• Journal of Chest Surgery
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• v.43 no.6
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• pp.804-807
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• 2010

Blunt bronchial injuries rarely occur in children. This can be a life threatening condition and respiratory management is important for successful treatment. We present here a pediatric patient who had traumatic bronchial transection with difficult airway management. Surgical treatment was carried out under ventilatory support using extracorporeal membrane oxygenation (ECMO) in the emergency room. During the application of ECMO, systemic heparization was unnecessary and. there were no thrormbotic complications. In conclusion， ventilatory SUpport using ECMO is useful for treating selected patients with blunt trauma regardless of using heparin.

• Journal of Chest Surgery
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• v.46 no.6
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• pp.391-401
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• 2013

Mechanical circulatory support (MCS) in the pediatric heart failure population has a limited history especially for infants, and neonates. It has been increasingly recognized that there is a rapidly expanding population of children diagnosed and living with heart failure. This expanding population has resulted in increasing numbers of children with medically resistant end-stage heart failure. The traditional therapy for these children has been heart transplantation. However, children with heart failure unlike adults do not have symptoms until they present with end-stage heart failure and therefore, cannot safely wait for transplantation. Many of these children were bridged to heart transplantation utilizing extracorporeal membranous oxygenation as a bridge to transplant which has yielded poor results. As such, industry, clinicians, and the government have refocused interest in developing increasing numbers of MCS options for children living with heart failure as a bridge to transplantation and as a chronic therapy. In this review, we discuss MCS options for short and long-term support that are currently available for infants and children with end-stage heart failure.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.1004-1008
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• 1999

Background: Total anomalous pulmonary venous return is a relatively rare disease which has a very high mortality(80% within a year) if not properly corrected surgically. Material and Method: Twenty-six infants with total anomalous pulmonary venous return underwent repair between May, 1991 and February, 1996. Result: There were 19 boys and 7 girls. The mean age at operation was 2.6 months(range: 5 day to 11 month) and the mean body weight was 4.3kg(range:2.8 to 6.7 kg). Preoperative stabilization included ventilator for 5 patients and inotropic support for 6 patients. There were 6 hospital mortalities. Significant risk factors of operative mortality were preoperative ventilator care(p<0.03) and preoperative inotropic support(p<0.05). Age, body weight at operation, pulmonary venous obstruction, high pulmonary arterial pressure, spurasystemic right ventricular pressure or emergency operation did not affected the operative outcome. Postperative pulmonary venous obstruction occurred in three patients 2 or 3 months later, among them one patient was reoperated. The actuarial survival was 76% at 40 months. Conclusion: Although early mortality was high, repair of total anomalous pulmonary venous return should be attempted in early life, but the patients receiving ventilator care or inotropic support need special attention.

• Journal of Chest Surgery
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• v.26 no.3
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• pp.224-227
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• 1993

We experienced one case of orthotopic cardiac transplantation in a patient with end stage dilated cardiomyopathy. This 50 year-old female recipient was suffered from NYHA functional class IV cardiac failure and dependent upon intravenous inotropic support for 2 months [recipient category 1]. Her preoperative condition was grave with left ventricular ejection fraction of 20% and estimated systolic pulmonary arterial pressure [from Doppler study] was 50mmHg. The brain-dead donor was 31 year-old male with head trauma. The body sizes [weight, height] of the donor/recipient were 70 Kg, 165 cm / 43 Kg, 160 cm and appropriately overmatched. Preoperatively, identical ABO/Rh blood group [A+] and nonreacting HLA crossmatching were confirmed. On November 11 1992 cardiac transplantation was performed without complication. Multiple organ procurement team and heart transplantation team were organized the operation schedule appropriately to minimize the ischemic time. The pump time was 126 minutes and aortic crossclamping time of recipient heart was 73 minutes and, as a result, total ischemic time of the transplanted heart was 75 minutes. Postoperatively, the vital signs were stable with minimal inotropic support. The immunosuppressive therapy was commenced from preoperatively and cyclosporine, azathioprine, and corticosteroid were used as a combination therapy as scheduled and monitored with blood drug concentration, WBC count, renal function and most importantly regular endomyocardial biopsy.Now, 5 months after transplantation, the patient is in NYHA functional class II with minimal cardiac drug support.

• Journal of Biomedical Engineering Research
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• v.30 no.6
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• pp.495-502
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• 2009

This paper investigated the effects of dynamic postural control for maintaining upright standing on a support surface during continuous sinusoidal horizontal translation in anterior-posterior direction. 15 healthy young subjects participated in this experiment. The analysis of body movement was analyzed using Ariel Performance Analysis System. Motion pattern was analyzed by seven markers on subject's body. Position of markers were head, chest, hip, right knee, left knee, right ankle and left ankle. Seven different frequencies of support surface were employed ; 0.1, 0.25, 0.5, 0.75, 1, 1.5 and 2Hz at 2cm of moving path of motionbase. The experiments were performed dynamic postural reponses at the condition of eye open. The results showed that median frequency of the knee, ankle were increased in all frequency bands. Following the frequency of perturbation increased, postural control strategy was changed from ankle strategy to combined strategy. The experiment results could be applied to the dynamic postural training for the elderly and the rehabilitation training for the patients to improving the ability of postural control.

• Journal of Sensor Science and Technology
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• v.24 no.1
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• pp.47-53
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• 2015

Fall-related injuries in elderly people are a major health care problem. This paper introduces determination of fall direction before impact using support vector machine (SVM). Once a falling phase is detected, dynamic characteristic parameters measured by the accelerometer and gyroscope and then processed by a Kalman filter are used in the SVM to determine the fall directions, i.e., forward (F), backward (B), rightward (R), and leftward (L). This paper compares the determination sensitivities according to the selected parameters for the SVM (velocities, tilt angles, vs. accelerations) and sensor attachment locations (waist vs. chest) with regards to the binary classification (i.e., F vs. B and R vs. L) and the multi-class classification (i.e., F, B, R, vs. L). Based on the velocity of waist which was superior to other parameters, the SVM in the binary case achieved 100% sensitivities for both F vs. B and R vs. L, while the SVM in the multi-class case achieved the sensitivities of F 93.8%, B 91.3%, R 62.3%, and L 63.6%.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.2
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• pp.243-255
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• 2017

Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.125-132
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• 1976

The author made clinical study of 100 cases of empyema in infancy and childhood that were treated at the Department of Chest Surgery, Busan University Hospital and Busan Children's Charity Hospital, from Jan 1962 to Nov. 1975. 1. In infancy and childhood, 62 cases out of my 100 cases of empyema were caused by .staphylococci and most of recent reports showed a gradual increase in number of staphylococcal empyema. 2. Most frequent lesion predisposing to empyema in infancy and childhood was pneumonia (72%), being remarkable in staphylococcal empyema (85.5%) to that of others. 3. Antibiotics sensitivity test for staphylococci revealed that the erythromycin was most susceptible (85. 5%). 4. The mortality rate was 6% in over all and the author believes that from the point of view of surgical treatment, failure of early continuous drainage on account of multiple thoracentesis for the early stage of empyema, and also early open thoracotomy procedure such as decortication were all the contributing factors to higher mortality in the empyema of infancy and childhood. 5. It may be concluded that the treatment of choice for empyema in infancy and childhood were early and prolonged continuous drainage of pus by closed thoracotomy with caution and administration of more susceptible antibiotics with nutritional support.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.847-850
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• 1995

For the purpose of evaluation of clinical characteristics in multiple rib fracture due to accident , 24 cases treated by surgical rib fixation using Judet`s strut for multiple rib fracture and flail chestduring the period from June 1993 to October 1994 were reviewed. There were 17 males and 7 females.They ranged in age from 19 years old to 56 years old. The causes of rib fracture were traffic accident in 18 cases, fall down in 3 cases, compression in 2 cases stab wound in 1 case. The number of rib fracture were five in 7 cases, six in 5 cases, four in 5 cases, three in 3 cases. Associated intrathoracic injuries were hemopneumothorax in 12 cases, hemothorax in 10 cases, lung laceration or hemorrhagic contusion in 7 cases. Associated extrathoracic injuries were abdominal injuries in 21 cases, orthopedic problem in 7 cases, head trauma in 4 cases. The most common fractured site was posterolateral portion of the ribs. The causes for operation were flail chest, severe rib displacement and pain, hemothorax or hemopneumothorax with continuous air leakage and stab wound. There were 6 postoperative complications ; one with hydrothorax, two with fibrothorax, two with wound infection and one case of death due to multiful organ failure. Postoperatively, all patients became comfortable and complained less painful. Twenty patients restored spontaneous breathing without ventilator support, three patients were ventilated during a day and one patient expired after 2 days. There were no morbidity and mortality related to operation.

• Journal of Chest Surgery
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• v.27 no.10
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• pp.850-853
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• 1994

Open lung biopsy was performed in thirty patients for the diagnosis and staging evaluation of interstitial lung disease during the period from January 1987 until December 1992. The age of the patients ranged from 14 to 71 years [mean 48 years], and the patients consisted of 14 males and 16 females. Preoperative FEV1`s were from 0.80 liter to 3.88 liters [mean 1.66]. Other non-invasive diagnostic studies such as PCNA, bronchoalveolar lavage, TBLB, and gallium scan were also done in addition to X-ray and high-resolution chest CT. Tweaty-eight were correctly diagnosed and 2 cases were not [diagnostic yield rate 93.3%]. Among the 28 cases,pathologic diagnosis influenced further treatment regimens and prognostic expectations in 23 cases [82.1%]. The diagnostic non-invasive studies other than open lung biopsy yielded a correct diagnosis without staging only in 5 cases. There was no mortality and only one complication, ARDS ; however, the patient recovered after 5 days ventilator support. Open lung biopsy, which is the gold standard for the diagnosis and staging evaluation of interstitial lung disease can be done safely and has value in clinical decision making. Also knowledge of the involvement of the lesion is important for proper selection of the biopsy site.