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 processing techniques are need to use the non-marketable paprika fruit because paprika that is difficult crop for cultivation and produced easily non-marketable fruits, such as physiological disorder fruit, malformed fruit, and small size fruit. This study was carried out to investigate the proper active modified atmosphere packaging (MAP) condition for enhancing the storability of fresh-cut paprika fruit. The fresh-cut paprika (cv 'Score', seminis) put into $7cm{\times}0.7cm$ size and packed them in 20 g bags. The active MAP and vacuum treated paprika fruits were packaged with LLDPE/Nylon, EVOH, Tie film, and injected partial pressures of $CO_2$ and $O_2$, and $N_2$ in the packages immediately after sealing to treat active MAP. The ratio of $CO_2$, $O_2$, and $N_2$ of active MAP conditions were 0 : 20 : 80 (air), 5 : 5 : 90, 30 : 10 : 60, 10 : 70 : 20 and vacuum treatment did not contain any gas. The passive packaging treated paprika packaged with $40{\mu}m$ ceramic film. After 7 days of storage at $9^{\circ}C$, the fresh weight decreased less than 2% in all treatments, and showed lower in 5 : 5 : 90 ($CO_2:O_2:N_2$) active-MAP treatment and higher in vacuum treatment than other treatments. The $CO_2$ and $O_2$ concentration in packages did not change remarkably in active-MA treatments except 30 : 10 : 60 active-MAP treatment that showed sharply decreased $O_2$, concentration and increased $CO_2$ concentration at $1^{st}$ day of storage at $9^{\circ}C$. The ethylene concentration in package was the highest in 30 : 10 : 60 active-MAP treatment and the lowest in the passive MAP treatment that packaged with gas permeable film during $9^{\circ}C$ storage for 7 days. The 30 : 10 : 60 active-MAP treatments were not proper condition to storage fresh-cut paprika. The visual quality was maintained higher in 0 : 20 : 80 (air), 5 : 5 : 90, and 10 : 70 : 20 active MAP treatments and passive MAP treatment than others and the firmness, off-odor, and electrolyte leakage was investigated at 7th day of storage at $9^{\circ}C$. The 5 : 5 : 90 and 10 : 70 : 20 active-MAP treatment showed higher firmness and lower off-odor than other treatments after $7^{th}$ day of storage at $9^{\circ}C$. In addition, the electrolyte leakage was reduced less than 20% at 0 : 20 : 80 (air), 5 : 5 : 90, 10 : 70 : 20, and passive MA treatments. Therefore, 10 : 70 : 20 ($CO_2:O_2:N_2$) and 0 : 20 : 80 (air) might be recommended for proper active MAP conditions.
Transactions of the Korean Society of Mechanical Engineers A
/
v.41
no.4
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pp.263-270
/
2017
The shipbuilding industry uses large stationary tanks to store low-pressure air, which is used to open and close large shut-off valves. However, when supplying air from the tank to a distant valve, there are problems related to the need for supplementary pipes and the pressure drop during transportation. In this study, a portable welded vessel for storing high-pressure nitrogen (11 kg, 10 L, and 50 bar) was designed to prevent air leakage and improve the convenience of workers. This pressure vessel was elliptical to reduce the number of welded parts, which are structurally weak. The thickness and ratio of the major and minor axes of the pressure vessel were calculated to verify its structure stability at the working pressure (50 bar), and that the proposed weight and capacity were satisfactory. The residual stress caused by the welding process was calculated by performing a transient thermal-structural coupled field analysis using the ANSYS parametric design language (APDL), and the fatigue life of the vessel was verified based on the Goodman criterion.
Kim Sun-Ja;Jeon Ywun-Seok;Lee Seung-Hak;Jeong Byung-Hwan;Lee Myung-Un;Choe Gyu-Ha
The Transactions of the Korean Institute of Power Electronics
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v.10
no.3
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pp.257-263
/
2005
Short-circuit rotor windings on a generator causes unstable oscillation of unbalance of flux, asymmetrical heat. In order to prevent serious accidents of short-circuit rotor windings, it is important to study the shorted-turn diagnosis method for rotor windings of the generator. To improve the defects of the diagnosis with sensors, the new sensorless method for rotor shorted-turn diagnosis is proposed, which is to measure the electrical values of the voltage and current at the generator and then to detect if the shorted-turned phenomena would occurred. For the feasibility of the suggested method the theoretical results are shown in the aspects of the air-gap flux density, the flux leakage, the generated output voltage and the shorted field current through the digital simulation. Also the possibility of decision for the suggested sensorless method could be shown in this paper.
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.
A clinical evaluation was performed on 56 patients[ 60 cases ] of open thoracotomy in spontaneous pneumothorax who were admitted and treated at department of Thoracic and Cardiovascular Surgery, Chung Ang University, Yong San Hospital during the past 3 years from March 1990 to February 1993. The results were as follows. 1. The sex ratio was male predominence [ M:F = 7:1 ]. 2. The most common age group were 2nd, 3rd decades. 3. The most common chief complaints were dyspnea and chest pain [46.3% ]. 4. The etiologic factors of spontaneous pneumothorax were primary spontaneous pneumothorax [ 78.3%], secondary tuberculosis [ 18.3%], and others [ 3.4% ]. 5. The site of spontaneous pneumothorax was 50% in right, 40% in left, and 10% in both. 6. The state of activity on attack was almost in the usual life [ 98.3% ]. 7. Average height was 172.5 $\pm$ 5.39 cm in male and 164.0 $\pm$ 3.51 cm in female, average weight was 59.1 $\pm$ 7.06 kg in male and 52.0 $\pm$ 4.97 kg in female. 8. The common indications of open thoracotomy were recurrence [ 34.4% ] and persistent air leakage [ 17.8% ]. 9. The operative procedures were bullectomy [ 73.3% ], partial resection [ 11.7% ], lobectomy [ 11.7% ], and others [ 3.3% ]. 10. The most frequent location of bulla or bleb were apical segment of RUL [ 43.3 % ] and apicoposterior segment of LUL [ 40.0% ]. 11. The number of visible bulla or bleb were mainly 1 to 5, and size was about 1 to 3 cm.
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.
Due to its less invasive nature and superior visual field, video-assisted thoracescopic excision of mediastinal mass is thought to be comparable to open thoracotomy. Material and Method : From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy Result: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2$\pm$35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6$\pm$7.0 minutes, mean postoperative tube stay was 4.2$\pm$0.4 days, mean postoperative hospital stay was 5.2$\pm$0.4 days, and mean number of injection of analgesics was 1.9$\pm$0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of videoassisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. Conclusion : As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.
Jeong, Sang Seok;Choi, Pil Jo;Yi, Jung Hoon;Yoon, Sung Sil
Journal of Chest Surgery
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v.50
no.2
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pp.86-93
/
2017
Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.
Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.
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