printer(which was the objective tool to grasp students' skills accuracy). 5) Gave out questionnaires to make students fill them in and then collected them. after completing the practical evaluation. Results: 1) In case of the attitude about cardiopulmonary resuscitation, Students' confidency rose from 19.28%(before the education) to 93.57(after the education)- which is a positive change. 2) As the result of the education, some elementary students scored 11 points (full score-16 points), up from 5 points before the education, in terms of the knowledge about cardiopulmonary resuscitation. The average point also reached 13.14 points(after the education), jump from 8.37(before the education), which was the rise of 29.8%. 3) When it comes to the practical performance, the skills accuracy was 80.93% on average, and the calculation method was as follows: total items were 16, and each item was marked form 0 to 2 points, meaning the full score was 32 points. The minimum score was 19 points and the maximum was 32($M{\pm}SD=25.90{\pm}2.88$), which was calculated based on percentage. 4) Regarding skills accuracy, respiration accuracy(%)($M{\pm}SD=30.20{\pm}27.16$) was higher than pressure accuracy(%) ($M{\pm}SD=15.34{\pm}25.27$). Conclusion: The result showed that students' attitude on cardiopulmonary resuscitation changed positively. and meaningful difference(p = .00) existed in the change of students' knowledge. In terms of skills accuracy. chest compression and airway control showed high accuracy, but the result of Anne/SkillReporter$^{(R)}$ performance showed that the accuracy of chest compression was lower than that of mouth-to-mouth resuscitation.

• 한국응급구조학회지
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• 제12권3호
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• pp.17-26
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• 2008

Purpose : This study aimed to make comparison before and after CPR training for health college students (departments of visual optics, occupational therapy, and health welfare administration). The questionnaire consisted of self-efficacy, knowledge, and attitudes toward CPR affect performance ability. Through this study, the researchers tried to provide basic data in developing of cardiopulmonary resuscitation training programs and training methods for health college students. Methods : This study was applied to 83 health college students (departments of visual optics, occupational therapy, and health welfare administration) in G Province. Data were collected from September 22 to October 9, 2008. Analysis was performed by using SPSS WIN 12.0 Version program. Frequency analysis, t-test, ANOVA, and Pearson's correlation coefficients were used. Statistical significance was based on p < .05. Results : 1. There was an increase with(${\rightarrow}$ in) 1.69 point before education and 3.01 after education of artificial ventilation(p < .001). There was an increase in 1.46 point before education and 3.24 after education of airway(p < .001). There was an increase in 1.54 point before education and 2.84 after education of chest compression location(p < .001). There was an increase in 1.97 point before education and 3.13 after education of chest compression(p < .001). 2. The difference between self-efficacy, knowledge, and attitude before and after CPR education, the self-efficacy increased from 2.08 point before education(p < .001 to 3.18 point after education. Knowledge increased from 2.09 point before education(p < .001) to 3.28 point after education. Attitude increased from 1.75 point before education(p < .001 to 3.05 point after education. 3. The correlation between self-efficacy, knowledge, and attitude toward CPR), was not changed before education. After education, knowledge showed quantitative correlation(r = .219, p < .05) with attitude. 4. In regression analysis with the aim of examining influence of self-efficacy, knowledge, and attitude upon performance ability, the effect wasn't given to performance ability before education. After education, the self-efficacy was indicated to have significant effect on performance ability(p < .05).

• 한국산학기술학회논문지
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• 제16권5호
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• pp.3303-3307
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• 2015

본 연구는 74세 여자 환자가 심정지 후 일반인과 119구급대원들에게 시행된 심폐소생술의 합병증인 기복증에 대한 증례를 경험하였기에 이에 대한 임상양상과 병태생리를 조사하기 위해 시도되었다. 평소 건강했던 74세 여자가 식당에서 일하던 중 갑자기 발생한 의식저하로 쓰러졌다. 증상발생 후 즉시 119에 신고를 하였고 현장에서 목격자에 의한 즉각적인 심폐소생술이 시행되었으며, 현장에 도착한 119구급대원에 의한 심폐소생술과 제세동이 시행된 결과 자발순환을 회복하였다. 자발순환 회복 후 환자는 인근 2차병원으로 이송되어 시행한 심전도 검사에서 급성심근경색이 의심되어 추가적인 검사와 치료를 위해 3차병원으로 이송되었다. 이후 시행한 X-ray 검사와 복부전산화 단층촬영 검사결과 위문접합부의 파열과 다량의 기복증을 보여 수술치료를 결정하였으나 수술실에서 다시 심정지가 발생하여 심폐소생술을 시행하였으나 환자는 결국 사망하였다. 따라서 병원 전 현장에서 심폐소생술을 시행 할 때 흉부압박의 정확한 위치 선정이 필요하며 양압 환기에 대한 신중한 고려가 필요하겠다. 또한 심폐소생술 후 발생한 기복증의 치료는 환자의 혈역학적 상태를 충분히 고려해야 할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1080-1084
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• 2000

Spinal neurenteric cyst results from the persistence of an abnormal communication between endodermal and ne-uroectodermal layer. Embryologically, neurenteric cyst is derived from endoderm that is fused with the developing notochord during the third week of gestation. It is a rare malformation that lead to spinal cord compression. The patient is 19-year-old male presented with chest pain, paresthesia and progressive weakness in his low extremities(grade II/II). Preoperative MR imaging revealed intradural extramedullary cyst with intracystic hemorrhage in T1 and T2 level that is ventrally located and compressed the spinal cord. Involved vertebral bodies were scalloped and fused. The cystic tumor were totally removed through costotransversectomy approach. Postoperatively, motor weakness of the low extremities were improved to the level of grade IV/V. And chest pain and paresthesia were gradually disappeared. Postoperative MR imaging showed the decompression of the thoracic spinal cord. Histologic examination revealed a ciliated columnar epithelial neurenteric cyst. The pre- and postoperative clinical, radiological features of a case of upper thoracic neurenteric cyst is described with review of literature.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.175-179
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• 2010

Purpose: Sternal fractures after blunt thoracic trauma can cause significant pain and disability. They are relatively uncommon as a result of direct trauma to the sternum and open reduction is reserved for those with debilitating pain and fracture displacement. We reviewed consecutive 11 cases of open reduction and fixation of sternum and tried to find standard approach to the traumatic sternal fractures with severe displacement. Methods: From December 2008 to August 2010, the medical records of 11 patients who underwent surgical reduction and fixation of sternum for sternal fractures with severe displacement were reviewed. We investigated patients' characteristics, chest trauma, associated other injuries, type of open reduction and fixation, combined operations, preoerative ventilator support and postoperative complications. Results: The mean patient age was 59.3years (range, 41~79). The group comprised 6 male and 5 female subjects. Among 11 patients who underwent open reduction and fixation for sternal fracture with severe displacement, 6 cases had isolated sternal fractures and the other 5 patients had associated other injuries. Sternal fractures were caused by car accidents (9/11, 81.8%), falling down (1/11, 9.1%) and direct blunt trauma to the sternum (1/11, 9.1%), respectively. 3 of the 7 patients (42.9%) who underwent sternal plating with longitudinal plates showed loosening of fixation. Otherwise, none of the 4 patients who underwent surgical fixation using T-shaped plate had stable alignment of the fracture. Conclusion: Sternal fractures with severe displacement need to be repaired to prevent chronic pain, instability of the anterior chest wall, deformity of the sternum, and even kyphosis. In the present study, a T-shaped plate with a compression-tension mechanism constitutes the treatment of choice for displaced sternal fractures.

• 한국의류산업학회지
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• 제25권2호
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• pp.210-220
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• 2023

Recently, smart wearable products, including electromyography (EMG) measurement devices and clothing, have been developed to monitor users' exercise levels, muscle activation, and muscle balance more effectively during fitness activities. However, technical and socioeconomic barriers, such as flexibility and durability, still pose challenges in terms of comfort, ease of wear, and wearability of smart clothing, which includes devices and circuits. To address these issues, this study developed a wearable EMG device integrated with clothing to collect valid EMG signals from desired muscles while maintaining comfort, functionality, and ease of wear. After deriving a combined structure that could stably position the wearable device within the clothing, a prototype was manufactured and evaluated for fit, compression, comfort, and exercise comfort test by ten participants (height = 176.2 cm, weight = 76.4 kg, chest circumference = 101.2 cm). The study found that the prototype had smaller circumferences around the chest, waist, and abdomen compared to commercial products, resulting in lower ratings for wearing comfort and ease of wear. However, the prototype received high ratings for fitting, pressure, and the exercise comfort test. Valid signals were obtained when the EMG device was combined to the prototype for the rectus femoris muscle, indicating stable positioning of the device during exercise.

• Journal of Chest Surgery
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• 제42권1호
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• pp.100-103
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• 2009

흉부 대동맥의 외상성 파열은 두부 손상 다음으로 흔한 교통사고의 사망원인으로 약 85%의 환자가 병원 도착 전에 사망한다. 가장 흔한 기전은 고속의 차량이 충돌 등으로 인한 급작스런 감속에 의해 발생되며 대동맥 협부가 전체 대동맥 손상의 95%에 해당된다. 또 다른 기전으로는 흉부 압박 손상에 의해 골절되어 전위된 흉골병과 흉부 척추 사이에 대동맥이 끼이면서 나타날 수 있는데 이로 인해 흔하지 않은 위치의 대동맥벽의 내막이 파열된다. 저자들은 감속사고가 아닌 흉부 압박에 의해 대동맥궁이 파열되어 박리된 증례에 대해 집중적인 내과 치료 후에 지연 수술로 완전 순환정지 하에 뇌보호를 시행하면서 상행 대동맥의 일부와 대동맥궁을 인조혈관으로 치환하였기에 보고하는 바이다.