EunYoung, Seo;ByoungGil, Yoon;GaEun, Kim;YougSeok, Kim
The Korean Journal of Emergency Medical Services
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v.26
no.3
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pp.37-46
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2022
Purpose: TThe experiment was designed to compare the efficiency of ventilation between conventional BVM ventilation and a newly devised A-BVM ventilation method with Tidal volume, total ventilation rate, average Ventilation speed, and average Ventilation volume. Methods: 40 Paramedical students who agreed to participate in the study were analyzed. Values were measured using IMB PASS after 2 minutes of Brayden Pro manikin with BVM and A-BVM ventilation. The difference in general characteristics was assessed by t-test and ANOVA and the difference in ventilation methods was analyzed by IBM SPSS. Results: A significant difference was found between the two ventilation methods in terms of tidal volume (t=-11.203, p<.001), ventilation time (t=-3.834, p<.001), and optimum ventilation probability (t=10.770, p<.001). A-BVM ventilation method, rather than BVM ventilation method, showed a value close to the appropriate amount recommended by Korean Advanced Life Support (500~600mL) in tidal volume, and higher in optimum ventilation probability. Conclusion: We could identify the a better mode of ventilation. Further studies on the efficacy of existing BVM ventilation methods as compared to device augmented BVM ventilation methods should be carried out to ensure that adequate ventilation is available to patients in clinical practice.
In veterinary medicine, a variety of disease are known to cause coagulation abnormalities. Identification of these coagulation abnormalities have been relied on traditional coagulation assays(platelet concentration, aPTT, PT, D-dimer, fibrinogen) which take only a small part of the coagulation pathways rather than global hemostatic capacity. Among of the hypercoagulable diseases, cardiovascular disease, such as mitral valvular disease, was not regarded as the cause of the hypercoagulability. The value of a thromboelastography (TEG) as an early predictor of coagulopathy, especially hypercoagulability, has been founded. It was associated with decreased R and K values, and increased MA and α angle. The objective of this study was to compare thromboelastography results and those of traditional coagulation tests between twenty adult dogs with mitral insufficiency (MVI group) and eleven adult healthy dogs (Healthy group). As a results, MA values in the patients with mitral insufficiency (68.8±7.8 mm) were significantly higher than the normal patients (60.4±4.8 mm) (P value<0.05). Although a little report has been reported in veterinary medicine, platelet activation seems to be related with hypercoagulability in MVI patients in human medicine. The result of this report can support this pathophysiology in veterinary medicine. In addition to traditional coagulation assay, global assessment of coagulopathy using TEG, especially ability to detect hypercoagulability, may be useful for customized treatment in MVI patients. To achieve this, further study is needed to define pathophysiology and effect of medication.
Lee, Jung Hee;Jeong, Dong Seop;Sung, Kiick;Kim, Wook Sung;Lee, Young Tak;Park, Pyo Won
Journal of Chest Surgery
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v.48
no.3
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pp.164-173
/
2015
Background: Hypertrophied myocardium is especially vulnerable to ischemic injury. This study aimed to compare the early and late clinical outcomes of three different methods of myocardial protection in patients with aortic stenosis. Methods: This retrospective study included 225 consecutive patients (mean age, 65{\pm}10 years; 123 males) with severe aortic stenosis who underwent aortic valve replacement. Patients were excluded if they had coronary artery disease, an ejection fraction <50%, more than mild aortic regurgitation, or endocarditis. The patients were divided into three groups: group A, which was treated with antegrade and retrograde cold blood cardioplegia; group B, which was treated with antegrade crystalloid cardioplegia using histidine-tryptophan-ketoglutarate (HTK) solution; and group C, treated with retrograde cold blood cardioplegia. Results: Group A contained 70 patients (31.1%), group B contained 74 patients (32.9%), and group C contained 81 patients (36%). The three groups showed significant differences with regard to the proportion of patients with a New York Heart Association functional classification ${\geq}III$ (p=0.035), N-terminal pro-brain natriuretic peptide levels (p=0.042), ejection fraction (p=0.035), left ventricular dimensions (p<0.001), left ventricular mass index (p<0.001), and right ventricular systolic pressure (p <0.001). Differences in cardiopulmonary bypass time (p=0.532) and aortic cross-clamp time (p=0.48) among the three groups were not statistically significant. During postoperative recovery, no significant differences were found regarding the use of inotropes (p=0.328), mechanical support (n=0), arrhythmias (atrial fibrillation, p=0.347; non-sustained ventricular tachycardia, p=0.1), and ventilator support time (p=0.162). No operative mortality occurred. Similarly, no significant differences were found in long-term outcomes. Conclusion: Although the three groups showed some significant differences with regard to patient characteristics, both antegrade crystalloid cardioplegia with HTK solution and retrograde cold blood cardioplegia led to early and late clinical results similar to those achieved with combined antegrade and retrograde cold blood cardioplegia.
The purpose of this study was to provide basic data for the development of educational material in Korean for patient3 being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out -patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows ; 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used (91.0%) . The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many Patients didn’t know the importance of a low salt diet(57.8%), and did not get any education on low salt diet (66.7%). Gimchi was included as one of the most commonly ingested foods (77.8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1% ). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1% of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%) . Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns (57.7%) related to nursing. needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical discomfort including the following : memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51.1%), sleep disturbance(46.7%) and other symptoms in that order of frequency. Nursing needs related to physical condition were a concern for all of them. The viability and function of the replaced valve(53.3%) and weight gain(60.0%) were mal or concerns. 6. Looking at their psychoemotional condition it was found that 36 patients(80.0%) were emotionally unstable. The causes were physical discomfort(17 patients), insufficient knowlege of open heart surgery(6 patients), fear of death(6 patients), familial over protection(2 patients ) and lack of support (5 patients).
"본 논문은 대한외과학회지 2006년 제70권제1호에 실렸던 논문으로 대한외과학회 편집위원회 승인을 득하고 본 협회지에 게재함.
Purpose: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no' gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. Methods Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion fey malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid-arm muscle circumference, serum albumin)in and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic(ROC) curve was drawn to choose a cutoff valve that maximizes sensitivity and specificity. Results' The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified7 patients(13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. Conclusion The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.
Solenoid operated valves (SOV) play important roles in industrial process to control the flow of fluids. Solenoid valves can be found in so many industries as well as the nuclear plant. The ability to be able to detect the presence of faults and predicting the remaining useful life (RUL) of the SOV is important in maintenance planning and also prevent unexpected interruptions in the flow of process fluids. This paper proposes a fault diagnosis method for the alternating current (AC) powered SOV. Previous research work have been focused on direct current (DC) powered SOV where the current waveform or vibrations are monitored. There are many features hidden in the AC waveform that require further signal analysis. The analysis of the AC powered SOV waveform was done in the time and frequency domain. A total of sixteen features were obtained and these were used to classify the different operating modes of the SOV by applying a machine learning technique for classification. Also, a deep neural network (DNN) was developed for the prediction of RUL based on the failure modes of the SOV. The results of this paper can be used to improve on the condition based monitoring of the SOV.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.3
/
pp.1639-1644
/
2015
A study on design and structural strength analysis of a positioner in robot overlay welding system of a ball for ball-valves. Turning-unit of positioner modeled, analysis was conducted by assuming the beam. Turning-unit is applied to the stress, it was shown by 366.85MPa when weight of the ball is $9,000kg_f$. This value is higher than the yield strength of the material. Based on the results of previous, it was modeled the turning-unit by modifying. Results of analysis by a modified modeling, The value of stress was confirmed to 296.11MPa. This value is a value lower than the yield strength of the material, it was found to support the weight of the ball.
Jung G. S.;Seong H. C.;Shim E. B.;Ko H. J.;Min B. G.
Proceedings of the KSME Conference
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2002.08a
/
pp.705-706
/
2002
Hemodynamics of the TPLS(Twin Pulse Life Support System) is numerically investigated to delineate the possibility of hemolysis in blood. Computational method employing finite element algorithm is utilized to solve the blood flow of the sac squeezed by moving actuator. We assume that the blood flow interacts with the sac material which is activated by the rigid body motion of the actuator. Valve dynamics at the ends of the sac is simplified as on/off type motion. We compute the transient viscous flow in the two-dimensional geometry of the blood sac. Incompressible laminar flow is simulated on the assumption of Newtonian fluid. Blood velocity has a step gradient near the throat of the sac formed by the moving actuator. According to the decrease of the gap size of blood passage, the magnitude of shear stress in the blood is dramatically increased. Numerical solutions show that the maximum value of shear stress in the blood flow in TPLS is relatively smaller than that of the roller type ECLS.
Toh, William;Tan, Long Bin;Tse, Kwong Ming;Raju, Karthikayen;Lee, Heow Pueh;Tan, Vincent Beng Chye
Steel and Composite Structures
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v.26
no.1
/
pp.55-66
/
2018
In this paper, the response of an underground fibreglass reinforced plastic (FRP) composite pipe system subjected to realistic loading scenarios that may be experienced by an actual buried pipeline is investigated. The model replicates an arbitrary site with a length of buried pipeline, passing through a $90^{\circ}$ bend and into a valve pit. Various loading conditions, which include effects of pipe pressurization, differences in response between stainless steel and fibreglass composite pipes and severe loss of bed-soil support are studied. In addition to pipe response, the resulting soil stresses and ground settlement are also analysed. Furthermore, the locations of potential leakage and burst have also been identified by evaluating the contact pressures at the joints and by comparing stresses to the pipe hoop and axial failure strengths.
Taussig-Bing anomaly is infrequently associated with interrupted aortic arch and size discrepancy of great arteries makes it difficult to undergo arch reconstruction and arterial switch operation. A 20-day old male infant was admitted with the diagnosis of Taussig-Bing anomaly with type B Interrupted aortic arch. Multi-organ failure, due to the diminution of ductal flow, was stabilized after 3 weeks of prostaglandin El and controlled ventilatory support. The surgical correction consisted of VSD closure, arterial swtich and extended aortic arch reconstruction. The marked disparity between the hypoplastic ascending aorta and the dilated main pulmonary artery was overcome by constructing distal neoaorta using both native ascending and descending aortic tissue. The patient was extubated on postoperative 2nd day Postoperative catheterization showed no left ventricular outflow obstruction, no intracardiac shunt, and no incompetence of neoaortic valve.
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