• Journal of Chest Surgery
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• 제13권1호
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• pp.60-65
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• 1980

We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

• 한국산학기술학회논문지
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• 제22권6호
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• pp.573-582
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• 2021

본 연구에서는 고폭탄과 같은 고위험 탄약에 대한 신뢰성 시험을 수행하는 기관에서 갖추어야 할 방호벽에 대해 유효 방호력을 평가하였다. 고폭탄이 인원에게 줄 수 있는 영향은 폭발압력에 의한 고막, 폐의 손상 등과 폭발과 동시에 발생한 파편에 의해 받을 수 있는 관통상이 있다. 따라서 COMP B가 충전되어있는 고폭탄을 기준으로, 피해 정도를 산정하기 위한 폭발방호 이론과 수치적 계산과 시뮬레이션을 통한 방호력 검증을 수행하였다. 수치적 계산 결과 시나리오로 설정된 방호벽과 폭발원점의 거리(7 m)에서 고폭탄 폭발 시 방호벽에 미치는 최대 폭발압력은 77.74 kPa이었으며, 50 mm 두께의 방호벽에 대한 파편의 관통력은 41.34 mm로 계산되었다. AUTODYN을 활용한 시뮬레이션 검증에서는 방호벽과 인원에게 영향을 주는 최대 폭발압력은 각각 58.68 kPa과 18.175 kPa이었으며, 파편의 관통력은 35.56 mm였다. 이 수치는 인간의 피해 한계보다 낮은 수치로 방호벽의 방호력은 유효할 것으로 판단되었다.