• Journal of Korean Biological Nursing Science
• /
• 제16권3호
• /
• pp.182-191
• /
• 2014

Purpose: The aim of this study was to identify necessary emergency treatment and nursing activities for severe trauma patients according to elapsed time and vital signs. Methods: A survey was conducted with 121 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. Collected data were analyzed with descriptive statistics, applying McNemar's test using SPSS 12.0. Results: Almost all of the subjects were men and the mean age was 46.9. Run-time for primary diagnosis, treatment decision, and leaving for the hospital room was 0.19, 4.36, and 4.21 hours, respectively, and stayover time was 9 hours. Regardless of vital signs, emergency treatments involving ambu-bagging, intubation, ventilator, and central vein catheterization insertion were offered within an hour. Central venous pressure, Foley catheter/Levin tube preparation and maintenance were performed in cases of unstable vital sign patients within an hour. Unrelated to vital signs, nursing activities for consciousness assessment, skin assesment and wound care, bed sore/fall down assesment and care, intravenous injection insertion and maintenance were conducted for all severe trauma patients within an hour. Foley catheter/Levin tube drainage care was performed for patients who had unstable vital signs within an hour. Conclusion: Emergency treatment and nursing activities for severe trauma patients were specific according to elapsed time and vital signs.

• Journal of Korean Neurosurgical Society
• /
• 제40권6호
• /
• pp.423-427
• /
• 2006

Objective : Postoperative brain swelling after resection of olfactory groove meningiomas by bifrontal interhemispheric transbasal approach is a knotty subject. Pathogenesis and predictive factors were investigated to prevent the problem. Methods : Eighteen patients of olfactory groove meningiomas who had undergone surgery were enrolled and retrospectively analyzed using their clinical and radiological data. Bifrontal inter hemispheric transbasal approach was used in all patients. Magnetic resonance imaging and transfemoral cerebral angiography were available for investigation in 18 and 14 patients respectively. Postoperative clinical course, tumor volume, peritumoral edema, tumor supplying vessels, and venous drainage patterns were carefully investigated in relation to postoperative brain swelling. Results : Seven patients [39%] developed clinically overt brain swelling after surgery. Among them, 4 patients had to undergo decompression surgery. In three patients, attempted bone flap removal was done by way of prevention of increased intracranial pressure resulted from intractable brain swelling and two of them eventually developed brain swelling which could be recovered without sequellae. Abnormal frontal base venous channel observed in preoperative angiography was significant predictive factor for postoperative brain swelling [p=0.031]. However, tumor volume, peritumoral edema, and existence of pial tumor supplying vessels from anterior cerebral arteries were failed to show statistical significances. Conclusion : To prevent postoperative brain swelling in olfactory groove meningioma surgery, unilateral approach to preserve frontal base venous channels or temporal bone flap removal is recommended when it is indicated.

• Journal of Biosystems Engineering
• /
• 제34권6호
• /
• pp.404-410
• /
• 2009

This study was carried out to develop a self-propelled type explosive subsoiler for improving the root zone soil conditions in orchard and other forest fields. Prototype was designed to be able to inject air and other soil improving material such as lime into soil at the same time, and thus improve the air permeability and drainage of orchard soils to promote the root growth of tree for high quality fruit production. Soil penetration device of explosive subsoiler is composed of air hammer, penetration rob and air injection nozzle. To support the soil penetration device of explosive subsoiler to penetrate vertically, modified Scott-Russel mechanism was used. Timing control device for simultaneous injection of soil improving material with air was attached to the out side wall of air cylinder and as the cylinder move, the soil improving material was injected into soil at the same time. Turning radius of prototype was 2.2-2.3 m with good mobility in sloped land. It took approximately 1 minute for lime injection system to reach the optimum pressure of 9.9 kg/$cm^2$, average 10-20 seconds were required to rupture soil with the depth of 50 cm and 2-3 seconds were required for explosion, so all in all about 1 minute and 20 seconds were required for one cycle of explosion. Maximum soil rupture depth and diameter were 50 cm and 3-4 m respectively depending on the soil type and soil moisture content. For final design of explosive subsoiler inclination angle of lime hopper was increased from 60 degree to 70 degree and the shape of hopper was changed from rectangular cone to circular cone to solve the clogging problem of lime at out let. Agitating system operated by compressed air was attached to the metering device of the prototype, thus more than 90 cc of lime was discharged per cycle from metering device without clogging problems.

• 한국추진공학회:학술대회논문집
• /
• 한국추진공학회 2011년도 제37회 추계학술대회논문집
• /
• pp.731-736
• /
• 2011

우주발사체 추진기관 공급계에서 공압구동용 솔레노이드밸브는 제어시시템의 명령이 주어지면 구동가스 배관의 통로를 개폐해서 공압제어장치를 작동시킨다. 공압구동용 솔레노이드밸브의 제작에 앞서 설계검증 및 기본적인 작동특성을 분석하기 위해 AMESim 상용코드를 이용하여 해석모델을 수립하였다. 입구압력에 따른 작동시간을 시험결과와 비교하여 모델을 검증하였고 내부유동 해석결과 (FLUENT)를 이용하여 3차원 형상을 고려하여 모델의 정확도를 높였다. 밸브모델을 이용하여 다양한 설계변수에 따른 밸브의 개폐압력, 작동시간을 계산하여 설계인자 검증 및 작동성능을 분석하였다. 설계변수인 컨트롤밸브의 시트 형상, 주 밸브와 배출밸브의 시트 형상, 실링 직경비, 컨트롤 캐비티부피에 대해 밸브의 동특성 해석을 수행하였다. 해석을 통해 밸브 개폐작동시간, 작동성능, 개방압력을 예상하였다. 본 연구 결과는 한국형발사체 공급계 공압구동용 솔레노이드밸브의 설계/해석능력을 확보하고 밸브의 개발과정에서 효율성을 높일 수 있으며 파생형 밸브의 설계 및 선행연구에 적용할 수 있을 것으로 판단된다.

• 한국터널지하공간학회 논문집
• /
• 제6권4호
• /
• pp.345-356
• /
• 2004

지하구조물을 축조하는 공법으로 기존에 가장 많이 사용해 온 것이 개착식 공법이나, 지상교통 흐름을 방해하고 공사소음 및 주변 지반의 침하로 인한 민원 발생 등 많은 문제점을 야기해 왔다. 많은 경우에 있어 지중에 매설된 상수도관 하수도관 도시가스관 고압 전력구 통신 케이블 등 지중 매설물의 위치가 정확하게 파악되지 않아서 안전한 시공에 어려움이 크고, 개착공사 시 지하지장물의 이설로 인한 공지지연 및 추가공사비가 소요될 것으로 판단되다. 따라서 본 논문에서는 기존 지하구조물 축조공법을 개선하여 슬래브강관과 PC벽체 트렌치를 이용한 터널축조공법 (T.R.c.M.)을 서울지하철 현장에 적용한 시공사례를 소개하고자 한다. 연구결과, T.R.c.M.공법은 진동과 소음을 최소화하여 주변환경과 교통의 흐름에 전혀 지장을 주지 않고 안정적으로 터널을 축조할 수 있는 공법임을 알 수 있었다.

• Journal of Korean Neurosurgical Society
• /
• 제39권5호
• /
• pp.335-339
• /
• 2006

Objective : The authors present eight cases of immediate post-operative epidural hematomas[EDHs] adjacent to the craniotomy site, describe clinical details of them, and discuss their pathogenesis. Methods : Medical records of eight cases were retrospectively reviewed and their clinical data, operation records, and radiological findings analyzed. Any risk factors of the EDHs were searched. Results : In 5 of 8 cases, adjacent EDHs developed after craniotomies for the surgical removal of brain tumors. Three cases of adjacent EDHs developed after a pterional approach and neck clipping of a ruptured anterior communicating artery aneurysm, a ventriculoperitoneal shunt, and a craniotomy for a post-traumatic EDH, respectively. In all eight cases, brain computed tomography[CT] scans checked immediately or a few hours after the surgery, revealed large EDHs adjacent to the previous craniotomy site, but there was no EDH beneath the previous craniotomy flap. After emergent surgical removal of the EDHs, 7 cases demonstrated good clinical outcomes, with one case yielding a poor result. Conclusion : Rapid drainage of a large volume of cerebrospinal fluid or intra-operative severe brain collapse may separate the dura from the calvarium and cause postoperative EDH adjacent to the previous craniotomy site. A high-pressure suction drain left in the epidural space may contribute to the pathogenesis. After the craniotomy for brain tumors or intracranial aneurysms, when remarkable brain collapse occurs, an immediate postoperative brain CT is mandatory to detect and adequately manage such unexpected events as adjacent EDHs.

• Journal of Korean Neurosurgical Society
• /
• 제30권3호
• /
• pp.366-370
• /
• 2001

Objective : The authors present three cases of brain tumors in which epidural hematomas(EDHs) were developed postoperatively in the remote areas from craniotomy sites. The preventive tactics as well as possible mechanisms of development of remote EDH are discussed. Material and Methods : The magnetic resonance imagings of three patients revealed a left lateral ventricular mass located just aside of foramen Monro in a 27-year-old male, a large cystic mass in the temporal lobe in a 35-year-old male, and a partially calcified pineal mass in a 27-year-old male patient. The surgical removals of these tumors were performed without any noticeable events during surgery via left frontal transcortical transventricular approach for lateral ventricular tumor, left temporal craniotomy for cystic temporal tumor, and right occipital transtentorial approach for pineal tumor. Results : Postoperative EDHs remote from the sites of craniotomy were detected by the immediate postoperative computerized tomographic scans. We obtained good outcomes without any morbidity in all three patients with emergent evacuation of the hematoma. The pathologic diagnoses were lateral ventricular ependymoastrocytoma, temporal craniopharyngioma and mixed germinoma of the pineal region. Conclusion : It is postulated that a sudden reduction of intracranial pressure(ICP) at the time of tumor removal may strip the dura from the inner table of the skull to cause EDH from the remote site of craniotomy. Gradual reduction of ICP with slow drainage of cerebrospinal fluid before tumor removal as well as lowering the head position of patient during surgery might be helpful for preventing this unusual complication.

• Journal of Korean Neurosurgical Society
• /
• 제38권4호
• /
• pp.281-286
• /
• 2005

Objective : The authors report our experience of urokinase thrombolysis in treating patients harboring nonaneurysmal spontanesous intraventricular hemorrhage[IVH] and evaluated complications, safety and feasibility of this procedure retrospectively. Methods : Fifty-three patients with nonaneurysmal IVH>15mL without underlying structural etiology or coagulopathy were recruited. The patients with Glasgow Coma Scale[GCS]<5 were excluded. A catheter was directed into the IVH. Hematoma aspiration was followed by instillation of urokinase at the ear level of drainage bag under intracranial pressure monitoring system. This was repeated every 6hours until half of its initial volume. For analysis of prognostic factors, we classified the patients into two groups by Glasgow outcome scale[GOS]; good [$GOS\;{\ge}3$] and bad [GOS<3] prognosis group, and performed comparative analysis between two groups. Results : Mean age was 60.2years. The baseline hematoma size ranged 16 to 72mL. IVH volume reduction was done by an average of 74.2%. As complications, there were 3cases of rebleeding and 2cases of ventriculitis. No intracranial adverse effects were observed during thrombolytic theraphy. At 6months after the procedure, 29patients had achieved a good recovery, 15remained vegetative. 9patients died in hospital. The main good prognostic factors were young age, small IVH volume, and high GCS. Conclusion : The results of this study suggest that this relatively easy and safe method of treatment will improve the prognosis. However, further clinical studies also must assess optimal thrombolytic dosage, frequency, and timing of urokinase instillation for safety and effectiveness and must include controlled comparisons of mortality, disability outcome, quality of life, time until convalescence, and cost of care in treated and untreated patients.

• Journal of Korean Neurosurgical Society
• /
• 제61권5호
• /
• pp.640-644
• /
• 2018

Objective : The purpose of this pilot study was to examine the safety and function of the newly developed cerebrospinal fluid (CSF) reservoir called the V-Port. Methods : The newly developed V-Port consists of a non-collapsible reservoir outlined with a titanium cage and a connector for the ventricular catheter to be assembled. It is designed to be better palpated and more durable to multiple punctures than the Ommaya reservoir. A total of nine patients diagnosed with leptomeningeal carcinomatosis were selected for V-Port insertion. Each patient was followed up for evaluation for a month after the operation. Results : The average operation time for V-Port insertion was 42 minutes and the average incision size was 6.6 cm. The surgical technique of V-Port insertion was found to be intuitive by all neurosurgeons who participated in the pilot study. There was no obstruction or leakage of the V-Port during intrathecal chemotherapy or CSF drainage. Also, there were no complications including post-operative intracerebral hemorrhage, infection and skin problems related to the V-Port. Conclusion : V-Port is a safe and an easy to use implantable CSF reservoir that addresses problems of other implantable CSF reservoirs. Further multicenter clinical trial is needed to prove the safety and the function of the V-Port.

• 한국지반공학회지:지반
• /
• 제3권1호
• /
• pp.7-24
• /
• 1987

울산만 북서측 임해지역체 발달된 연약해성점토를 개양하기 위하려 선행대중과 Wick Drain공법의 병용공법이 적용되었다. 상기 공법의 적용에 따른 연약해성점토의 거동 및 강침특성을 요명하여, 안전하고 신속하게 시공을 실시하기 위하여 현장계측에 의한 공학적인 시공관리를 실시하였다. 본 고는 연약해성점토를 개량하기 위하여 적용한 선행하중과 Wick Drain공법의 설계, 시공 및 안전관리방법을 수록하고 있다.