• Journal of Chest Surgery
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• v.19 no.4
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• pp.744-749
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• 1986

Even in the hands of the expert endoscopists, an occasional instrumental perforation of the esophagus occurs. But instrumental perforation of the esophagus should not be difficult to diagnose if the possibility is borne in mind. Occasionally patient with esophageal perforations show little reaction at first, but usually they develop systemic manifestation if surgical management is delayed. Early surgical drainage of esophageal perforation is very important & effective therapeutic method. The delayed surgical treatment of esophageal perforation would have increased the morbidity & mortality by allowing mediastinitis & empyema thoracis. We have experienced 6 cases of delayed surgical management of instrumental perforation of esophagus from May 1974 to April 1986 in the department of thoracic and cardiovascular surgery, Yonsei University, college of the medicine. The ages ranged from 4 years to 57 years. The underlying esophageal diseases consisted of esophageal stricture in 3 cases, foreign bodies in the esophagus in 2 cases and esophageal ca. in one case. Most clinical manifestations on admission were high fever, chest discomfort, chest pain, dysphagia and subcutaneous emphysema. Most complications due to esophageal rupture were acute mediastinitis with or without empyema thoracis. Failure to diagnose promptly and failure to promptly institute adequate treatment undoubtedly were largely responsible for this patients death. All 6 patients had been taken delayed surgical drainage more than 24 hours following esophageal perforation. One patient had been in the open drainage state for long time and the another patient has been in the tracheostomy with postintubation vocal cord ulceration. The third patient died due to respiratory failure and sepsis due to fulminant mediastinitis & empyema thoracis. Even if the patients with esophageal perforation have been taken delayed surgical management, the patients should be survived with aggressive & effective surgical drainage with intensive post-operative care.

• Journal of Soil and Groundwater Environment
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• v.16 no.3
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• pp.17-27
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• 2011

Recently, a physically based model of water-table fluctuation due to precipitation is developed based on aquifer water balance model. In the model, it was assumed that the water infiltration into ground surface is advection dominant and immediately reaches to water-table. The assumption may be suited for the sites where the water-table is shallow and/or the permeability of the unsaturated zone is high. However, there are more cases where the model is not directly applicable due to thick and low permeable unsaturated zone. For the low permeability unsaturated zone, the pattern of water flux passing through unsaturated zone is diffusive as well as advective. In this study, to improve the previously developed water-table fluctuation model, we combined the delayed drainage model, which has long been used in well hydraulics, to the water-table fluctuation model. To test the validity of the development, we apply the developed model to 5 different domestic sites. The model parameters are calibrated based on the groundwater hydrograph and the precipitation time series, and the correlation analyses among the parameters are pursued. The overall analyses on the delineated model parameters indicate that the delayed drainage parameters or delay index used in the developed model are able to reveal drainage information in the unsaturated zones.

• Journal of Industrial Technology
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• v.27 no.A
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• pp.111-120
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• 2007

This paper is results of experimental research on the effect of application of similarity related to permeability of soil on the consolidation behavior as centrifuge modeling of consolidation is performed with the centrifuge model facility. In this research, the permeability of soil was controlled by changing the viscosity of porewater as the mixed water with glycerin was used during the centrifuge model experiments. The effect of drainage path on consolidation was investigated by installing the vertical drains. A serise of centrifuge model tests with conditions of single vertical and radial horizontal drainage were carried out. Kaolinite and Jumunjin standard sand were used as soft clay and surcharges respectively during tests. For testing condition of single vertical drainage considering similarity of permeability, it was found that consolidation with mixed porewater with glycerin was delayed in comparisons sons with test results with water only. For conditions of horizontal drainage with vertical drains, a low permeability by changing the viscosity of pore water resulted in delayed degree of consolidation at an initial stage of consolidation. But, it predicted not much differences in settlement as long as the consolidation time was sufficiently long enough to finish consolidation. Consequently, it was found that similarity in permeability should be considered to be critical for the case of centrifuge model experiments related to consolidation with long drainage path.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.161-165
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• 2002

Descending necrotizing mediastinitis is a life-threatening infection originating in the head or the neck and descends into the mediastinum. Even in the era of antibiotics, mortality rate has been reported to be 25 ∼ 40%. Prompt diagnosis and treatment is mandatory for delayed diagnosis and inappropriate drainage of the mediastinum are the main causes of high mortality Surgical management ranges from cervical drainage to routin thoracotomy:however, the optimal management still needs to be defined particularly in respect to effective mediastinal drainage. Although posterolateral thoracotomy incision has been considered as a standard approach, potential disadvantages including postoperative pain, risk of wound complication and delayed recovery remain to be concerned. Thoracoscopic approach is an attractive treatment modality as it can provide an excellent exposure with minimal incision and can complete drainage from the mediastinum and the neck in one-staged manner We describe here two cases of descending necrotizing mediastinitis successfully managed by thoracoscopic drainage.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.206-212
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• 2023

Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.42 no.3
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• pp.323-332
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• 1997

Drainage is needed to run off excessive water stress during the rainy season for soybean cultivation in the converted upland from paddy field. This study was conducted to evaluate the effect of planting dates and drainage methods on growth and yield of sprout soybeans in the converted upland from paddy field. The stem and root growth at flowering stage showed no difference by drainage method but plant height, number of nodes and branches, and fresh weight of stem and root were much greater as planting date delayed. Seed yield was correlated positively with fresh weight of stem and root, and T/R ratio at the flowering stage, respectively. Lodging degree was not different by drainage method but was higher in planting at June 16 than May 15. Number of pods and 100 seed weight were not different by drainage method and 100 seed weight was heavy in Eunhakong, light in Kwangankong as planting date delayed. Higher seed yield was observed in surface drainage than open ditched drainage. Yield performance of Eunhakong was good in late planting, while that of Kwangankong was in early planting.

• Journal of Veterinary Clinics
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• v.37 no.3
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• pp.157-162
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• 2020

A 6-year-old Thoroughbred mare presented to the Korea Racing Authority Equine Hospital with dropping of the left front fetlock due to an injury sustained while racing. Radiographic examination revealed a comminuted fracture of both proximal sesamoid bones of the affected fetlock. Arthrodesis of the fetlock joint using a broad dynamic compression plate with a tension band wire was performed as a salvage procedure for the future use as a broodmare. After surgery, however, a delayed union of the bones and surgical site infection was present for a prolonged period. Staphylococcus aureus was persistently identified from the surgical site, and antimicrobial therapies were based on antibiotic sensitivity tests, including regional perfusions. The removal and replacement of surgical implants associated with seropurulent discharge was based on coordinating the development of fetlock ankylosis and infection control over 13 months. Firstly, seven screws associated with surgical drainage were replaced and bone morphogenetic protein-2 (BMP-2) and local antibiotics were placed into the surgical site to accelerate bone fusion at postoperative month 7. Further six screws, along with drainage, were removed at postoperative month 10. The plate and screws were removed from the limb due to the progression of bone fusion at postoperative month 13; BMP-2 and local antibiotics were also used. Delayed healing of arthrodesis due to surgical site infection and implant instability were treated by implant removals and antibiotic therapies, and the horse eventually showed improved weight-bearing ability of the affected limb.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.108-111
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• 2013

Burr hole drainage has been widely used to treat chronic subdural hematomas (SDH), and most of them are easily treated by simple trephination and drainage. However, various complications, such as, hematoma recurrence, infection, seizure, cerebral edema, tension pneumocephalus and failure of the brain to expand due to cerebro-cranial disproportion may develop after chronic SDH drainage. Among them, intracerebral hemorrhage after evacuation of a recurrent chronic SDH is very rare. Here, we report a fatal case of delayed intracerebral hemorrhage caused by coagulopathy following evacuation of a chronic SDH. Possible pathogenic mechanisms of this unfavorable complication are discussed and a review of pertinent literature is included.

• Korean Journal of Air-Conditioning and Refrigeration Engineering
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• v.11 no.1
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• pp.38-47
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• 1999

An improved one-dimensional modeling of snow melting was obtained by considering both the effect of heat capacity and the decreasing influence of porosity. Using the improved model, the effects of initial snow temperature, initial snow density and the heat flux on the snow melting were investigated. It is found that the drainage starting time is delayed and the drainage rate becomes smaller with lower initial snow temperature. ResuIts also show that the drainage starts at the same time when an initial snow density is over a certain value. Melting efficiency increases linearly with an increasing initial snow temperature. With increasing the initial density of the snow and the amount of heat supplied, the melting efficiency increases, then converges to a constant value.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.404-407
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• 2021

We present a case study of necrotizing fasciitis (NF), a very rare but dangerous complication of chest tube management. A 69-year-old man with shortness of breath underwent thoracostomy for chest tube placement and drainage with antibiotic treatment, followed by a computed tomography scan. He was diagnosed with thoracic empyema. Initially, a non-cardiovascular and thoracic surgeon managed the drainage, but the management was inappropriate. The patient developed NF at the tube site on the chest wall, requiring emergency fasciotomy and extensive surgical debridement. He was discharged without any complications after successful control of NF. A thoracic surgeon can perform both tube thoracostomy and tube management directly to avoid complications, as delayed drainage might result in severe complications.