• 한국간담췌외과학회지
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• 제27권2호
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• pp.189-194
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• 2023

Backgrounds/Aims: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is a source of major morbidity and mortality. Early diagnosis and treatment of POPF is mandatory to improve patient outcomes and clinical risk scores may be ombined with postoperative drain fluid amylase (DFA) values to stratify patients. The aim of this pilot study was to etermine if intraoperative fluid amylase (IFA) values correlate with DFA1 and POPF. Methods: In patients undergoing PD from February to November 2020, intraoperative samples of intra-abdominal fluid adjacent to the pancreatic anastomosis were taken and sent for fluid amylase measurement prior to abdominal closure. Data regarding patient demographics, postoperative DFA values, complications, and mortality were prospectively collected. Results: Data were obtained for 52 patients with a median alternative Fistula Risk Score (aFRS) of 9.9. Postoperative complications occurred in 20 (38.5%) patients (five Clavien grade ≥ 3). There were eight POPFs and two patients died (pneumonia/sepsis). There was a significant correlation between IFA and DFA1 (R² = 0.713; p < 0.001) and DFA3 (p < 0.001), and the median IFA was higher in patients with POPF than patients without (1,232.5 vs. 122; p = 0.0003). IFA > 260 U/L predicted POPF with sensitivity, specificity, positive and negative predictive values of 88.0%, 75.0%, 39.0%, and 97.0%, respectively. The incidence of POPF was 43.0% in high-risk (high aFRS/IFA) and 0% in lowrisk patients (low aFRS/IFA). Conclusions: IFA correlated with POPF and may be a useful adjunct to clinical risk scores to stratify patients during PD. Larger, prospective studies are needed to determine whether IFA has clinical utility.

• 복식
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• 제57권6호
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• pp.87-100
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• 2007

In the Joseon Dynasty, a Court Ladies' full dress was Slanted by the Ming Dynasty. Since the Ming Dynasty had declined, a Court Ladies' full dress, Jeok-ui began to be made by the Joseon Dynasty. It was based on the Chinese Court Ladies' full dress, Desam, but it became Joseon's own style, which was different from the Chinese one. The formula of Jeok-ui was completed in the time of King Yongjo. Since then, Jeok-ui for big ceremonies was called Bub-bok. It was recorded on the Regular rule of Sang-uiwon. The color of Jeok-ui was departmentalized for the wearer; red one for the Queen, bluish black one for the Crown Princess, and purple one for the Queen mother. There were some differences between Jeok-ui for feasts and for big ceremonies. In the case of Jeok-ui for big ceremonies, the pattern of Hyung-bae for the Queen was a dragon with five claws, and for the Crown Princess, a dragon with four claws. On the other hand, in the case of Jeok-ui for feasts, the pattern of Hyung-bae was phoenixes for the Queen, Crown Princess and the Queen mother. The number of embroidered round badges, which were attached to Jeok-ui, was 51 for big ceremonies, and 36 for feasts. The skirt for big ceremonies was a Jeonang-ut-chima with dragons pattern for the Queen, and phoenixes for the Crown Princess. The Queen's skirt for feasts was a Jeonang-ut-chima with phoenixes pattern, and the Queen mother's also. The Crown Princess' was a double skirt with phoenixes pattern. The pearls were not decorated on the shoes for big ceremonies, but shoes for feasts had six big pearls fer decoration. When the royal woman wore Jeok-ui for big ceremonies, it was prepared for Kyu, Pe-ok and belt with jade. But those were not necessary for Jeok-ui for feasts.

• 복식
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• 제53권3호
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• pp.89-106
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• 2003

The purpose of this study is to analyze the expressive effects of Queen Elizabeth I's robes in cinema and also to present two examples of Queen Elizabeth I's robes designed and made based on these expressive effects. To this end, this study wilt first examine Queen Elizabeth I's robes in her portraits according to the visual definers and emblematic meanings. Then on the basis of these knowledges, analyze visual definers and viewing priorities of Queen Elizabeth I's robes in five movies. Thereinafter, these robes will be classified based upon Belong(1998)'s four expressive effects. excitement. calmness, strength and delicacy. Finally, this study will demonstrate calmness and delicacy among four expressive effects through two robes made for the purpose. After analyzing the expressive effects of robes in five Queen Elizabeth I's movies, one can conclude excitement. calmness, strength, and delicacy can be found according to the flow of the story. Since this analysis focuses mainly on one particular person during one Particular period of time, there was a fundamental silhouette prevalent among the Queen's robes which then can be classified into different forms. Moreover, Queen's character in itself embodies authority and grace which. in turn, facilitates the presentation of the four expressive effects along the story line. In conclusion, thorough historical research on the character and the period. in addition to analysis of the visual definer and viewing priorities, is imperative when designing a historical costume.

• 한국간담췌외과학회지
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• 제26권3호
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• pp.257-262
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• 2022

Backgrounds/Aims: Middle hepatic vein (MHV) is usually preserved as a part of the right or left hepatectomy in order preserve the venous outflow of remnant liver. The aim of this study was to evaluate if resection of MHV could influence post-resection outcomes of standard right or left hepatectomy. Methods: Patients who underwent standard right or left hepatectomy between January 2015 and December 2019 were included. Anatomical remnant liver volumes were measured retrospectively using the Hermes workstation (Hermes Medical Solutions AB, Stockholm, Sweden). Uni- and multi-variate analyses were performed to assess the difference in outcomes of those with preservation of MHV and those without preservation. Results: A total of 144 patients were included. Right hepatectomy was performed for 114 (79.2%) and left hepatectomy was performed for 30 (20.8%) patients. MHV was resected for 13 (9.0%) in addition to the standard right or left hepatectomy. Median remnant liver volume was significantly higher in the MHV resected group (p < 0.01). There was no significant difference in serum level of bilirubin, international normalized ratio, alanine aminotransferase, creatinine on postoperative day 1, 3, 5, or 10, ≥ grade IIIa complications (p = 0.44), or 90-day mortality (p = 0.41). On multivariable analysis, resection of the MHV did not influence the incidence of post hepatectomy liver failure (p = 0.52). Conclusions: Resection of the MHV at standard right or left hepatectomy did not have a negative impact on postoperative outcomes of patients with adequate remnant liver volume.

• 복식문화연구
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• 제13권2호
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• pp.300-313
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• 2005

Hybrid trend of the 21st century is an important basis to express fashion Alexander McQueen is a representative designer of Hybrid trend which combines heterogeneous elements into oneconcept. Accordingly, this study distributed and analyzed Hybrid trend which was in Alexander McQueen's work like below. First, there was a racial Hybrid trend which combined different local culture in shared space of the world in his fashion work and he challenged to Westernized ideal beauty with new recognition and knowledge about beside countries of Western Europe which were considered as not important culture due to perceiving relative value of a pluralist society and created new way aesthetic consciousness. Second, he expressed a historical character of a combination of tradition and modern by his fashion work based on wide historical knowledge of a dress. He created a new line in contrast to the past with a perfect design through combination of the style from the tradition with the parody and displayed his own design world. Third, he treated instability and disorder from the interior essential dissolution, thus he had a cultural character which broke down the boundary of cultural genre and style. This attitude showed transformation of constructivism and deconstruction view, secession and distortion, mixture, duplication, secession and insert by his fashion work.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.293-300
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• 2017

Background Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here. Methods A step-by-step dissection guide on how to perform the chicken thigh adductor profundus free muscle flap is demonstrated. Forty trainees performed the novel simulation muscle flap on the last day of a 5-day microsurgery course. Pre- and post-course microvascular anastomosis assessment, along with micro dissection and end product (anastomosis lapse index) assessment, demonstrated skills acquisition. Results The average time to dissect the flap by novice trainees was $82{\pm}24$ minutes, by core trainees $90{\pm}24$ minutes, and by higher trainees $64{\pm}21$ minutes (P=0.013). There was a statistically significant difference in the time to complete the anastomosis between the three levels of training (P=0.001) and there was a significant decrease in the time taken to perform the anastomosis following course completion (P<0.001). Anastomosis lapse index scores improved for all cohorts with post-test average anastomosis lapse index score of $3{\pm}1.4$ (P<0.001). Conclusions The novel chicken thigh adductor profundus free muscle flap model demonstrates face and construct validity for the introduction of the principles of free tissue transfer. The low cost, constant, and reproducible anatomy makes this simulation model a recommended addition to any microsurgical training curriculum.

• 복식
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• 제7권
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• pp.5-19
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• 1983

Sacredotal robe(法服) means full court dress. We can't know about the shape of sacredotal robe before Dae-Han Empire(大韓帝國) since there are no remains of it. The study of sacredotal robe for queen have also been made centering around the socredotal robe granted from Ming(明) dynasty and the system of Juck-Eui(翟衣) in Dae-Han Empire. In this thesis I tried to study about the sacredotal robe for queen from King Gong-Min(恭愍王) of Koryeo(高麗) dynasty to the close the Cho-Sun(朝鮮) dynasty by investigating the Literature of Cho-sun Dynasty Chronicles(朝鮮王朝實錄), Ga Rae Do Gam Eui Gue(嘉禮都監儀軌), Sang Bang Jung Rae(尙方定例), Gook Hon Jung Rae(國婚定例), Sok-Orae Eui-Bo(續五禮儀補), and Dae Myung Whe Jeon(大明會典). The first documents on sacredotal robe for queen is regarded as that in the period of King Gong Min., which says that Chil Whee Gu Bong Gwan and Juck Eui of the 9th grade had been given from Ming dynasty. The sacredotal robe for queen in Chosun had been granted from Ming dynasty since the 3th years of King Tae-Jo(太祖) to the 3th years of King In-Jo(仁祖). They were Ju Chui Chil Juck Gwan, red Dae Sam(大衫), Bae Ja(褙子) embroidered with. pheasants on blue silk, and ivory flat baton (笏), which belonged to the court dress for the first class of court lady. When Qing(淸) dynasty succeeded to Ming dynasty, Cho-sun adopted the system of luck Eui which had it's origin in the system of Ming, denying to comply with Chung. But as a matter of fact, the system of sacredotal robe for queen actually used was one which were different from the dress system of Ming and converted into our national ways. In the latter period. of Cho-sun, the system of Bae Ja or Juck Eui were used together until the period of King Young Jo(英祖), and the system of Juck Eui which was written in Gook Hon Jung Rae was continually used from King Young Jo to the close of Cho-sun. It was composed of Juck Eui, Beol Eui(別衣), Nae Eui(內衣), Pe Sool(蔽膝), Dae Dae(大帶), HaPi, Sang(裳), Ok Dae(玉帶), Pae Ok(佩玉), Gue(圭), Mal(襪), Suk, and Myun sa(面紗), The headdress was used in our own ways, not complying with Juck Gwan(翟冠). The color of Juck Eui was red for queen, deep blue for the consort of the crown prince. The color of Juck Eui in DaHan Empire was deep blue, different from that of Juck Eui in Cho-sun. Bo(補) for queen wus embroidered with dragon with five claws and the one for the consort of crown prince with dragon with four claws. The back length of Juck Eui was longer than front about 28cm (1尺), and the front opening was straight down. 51 motifs of a brace of pheasants which were similiar to Bong(鳳) were embroidered on Juck Eui for queen. But we can't find out whether there 31 or 51 on Juck Eui for the consort of the crown prince. The system shows independant aspects, because there are Bo, Myun Sa, Sang, Ha Pi, Beol Eui, and Nae Eui which were not found in the system of Ming. As mentioned above, I have studied on the sacredotal robe for queen. But we can't guess the detail of sacredotal robe for queen, because there are no remains at all. Therefore I expect more study on this.

• 한국의사학회지
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• 제32권1호
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• pp.11-20
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• 2019

Queen Myeongseong was the wife of King Hyeonjong, the 18th king of the Joseon Dynasty, and the mother of King Sukjong. The clinical records of Queen Myeongseong are summarized on the basis of the Seungjeongwon Ilgi (The Daily Records of Royal Secretariat of Joseon Dynasty 承政院日記) and reviewed through Donguibogam. Queen Myeongseong gave birth to one male and three female children in the time of the queen. She took Geumgaedangguihwan (金櫃當歸丸), Dalsaengsan (達生散), Antaeum (安胎飮) during her pregnancy and Gungguitang (芎歸湯) during postnatal care. Since 1669, chest tightness, sleeplessness, arm pain and numbness of arms had been appeared. Ondamtang (溫膽湯) and Dodamtang (導痰湯) were used but they were not effective. However, when her symptoms were regarded as a benign tumor due to cold and wetness, there was a difference in the use of Ohjuksan (五積散). In 1683, when king Sukjong was caught in a smallpox, she took care of him. She exorcised in the middle of winter to pray for her son's recovery, and died of the flu.

• 한국간담췌외과학회지
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• 제26권1호
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• pp.31-39
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• 2022

In patients with neuroendocrine tumors with liver metastases (NETLMs), complete resection of both the primary and liver metastases is a potentially curative option. When complete resection is not possible, debulking of the tumour burden has been proposed to prolong survival. The objective of this systematic review was to evaluate the effect of curative surgery (R0-R1) and debulking surgery (R2) on overall survival (OS) in NETLMs. For the subgroup of R2 resections, outcomes were compared by the degree of hepatic debulking (≥ 90% or ≥ 70%). A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines using PubMed, Medline, CINAHL, Cochrane, and Embase databases. Hazard ratios (HRs) were estimated for each study and pooled using a random-effects inverse-variance meta-analysis model. Of 538 articles retrieved, 11 studies (1,729 patients) reported comparisons between curative and debulking surgeries. After pooling these studies, OS was found to be significantly shorter in debulking resections, with an HR of 3.49 (95% confidence interval, 2.70-4.51; p < 0.001). Five studies (654 patients) compared outcomes between ≥ 90% and ≥ 70% hepatic debulking approaches. Whilst these studies reported a tendency for OS and progression-free survival to be shorter in those with a lower degree of debulking, they did not report sufficient data for this to be assessed in a formal meta-analysis. In patients with NETLM, OS following surgical resection is the best to achieve R0-R1 resection. There is also evidence for a progressive reduction in survival benefit with lesser debulking of tumour load.

• Wind and Structures
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• 제11권4호
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• pp.303-321
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• 2008

When first commissioned, the 1.6 km span 275kV Severn Crossing Conductor experienced large amplitude vibrations in certain wind conditions, but without ice or rain, leading to flashover between the conductor phases. Wind tunnel tests undertaken at the time identified a major factor was the lift generated in the critical Reynolds number range in skew winds. Despite this insight, and although a practical solution was found by wrapping the cable to change the aerodynamic profile, there remained some uncertainty as to the detailed excitation mechanism. Recent work to address the problem of dry inclined cable galloping on cable-stayed bridges has led to a generalised quasi-steady galloping formulation, including effects of the 3D geometry and changes in the static force coefficients in the critical Reynolds number range. This generalised formulation has been applied to the case of the Severn Crossing Conductor, using data of the static drag and lift coefficients on a section of the stranded cable, from the original wind tunnel tests. Time history analysis has then been used to calculate the amplitudes of steady state vibrations for comparison with the full scale observations. Good agreement has been obtained between the analysis and the site observations, giving increased confidence in the applicability of the generalised galloping formulation and providing insight into the mechanism of galloping of yawed and stranded cables. Application to other cable geometries is also discussed.