• Journal of Chest Surgery
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• v.11 no.1
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• pp.35-41
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• 1978

After the advent of the effective antimicrobial drugs, empyema of the pleural cavity came to be considered an infrequent disease. However, in recent years the problem of empyema is increasing, probably due to bacterial changes associated with the use and misuse of antimicrobials as well as alterations in the host associated with increased longevity and chronic disease. During the 10 years period from 1957, Sop. to 1977, Aug., we experienced 152 cases of empyema, of which 37 were scheduled on open thoracotomy drainge for chronic empyema. 1. The ratio of male to female was 3.6:1 with male predominance and 64% of total was above 40 years old in age distribution. 2. The cardinal symptoms were fever[70%], dyspnea[40.5%], and sputum[40.5%]. The leucocytosis were observed in 75.7% of all cases. The hemoglobin level showed subnormal in 21.6% of all cases. 3- The underlying pathology predisposing to empyema were postoperative empyema [35.1%] and tuberculosis[32.4%] in order. 4. The pathologic organisms by bacterial culture in 37 patients were Pseudomonas [24.3%], Staphylococccus [21.6%], Streptococcus [21.6%]., no growth [8. 1%] and the remainders. 5. The late results were as follow; a. Spontaneous closure was seen in 10 patients and all of them belongs to non-tuberculous group. Their mean duration was 14 months. b. Still opened are eight; 6 in tuberculous group, remainders in non-tuberculous group. c. Secondary closure was performed in 6 patients, of which 5 cases showed successful secondary closure but one failed. The mean duration from OTD to secondary closure was 46.3 days. d. Eleven patients were not followed. e. Two patients were expired; one was due to progressive cachexia and pulmonary insufficiency, the other due to gastrointestinal bleeding unrelated to empyema.

• Journal of Chest Surgery
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• v.49 no.2
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• pp.85-91
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• 2016

Background: This study was conducted to determine the efficacy of staple line coverage using a polyglycolic acid patch and fibrin glue without pleural abrasion to prevent recurrent postoperative pneumothorax. Methods: A retrospective analysis was carried out of 116 operations performed between January 2011 and April 2013. During this period, staple lines were covered with a polyglycolic acid patch and fibrin glue in 58 cases (group A), while 58 cases underwent thoracoscopic bullectomy only (group B). Results: The median follow-up period was 33 months (range, 22 to 55 months). The duration of chest tube drainage was shorter in group A (group A $2.7{\pm}1.2day$ vs. group B $3.9{\pm}2.3day$, p=0.001). Prolonged postoperative air leakage occurred more frequently in group B than in group A (43% vs. 19%, p=0.005). The postoperative recurrence rate of pneumothorax was significantly lower in group A (8.6%) than in group B (24.1%) (p=0.043). The total cost of treatment during the follow-up period, including the cost for the treatment of postoperative recurrent pneumothorax, was not significantly different between the two groups (p=0.43). Conclusion: Without pleural abrasion, staple line coverage with a medium-sized polyglycolic acid patch and fibrin glue after thoracoscopic bullectomy for primary spontaneous pneumothorax is a useful technique that can reduce the duration of postoperative pleural drainage and the postoperative recurrence rate of pneumothorax.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.374-379
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• 2013

Background To date, various types of acellular dermal matrix (ADM) have been developed for clinical use. AlloDerm is the most familiar type of ADM to most surgeons in breast reconstruction. It is prepared by freeze-drying. CG CryoDerm is the first form of ADM that requires no drying process. Therefore, theoretically, it has a higher degree of preservation of the dermal structures than AlloDerm. We conducted this study to compare the clinical course and postoperative outcomes of patients who underwent direct-to-implant breast reconstructions using AlloDerm and those who did using CG CryoDerm. Methods We performed a retrospective analysis of the medical records in a consecutive series of 50 patients who underwent direct-to-implant breast reconstruction using AlloDerm (n=31) or CryoDerm (n=19). We then compared the clinical course and postoperative outcomes of the two groups based on the overall incidence of complications and the duration of drainage. Results The mean follow-up period was 16 months. There were no significant differences in the overall incidence of complications (seroma, infection, skin flap necrosis, capsular contracture, and implant loss) between the two groups. Nor was there any significant difference in the duration of drainage. Conclusions CG CryoDerm has the merits of short preparation time and easy handling during surgery. Our results indicate that CG CryoDerm might be an alternative allograft material to AlloDerm in direct-to-implant breast reconstruction.

• Journal of Korean Society on Water Environment
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• v.32 no.6
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• pp.528-536
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• 2016

The purpose of Total Pollution Load Control at Tributary is to obtain maximum improvement effect of water quality through finding the most impaired section of water-body and establishing the proper control measure of pollutant load. This study was implemented to determine the optimal management of reach, period, condition, watershed, and pollution source and propose appropriate reduction practices using the Load duration curve (LDC) and field monitoring data. With the data of measurement, LDC analysis shows that the most impaired condition is reach V (G4~G5), E group (flow exceedance percentile 90~100%) and winter season. For this reason, winter season and low flow condition should be preferentially considered to restore water quality. The result of pollution analysis for the priority reach and period shows that agricultural nonpoint source loads from onion and garlic culture are most polluting. Therefore, it is concluded that agricultural reuse of surface effluent (storm-water runoff with non-point sources) and low impact farming that includes reducing fertilization and controlling the height of drainage outlet are efficient water quality management for this study watershed.

• Korean Journal of Bronchoesophagology
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• v.13 no.1
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• pp.19-22
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• 2007

Background and Objectives: The Objective of this study was to compare the effectiveness of the needle aspiration method and the I&D method in the treatment of peritonsillar abscess. Materials and Methods: A prospective clinical study was performed on 83 patients. All the patients were hospitalized after random treatment with either I&D or needle aspiration alone, received the same intravenous antibiotic therapy. Among the 83 patients, 73 patients who could be observed for longer than 6 months and had not undergone a tonsillectomy during the follow-up period, were analyzed for treatment outcomes. Results: There was no statistically significant difference in the initial failure rate(p=0.572), the hospitalized days(p=0.956), the recurrence rate(p=0.531) for the needle aspiration(35 patients) and I&D groups(38 patients). But, The mean duration of fever were statistically different in the needle aspiration(1.51 hours) and I&D groups(3.05 hours) (p=0.031). Conclusion: Two methods are thought to be similar in effectiveness, except that duration of fever was longer in the I&D group than in the needle aspiration group. However, taking advantages of the needle aspiration method into consideration, the needle aspiration of peritonsillar abscess may be more appropriate than I&D as an initial method for peritonsillar abscess

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.573-581
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• 2005

Breast cancer is the second leading cause of death in woman. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea. This paper introduces the breast reconstruction by use of pectoralis major muscle transfer with breast implant for small size defect after skin sparing mastectomy for more satisfaction. We reviewed 24 consecutive patients who underwent breast reconstruction by pectoralis major muscle transfer with implant and only breast implant in Dong-A University from April 2002 to March 2004. The patient's age ranged between 29 and 54 years with mean of 42.3 years. We used pectorals major muscle transfer with breast implant in 12 patients and breast implant alone in 12 patients as control. The follow-up period of patients ranged from 10 months to 3 years with mean of 18.5 months. The points of comparison with control group reconstructed by breast implant alone were doctor and patient satisfaction score, operation time, duration of admission, amount of drainage, complication and satisfaction according to mass location. In conclusion, there is no difference with control group in the point of operation time, mount of drainage, duration of admission. And there is higher level of doctor's and patient's satisfaction in group reconstructed by pectoralis major muscle transfer with breast implant than implant only group. Especially, pectoralis major muscle transfer with breast implant was especially necessary for the defect in upper lateral quadrant of the breast to get more satisfaction. The advantage of pectoralis major muscle transfer with breast implant is prevention of the protruding and palpability of implant and aesthetically satisfactory result by intraoperative modification of breast shape.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.20-25
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• 2020

Background Ultrasonic dissection devices cause less thermal damage to the surrounding tissue than monopolar electrosurgical devices. We compared the effects of using an ultrasonic dissection device or an electrocautery device during prosthetic breast reconstruction on seroma development and short-term postoperative complications. Methods We retrospectively reviewed the medical records of patients who underwent implant-based reconstruction following mastectomy between March 2017 and September 2018. Mastectomy was performed by general surgeons and reconstruction by plastic surgeons. From March 2017 to January 2018, a monopolar electrosurgical device was used, and an ultrasonic dissection device was used thereafter. The other surgical methods were the same in both groups. Results The incidence of seroma was lower in the ultrasonic dissection device group than in the electrocautery group (11 [17.2%] vs. 18 [31.0%]; P=0.090). The duration of surgery, total drainage volume, duration of drainage, overall complication rate, surgical site infection rate, and flap necrosis rate were comparable between the groups. Multivariate analysis revealed that the risk of seroma development was significantly lower in the ultrasonic dissection device group than in the electrocautery group (odds ratio for electrocautery, 3.252; 95% confidence interval, 1.242-8.516; P=0.016). Conclusions The findings of this study suggest that the incidence of seroma can be reduced slightly by using an ultrasonic dissection device for prosthesis-based breast reconstruction. However, further randomized controlled studies are required to verify our results and to assess the cost-effectiveness of this technique.

• Journal of Korea Water Resources Association
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• v.34 no.5
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• pp.415-426
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• 2001

After Disaster Impact Assessment(DIA) Program was particed, the wide variety of hydrological data are estimated by introducing the concept of critical storm duration to calculate the stormwater impoundments as the alternative of increasing runoff due to many developments. Critical storm duration is varied by a lot of hydraulic structures, drainage characteristics, temporal distribution of design rainfall, return period, and runoff models. In this study the methods of estimating the proper volume to design the stormwater impoundments are proposed to determine the required volume by comparing and analyzing the maximum stormwater impoundments in accordance with the impoundment volume and rainfall duration by using the concept of storage ratio presented in the existing studies. The methods of determining the critical storm duration of design rainfall which cause the maximum load from the runoff hydrograph will be studied as analyzing rainfall-runoff using the various runoff models and observed data.

• Journal of Korean Society of Water and Wastewater
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• v.36 no.4
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• pp.229-237
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• 2022

The sewer capacity design have been based on the Huff model or the rational equation in South Korea and often failed to determine optimal capacity, resulting in frequent urban flooding or over-sizing. A time distribution of rainfall (i.e., Huff or ABM method) could be used instead of a rainfall hyetograph obtained from statistical analysis of previous rainfalls. In this study, the Huff method and the ABM method, which predict the time distribution of rain intensity, which are widely used to calculate sewage pipe drainage capacity using the SWMM, were compared with the standard rainfall intensity hyetograph of Seoul. If the rainfall duration was 30 minutes to 180 minutes, the rainfall intensity value calculated by the Huff model tended to be less than the rainfall intensity value of the standard rainfall intensity in the initial 5-10 minutes. As a result, more than 10% to 30% of under-design would be made. In addition, the rainfall intensity value calculated by the Huff model from the section excluding the initial 5-10 minutes of rainfall to the rainfall duration was calculated larger than the value using the standard rainfall intensity equation, which would result in an over-design of 10% to 30%. In the case of a relatively long rainfall duration of 360 minutes (6 hours) to 1,440 minutes (24 hours), it showed an lower rainfall intensity of 60 to 90% in the early stages of rainfall, but the problem of under-design had been solved as the rainfall duration time had elapsed. On the other hand, in the alternating block method (ABM) method, it was found that the rainfall intensity at the entire period at each assumed rainfall duration accurately matched the standard rainfall intensity hyetograph of Seoul.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.404-410
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• 2003

Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.