• Archives of Plastic Surgery
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• v.47 no.1
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• pp.33-41
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• 2020

Background Closed-suction drains are widely used in expander-based breast reconstruction. These drains are typically removed using a volume-based criterion. The drainage volume affects the hospital stay length and the recovery time. However, few studies have analyzed the factors that influence drainage volume after expander-based breast reconstruction. Methods We retrospectively analyzed data regarding daily drainage from patients who underwent expander-based breast reconstruction between April 2014 and January 2018 (159 patients, 176 expanders). Patient and operative factors were analyzed regarding their influence on total drainage volume and drain placement duration using univariate and multivariate analyses and analysis of variance. Results The mean total drainage volume was 1,210.77±611.44 mL. Univariate analysis showed correlations between total drainage volume and age (B=19.825, P<0.001), body weight (B=17.758, P<0.001), body mass index (B=51.817, P<0.001), and specimen weight (B=1.590, P<0.001). Diabetes history (P<0.001), expander type (P<0.001), and the surgical instrument used (P<0.001) also strongly influenced total drainage. The acellular dermal matrix type used did not affect total drainage (P=0.626). In the multivariate analysis, age (B=11.907, P=0.004), specimen weight (B=0.927, P<0.001), and expander type (B=593.728, P<0.001) were significant predictors of total drainage. Conclusions Our findings suggest that the total drainage and the duration of drain placement needed after expander-based breast reconstruction can be predicted using preoperative and intraoperative data. Patient age, specimen weight, and expander type are important predictors of drainage volume. Older patients, heavier specimens, and use of the Mentor rather than the Allergan expander corresponded to a greater total drainage volume and a longer duration of drain placement.

• Journal of The Korean Society of Agricultural Engineers
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• v.46 no.3
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• pp.3-14
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• 2004

A two-dimensional numerical model based on a finite volume method was formulated to solve the shallow water equations and applied for evaluating drainage characteristics at large-sized paddy fields. Manning roughness coefficient was calibrated using the observed inundating depths at drainage tests, and used for validating the model with the results from another drainage test. The simulated results were in good agreement with the observed inundating depths. The result of surface drainage showed that the longer width of the outlet was or the more the number of drainage outlet was, the shorter the drainage time was taken, and the larger the size of the field become, the longer the drainage time was taken, and the field shape had little effect on drainage time. To reduce the drainage time to 24 hours, the outlet is located lower than the elevation of the basin and small drainage ditch is constructed at the field. The results showed that the drainage time was taken short as the small drainage ditch was constructed. The comparison of drainage time as to the size of field constructed small drainage ditch showed the field, 100m ${\times}$ 200 m, can be drained in 24 hours.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.8
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• pp.449-455
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• 2019

The increase in impermeable pavement from recent urbanization has resulted in an increase in surface runoff. The surface runoff has also increased the burden of the existing drainage system. This drainage system has structural limitations in that the catchment area is reduced by the waste particles transported with the surface runoff. In addition, the efficiency of the drainage system is decreased. To overcome these limitations, a new type of drainage system with a drainage layer was developed and applied. In this study, various volume porosity and permeability of the lower drainage layer were simulated using ANSYS CFX, which is a three dimensional computational fluid dynamics program. The results showed that the outlet velocity of the 35% volume porosity was faster than that of the 20% and 50% cases, and there was no relationship between the volume porosity and drainage performance. The permeability of the drainage layer can be determined from the particle size of the material, and a simulation of five conditions showed that 2 mm sand grains are most suitable for workability and usability. This study suggests appropriate values of the volume porosity and particle size of the drainage layer. This consideration can be advantageous for reducing and preventing flood damage.

• Journal of Bio-Environment Control
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• v.27 no.1
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• pp.1-6
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• 2018

Also, t-cincreaseisdecreasein order In hydroponics, the accumulation of inorganic ions in the root zone are closely related to the irrigation volume. Therefore, the effects of irrigation volume on the growth and yield of tomatoes are very signigicant. This study was conducted to investigate the effect of irrigation volume on inorganic ions of root zone in hydroponic culture using coir substrate. The irrigation volume was adjusted to 4 levels depending on the integrated solar radiation for each growth period. The drainage ratio was calculated by daily amount of irrigation and drainage. The higher irrigation volume is, drainage ratio and water absorption tended to increase. But, the water absorption in the treatment of high irrigation volume was decreased in February and March compared to the treatment of medium high irrigation volume. By calculating monthly average irrigation volume and the drainage ratio, 120 to 1$40J/cm^2$ in January, 100 to $120J/cm^2$ in February, 80 to $100J/cm^2$ in March, 70 to $90J/cm^2$ in April and 60 to $75J/cm^2$ in May was detected as appropriate irrigation volume ranges which drainage ratio was 20-30%. The higher irrigation volume, the lower the concentration of ions decrease, which could prevent the accumulation of nutrients in the root zone. However, due to the characteristics of the coir substrate that absorbs ions, concentration of ions was significantly high when the drainage ratio was 20-30%. However, concentrations of P and K were sometimes lower in the drainage than that of irrigation water regardless of the treatment. Mg and S were the most highly accumulated ions even in the treatment of high irrigation volume. In low radiation season, there was no difference in the ion concentration in the drainage depending on the irrigation volume. In high radiation season, the lower irrigation volume, resulted to the higher ion concentration in the drainage. After March, it was difficult to prevent the increase of ions concetration in the drainage by only adjusting irrigation volume. Thus, it is necessary to decrease the EC of irrigation solution to prevent the accumulation of nutrients in the root zone.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.583-589
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• 2021

Background In prosthesis-based breast reconstruction patients, the drain tends to be kept in place longer than in patients who undergo only mastectomy. Postoperative arm exercise also increases the drainage volume. However, to preserve shoulder function, early exercise is recommended. In this study, we investigated the effect of early exercise on the total drainage volume and drain duration in these patients. Methods We designed a prospective randomized trial involving 56 patients who underwent immediate breast reconstruction following mastectomy using tissue expanders. In each group, the patients were randomized either to perform early arm exercises using specific shoulder movement guidelines 2 days after surgery or to restrict arm movement above the shoulder height until drain removal. The drain duration and the total amount of drainage were the primary endpoints. Results There were no significant differences in age, height, weight, body mass index, or mastectomy specimen weight between the two groups. The total amount of drainage was 1,497 mL in the early exercise group and 1,336 mL in the exercise restriction group. The duration until complete removal of the drains was 19.71 days in the early exercise group and 17.11 days in the exercise restriction group. Conclusions Exercise restriction after breast reconstruction did not lead to a significant difference in the drainage volume or the average time until drain removal. Thus, early exercise is recommended for improved shoulder mobility postoperatively. More long-term studies are needed to determine the effect of early exercise on shoulder mobility in prosthesis-based breast reconstruction patients.

• Clinical Endoscopy
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• v.56 no.2
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• pp.135-142
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• 2023

Endoscopic biliary drainage strategies for managing unresectable malignant hilar biliary obstruction differ in terms of stent type, drainage area, and deployment method. However, the optimal endoscopic drainage strategy remains unclear. Uncovered self-expandable metal stents (SEMS) are the preferred type because of their higher functional success rate, longer time to recurrent biliary obstruction (RBO), and fewer cases of reintervention than plastic stents (PS). Other PS subtypes and covered SEMS, which feature a longer time to RBO than PS, can be removed during reintervention for RBO. Bilateral SEMS placement is associated with a longer time to RBO and a longer survival time than unilateral SEMS placement. Unilateral drainage is acceptable if a drainage volume of greater than 50% of the total liver volume can be achieved. In terms of deployment method, no differences were observed in clinical outcomes between side-by-side (SBS) and stent-in-stent deployment. Simultaneous SBS boasts a shorter procedure time and higher technical success rate than sequential SBS. This review of previous studies aimed to clarify the optimal endoscopic biliary drainage strategy for unresectable malignant hilar biliary obstruction.

• Archives of Plastic Surgery
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• v.39 no.5
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• pp.509-513
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• 2012

Background The extended latissimus dorsi flap is important for breast reconstruction. Unfortunately, donor site seroma is the most common complication of extended latissimus dorsi flap for breast reconstruction. Although using fibrin sealant in the donor site reduces the rate of seroma formation, donor site seroma remains a troublesome complication. The purpose of this study was to analyze the effectiveness of the combination of quilting sutures and fibrin sealant in the latissimus dorsi donor site for the prevention of seroma. Methods Forty-six patients who underwent breast reconstruction with extended latissimus flap were enrolled in the study. The patients received either fibrin sealant (group 1, n=25) or a combination of fibrin sealant and quilting sutures (group 2, n=21) in the extended latissimus dorsi donor site. Outcome measures were obtained from the incidence, volume of postoperative seroma, total drainage amount, indwelling period of drainage, and duration of hospital stay. Results The incidence of seroma was 76% in group 1 and 42.9% in group 2 (P=0.022). We also found significant reductions in seroma volume (P=0.043), total drainage amount (P=0.002), indwelling period of drainage (P=0.01), and frequency of aspiration (P=0.043). The quilting sutures did not affect the rate of drainage, tube reinsertion, or hospital stay. Conclusions The use of quilting sutures combined with fibrin sealant on the latissimus dorsi flap donor site is helpful for reducing the overall seroma volume, frequency of aspiration, and total drainage amount.

• Proceedings of the Korean Society of Agricultural Engineers Conference
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• 2000.10a
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• pp.162-168
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• 2000

A two-dimensional numerical model based on a finite volume method was formulated to solve the shallow water equations and applied for evaluating irrigation and drainage characteristics at large-sized paddy fields. Manning roughness coefficient was calibrated using the observed inundating depths at drainage tests and used for validating the model with the results from irrigation and drainage test. The simulated results were in good agreement with the observed inundating depths.

• Physical Therapy Rehabilitation Science
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• v.9 no.1
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• pp.43-48
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• 2020

Objective: Breast cancer-related lymphedema (BCRL) is a major sequela after surgery or radiotherarpy for breast cancer. Manual lymphatic drainage (MLD) is designed to reduce lymph swelling by facilitating lymphatic drainage. This study attempted to determine the histologic changes in the skin and subcutaneous layer, and the immediate effect of MLD in decreasing lymphedema using ultrasound imaging, which is the method used most commonly to eliminate BCRL. Design: A single-group experimental study. Methods: Five subjects who were diagnosed with hemiparetic upper extremity lymphedema more than six months after breast cancer surgery participated in the study. MLD was performed for 60 minutes in the order of the thorax, breast, axilla, and upper arm of the affected side. In order to determine the effect of MLD, ultrasound imaging and limb volume were assessed. Two measurement tools were used for asessing lymphedema thickness among the pretest, posttest, and 30-minute follow-up period. Results: Significant diferences in ultrasound imaging and upper limb volume were found between the affected side and non-affected side (p<0.05). On the affected side, although ultrasound imaging showed a significant decrease after MLD (p<0.05), there were no significant difference in upper limb volume when compared to the baseline. Conclusions: In this study, a significant decrease in lymphedema by MLD was demonstrated by ultrasound imaging, which is considered to be more useful in assessing histological changes than limb volume measurements. Further research on the protocol for eliminating lymphedema will be needed.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.28 no.1C
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• pp.9-17
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• 2008

In this research, an analytical solution for the coefficient of permeability of soils during consolidation is suggested. The pore pressure and the flow rate measurements at different locations during consolidation are utilized. The void ratio and volume compressibility of soils under consolidation are also estimated. A large consolidation testing device, possible in both vertical and radial drainage is designed and manufactured. And consolidation test with kaolinite soils were performed under radially inward drainage direction. Pore pressures in varying radial distances and flow rate with time were measured as well as vertical deformations. From the test results, the changes of permeability, volume compressibility and void ratio under consolidation and their spatial variations are estimated. Thus the proposed solution is verified by comparing with the experimentally estimated test results. In addition, it is confirmed that permeability, void ratio and volume compressibility decrease as consolidation and loading steps progress. Also, these soil characteristics increase with radial distant from drainage boundary, where lowest values observed, and slightly decrease as approaching undrained boundary.