• Archives of Plastic Surgery
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• 제39권6호
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• pp.643-648
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• 2012

Background Aggressive treatment of sternoclavicular joint (SCJ) infection involves systemic antibiotics, surgical drainage and resection if indicated. The purpose of this paper is to describe a classification of post resectional SCJ defects and highlight our reconstructive algorithm. Defects were classified into A, where closure was possible often with the aid of topical negative pressure dressing; B, where parts of the manubrium, calvicular head, and first rib were excised; and C, where both clavicular, first ribs and most of the manubrium were resected. Methods Twelve patients (age range, 42 to 72 years) over the last 8 years underwent reconstruction after SCJ infection. There was 1 case of a type A defect, 10 type B defects, and 1 type C defect. Reconstruction was performed using the pectoralis major flap in 6 cases (50%), the latissimus dorsi flap in 4 cases (33%), secondary closure in 1 case and; the latissimus and the rectus flap in 1 case. Results All wounds healed uneventfully with no flap failure. Nine patients had good shoulder motion. Three patients with extensive clavicular resection had restricted shoulder abduction and were unable to abduct their arm past $90^{\circ}$. Internal and external rotation were not affected. Conclusions We highlight our reconstructive algorithm which is summarised as follows: for an isolated type B SCJ defect we recommend the ipsilateral pectoralis major muscle for closure. For a type C bilateral defect, we suggest the latissimum dorsi flap. In cases of extensive infection where the thoracoacromial and internal mammary vessels are thrombosed, the pectoralis major and rectus abdominus cannot be used; and the latissimus dorsi flap is chosen.

• Journal of Chest Surgery
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• 제19권4호
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• pp.618-626
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• 1986

Univentricular heart is a rare congenital cardiac anomaly in which the atrial chambers are connected to only one ventricular chamber and it consists of a diverse group of cardiac malformation characterized by both AV valves or a common AV valve opening into the same ventricle, or the presence of only a solitary AV valve. In spite of recent development in cardiac surgery, corrective operations for univentricular heart still have high mortality and complication rate. Twenty eight patients underwent corrective operation for univentricular heart at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital from February 1979 to July 1986. Of the 28 patients, 7 patients were operated on by ventricular septation and 21 patients by modified Fontan operation. Of the 28 patients, 19 patients were male and 9 patients female and ages ranged from 5 months to 18 years old with the average age of 7.3 years. There were 2 mortalities in 7 patients operated on by septation with the mortality rate of 28.6% and 5 complications, 3 complete AV block, 1 low cardiac output and 1 arrhythmia. All survived patients are being followed up without specific problem till now. There were 10 mortalities in 21 patients operated on by modified Fontan operation with the mortality rate of 47.6% and 10 complications, 2 low cardiac output, 2 respiratory failure necessitating tracheostomy, 2 persistent cyanosis, 2 arrhythmia, 1 missing of left AV valve in situs inversus patient due to misdiagnosis and one rupture of closed right AV valve. Incremental risk factors for operative mortality are young age less than 5 years old, anomalous pulmonary and systemic venous drainage and atrial septation procedure. In 11 survived patients, 9 patients show good follow-up results but one patient complains of persistent cyanosis and another one patient is suffered from CHF. In our series, results of corrective operation for univentricular heart shows continuing improvement but still high mortality and complication rate. So there must be continuing improvement in surgical result by selection of patient, by adequate decision making for timing and method of operation and by improving operative methods.

• 한국농공학회지
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• 제30권1호
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• pp.38-49
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• 1988

This paper presented as follows results of laboratory model tests with various shaped footings on soil bed reinforced with the strips on the base of behaviour of soil structure according to the loads and triaxial test results reinforced with geotextiles. Their parameters studied were the effects on the bearing capacity of a footing of the first layer of reinforcement, horizontal and vertical spacing of layers, number of layers, tensile strength of reinforcement and iclination load to the vertical 1.Depending on the strip arrangement, ultimate bearing capacity values could be more improved than urreinforced soil and the failure of soil was that the soil structure was transfered from the macrospace to microspase and its arrangement, from edge to edge to face to face. 2.The reinforcement was produced the reinforcing effects due to controlling the value of factor of one and permeable reinforcement was never a barrier of drainage condition. 3.Strength ratio was decreased as a linear shape according to increment of saturation degree of soil used even though at the lower strength ratio, the value of M-factor was rot influenced on the strength ratio but impermeable reinforcement decreased the strength of bearing capacity. 4.Ultimate bearing capacity under the plane-strain condition was appeared a little larger than triaxial or the other theoretical formulars and the circular footing more effective. 5.The maximum reinforcing effects were obtained at U I B=o.5, B / B=3 and N=3, when over that limit only acting as a anchor, and same strength of fabric appeared larger reinforcing effects compared to the thinner one. 6.As the LDR increased, more and more BCR occurred and there was appeared a block action below Z / B=O.5, but over the value, decrement of BCR was shown linear relation, and no effects above one. 7.The coefficient of the inclination was shown of minimum at the three layers of fabrics, but the value of H / B related to the ultimate load was decreased as increment of inclination degree, even though over the value of 4.5 there wasn't expected to the reinforcing effects As a consequence of the effects on load inclination, the degree of inclination of 15 per cent was decreased the bearing capacity of 70 per cent but irnproved the effects of 45 per cent through the insertion of geotextile.

• 한국산학기술학회논문지
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• 제14권4호
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• pp.2006-2012
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• 2013

이 연구에서는 경기도에 위치한 ${\bigcirc}{\bigcirc}$대학교 캠퍼스 내 외곽도로 신설을 위해서 설치된 보강토옹벽의 붕괴사례를 통해 다양한 원인조사 및 분석에 대한 내용을 다루었다. 붕괴된 보강토옹벽에 대한 안정성 평가 및 설계도서 검토결과 다짐불량, 기초지반의 지지력 검토 누락, 보강재 설치 길이와 간격, 배수시설 문제 등의 시공과 관련한 문제들로 인해서 붕괴가 발생한 것으로 판단되었다. 설계 시 고려해야 할 전체 사면활동에 대한 안정성 검토, 2단 형태의 보강토옹벽에서 일반적으로 사용되는 FHWA 또는 NCMA 제안방법을 적용하지 않는 등의 여러 설계상의 문제점들도 확인하였다. 또한, 이러한 안정성 평가 내용을 바탕으로 재시공될 보강토옹벽의 안정을 위한 보강대책 및 시공방안 등을 제시하였다.

• 터널과지하공간
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• 제23권2호
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• pp.99-109
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• 2013

노천광산사면은 일반적으로 경제성 문제로 지보대책을 고려하지 않고 설계된다. 그러나 최종 잔벽사면은 장기적인 안정성이 필요하므로 경우에 따라서는 안정성을 높일 수 있는 적절한 대책이 필요하다. 본 연구를 위해 S 석회석 광산의 지질 및 불연속면 조사, 암반평가, 강도시험 등 현장조사를 수행하였다. 그리고 최종 잔벽사면에 대해 평사투영, SMR, 수치해석을 통한 안정성 평가를 실시하고, 최종 잔벽사면의 처리방안을 제안하였다. 해석결과, 사면 전체규모에서 파괴는 예상되지 않지만, 벤치규모의 사면파괴는 발생할 가능성이 있다. 최종 잔벽사면은 프리스플리팅 발파로 정리하고, 중간 소단에 폭이 넓은 berm을 설치하거나 국부적으로 지하수 유출이 있는 곳에는 수평배수공 등을 시공하여 벤치사면의 안정성을 높일 수 있을 것이다.

• Geomechanics and Engineering
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• 제5권6호
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• pp.575-594
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• 2013

Organic soils exhibit problematic properties such as high compressibility and low shear strength; these properties may cause differential settlement or failure in structures built on such soils. Organic soil removal or stabilization are the most important methods to overcome geotechnical problems related to peat soils' engineering characteristics. This paper presents soil mechanical intervention for stabilization of peat with sand columns and focuses on a comparison between the mechanical characteristics of undisturbed peat and peat stabilized with 20%, 30% and 40% of sand on the laboratory scale. Cylindrical columns were extruded in different diameters through a nearly undisturbed peat sample in the laboratory and filled with sand. By adding sand columns to peat, higher permeability, higher shear strength and a faster consolidation was achieved. The sample with 70% peat and 30% sand displayed the most reliable compressibility properties. This can be attributed to proper drainage provided by sand columns for peat in this specific percentage. It was observed that the granular texture of sand also increased the friction angle of peat. The addition of 30% sand led to the highest shear strength among all mixtures considered. The peat samples with 40% sand were sampled with two and three sand columns and tested in direct shear and consolidation tests to evaluate the influence of the number and geometry of sand columns. Samples with three sand columns showed higher compressibility and shear strength. Following the results of this laboratory study it appears that the introduction of sand columns could be suitable for geotechnical peat stabilization in the field scale.

• Archives of Plastic Surgery
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• 제47권1호
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• pp.3-8
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• 2020

Genital lymphedema (GL) is an uncommon and disabling disease that manifests as enlargement of the genital region resulting from the disturbance of lymphatic drainage. Although conservative treatment such as decompression is typically the first-line approach, surgical intervention has been shown to be effective in certain cases. This study aimed to systematically review studies evaluating available surgical alternatives for the treatment of male GL. A systematic search strategy using keyword and subject headings was applied to PubMed, Scopus, EMBASE, and Cochrane Library in May 2019. Studies investigating various surgical techniques to treat penile and scrotal lymphedema were included. The potential risk of bias of included trials was evaluated using the methodological index for non-randomized studies (MINORS). In total, 13 studies met the inclusion criteria, nine of which were determined to be high-quality. The average MINORS score was 12.45 for studies involving excision and 14 for studies involving lymphovenous anastomosis (LVA). The most common reason for a low score was a failure to describe the inclusion criteria. Recurrence of lymphedema during follow-up was reported in four studies involving excision and in no studies involving LVA. In general, the quality of the included literature was considered to be fair. Although surgical intervention might not always prevent the recurrence of lymphedema, all of the studies reported improved quality of life after the procedure. This study could be used as the basis for evidence-based guidelines to be applied in clinical practice for managing male GL.

• 한국지형학회지
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• 제15권2호
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• pp.25-35
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• 2008

2006년 7월의 태풍 에위니아와 빌리스에 의한 집중호우로 인해 급경사의 사면이 많고 기복이 큰 강원도 지역에서 토사재해가 크게 발생하였다. 특히 한계령을 관통하는 국도 44호선 도로는 단층선곡을 따라 건설되어 토사재해의 가능성이 가장 높은 편에 속하는 지역이다. 오색천 주변에서 발생한 토석류는 호우에 의해 공극수압이 상승하고 사면부의 무게가 증가하면서 발생한 능선부와 산정부의 산사태에 의해 촉발되었다. 또한 기존의 붕적물 또는 계안퇴적물에 가해진 하천의 압력에 의해서도 특히 공격사면 쪽에서 많은 토석류가 발생하였다. 하천의 상류부에서는 도로주변의 급경사의 절개지와 사면부의 얇은 풍화층에서 산사태가 발생한 반면, 중류부에서는 계류부의 토석류가 도로변의 배수구조물 용량을 초과하여 월류가 발생하여 도로와 교량이 파괴되었고, 하류부에서는 하천범람에 의한 계류부 양안의 침식과 토석류에 의한 피해가 가장 크게 나타났다. 하류부 퇴적층의 경우 토석류가 일회성이 아니라 과거 수차례 더 발생했었다는 사실을 보여주고 있다. 따라서 기후변화와 관련하여 호우의 빈도와 강도가 높아질 것으로 예측되는 만큼 추후 토사재해와 관련된 정보시스템의 구축과 관리시스템에 대한 연구가 절실히 요구된다.

• 한국자원공학회지
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• 제55권6호
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• pp.546-552
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• 2018

금번 6차 광해방지 국제심포지움 발표사례로 볼 때, 국가별 광산개발의 역사, 지리여건, 경제상황 등이 상이하나, 과거 개발된 광산으로 인해 발생한 산성광산배수로 인한 수질오염, 광물찌꺼기 유실로 인한 토양오염 및 수질오염, 사면파괴로 인한 산사태, 지하갱도 붕괴로 인한 지반침하 등으로 인간의 생활이 위협당하고 있다. 나라별로 기술력과 법제도의 차이가 있고, 광해복구가 진행 중인 나라와 이제 시작하려고 제도마련 및 기술지원을 받아야 하는 나라도 있다. 광해복구를 시작하려는 나라에서는 국제사회에 도움을 요청하고 있어 기술적 제도적으로 앞선 선진국에서는 복구를 시작하려는 나라와 공조를 통해 광해를 복구해야할 필요가 있다.

• 한국지반환경공학회 논문집
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• 제20권12호
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• pp.49-55
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• 2019

사면 붕괴에 대한 해석은 지반특성과 여러 가지 복합적인 인자들로 인해 정확한 해석은 어려운 것이 사실이다. 지속적으로 발생하는 사면재해로 인하여 사면재해 발생 원인을 규명하기 위한 많은 연구가 이루어지고 있지만, 사면 붕괴의 가장 중요한 요소인 강우특성 및 강우로 인한 침투능에 따른 사면 안정성 평가는 미흡한 실정이다. 본 연구에서는 주문진표준사를 이용하여 단위중량별 정수위 투수시험을 통한 투수계수를 산정하였으며, 투수계수와 강우강도의 영향을 고려하여 침투능 및 침투량을 산정할 수 있는 강우강도별 일차원 침투실험을 실시하였다. 실험결과를 바탕으로 사질토지반에서의 기존 경험식의 적용성을 분석하였다.