• Title/Summary/Keyword: Discharge procedure

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Topical EMLA Cream as a Pretreatment for Facial Lacerations

  • Park, Sung Woo;Oh, Tae Suk;Choi, Jong Woo;Eom, Jin Sup;Hong, Joon Pio;Koh, Kyung S.;Lee, Taik Jong;Kim, Eun Key
    • Archives of Plastic Surgery
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    • v.42 no.1
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    • pp.28-33
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    • 2015
  • Background Topical anesthetics, such as eutectic mixture of local anesthetics (EMLA) cream, can be applied to reduce pain before minor procedure. This trial evaluated EMLA as pretreatment for facial lacerations and compared pain, discomfort and overall satisfaction. Methods This trial included consecutive emergency department patients ${\geq}16years$ of age who presented with simple facial lacerations. At triage, lacerations were allotted to either the routine processing group or EMLA pretreatment group according to date of admission. Initially, the emergency department doctors inspected each laceration, which were dressed with saline-soaked gauze. In the pretreatment group, EMLA cream was applied during wound inspection. The plastic surgeon then completed primary closure following the local injection of an anesthetic. After the procedure, all patients were given a questionnaire assessing pain using the 10-point visual analog scale (VAS) ("no pain" to "worst pain"). All questionnaires were collected by the emergency department nurse before discharge. Results Fifty patients were included in the routine processing group, and fifty patients were included in the EMLA pretreatment group. Median age was 39.9 years, 66% were male, and the average laceration was 2.67 cm in length. The EMLA pretreatment group reported lower pain scores in comparison with the routine processing group (2.4 vs. 4.5 on VAS, P<0.05), and lower discomfort scores during the procedure (2.0 vs. 3.3, P=0.60). Overall satisfaction was significantly higher in the EMLA pretreatment group (7.8 vs. 6.1, P<0.05). Conclusions Pretreating facial lacerations with EMLA topical cream aids patients by reducing pain and further enhancing overall satisfaction during laceration treatment.

Effect of Planned Nursing Intervention on the Stress, the Maternal Role Strain, and the Maternal Role Performance of Mothers of Premature Infants (계획된 간호 중재가 미숙아 어머니의 스트레스, 모성 역할 긴장과 역할 수행에 미치는 영향)

  • Joung Kyoun -Hwa
    • Child Health Nursing Research
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    • v.5 no.1
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    • pp.70-83
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    • 1999
  • The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

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Calculation of Unit Hydrograph from Discharge Curve, Determination of Sluice Dimension and Tidal Computation for Determination of the Closure curve (단위유량도와 비수갑문 단면 및 방조제 축조곡선 결정을 위한 조속계산)

  • 최귀열
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.7 no.1
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    • pp.861-876
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    • 1965
  • During my stay in the Netherlands, I have studied the following, primarily in relation to the Mokpo Yong-san project which had been studied by the NEDECO for a feasibility report. 1. Unit hydrograph at Naju There are many ways to make unit hydrograph, but I want explain here to make unit hydrograph from the- actual run of curve at Naju. A discharge curve made from one rain storm depends on rainfall intensity per houre After finriing hydrograph every two hours, we will get two-hour unit hydrograph to devide each ordinate of the two-hour hydrograph by the rainfall intensity. I have used one storm from June 24 to June 26, 1963, recording a rainfall intensity of average 9. 4 mm per hour for 12 hours. If several rain gage stations had already been established in the catchment area. above Naju prior to this storm, I could have gathered accurate data on rainfall intensity throughout the catchment area. As it was, I used I the automatic rain gage record of the Mokpo I moteorological station to determine the rainfall lntensity. In order. to develop the unit ~Ydrograph at Naju, I subtracted the basic flow from the total runoff flow. I also tried to keed the difference between the calculated discharge amount and the measured discharge less than 1O~ The discharge period. of an unit graph depends on the length of the catchment area. 2. Determination of sluice dimension Acoording to principles of design presently used in our country, a one-day storm with a frequency of 20 years must be discharged in 8 hours. These design criteria are not adequate, and several dams have washed out in the past years. The design of the spillway and sluice dimensions must be based on the maximun peak discharge flowing into the reservoir to avoid crop and structure damages. The total flow into the reservoir is the summation of flow described by the Mokpo hydrograph, the basic flow from all the catchment areas and the rainfall on the reservoir area. To calculate the amount of water discharged through the sluiceCper half hour), the average head during that interval must be known. This can be calculated from the known water level outside the sluiceCdetermined by the tide) and from an estimated water level inside the reservoir at the end of each time interval. The total amount of water discharged through the sluice can be calculated from this average head, the time interval and the cross-sectional area of' the sluice. From the inflow into the .reservoir and the outflow through the sluice gates I calculated the change in the volume of water stored in the reservoir at half-hour intervals. From the stored volume of water and the known storage capacity of the reservoir, I was able to calculate the water level in the reservoir. The Calculated water level in the reservoir must be the same as the estimated water level. Mean stand tide will be adequate to use for determining the sluice dimension because spring tide is worse case and neap tide is best condition for the I result of the calculatio 3. Tidal computation for determination of the closure curve. During the construction of a dam, whether by building up of a succession of horizontael layers or by building in from both sides, the velocity of the water flowinii through the closing gapwill increase, because of the gradual decrease in the cross sectional area of the gap. 1 calculated the . velocities in the closing gap during flood and ebb for the first mentioned method of construction until the cross-sectional area has been reduced to about 25% of the original area, the change in tidal movement within the reservoir being negligible. Up to that point, the increase of the velocity is more or less hyperbolic. During the closing of the last 25 % of the gap, less water can flow out of the reservoir. This causes a rise of the mean water level of the reservoir. The difference in hydraulic head is then no longer negligible and must be taken into account. When, during the course of construction. the submerged weir become a free weir the critical flow occurs. The critical flow is that point, during either ebb or flood, at which the velocity reaches a maximum. When the dam is raised further. the velocity decreases because of the decrease\ulcorner in the height of the water above the weir. The calculation of the currents and velocities for a stage in the closure of the final gap is done in the following manner; Using an average tide with a neglible daily quantity, I estimated the water level on the pustream side of. the dam (inner water level). I determined the current through the gap for each hour by multiplying the storage area by the increment of the rise in water level. The velocity at a given moment can be determined from the calcalated current in m3/sec, and the cross-sectional area at that moment. At the same time from the difference between inner water level and tidal level (outer water level) the velocity can be calculated with the formula $h= \frac{V^2}{2g}$ and must be equal to the velocity detertnined from the current. If there is a difference in velocity, a new estimate of the inner water level must be made and entire procedure should be repeated. When the higher water level is equal to or more than 2/3 times the difference between the lower water level and the crest of the dam, we speak of a "free weir." The flow over the weir is then dependent upon the higher water level and not on the difference between high and low water levels. When the weir is "submerged", that is, the higher water level is less than 2/3 times the difference between the lower water and the crest of the dam, the difference between the high and low levels being decisive. The free weir normally occurs first during ebb, and is due to. the fact that mean level in the estuary is higher than the mean level of . the tide in building dams with barges the maximum velocity in the closing gap may not be more than 3m/sec. As the maximum velocities are higher than this limit we must use other construction methods in closing the gap. This can be done by dump-cars from each side or by using a cable way.e or by using a cable way.

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Critical Pathway Development for the Hysterectomy Patients and its applied Effect (자궁적출술 환자를 위한 critical pathway 개발과 적용효과)

  • Noh, Gi-Ok;Park, Kyung-Sook
    • Women's Health Nursing
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    • v.6 no.2
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    • pp.234-257
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    • 2000
  • At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

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A Study on the Direct Discharge Test for Verifying Design Concentration and Soaking Time for CO2 Fire Extinguishing System of Total Flooding (전역방출방식 CO2 소화설비의 설계농도 및 유지시간 검증을 위한 직접방사실험에 관한 연구)

  • Lee, Se-Myeoung;Moon, Sung-Woong;Ryu, Sang-Hoon
    • Fire Science and Engineering
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    • v.26 no.6
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    • pp.15-23
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    • 2012
  • Indirect Test Method is often used instead of direct test method in test method for extinguishing performance of $CO_2$ extinguishing facility because of high cost, environment problems and difficulties of procedure. But in the danger facilities for a unit of nation, such as a petrochemical plant, a nuclear power plant, or etc. is better to verify the performance of the extinguishment through direct discharge test. In $CO_2$ extinguishing system for total flooding system installed in dangerous facilities in Korea, each protected area in surface fire and deep-seated fire had selected and verified of extinguishing performance of $CO_2$ extinguishing facilities. To get recognized as extinguishing performance, discharged $CO_2$ concentration to protected area should be equivalence with design concentration standards (NFSC and NFPA). The Design Concentration means that $CO_2$ extinguishing agent is considerate of concentration for percentage of allowance (20 %) from extinguishing concentration which available to control of flame. As test result, surface fire and deep seated fire in protected area is obtained $CO_2$ design concentration and maintained design concentration more than 20 minutes as deep-seated fire. Through this study, we introduced direct discharging test method and decision method. And furthermore, especially in the dangerous facilities as a unit of Nation, we suggested necessity about reliability of extinguishing facilities to use direct test method.

A Clinical Study of Branchial Apparatus Anomalies (새성기형 50예의 임상적 고찰)

  • Gam Bong-Soo;Joo Jong-Soo;Kim Sang-Hyo;Paik Nak-Whan
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.1
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    • pp.6-13
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    • 1992
  • Branchial apparatus anomaly is rarely encountered congenital neck disease, it presents a palpable non-tender mass or fistulous opening existed at any site from external auditory canal or mandible angle to lower part of neck We have reviewed the records of 50 patients operated upon for branchial cleft anomaly, at Department of Surgery, Inje University Hospital, between 1981 and 1990, and the following results were obtained. I) In the classificiation of branchial cleft anomaly, first branchial fistula was 1 case, second branchial cyst 32 cases, second branchial sinus 11 cases, second branchial fistula 5 cases and third branchial fistula 1 case. 2) There were 20 men and 30 women in this series and male to female ratio was 2:3. 3) The age at first clinical presentation was 1st decade 15 cases, 2nd decade 10 cases, 3rd decade 17 cases, 4th decade 5 cases and 5th decade 3 cases. The peak age incidence was 3rd decade in overall, but the cyst was most common in 2nd decade, and majority of sinus or fistula was seen below 10 years old age. 4) The prevalent side of this anomaly was right side in 19 cases, left side in 29 cases and bilateral 2 cases, and so left side was more common than right. 5) The clinical presentation was characterized by the lesion along anterior border of sternocleido muscle, non-tender palpable mass were 28 cases, drainage sinus 18 cases, recurrent abscess and drainage 5 cases and intermittent ear discharge 1 case. 6) The mean size of cyst was about 4cm that containing turbid white-yellowish fluid but discharge from sinus or fistula was clear mucoid. 7) The culture of cyst fluid was no bacteria, but 2 cases showed staphyloccoci suggesting secondary infection. 8) The surgical procedure were complete excision of cyst 32 cases, sinus excision 11 cases, fistula excision 6 cases and I&D 1 case. And the recurrent 1 case was that fistula tract could not be identified due to severe scar from previous several operations.

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Determination of Nursing Activities for Estimation of Nursing Fees Based on 9 KDRGs (Korean Diagnosis-Related Groups) (한국형 진단명 기준 환자군(KDRG)별 간호수가 산정을 위한 간호행위 규명;9개 질환군을 대상으로)

  • Lee, Eun-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.547-561
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    • 1999
  • The purpose of this study was to determine which nursing activities are performed for patients in each of the nine KDRGs and to examine common nursing activities between patients with the nine KDRGs and special nursing activities which were not common to patients with the nine KDRGs. The study will provide basic data for estimation of nursing fees. The nine KDRGs in model project are Lens procedures, tonsillectomy, &/or adenoidectomy, appendectomy &/or not complicate principal diagnosis, vaginal delivery, cesarean section, anal & stomal procedures, inguinal & femoral hernia, uterine & adneza procedure for nonmalignancy, and simple pneumonia & pleurisy. To determine the nursing activities for each of the nine KDRG, checklists of nursing activities in each nine KDRG were developed from the literature and a total of 115 records of patients 'who were diagnosed and discharged between January and April, 1999 from a tertiary medical center. Nursing activities for each of the nine KDRG were verified through two consecutive content analyses. The results of study are followed as: 1. The checklists of nursing activities developed included direct and indirect nursing activities, for a total of 241 nursing activities. Direct nursing consisted of physical, educational, emotional-socioecomomic-spiritual nursing in 17 areas. Indirect nursing had four areas. 2. Through the two consecutive content analyses, 197 nursing activities were selected, having item CVIs of .83 or more. Those included 81 nursing activities for Lens procedures, 95 for Tonsillectomy &/or Adenoidectomy. 93 in Appendectomy &/or not complicated principal diagnosis, 155 for vaginal delivery, 172 for cesarean section, 89 for anal & stomal procedures, 93 for inguinal & femoral hernia, 108 for uterine & adneza procedures for non-malignancy, and 68 for simple pneumonia & pleurisy. 3. Nursing activities for each of the nine KDRG were compared. Activities with 80% or higher commonality within the nine KDRGs consisted of 86 of 197 nursing activities for the total designated common nursing activities, 30 common nursing activities for patients in the operation group, 45 common activities for patients in the delivery Group. Special nursing activities not common within the nine KDRGs were : 3 for Lens procedures, 1 for Tonsillectomy &/or Adenoidectomy. 2 for Appendectomy &/or not complicated principal diagnosis, 27 for vaginal delivery, 21 for Cesarean section, 6 for anal & stomal procedures, 3 for inguinal & femoral hernia, 16 for uterine & adneza procedure for non-malignancy, 8 for simple pneumonia & pleurisy. In this study, nursing activities for each of the nine KDRGs verified through two consecutive content analyses are those that are performed in the hospital. And, nursing activities for each of the nine KDRGs included all nursing activities from hospital admission to discharge. So. the checklists consisted of nursing activities that allow for an estimation of nursing fees under PPS. The classification of nursing activities in the study will provide a reference for the development of a nursing activity classification.

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A Methodology for the Estimation of Design Flood of a Small Watershed (소하천유역(小河川流域)의 계획홍수량(計劃洪水量) 산정방법(算定方法)의 개발(開發))

  • Yoon, Yong Nam;Ahn, Tae Jin
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.4 no.1
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    • pp.103-112
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    • 1984
  • This study is an effort to develop a series of empirical procedure for the determination of design flood for a small watershed based on the unit hydrograph theory. It is shown that a flood discharge of a watershed with a specific return period can be expressed as a product of its watershed area, rainfall factor, runoff factor and flood peak reduction factor. Since the procedures for the determination of rainfall factor and runoff factor were already developed in the previous study (13) a series of step-by-step procedure is devised to empirically determine the flood peak reduction factor in the present study. Using the methodology developed herein the 50-year design flood, which is of concern in the drainage of agricultural lands, is estimated for a watershed on upper Kyungan River and compared with the design floods by the existing methods now in use. The flood peak reduction factor was correlated with the dimensionless parameter consisted of the rainfall duration divided by the basin lag time, which was computed from the derived unit hydrographs by the method of moment. The unit hydrographs of various durations were synthesized by the method of build up and S-curve. A multiple correlation was also made between the basin lag time and the physiographic parameters of the watershed, i.e., the stream length and the average stream slope.

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New Method of Computing the Stokes Drift Including Shear Effect in the Cross-Sectional Flow Field (유수단면 흐름장에서 Shear 효과를 갖는 Stokes Drift의 계산법)

  • Kim, Jong-Hwa;Park, Byong-Su
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.33 no.1
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    • pp.9-26
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    • 1997
  • Stokes drift(SD) and Lagrangian discharge(LD) are important factors for analysis of flushing time, tidal exchange, solute transport and pollutant dispersion. The factors should be calculated using the approached method to flow phenomena. The aim of this paper re-examines the previous procedures for computing the SD and LD, and is to propose the new method approached to stratified flow field in the cross-section of coastal region, e.g. Masan Bay. The intensity of velocity near the bottom boundary layer(BBL) depends on the sea-bed irregularity in the coastal estuaries. So we calculated the depth mean velocity(DMV) considering that of BBL omitted in Kjerfve's calculation method. It revealed that BBL effect resulting in application of the bay acts largely on DMV in half more among 1l stations. The new expression of SD and LD per unit width in the cross-section using the developed DMV and proposed decomposition procedure of current were derived as follow : $$Q=u_0+\frac{1}{2}H_1{U_1cos(\varphi_h-\varphi_u)+U_3cos(\varphi_h-\varphi{ud})} LD ED SD$(Q_{skim}+Q_{sk2}) The third term, $Q_{sk2}$, on the right-hand of the equation is showed newly and arise from vertical oscillatory shear. According to the results applied in 3 cross-sections including 11 stations of the bay, the volume difference between proposed and previous SD was founded to be almost 2 times more at some stations. But their mean transport volumes over all stations are 18% less than the previous SD. Among two terms of SD, the flux of second term, $Q_{skim}$, is larger than third term, $Q_{sk2}$, in the main channel of cross-section, so that $Q_{skim}$ has a strong dependence on the tidal pumping, whereas third term is larger than second in the marginal channel. It means that $Q_{sk2}$ has trapping or shear effect more than tidal pumping phenomena. Maximum range of the fluctuation in LD is 40% as compared with the previous equations, but mean range of it is showed 11% at all stations, namely, small change. It mean that two components of SD interact as compensating flow. Therefore, the computation of SD and LD depend on decomposition procedure of velocity component in obtaining the volume transport of temporal and spacial flow through channels. The calculation of SD and LD proposed here can separate the shear effect from the previous SD component, so can be applied to non-uniform flow condition of cross-section, namely, baroclinic flow field.

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Advantage of Middle Meatal Antrostomy in Transnasal Endoscopic Reconstruction of Medial Orbital Blow-out Fracture (안와내벽외향골절의 비내시경적정복술에 있어 중비도상악동절개술의 장점)

  • Kim, Soon Heum;Lee, Soo Hyang;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Kim, Bo Hyung
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.735-740
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    • 2007
  • Purpose: Blowout fracture is an outward fracture of the orbital wall. That usually occurs at inferior or medial wall of the orbit. The main pathophysiology is high intraocular pressure derived from impact of trauma. Among the four orbital wall, the medial wall is thinnest and most vulnerable to trauma. Many kinds of methods were introduced for correction of medial orbital wall fracture. Recently, transnasal endoscopic reconstruction methods were widely used. Endoscopic methods had many advantages. However, we experienced some cases of postoperative maxillary sinusitis. This study was planned to find out the effectiveness of middle meatal antrostomy after endoscopic reconstruction of medial orbital wall fracture. Methods: This study was retrospective analysis of 28 patients who underwent transnasal endoscopic repair of medial orbital wall fracture. The 18 male and 10 female patients were ranged from 17 to 57 years of age(mean, 30.9 years). Among 28 patients, randomly selected 17 patients underwent middle meatal antrostomy as additional procedure by the same surgeon. After at least 12 months of follow-up period, we examined the nasal symptom, endoscopic and CT findings. Results: One patient complained of nasal obstruction in middle meatal antrostomy group and four patients complained nasal symptoms in non middle meatal antrostomy group. On the endoscopic findings, three patients of non middle meatal antrostomy group had continuous nasal discharge. But middle meatal antrostomy group had no abnormal endoscopic findings. The abnormal CT finding(abnormal mucosal hypertrophy) were detected in four patient of non middle meatal antrostomy group. There were no abnormal CT findings in middle meatal antrostomy group. The data were statistically significant at comparative study. Conclusion: Authors think that the middle meatal antrostomy has some advantages as a additional procedure of endoscopic reconstruction of medial orbital wall fracture. Especially, it is good at preventing postoperative maxillary sinusitis. But, more larger group and strict application of disease entity are need for correct evaluation of middle meatal antrostomy effect.