• Title/Summary/Keyword: 공기누출

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The Effects of Autologous Blood Pleurodesis in the Pneumothorax with Persistent Air Leak (지속성 기흉에서 자가혈액을 이용한 흉막유착술의 효과)

  • Yoon, Su-Mi;Shin, Sung-Joon;Kim, Young-Chan;Shon, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Chung, Won-Sang;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.724-732
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    • 2000
  • Background : In patients with severe chronic lung diseases even a small pneumothorax can result in life-threatening respiratory distress. It is important to treat the attack by chest tube drainage until the lung expands. Pneumothorax with a persistent air leak that does not resolve under prolonged tube thoracostomy suction is usually treated by open operation to excise or oversew a bulla or cluster of blebs to stop the air leak. Pleurodesis by the instillation of chemical agents is used for the patient who has persistent air leak and is not good candidate for surgical treatment. When the primary trial of pleurodesis with common agent fails, it is uncertain which agent should be used f or stopping the air leak by pleurodesis. It is well known that inappropriate drainage of hemothorax results in severe pleural adhesion and thickening. Based on this idea, some reports described a successful treatment with autologous blood instillation for pneumothorax patients with or without residual pleural space. We tried pleurodesis with autologous bood for pneumothorax with persistent air leak and then we evaluated the efficacy and safety. Methods : Fifteen patients who had persistent air leak in the pneumothorax complicated from the severe chronic lung disease were enrolled. They were not good candidates for surgical treatment and doxycycline pleurodesis failed to stop up their air leaks. We used a mixture of autologous blood and 50% dextrose for pleurodesis. Effect and complications were assessed by clinical out∞me, chest radiography and pulmonary function tests. Results : The mean duration of air leak was 18.4${\pm}$6.16 days before ABP (autologous blood and dextrose pleurodesis) and $5.2{\pm}1.68$ days after ABP. The mean severity of pain was $2.3{\pm}0.70$ for DP(doxycycline pleurodesis) and $1.7{\pm}0.59$ for ABDP (p<0.05). There was no other complication except mild fever. Pleural adhesion grade was a mean of $0.6{\pm}0.63$. The mean dyspnea scale was $1.7{\pm}0.46$ before pneumothrax and $2.0{\pm}0.59$ after ABDP (p>0.05). The mean $FEV_1$ was $1.47{\pm}1.01$ before pneumothorax and $1.44{\pm}1.00$ after ABDP (p>0.05). Except in 1 patient, 14 patients had no recurrent pneumothorax. Conclusion : Autologous blood pleurodesis (ABP) was successful for treatment of persistent air leak in the pneumothorax. It was easy and inexpensive and involved less pain than doxycycline pleurodesis. It did not cause complications and severe pleural adhesion. We report that ABP can be considered as a useful treatment for persistent air leak in the pneumothorax complicated from the severe chronic lung disease.

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A Methodology for Assessing Risk from Released Hydrocarbon (탄화수소 누출로 인한 위험분석 평가 방법론 연구)

  • Keun-Won Lee
    • Journal of the Korean Society of Safety
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    • v.13 no.2
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    • pp.170-180
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    • 1998
  • This study presents a method for calculating the concentration of hydrocarbon releases in enclosed areas using empirical equations of evaporation rate. The approach of the method is to estimate the hydrocarbon exposure concentration in the air under conditions assumed. A methodology for assessing risk was suggested to individual risk assessment to exposed workers or others by probit expressions. The toxicity criteria and available human exposure data were examined and guidelines for risk assessment suggested for benzene-air and toluene-air systems. The value of probit constants with mole fractions of lethal concentrations in a mixture of hydrocarbons and a non-toxic substance was predicted. The probit values calculated with mole fractions can be used to estimate guidelines to prevent toxicity within enclosed working areas.

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A Study on Optimal Ventilation Design for Gas Boxes Installed in Semiconductor Manufacturing Equipment Handling Flammable Liquids (인화성 가스를 취급하는 반도체 제조장비에 설치된 가스박스 최적 환기 설계에 대한 연구)

  • Gyu Sun Cho;Sang Ryung Kim;Won Baek Yang
    • Journal of the Korean Institute of Gas
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    • v.27 no.1
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    • pp.63-69
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    • 2023
  • Although Korea is the world's No. 1 semiconductor producing country, most studies are conducted with risk assessment for simple material risks due to the closedness of the site for industrial protection. In terms of industrial safety, a monitoring system such as a gas detector to determine the leakage of hazardous substances has been established, but research on effectively discharging harmful gastritis substances in case of leakage has only recently begun. Semiconductor manufacturing facilities (gas boxes) where a large amount of flammable materials are handled are currently being safety managed by using a gas detector and blocking the air inlet. It is difficult to dilute in a short time in case of leakage of flammable substances. Therefore, in this study, based on various criteria, the size of the duct according to the size of the gas box is determined and the appropriate size of the air inlet is studied to minimize the exhaust performance requirement without exposing hazardous chemicals to the outside in the event of a flammable leak. We want to do an optimal exhaust design.

트럭 ㆍ버스용 타이어의 블리딩 C.B.U.

  • Lee, Gwang-Jae
    • The tire
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    • s.132
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    • pp.23-39
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    • 1987
  • 타이어는 여러가자의 중요한 기능을 갖추고 있으나 공기압이 부족하거나 또는 공기가 누출된 상태에서 사용하여 타이어가 손상된 경우에는 자동차의 조종성, 안정성에 중대한 영향이 미친다는 것은 명백한 사실이다. 이러한 타이어 손상의 일례로서 트럭ㆍ버스용 타이어의 블리딩(bleeding) C.B.U.가 있다. 본고는 이와같은 손상에 대하여 실제 사용조건에서 재현 테스트를 실시하여 그 발생요인을 해석한 일본 자동차 타이어 협회의 자료에서 발췌한 것이다.

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The Covering of the Suture Area with an Absorbable Cellulose Mesh and Fibrin Glue in Bullectomy of Primary Spontaneous Pneumothorax (일차성 자연기흉의 수술시 흡수성 셀룰로스 망사 및 Fibrin glue의 도포와 재발에 대한 임상적 고찰)

  • 허동명;김병호
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.393-398
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    • 2001
  • 배경: 일차성 자연기흉의 재발방지를 위해서 폐기포절부위에 흡수성 셀룰로스망사와 Fibrin gluefm 도포하여 수술후 재발율을 줄일 수 있는 지 알아보았다. 대상 및 방법: 1996.4우러부터 2000.6월까지 2명의 술자가 222례의 일차성 자연기흉을 수술하였으며, 수술시기와 치료방법에 따라 4군으로 나누어 비교하였다. 제1군은 1996년부터 1997년가지 비디오흉강경수술 및 기계적 늑막유착술로 시술받은 군(25례), 제 2군은 같은 기간동안 액와개흉술 및 늑막유착술로 시술받은 군(53례), 제 3군은 1998년부터 2000.4월까지 흉강경수술 및 늑만유착술로시술받은 군(110례), 제 4군은 1999.7월부터 2000.6월까지 흉강경수술 및 봉합부위를 셀룰로스망사와 Fibrin glue로 보강한 군(34례)이었다. 각 군간, 엑스선상 기흉의 크기 및 폐기포의 수나 크기에 따라 재발율, 공기누출시간 및 흉관지속지간등을 일반선형모델을 사용하여 비교 분석하였다. 결과: 대상환자는 남자 203례, 여자 19례 이었고, 나이는 14게에서 68세이었고, 평균연령은 23.2$\pm$9.6세였다. 재발한 경우는제 1군이 5례(25%), 제 2군이 2례(3.8%), 제 3군이 5례(4.5%)이었고, 제 4군은 재발례가 없었다. 재발례는 모두 수술자의 수술경험이 2년이내일 때 발생하였다. 흉관지속기간은 제 4군이 제 3군(p<0.0006) 및 제1, 제2군(p<0.0001)에 비해서 더 짧았고, 술후 공기누출이 제 4군에서는 없었다. 술전흉부엑스선상 기흉의 크기에 따른 수술후 기흉의 재발울은 경도의 기흉에서 14.3%(2/14)이었고, 중등도 기흉에서 7.4%(10/134)이었으며, 심한 기흉에서는 재발례가 없었다. 재수술한 12례중 봉합부위근처에서 기포가 발행된 경우가 9례(75%)로 많았다. 결론: 재발방지를 위한 시술로 늑막유착술을 시행하지 않고 폐기포절제부위를 흡수성 셀룰로스망사와 Fibrin glue로 덮어주는 시술은 비교적 용이하며, 수술 후 공기 누출이 없었고, 수술 후 흉관지속기간이 더 짧았고, 단기간 추적에서 재발이 없었다. 재발에 영향을 미치는 것으로 흉부엑스선상 기흉의 크기가 작은 경우에는 재발율이 더 높았고, 수술자의 경험이 중요하였다.

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Clinical Analysis of the Surgical Treatments for Large Primary Spontaneous Pneumothorax (외과적 치료를 시행한 대량 일차성 자연기흉의 임상분석)

  • Kim, Byung-Ho;Huh, Dong-Myung;Han, Won-Kyung
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.344-349
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    • 2009
  • Background: The clinical history and physical findings of the patients with spontaneous pneumothorax depend largely on the extent of the collapse of the lung and the presence of pre-existing pulmonary disease. Large primary spontaneous pneumothorax is a possible serious condition and. so more active treatment will be necessary for these patients. The therapeutic guideline for large pneumothorax remains controversial. Therefore, by assessing the clinical results of surgical treatment for large primary pneumothorax, we aim to determine the indicators of treatment. Material and Method: Among 348 patients with primary spontaneous pneumothorax and who underwent surgical treatment from August 2004 through December 2007, 58 patients who responded to treatment for a large primary pneumothorax were included in the current study. We then retrospectively evaluated the operative findings and the surgical results. The patients with a pneumothorax of 80% or more, including those patients with tension pneumothorax, were considered to have a "large pneumothorax". Most of these patients Should be treated with a 12F chest tube. Thoracoscopic wedge resection was considered for treating recurrent pneumothorax, continuous air leakage, controlateral pneumothorax and first episode pneumothorax with visible blebs (> 1cm) seen on the computed tomography. Result: There were 50 men and 8 women with a mean age of 28.2 years (range: $14\sim54$ years). The mean length of hospitalization was 5.3 days (range: $2\sim10$ days). Nine patients underwent chest tube drainage only. Forty-nine patients underwent thoracoscopic wedge resection. The mean follow up time was 27.8 months (range: $10\sim58$ months). The actual site of air leakage could be located in 35 patients (71.4%) and this was correlated with pleural adhesion (p=0.005). The initial air leakage tended to be more correlated with intra-operative air leakage, although this was not statistically significant (p=0.066). The recurrence rate was 11.1 % for the patients with chest tube drainage and 2.0% for the patients with thoracoscopic wedge resection. Conclusion: Large primary pneumothorax requires an early diagnosis and early treatment. Thoracoscopic wedge resection may help to prevent recurrence of large primary pneumothorax.

Efficacious Pleurodesis with OK-432 Plus Autoblood or OK-432 Against the Pneumothorax with Persistent Air Leak (지속성 기흉에서 OK-432와 자가혈액을 이용한 흉막 유착술의 효과)

  • Kim, Hyoung Soo;Choi, Goang Min
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.72-75
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    • 2006
  • Background : This report reviews our experience with persistent air leaks in the peumothorax that were not considered candidates for surgical treatment in order to evaluate the efficacy and risks of the OK-432 plus autoblood or OK-432 pleurodesis. Material & Methods : From March 2004 to July 2005, 8 consecutive patients who had an air leak in the pneumothorax over 5 days and had been treated with OK-432 plus autoblood or OK-432 pleurodesis. The patients were not considered candidates for surgical treatments because the chest CT findings revealed severe chronic lung disease with multiple bullae and/or bullous changes. A prolonged air leak with/without dead space was treated with either OK-432 plus autoblood or OK-432 pleurodesis. The efficacy and side effects of OK-432 pleurodesis were assessed by determining the duration of the air leak, the number of pleurodesis, the patients' symptoms, measurements of the white blood cell count and the c-reactive protein level. Results : All of eight patients were male and the mean age was $72.4{\pm}8.5$. The mean number of pleurodesis was $1.9{\pm}1.1$ and the mean duration of the air leak was $4.6{\pm}4.6days$ after pleurodesis. Side effects after pleurodesis were encountered in 7 patients, which included a chilling sensation in 7 cases, chest pain in 5 cases, headache in 3 cases, local heat sensation in 2 cases, and fever in 1 case. Leukocytosis was observed in 6 patients, and the mean of WBC count and CRP were $14500{\pm}2100$ and $21.9{\pm}11.4mg/dL$, respectively. Conclusion : Either OK-432 plus autoblood or OK-432 pleurodesis has acceptable side effects, and can be considered a treatment option for persistent air leaks in the pneumothorax that are not candidates for surgical treatment.

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.

The Methodology for Prediction and Control of Hazardous Chlorine Gas Flow Releases as Meteorological Data (기상조건에 따른 유해독성염소가스의 가상흐름누출에 관한 예측 및 제어론)

  • Kim, Jong-Shik;Park, Jong-Kyu
    • Applied Chemistry for Engineering
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    • v.10 no.8
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    • pp.1155-1160
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    • 1999
  • The screening methodology modeling, dispersion modeling procedures for continuous and instantaneous releases of the gas phase flow from the storage tank and pressure relief valve were considered. This study was performed to develop the screening methodology for prediction and control of hazardous/toxic gas releases by estimating the 1-hr average maximum ground-level concentration of $Cl_2$ gas vs. downwind distance by incorporating source term model including the general/physical properties of released material and release mode of the $Cl_2$ storage tank of the chemical plant facilities, dispersion model, and meteorological/topographical data into the TSCREEN model. As the results of the study, it was found that dispersion modes of the dense gas were affected by the state of the released material, the released conditions, physical-chemical properties of released material, and the released modes (continuous and instantaneous releases), and especially largely affected by initial (depressurized) density of the released material and release emission rate as well as the wind velocity. Especially, this study was considered to release hazardous material as meteorological data. It was thought that this screening methodology can be useful as a preliminary guideline for application of the refined analysis model by developing the generic sliding scale methodology for various senarios selected.

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Sensitivity Analysis of Design Parameters of Air Tightness in Underground Lined Rock Cavern (LRC) for Compressed Air Energy Storage (CAES) (복공식 지하 압축공기에너지 저장공동 기밀시스템 설계변수의 민감도 해석)

  • Kim, Hyung-Mok;Rutqvist, Jonny;Ryu, Dong-Woo;Sun-Woo, Choon;Song, Won-Kyong
    • Tunnel and Underground Space
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    • v.21 no.4
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    • pp.287-296
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    • 2011
  • We performed a numerical modeling study of thermodynamic and multiphase fluid flow processes associated with underground compressed air energy storage (CAES) in a lined rock cavern (LRC). We investigated air tightness performance by calculating air leakage rate of the underground storage cavern with concrete linings at a comparatively shallow depth of 100 m. Our air-mass balance analysis showed that the key parameter to assure the long-term air tightness of such a system was the permeability of both concrete linings and surrounding rock mass. It was noted that concrete linings with a permeability of less than $1.0{\times}10^{-18}\;m^2$ would result in an acceptable air leakage rate of less than 1% with the operational pressure range between 5 and 8 MPa. We also found that air leakage could be effectively prevented and the air tightness performance of underground lined rock cavern is enhanced if the concrete lining is kept at a higher moisture content.