• Journal of Chest Surgery
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• 제19권4호
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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.

• 한국지하수토양환경학회지:지하수토양환경
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• 제16권3호
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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.

• 산업기술연구
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• 제27권A호
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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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• 제35권2호
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• pp.161-165
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• 2002

하행 괴사성 종격동염은 대부분 경부 부위의 농양으로 시작하여 종격동으로 파급되는 매우 치명적인 질환이며 저자에 따라 25∼40%의 사망률을 보고하고 있다. 빠른 진단과 적절한 수술적 치료가 중요하며 수술적 치료의 방법에는 아직 여러 가지 방법들이 보고되고 있지만 농양의 완전한 배농이 특히 중요하다고 보고하고 있다. 배농술은 경부 절개를 통한 배농과 함께 흉부 내의 종격동 배농술이 필요하며 종격동 배농술은 대부분 개흉술을 통하여 시행되어 왔으나 개흉술에 따른 합병증과 수술부위의 감염 등이 술후 이환율을 증가시키는 원인이 될 수 있다. 반면에 흥강경을 이용한 배농은 경부 배농술 및 흉부 배농술을 동시에 시행할 수 있으며 좋은 수술시야를 보여주고 술후 환자의 회복이 빨라 하행 괴사성 종격동염의 좋은 치료 방법이라 생각된다.

• Journal of Chest Surgery
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• 제56권3호
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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.

• 한국작물학회지
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• 제42권3호
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• pp.323-332
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• 1997

남부지방의 답전환전에서 나물콩인 은하콩과 광안콩을 5월 15일과 6월 16일의 두 파종기를 두어 명거배수와 지표배수에서 재배하여 이에 대한 생육 및 수량을 알아 본 결과 다음과 같다. 1. 개화기까지의 경장, 마디수, 분지수는 배수처리에 따른 차이는 없었지만 답전환전이 밭보다는 짧거나 적었고, 파종기가 늦을수록 답전환전에서 길거나 많았다. 2. 개화기까지의 줄기 및 뿌리의 생체중은 배수처리에 따른 차이는 없었지만 답전환전이 밭보다는 적었고, 파종기가 늦을수록 은하콩에서 증가하였다. 3. 개화기의 줄기 및 뿌리의 생체중은 수량과 각각 고도의 정의 상관을 나타내었고, 근류수와 근류중도 고도의 정의 상관을 나타내었다. 4. 도복은 배수처리간 차이는 없었으며 5월 15일 파종보다 6월 16일 파종시 심하였고, 은하콩이 광안콩보다 덜 심했다. 5. 협수 및 100립중은 배수처리에 따른 차이는 없었으며, 100립중은 파종기가 늦을수록 은하콩은 무거웠고 광안콩은 가벼워TEk. 균일도는 5.00∼5.60mm에서 배수처리간 차이는 없었지만, 파종기가 은하콩은 늦을수록 낮아지고 광안콩은 높아지는 경향이었다. 6. 수량은 지표배수에서 명거배수보다 높았으며, 은하콩은 6월 16일 파종시에서, 광안콩은 5월 15일 파종시에서 높은 수량을 보였다.

• Clinical Endoscopy
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• 제57권1호
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• pp.105-111
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• 2024

Background/Aims: The pancreatic pseudocyst (PP) is a type of fluid collection that typically develops as a delayed complication of acute pancreatitis. Drainage is indicated for symptomatic patients and/or associated complications, such as infection and bleeding. Drainage modalities include percutaneous, endoscopic, laparoscopic, and open drainage. This study aimed to assess trends in the utilization of different drainage modalities for treating PP from 2016 to 2020. The trends in mortality, mean length of hospital stay, and mean hospitalization costs were also assessed. Methods: The National Inpatient Sample database was used to obtain data. The variables were generated using International Classification of Diseases-10 diagnostic and procedural codes. Results: Endoscopic drainage was the most commonly used drainage modality in 2018-2020, with an increasing trend over time (385 procedures in 2018 to 515 in 2020; p=0.003). This is associated with a decrease in the use of other drainage modalities. A decrease in the hospitalization cost for PP requiring drainage was also noted (29,318 United States dollar [USD] in 2016 to 18,087 USD in 2020, p<0.001). Conclusions: Endoscopic drainage is becoming the most commonly used modality for the treatment of PP in hospitals located in the US. This new trend is associated with decreasing hospitalization costs.

• 한국임상수의학회지
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• 제37권3호
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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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• 제53권2호
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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.

• 설비공학논문집
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• 제11권1호
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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.