• Archives of Plastic Surgery
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• 제47권1호
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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.

• 한국농공학회논문집
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• 제46권3호
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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.

• 한국산학기술학회논문지
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• 제20권8호
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• pp.449-455
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• 2019

최근 도시화로 인한 불투수면의 증가는 지표 유출수를 집수하여 배수하는 기존의 배수시스템의 부담을 증가시킨다. 이러한 방식의 우수배수시스템은 표면유출수와 함께 이송되는 각종 쓰레기, 낙엽, 등의 부유물질에 의해 배수면적이 감소하는 구조적 한계를 가지고 있다. 이러한 한계를 극복하기 위해 최근 새로운 형태의 배수시스템이 개발 및 적용되고 있다. 본 연구는 3차원 전산 유체역학 프로그램 중 하나인 ANSYS CFX를 이용하여 투수성 포장 하부에 위치한 배수층의 체적 공극과 투수도 결정을 위한 모의를 각각 수행하였다. 모의결과 35% 체적공극을 가진 배수층의 배수구 유속이 20%, 50%에 해당하는 배수층보다 큰 값을 보여 체적공극과 배수성능 사이의 상관관계는 없는 것으로 파악되었다. 투수도는 구성물질의 입경에 따라 결정되며, 5가지 조건을 모의하여 배수구 유속을 분석한 결과 입경 2 mm의 사질토가 사용성과 시공성 측면에서 가장 적절하다고 분석되었다. 본 연구는 배수층의 적절한 체적 공극과 구성물질의 입경을 제시하였고 이러한 조건을 갖는 배수층이 침수피해를 저감 및 방지의 측면에서 유리할 것으로 판단된다.

• 생물환경조절학회지
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• 제27권1호
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• pp.1-6
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• 2018

수경재배에서는 근권내 양분의 집적 정도는 급액의 양과 밀접한 관계를 가지기 때문에 급액의 양(횟수)이 토마토의 생육과 수량에 미치는 영향이 크다. 따라서 본 시험에서는 코이어를 이용한 토마토 장기 수경재배에 급액량이 근권의 무기이온에 미치는 영향을 구명하고자 하였다. 적산일사량을 기준으로 급액량을 조절하였으며 생육시기별로 적산일사량 설정치를 변경하며 급액량을 4수준으로 처리하였다. 처리별 매일의 급액량과 배액량을 조사하였고 배액율을 계산하였다. 급액량이 많을수록 토마토의 수분 흡수량은 증가하는 경향이었다. 그러나 High 처리구는 2월과 3월에 Medium high 처리구에 비하여 수분 흡수가 감소하였다. 월별 평균 급액량과 배액율을 계산하여 배액율이 20-30%되는 급액 구간으로 1월은 $120-140J/cm^2$, 2월은 $100-120J/cm^2$, 3월은 $80-100J/cm^2$, 4월은 $70-90J/cm^2$, 5월은 $60-75J/cm^2$로 적정한 범위를 정할 수 있었다. 급액량이 많을수록 이온들의 농도가 낮아서 근권의 양분집적을 상당 부분 방지할 수 있었는데 양분을 흡착하는 코이어 배지의 특성 때문에 배액율이 20-30%인 경우 근권의 무기이온의 농도는 상당히 높았다. 그런데 P와 K는 처리에 관계없이 배액에서 급액농도 보다 낮아지는 경우가 발생하였으며, 급액량이 많은 처리에서도 Mg와 S가 가장 잘 집적되는 이온이었다. 일사량이 적은 시기에는 급액량에 따른 배액내 무기이온의 농도는 큰 차이를 나타내지 않았으나, 일사량이 많은 시기에는 급액량이 적을수록 배액의 무기이온의 농도가 높았다. 특히, 3월 이후에는 급액량 조정만으로는 배액의 이온농도 상승을 방지하기 어려워 우선적으로 급액 EC를 낮춰 근권에 양분이 집적되는 것을 막을 필요가 있었다.

• Archives of Plastic Surgery
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• 제48권6호
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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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• 제56권2호
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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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• 제39권5호
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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.

• 한국농공학회:학술대회논문집
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• 한국농공학회 2000년도 학술발표회 발표논문집
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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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• 제9권1호
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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.

• 대한토목학회논문집
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• 제28권1C호
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• pp.9-17
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• 2008

본 연구에서는 압밀 중에 위치별 간극수압의 측정을 통하여 시료 내 여러 위치에서 투수계수를 산정할 수 있는 이론해를 제시하였으며, 이를 바탕으로 간극비 및 체적압축계수를 산정할 수 있는 방법을 제안하였다. 또한 여러 위치에서 간극수압을 측정할 수 있는 방사내측배수가 가능한 대형압밀시험기를 제작하고 카올리나이트를 이용하여 압밀시험을 실시하였다. 시험결과로부터 압밀 중 투수계수, 간극비, 체적압축계수의 변화 및 시료 내 위치별 분포를 평가하였으며, 압밀완료 후 시료의 함수비 측정으로 평가된 값들과의 비교를 통하여 실험결과의 신뢰성을 검증하였다. 실험결과 투수계수, 체적압축계수, 간극비는 압밀 중 감소하며, 재하단계에 따라서도 감소함을 확인하였다. 또한 그 분포형태는 배수면 근처에서 가장 작고 배수거리에 따라 증가하며 비배수 경계면 근처에서는 오히려 약간 작은 것으로 나타났다.