• The Korean Journal of Emergency Medical Services
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• v.9 no.1
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• pp.89-93
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• 2005

Penetrating chest trauma by stab injury may result in massive hemothorax from damage to single or multiple intrathoracic organs such as heart, aorta, internal mammary artery, intercostal artery or pulmonary parenchyme. Prognosis of massive hemothorax necessitating emergency thoracotomy is fatal especially so if there exists concomitant underlying compromise of cardiopulmonary function. A 56 year old man with destroyed left lung due to old pulmonary tuberculosis was stabbed in right parasternal lesion through third intercostal space. Intubation with cardiopulmonary resuscitation and closed thoracostomy were performed to resuscitate from cardiac asystole from hemorrhagic shock and acute respiratory distress. Midsternotomy was made to expose active bleeding foci in right mammary artery, subclavian vein, intercostal artery and anterior segment of right upper lung showing severe bullous change and pleural adhesion. Postoperative care included ventilator support, inotropic instillation and cautious, balance fluid therapy ; successful extubation was done on third postoperative day and patient was discharged on tenth postoperative day without any complication.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.239-243
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• 1996

Chest wall reconstruction Is difficult because of the physiological and anatomical functions of thoracic cavity where the thoracic cavity must be stabilized in order to prevent paradoxical motion, and adequate protection must be provided to the mediastinal structures. A 37-year-old male patient with full-thickness defect on the left anterior thoracic cavity due to traffic accident was treated. Emergency operation was performed for debridement and bleeding control, and on postoperative 25 days, chest wall reconstruction was performed as a second-stage operation. Left anterior chest wall was reconstructed with latissimus dorsi myocutaneous flap which had thoracodorsal arterial pedicle, and split-thickness skin grift from the left thigh was done. After chest wall reconstruction, spontaneous self-respiration was possible without ventilatory support. The pulmonary function test performed at postoperative 3 months revealed 80% of predicted values (FVC, FEV1.0). The postoperative result of chest wall reconstruction using latissimus dorsi myocutaneous flap was excellent anatomically, physiologically and aesthetically.

• The Korean Journal of Emergency Medical Services
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• v.17 no.2
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• pp.21-28
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• 2013

Purpose : The aim of the study is to compare the effect of cardiopulmonary resuscitation (CPR) with voice and CPR without voice by one rescuer. Methods : Subjects were 26 students in C University who had basic life support certificate for Healthcare Provider. They performed 30:2 CPR for 6 minutes by two groups of CPR with voice and CPR without voice by one rescuer from August 14 to 16, 2012. They performed CPR with Resusci Anne SkillReporter$^{TM}$ and Laerdal PC SkillReporting System Ver. 2.4.1(Laerdal Medical, Norway and recored voice using TES-1350A(TES Electrical Electronic Corp, Taiwan). Between each experiment, 1 day of rest was given, providing enough time to recover from the fatigue of CPR. Results : The depth, rate of chest compression, and ventilation volume were not affected by a voice (p >.05), and the ratio of chest compression to ventilation kept 30:2, when the subject made a sound (p <.05). Conclusion : Making voice during CPR was associated with an accurate ratio of 30:2 and the reduction in hands off time.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.214-218
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• 2008

Purpose: Reconstruction of microtia using costal cartilage graft is commonly used technique nowadays. The chest wall depression at the donor site after the graft, however, has been noticed in many articles. Prevention or correction technique for the depression at the donor site also has been reported and we also have been concerned about the problem. This article is a case report about a new technique preventing chest wall depression after costal cartilage graft. Methods: We selected total 15 microtia patients who visited our clinic, from December 2005 to July 2007. They were 10 male and 5 female patients and the mean age was 11.9 years. The average follow up period was 9.2 months(2 to 15 months). We used 6, 7, and $8^{th}$ costal cartilage for microtia reconstruction. And then we turned over pivot of cartilage resection margin, after bihalving costal cartilage involving about 5-6 cm of $6^{th}$ and $7^{th}$ rib bone. After microtia reconstruction, chest donor sites were evaluated by physical examination and radiography. Results: Postoperative depression at the donor site was much less when the costal cartilage turnover technique was performed. Postoperative physical examination and three dimensional reconstruction CT showed that the rest part of rib bone was turned over and it supported the soft tissue defect during respiration. Conclusion: We expect that the turnover rib bone will not be absorbed after graft, as well as offering mechanical support, compared to the other reports.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.151-156
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• 2016

Background: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.33-45
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• 2004

The study is designed to develop an educational CD-Title for Basic Life Support. The study is conducted from July to December, 2002, Based on the course of program development suggested by Dick and Cray. the study followed the planning, development, education and evaluation of a program. The developed CD-Title consists of 8 parts. 1. Intro include Introduction, Adult CPR, Child CPR, Infant CPR, Adult Foreign-Body Airway Obstruction, Infant Foreign-Body Airway Obstruction, and Exercise in Menu at Right of screen. 2. Introduction consist of death process at cardiac arresst, chain of survival, introduction of CPR, respiratory & ciculatory anatomy and physiology. 3. Adult CPR consist of assessment responsiveness, activating EMS system, position victim, opening a airway, checking for breathing, rescue breathing, checking for sign of circulation, chest compression, 1 person & 2 persion adult CPR video. 4. Child & Infant CPR consist of, causes, assessment responsiveness, position victim, opening the airway, checking for breathing, rescue breathing, checking for sign of circulation, chest compression, activating EMS system, child & infant CPR video. 5. Adult Foreign-Body Airway Obstruction include assessment responsiveness, activating EMS system, position victim, opening a airway, checking for breathing, 2 rescue breathing, reopening the airway, 2 rescue breathing, finger sweep, 5 abdominal thrusts, unresponsiveness adult Foreign-Body Airway Obstruction video. 6. Infant Foreign-Body Airway Obstruction consist of, causes, assessment responsiveness, position victim, opening the airway, checking for breathing, 2 rescue breathing, reopening the airway, 2 rescue breathing, checking foreign-body object in oral cavity of victim, 5 back blow, 5 chest thsusts, activating EMS system, video. 7. 32 exercise consist of 8 Adult CPR, 12 Child & Infant CPR, 5 Adult Foreign-Body Airway Obstruction, 7 Infant Foreign-Body Airway Obstruction. Every part consist of animations to trigger students interests. This CD-Title will be useful education for first responders and lay rescuers.

• The Korean Journal of Pain
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• v.27 no.2
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• pp.162-167
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• 2014

Background: Although a physician may be the nearest to the radiation source during C-arm fluoroscope-guided interventions, the radiographer is also near the fluoroscope. We prospectively investigated the radiation exposure of radiographers relative to their location. Methods: The effective dose (ED) was measured with a digital dosimeter on the radiographers' left chest and the side of the table. We observed the location of the radiographers in each procedure related to the mobile support structure of the fluoroscope (Groups A, M and P). Data about age, height, weight, sex, exposure time, radiation absorbed dose (RAD), and the ED at the radiographer's chest and the side of the table was collected. Results: There were 51 cases for Group A, 116 cases for Group M and 144 cases for Group P. No significant differences were noted in the demographic data such as age, height, weight, and male to female ratio, and exposure time, RAD and ED at the side of the table. Group P had the lowest ED ($0.5{\pm}0.8{\mu}Sv$) of all the groups (Group A, $1.6{\pm}2.3{\mu}Sv$; Group M, $1.3{\pm}1.9{\mu}Sv$; P < 0.001). The ED ratio (ED on the radiographer's chest/ED at the side of the table) of Group A was the highest, and the ED radio of Group P was the lowest of all the groups (Group A, $12.2{\pm}21.5%$; Group M, $5.7{\pm}6.5%$; Group P, $2.5{\pm}6.7%$; P < 0.001). Conclusions: Radiographers can easily reduce their radiation exposure by changing their position. Two steps behind the mobile support structure can effectively decrease the exposure of radiographers by about 80%.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.4
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• pp.1498-1503
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• 2010

PC Skillreporting feedback during cardiopulmonary resuscitaion would improve the performance of chest compression and ventilation during cardiac arrest. BLS skills were measured using Laerdal Skillreporter manikin(Laerdal, Norway) connected to a Laerdal PC Skillreporting system. Ventilation volume, chest compression accuracy, velocity of compression, depth of compression, hand position and chest recoil were measured between the two groups. Ventilation volume was significantly higher in the experimental group than that of control group(p<0.002). Chest compression depth was significantly higher in experimental group than that of control group(p=0.000). The quality of CPR can be improved by the use of PC Skillreporting system.

• The Korean Journal of Emergency Medical Services
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• v.23 no.3
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• pp.67-81
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• 2019

Purpose: The purpose of this study was to compare the difference in compression quality and fatigue levels in a rescuer for three different hand techniques used in cardiopulmonary resuscitation (CPR). Methods: The participants were paramedic students at the basic life support provider level. The hands-only CPR was performed for 10 minutes for each of the three hand techniques without disruption, and the quality of chest compressions and fatigue levels were analyzed. Results: There was no difference between the sexes in the chest compression quality and the physiologic parameters before and after compression. Among the quality indexes of chest compression with each of the techniques performed for 10 minutes, the mean depth (p<.01) and mean accuracy (p=.000) of the compression were found to be higher in the five finger fulcrum technique, while the mean compression rate and relaxation accuracy showed no significant differences. Regarding fatigue levels, the five finger fulcrum technique caused lesser subjective fatigue as compared to other techniques (p<.05), although the heart rate and blood pressure revealed no difference. Conclusion: The five finger fulcrum technique was found to be better than the other techniques in terms of chest compression quality and subjective levels of fatigue, indicating that it should be used in CPR education.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.35 no.9
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• pp.991-997
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• 2011

This paper deals with the basic principles and procedures involved in the steam-chest molding process used for manufacturing expanded polypropylene (EPP) bead foam. Steam-chest molding is an integral process for EPP technology. However, little research has been carried out on the processing conditions for steam-chest molding this process. The characteristics of EPP foam are energy absorption, multiple-impact protection, low weight, structural strength, and durability. In this study, the steam pressure in steam-chest molding was varied to determine the optimum conditions for manufacturing EPP foam. Moreover, annealing was performed after EPP-foam molding to prevent the shrinkage of the steam-molded product. It was possible to verify the mechanism of foam shrinkage by observing the change in weight with time at different annealing temperatures. Moreover, a tensile test and scanning electron microscopy (SEM) analysis were performed to support these experimental results. The dimensional stability of each molded product was investigated at different steam pressures.