• Journal of Chest Surgery
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• v.55 no.1
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• pp.88-90
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• 2022

Tracheo-innominate artery fistula (TIF) is a rare, life-threatening complication of tracheostomy that makes it difficult to secure the airway due to massive bleeding, constituting a medical emergency. Therefore, most successful surgical treatments include innominate artery debridement and tracheal fistula repair. Herein, we report a case of successful surgical treatment of a TIF while maintaining cerebral blood flow through an artificial vascular graft.

• Journal of Biomedical Engineering Research
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• v.27 no.4
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• pp.143-153
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• 2006

The purpose of this work was to assess and quantify the beneficial effects of gas exchange, while testingto the various frequencies of the sinusoidal wave that was excited by the PZT actuator, for patients suffering from acute respiratory distress syndrome (ARDS) or chronic respiratory problems. Also, this paper considered a simulator to design a hollow type artificial lung, and a mathematical model was used to predict a behavior of blood. This simulation was carried out according to the Montecarno's simulation method, anda fourth order Runge-Kutta method was used to solve the equation. The experimental design and procedure are then applied to the construction of a new device to assess the effectiveness of the membrane vibrations. As a result, the vibration method is very effective in the increase of gas transport. The gas exchange efficiency for the vibrating intravascular lung assist device can be increased by emphasizing the following design features: consistent and reproducible fiber geometry, and most importantly, an active means of enhancing convective mixing of water around the hollow fiber membranes. The experimental results showed the effective performance of the vibrating intravascular lung assist device. Also, we concluded that important design parameters were blood flow rates, fiber outer diameter and oxygen pressure drop. Based on the present results, it was believed that the optimal level of blood flow rates was 200$cm^3$/min.

• Clinical and Experimental Pediatrics
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• v.63 no.4
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• pp.135-140
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• 2020

Background: Breastfeeding reportedly reduces the overall frequency of infections. Respiratory syncytial virus (RSV), the most common respiratory pathogen in infants, involves recurrent wheezing and has a pathogenic mechanism related to airway structural damage. Purpose: This study aimed to investigate whether breastfeeding has a beneficial effect against RSV-induced respiratory infection compared to formula feeding among infants in Korea. Methods: We retrospectively reviewed the medical records of infants under 1 year of age who were admitted with RSV infection between January 2016 and February 2018 at the department of pediatrics of 4 hospitals. We investigated the differences in clinical parameters such as cyanosis, chest retraction, combined infection, fever duration, oxygen use, oxygen therapy duration, intensive care unit (ICU) admission, and corticosteroid treatment of exclusive breast milk feeding (BMF), artificial milk formula fed (AMF), and mixed feeding (MF) groups. Results: Among the 411 infants included in our study, 94, 161, and 156 were included in the BMF, MF, and AMF groups, respectively. The rates of oxygen therapy were significantly different among the BMF (4.3%), MF (8.1%), and AMF (13.5 %) groups (P=0.042). The odds ratios (ORs) for oxygen therapy was significantly higher in the AMF group than in the BMF group (adjusted OR, 3.807; 95% confidence interval, 1.22-11.90; P=0.021). The ICU admission rate of the BMF group (1.1%) was lower than that of the MF (3.5%) and AMF (4.5%) groups; however, the dissimilarity was not statistically significant (P=0.338). Conclusion: The severity of RSV infection requiring oxygen therapy was lower in the BMF than the AMF group. This protective role of human milk on RSV infection might decrease the need for oxygen therapy suggesting less airway damage.

• Journal of Korean Biological Nursing Science
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• v.23 no.2
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• pp.138-150
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• 2021

Purpose: This retrospective study aimed to investigate nursing interventions in patients with severe thoracic injury in trauma bay of a regional trauma center. Methods: Of the 1,780 patients admitted to the trauma bay of a regional trauma center in a university hospital in the Gyeonggi Province between January 1, 2019 and December 31, 2019, 120 adult patients with severe thoracic injury who met the inclusion criteria were enrolled. Participants' clinical characteristics and nursing interventions were collected from electronic medical records after receiving ethical approval. Nursing interventions were classified using the terminology in the Nursing Intervention Classification. Results: The mean age of participants was 52.25 years and 72.5% of participants were male. The main areas of thoracic injury included lung parenchyma and pleura (95.8%). The mean Abbreviated Injury Scale (AIS) for thoracic injury was 3.13 and the mean Injury Severity Score (ISS) was 17.81. Fluid resuscitation, invasive hemodynamic monitoring, chest tube care, respiratory monitoring, artificial airway management, gastrointestinal tube care, mechanical ventilation management: airway insertion and stabilization, blood product administration, allergy management, and surgical preparation were performed significantly more frequently in thoracic injury patients with unstable vital signs or a higher AIS score. Conclusion: This study is significant as it investigated the types of nursing interventions given to patients with severe thoracic injury in the trauma bay. These results would contribute to developing more detailed educational materials for initial nursing interventions in trauma bay.

• The Korean Journal of Emergency Medical Services
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• v.15 no.3
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• pp.5-17
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• 2011

purpose : The purpose of this study was to analyze the effect of basic life support performance by video simulation training. Methods : The subjects in this study consisted of 24 persons of experimental group and 24 persons of control group in freshmen and sophomore EMT students. The data were collected from September 1 to 30, 2010. Results : 1. Hypothesis one: experimental group is meaningful higher than control group at the operation point (p<0.05) of adult/infant's basic life support for one person. In subcategory that identifying breath, artificial respiration, pulse rate, 30 compressions, Ability to perform all the processes, the experimental group showed statistically higher score (p<0.05) than control group, and sequence from checking reaction to keeping airway management isn't statistically significant difference between experimental group and control. 2. Hypothesis two: In the hypothesis, the experimental group's point of adult basic life support by two persons and use of Automated External Defibrillator is good in experimental group than control group's point(p<0.05). As the result of researching 11 contents of check list about adult basic life support by two persons and Automated External Defibrillator(AED), by dividing into 7 subcategories, every subcategory shows that the experimental group is significant higher than control group(p<0.05). 3. Hypothesis three: In the hypothesis, the experimental group gets higher point of infant basic life support by one or two persons than the control group (p<0.05). As the results of researching 15 contents of check list about infant basic life support by one or two persons, by dividing into 8 subcategories, the experimental group is statistically meaningful higher (p<0.05) than the control group in process of keeping airway, indentifying breathing, identifying pulse, 30 compressions, Ability to perform all the processes. There isn't statistically significant difference between the groups in process of checking reaction, reporting 119, and artificial respiration by giving 2 breaths(p<0.05). Conclusion : As summarizing the results, the group, receiving using video, gets higher points of knowledge of basic life support and operating skill than the general educated group. It is found that the Video simulation training could be effective, because of these positive effects to improve clinical working performance of students, who participate in the department of Emergency Medical Technology.

• Journal of the Institute of Convergence Signal Processing
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• v.12 no.3
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• pp.157-162
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• 2011

This study is about implementing wireless transferring system in pre-hospital cardiopulmonary resuscitation(CPR). Also, this study includes monitoring based feedback between patient and hospital to increase the survival rate of emergency patient by developing the performance of cardiopulmonary resuscitation in pre-hospital. It minimizes the loss of flow rate or gastric inflation through the space between the airway and the esophagus, which enables the inspiration-expiration rate to be measured more precisely. Due to these reasons this study applied ET insertion based respiratory sensor to measure flow rate. The main indices of artificial ventilation are justified from minute respiration(V), end-tidal $CO_2(E_TCO_2)$, and tracheal pressure($P_{tr}$). The simulation is performed to verify the bandwidth and delay time of transport network for in-hospital monitoring even as transporting images and voice information simultaneously. The total bandwidth is 815 kbps, and WLAN (IEEE 802.11x) is used as communication protocol. The network load is under 1.5% and the transmit delay time is measured under 0.3 seconds.

• The korean journal of orthodontics
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• v.49 no.6
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• pp.413-426
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• 2019

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

• Journal of the Korean Society of School Health
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• v.23 no.2
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• pp.133-142
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• 2010

Purpose: The purpose of this study was to identify awareness, attitude and perceived competence about cardiopulmonary resuscitation in elementary school students. Methods: Data were collected from a convenience sample of 616 5th and 6th grade elementary school students in Korea during September and December 2008. A self-questionnaire was used to gather the data. Descriptive statistics, t-test, $x^2$ test, Pearson correlation coefficients and multiple stepwise regression with the SPSS program were used to analyze the data. Results: Among the items related to elementary school students' awareness of cardiopulmonary resuscitation, artificial respiration was perceived at the highest rate (91.9%) and was followed by cardiopulmonary resuscitation, chest compression and airway management. The mean score for attitude 3.51, perceived competence 3.47. There was a positive correlation between awareness, attitude and perceived competence. Attitude and awareness were significant predictors and explained 57.5% of perceived competence about cardiopulmonary resuscitation. Conclusion: The results indicate the necessity of developing effective cardiopulmonary resuscitation education programs for elementary school students.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.238-243
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• 1996

Aspiration of foreign bodies into the tracheobronchial tree is unusual in adults and it may result in Proximal airway obstruction and acute life-threatening asphyxia. It can be diagnosed by history of aspiration or visualizing the foreign body by chest roentgenogram or bronchoscopy. But it is rarely considered in adults with subacute or chronic respiratory symptoms without a definite history which suggests an aspiration. A 70-year-old woman was admitted to the hospital due to productive cough for two months and dyspnea which aggravated since the day before admission. Chest X-ray showed Pneumonic infiltration on left upper lobe and right lower lobe. Despite several days of conventional therapy, the patient complained of severe dyspnea and wheezing. We performed chest CT to rule out endobronchial stenosis, and it revealed the narrowing of left main stem bronchus compatible with endobronchial tuberculosis. Fiberoptic bronchoscopy for confirmation disclosed a $3.2{\times}0.7{\times}0.2$cm sized foreign body located longitudinally at the left main stem bronchus. We removed it with alligator forcep and it proved In be a piece of artificial denture. The patient remembered losing it while severe coughing on the day before admission. The microscopic examination of bronchial washing fluid revealed numerous acid fast bacilli. After removal of the foreign body, the patient showed marked improvement in symptom and pulmonary function test. Here we report a case of Pulmonary aspiration of foreign body which is confused with endobronchial tuberculosis with a review of the literature.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.12 no.3
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• pp.395-403
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• 2005

Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUS). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. Method: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. Result: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. Conclusion: Our findings give support to recent studies that suggest that frequent physical contact maγ increase the nosocomial acquisition of MRSA in a neurosurgical ICU.