• 대한족부족관절학회지
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• 제21권3호
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• pp.113-116
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• 2017

Synovial fistula of the ankle joint is an uncommon complication from an ankle sprain. This may likely result in an unhealed wound around the ankle joint due to continuous leakage of joint fluid. However, in the event of an open wound on the lower leg, and not on the joint, it may be difficult to consider synovial fistula as a cause of the open wound. We experienced an interesting case with an unhealed open wound on the lower leg due to a synovial fistula of the ankle joint following an ankle sprain. We obtained good results after a treatment using a self-produced suction drainage device on the unhealed open wound.

• Journal of Chest Surgery
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• 제21권6호
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• pp.1084-1094
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• 1988

Conservative management of 3 iatrogenic perforations of intrathoracic esophagus was reviewed. The primary disorders were achalasia in 2 patients and congenital tracheoesophageal fistula in 1 patient. Perforation occurred after treatment of the primary disorders in the distal esophagus in 2 patients and mid-thoracic esophagus in 1 patient. All the perforations appeared late after the previous treatments and the inflammation spread to mediastinum and pleural cavity in all the 3 patients. Conservative management of esophageal perforation was carried out with intraluminal drainage from the perforated site of esophagus[insertion of Levin`s tube and continuous suction], pleural drainage and feeding of liquid diet through gastrostomy tube with Fowler`s position. The patients revealed spontaneous closure of perforated sites about 3 to 4 weeks after this conservative management without open thoracotomy. This result suggests that this conservative management may be accepted as therapeutic method in the thoracic esophageal perforations regardless of cause and time of the perforation.

• Environmental Engineering Research
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• 제25권2호
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• pp.251-257
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• 2020

This study was performed to verify the possibility of nitrification and denitrification in a single reactor. In batch type experiment, optimal point of experimental conditions could be found by performing the experiments. When supply location of microbubbles was located at half of width of the aeration tank and operating pressure of 0.5 bar, it was possible for zones in the aeration tank to be separated into anoxic and aerobic by controlling air suction rate according to operating pressure of the generator. To be specific, the concentration of dissolved oxygen (DO) in zone 1 and 2 of the aeration tank could be maintained as less than 0.5 mg/L. Also, in the case of concentration of oxygen in zone 3 and 4, the concentration of DO was increased up to 1.7 mg/L due to effects of microbubbles. In continuous flow type experiment based on the results of batch type experiments, the removal efficiency of nitrogen based on T-N was observed as 39.83% at operating pressure of 0.5 bar and 46.51% at operating pressure of 1 bar so it was able to know that sufficient air suction rate should be required for nitrification. Also, denitrification process could be achieved in a single reactor by using ejector type microbubble generator and organic matter and suspended solid could be removed. Therefore, it was possible to verify that zones could be separated into anoxic and aerobic and nitrification and denitrification process could be performed in a single reactor.

• 한국지반환경공학회 논문집
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• 제19권3호
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• pp.5-13
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• 2018

최근 해빙기에 발생하는 지반붕괴로 인한 건설재해가 증가하고 있으며 이는 동절기에 시행되는 다짐시공과 관련이 많다. 영하온도에서 다짐을 실시할 경우 다짐효과가 감소하며 이에 따른 해빙기 지반의 거동 변화를 파악하는 것은 유용한 자료로 활용될 수 있을 것으로 판단된다. 또한 최근 국내 지반공학 분야에서 불포화 영역에 대한 관심이 높아지고 있는 만큼 지반재료의 영하온도 다짐 및 동결융해에 따른 불포화 특성을 파악한다면 앞으로 관련 분야의 연구자들에게도 좋은 정보를 제공할 수 있을 것으로 판단된다. 따라서 본 연구에서는 동절기 다짐에 따른 지반의 불포화 특성을 파악하기 위해 상온($18^{\circ}C$)과 영하온도($-3^{\circ}C$, $-8^{\circ}C$)에서 수행한 다짐시험의 결과를 바탕으로 성형한 시료에 불포화 함수특성시험과 불포화 일축압축시험을 수행하였으며, 시료에 동결융해를 반복적으로 가한 후 불포화 함수특성시험 및 일축압축시험을 수행하여 동결융해가 작용함에 따른 지반의 흡수력 및 불포화 특성의 변화를 파악하였다. 시험결과 영하온도에서의 다짐 및 동결융해에 의한 흡수력의 변화와 강도 및 강성의 감소를 확인하였다. 특히 풍화토의 경우 영하온도에서의 다짐과 동결융해가 진행될수록 강도와 흡수력이 상당히 감소하는 것으로 나타나 지반의 안정성에 상당한 영향을 미칠 것으로 판단된다.

• 대한토목학회논문집
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• 제29권1C호
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• pp.1-9
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• 2009

본 연구에서는 국내 풍화토 사면에서의 일반적 적용 경사 기준인 1:1.5, 1:1.8, 1:2.0 경사에 대하여 함수특성과 투수특성 을 고려한 강우 시 사면의 침투거동특성을 SEEP/W 로 평가하였고, 그 결과를 활용하여 SLOPE/W 로 간극수압의 변화에 따른 무한사면 거동을 분석하였다. 또한 기존 이론인 Fredlund and Xing을 이용하여 함수특성곡선을 결정하고 강우강도에 대하여 지속시간이 달라지는 경우 화강풍화토 사면의 지반조건을 변화시켜 포화깊이, 안전율 변화를 수치해석적으로 접근하여 검토하였다. 본 연구결과 강우의 지속시간이 증가함에 따라 포화심도가 증가하는 것을 볼 수 있었고, 사면의 기울기가 완만해짐에 따라 포화심도가 증가하는 것으로 나타났으며, 지속강우특성을 고려한 해석을 통해 안전율의 경향을 확인할 수 있었다. 실제의 사면 거동을 좀 더 정확히 모사하기 위해서는 지속강우특성을 고려한 불포화토 해석을 통해 간극수압 분포를 산정한 후 사면안정해석을 실시하는 것이 필요하다고 판단된다.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.227-232
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• 2010

Purpose: Continuous irrigation method is an important step in managing wound infection. V.A.C. devices have been used in intractable wounds for reducing discharge, improving local blood flow, and promoting healthy granulation tissue. We expect synergistic effects of reduced infection and more satisfactory, accelerated wound healing when using both methods simultaneously. This study evaluated continuous irrigation combined with V.A.C. appliance for treatment of infected chronic wounds. Methods: We reviewed data from 17 patients with infected intractable chronic wounds. V.A.C. device (Group A) was used in 9 patients, and V.A.C. with antibiotics irrigation (Group B) was used in 8 patients. We placed Mepitel$^{(R)}$ on the surface of wound and placed an irrigation and aspiration tube on each side. A sponge was placed on the Mepitel$^{(R)}$ and covered with film dressing. The wound was irrigated continuously with mixed antibiotics solution at the speed of 200 cc/hr and aspirated through the wall suction at the pressure of -125 mmHg. V.A.C. applied time, wound culture and wound size were compared between the two groups. Results: No complication were seen in two groups. Compared with Group A, in the Group B, V.A.C. applied time was shortened from 32.7 days to 25.6 days and showed efficacy in the reduction rate of wound size. No statistical differences were shown in bacterial reversion. Conclusion: V.A.C. appliance with continuous irrigation is an effective new method of managing infected chronic wounds and useful to reduce treatment duration and decrease wound size. Moreover it could be applied more widely to infected wound.

• 한국지반공학회논문집
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• 제35권9호
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• pp.5-13
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• 2019

함수특성 곡선은 불포화 지반의 침투 또는 전단 거동 예측을 위해 필요한 입력 변수 중 하나이며, 불포화 함수특성의 이력현상에 따라 다른 거동을 보이기 때문에 건조과정과 습윤과정이 고려되어야 한다. 보편적으로 단계적 가압식을 이용하여 함수특성 곡선을 획득하지만, 함수특성 곡선의 건조과정과 습윤과정을 모두 측정하기 위해서는 오랜 시간 소요된다는 단점이 있다. 연속 가압시험법은 이러한 단점이 개선되었으며, 기존의 시험 방법보다 측정시간이 크게 단축되는 결과가 나타났다. 하지만, 새롭게 제안된 연속 가압시험법의 결괏값에 대한 검증이 부족한 상황이다. 이에 본 연구에서는 연속 가압방법으로 획득한 함수특성 곡선을 기존의 시험법인 단계 가압방법과 증발방법의 결과와 비교하였다. 비교 결과, 서로 다른 시험법으로 획득한 함수특성 곡선과 차이가 거의 존재하지 않았으며, 측정시간이 크게 단축되는 결과를 보였다. 따라서, 연속 가압방법을 통하여 다양한 조건에서의 함수특성 곡선을 빠르고 정확하게 획득할 수 있을 것으로 판단된다.

• Journal of Chest Surgery
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• 제17권4호
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• pp.729-734
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• 1984

Bochdalek hernia is a type of congenital diaphragmatic defect in the posterolateral portion of the diaphragm. The defect is usually Lt. sided due to protective effect of liver on right. Sex distribution is male preponderance [2:1] and it is diagnosed during neonate, mostly first 24 hours, due to severe respiratory distress. We experienced a rare case of old aged female patient with congenital Bochdalek hernia on Rt. side which was found incidentally during treatment of spontaneous pneumothorax of Rt. side. 17 year old female patient was admitted to CS department for chest discomfort on right and mild dyspnea with duration of 20 days. Under the diagnosis of spontaneous pneumothorax, Rt. closed thoracostomy and underwater sealed drainage with continuous suction was applied. On follow-up chest x-ray, poorly defined hazy increased density with multiple air-fluid levels in Rt. lower lung field and Lt. subphrenic free air were noted. So, Barium enema was done under the impression of Rt. diaphragmatic hernia, and nearly entire colon proximal to sigmoid was demonstrated in the Rt. hemithorax. Operation was done-for surgical repair of defected diaphragm through Rt. posterolateral thoracotomy. Operative findings were as follows; 1.Hypoplastic Rt. lung, esp. RML & RLL. 2.Nearly entirely intestines were herniated. 3.Diaphragmatic defect was located on posterolateral portion of the diaphragm, about 10x3cm in size with blunt smooth margin. 4.A large bleb on apex of RUL of lung. Herniated intestines were repaired into abdominal cavity manually and defect of diaphragm was repaired with No. I black silk interrupted sutures directly, and bleb was resected. Postoperative courses were uneventful and the patient was discharged with good condition on POD 14th.

• Advances in pediatric surgery
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• 제1권1호
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• pp.53-58
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• 1995

기관식도루를 동반하지 않은 원간격결손 식도폐쇄증 1예를 미리 조성한 위루와 경구를 통하여 주기적 부지를 함으로써 식도길이를 확장하여 식도-식도단단문합술로 식도의 개통복원을 할 수 있었음을 경험하였다. 이때 상부식도맹단부로부터 이중관을 이용한 지속적인 섬프배액술이 경과에 아주 긴요하며, 수술시 식도길이의 여유를 위하여 식도근환상절개술을 한 후에는 근절개부위의 협착 발생 가능성에 항상 주의하여 술 후 조기(술 후 2-4주)에 추시함이 꼭 필요하다고 생각하였다. 식도부지를 할 때에는 길이 뿐만 아니라 직경확장(특히 하부식도에서)에도 관심을 갖이면 더욱 좋은 결과를 얻을 수 있다고 판단된다.

• Journal of Korean Neurosurgical Society
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• 제45권5호
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• pp.318-321
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• 2009

Tension pneumocephalus may follow a cerebrospinal fluid(CSF) leak communicating with extensive extradural air. However, it rarely occurs after diagnostic lumbar puncture, and its treatment and pathophysiology are uncertain. Tension pneumocephalus can develop even after diagnostic lumbar puncture in a special condition. This extremely rare condition and underlying pathophysiology will be presented and discussed. The authors report the case of a 44-year-old man with a basal skull fracture accompanied by pneumothorax necessitating chest tube suction drainage, who underwent an uneventful lumbar tapping that was complicated by postprocedural tension pneumocephalus resulting in an altered mental status. The patient was managed by burr hole trephination and saline infusion following chest tube disengagement. He recovered well with no neurologic deficits after the operation, and a follow-up computed tomography (CT) scan demonstrated that the pneumocephalus had completely resolved. Tension pneumocephalus is a rare but serious complication of lumbar puncture in patients with basal skull fractures accompanied by pneumothorax, which requires continuous chest tube drainage. Thus, when there is a need for lumbar tapping in these patients, it should be performed after the negative pressure is disengaged.