• Title/Summary/Keyword: Effective discharge

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Hydro-meteorological Effects on Water Quality Variability in Paldang Reservoir, Confluent Area of the South-Han River-North-Han River-Gyeongan Stream, Korea (남·북한강과 경안천 합류 수역 팔당호의 수질 변동성에 대한 기상·수문학적 영향)

  • Hwang, Soon-Jin;Kim, Keonhee;Park, Chaehong;Seo, Wanbum;Choi, Bong-Geun;Eum, Hyun Soo;Park, Myung-Hwan;Noh, Hye Ran;Sim, Yeon Bo;Shin, Jae-Ki
    • Korean Journal of Ecology and Environment
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    • v.49 no.4
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    • pp.354-374
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    • 2016
  • This study explored spatiotemporal variability of water quality in correspondence with hydrometeorological factors in the five stations of Paldang Reservoir located in the Han River during 4 years from May 2012 to December 2015. Variability of basic water quality factors were largely related with seasonal fluctuations of hydrology. Temperature stratification occurred in the deep dam station, and prolonged hypoxia was observed during the draught year. Nitrogen nutrients were increased with decreasing inflow in which changing pattern of $NH_4$ reversed to $NO_3$ by the effect of treated wastewater effluent. Phosphorus increase was manifest during the period of high inflow or severe drought. Chl-a variation was reversely related with both flow change and AGP(algal growth potential) variations. Our study demonstrated that water quality variability in Paldang Reservoir was largely attributed to both natural and operational changes of inflow and outflow (including water intake) based on major pollution source of the treated wastewater (total amount of $472{\times}10^3m^3d^{-1}$) entering to the water system from watershed. In the process of water quality variability, meteorological (e.g., flood, typhoon, abnormal rainfall, scorching heat of summer) and hydrological factors (inflow and discharge) were likely to work dynamically with nutrients pulse, dilution, absorption, concentration and sedimentation. We underline comprehensive limnological study related to hydro-meteorolology to understand short- and long-term water quality variability in river-type large reservoir and suggest the necessity of P-free wastewater treatment for the effective measure of reducing pollution level of Paldang drinking water resource.

Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2015 (설비공학회 분야의 최근 연구 동향 : 2015년 학회지 논문에 대한 종합적 고찰)

  • Lee, Dae-Young;Kim, Sa Ryang;Kim, Hyun-Jung;Kim, Dong-Seon;Park, Jun-Seok;Ihm, Pyeong Chan
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.28 no.6
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    • pp.256-268
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    • 2016
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2015. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) The research works on the thermal and fluid engineering were carried out in the areas of flow, heat and mass transfer, cooling and heating, and air-conditioning, the renewable energy system and the flow inside building rooms. Research issues dealing with air-conditioning machines and fire and exhausting smoke were reduced. CFD seems to be spreading to more research areas. (2) Research works on heat transfer area were carried out in the categories of heat transfer characteristics, pool boiling and condensing heat transfer and industrial heat exchangers. Researches on heat transfer characteristics included the economic analysis of GHG emission, micro channel heat exchanger, effect of rib angle on thermal performance, the airside performance of fin-and-tube heat exchangers, theoretical analysis of a rotary heat exchanger, heat exchanger in a cryogenic environment, the performance of a cross-flow-type, indirect evaporative cooler made of paper/plastic film. In the area of pool boiling and condensing, the bubble jet loop heat pipe was studied. In the area of industrial heat exchangers, researches were performed on fin-tube heat exchanger, KSTAR PFC and vacuum vessel at baking phase, the performance of small-sized dehumidification rotor, design of gas-injection port of an asymmetric scroll compressor, effect of slot discharge-angle change on exhaust efficiency of range hood system with air curtain. (3) In the field of refrigeration, various studies were carried in the categories of refrigeration cycle, alternative refrigeration/energy system, system control. In the refrigeration cycle category, a cold-climate heat pump system, $CO_2$ cascade systems, ejector cycles and a PCM-based continuous heating system were investigated. In the alternative refrigeration/energy system category, a polymer adsorption heat pump, an alcohol absorption heat pump and a desiccant-based hybrid refrigeration system were investigated. In the system control category, turbo-refrigerator capacity controls and an absorption chiller fault diagnostics were investigated. (4) In building mechanical system research fields, eighteen studies were reported for achieving effective design of the mechanical systems, and also for maximizing the energy efficiency of buildings. The topics of the studies included energy performance, HVAC system, ventilation, and renewable energies, piping in the buildings. Proposed designs, performance tests using numerical methods and experiments provide useful information and key data which can improve the energy efficiency of the buildings. (5) The field of architectural environment was mostly focused on indoor environment and building energy. The main researches of indoor environment were related to the user and location awareness technology applied dimming lighting control system, the lighting performance evaluation for light-shelves, the improvement evaluation of air quality through analysis of ventilation efficiency and the evaluation of airtightness of sliding and LS window systems. The subjects of building energy were worked on the energy saving estimation of existing buildings, the developing model to predict heating energy usage in domestic city area and the performance evaluation of cooling applied with economizer control. The studies were also performed related to the experimental measurement of weight variation and thermal conductivity in polyurethane foam, the development of flame spread prevention system for sandwich panels, the utilization of heat from waste-incineration facility in large-scale horticultural facilities.

River Water Quality Impact Assessment in an Intensive Livestock Farming Area During Rainfall Event using Physicochemical characteristics and Nitrogen Stable Isotopes (이화학적 특성과 질소 안정동위원소비를 활용한 강우시 가축사육 밀집 지역의 하천 수질 영향 평가)

  • Ryu, Hong-Duck;Baek, Un-Il;Kim, Sun-Jung;Kim, Deok-Woo;Kim, Chansik;Kim, Min-Seob;Shin, Dongseok;Lee, Jae-Kwan;Chung, Eu Gene
    • Journal of Environmental Science International
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    • v.28 no.1
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    • pp.7-18
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    • 2019
  • This study aimed to assess the impact of livestock excreta discharged from an Intensive Livestock Farming Area (ILFA) on river water quality during a rainfall event. The Bangcho River, which is one of the 7 tributaries in the Cheongmi River watershed, was the study site. The Cheongmi River watershed is the second largest area for livestock excreta discharge in Korea. Our results clearly showed that, during the rainfall event, the water quality of the Bangcho River was severely deteriorated due to the COD, $NH_4-N$, T-N, $PO_4-P$, T-P, and heavy metals (Cu, Zn, and Mn) in the run-off from nearby farmlands, where the soil comprised composted manure and unmanaged livestock excreta. In addition, stable isotope analysis revealed that most of nitrogen ($NH_4-N$ and $NO_3-N$) in the run-off was from the ammonium and nitrate in the livestock excreta. The values of ${\delta}^{15}N_{NH4}$ and ${\delta}^{15}N_{NO3}$ for the Bangcho River water sample, which was obtained from the downstream of mixing zone for run-off water, were lower than those for the run-off water. This indicates that there were other nitrogen sources upstream river in the river. It was assumed from ${\delta}^{15}N_{NH4}$ and ${\delta}^{15}N_{NO3}$ stable isotope analyses that these other nitrogen sources were naturally occurring soil nitrogen, nitrogen from chemical fertilizers, sewage, and livestock excreta. Therefore, the use of physicochemical characteristics and nitrogen stable isotopes in the water quality impact assessment enabled more effective analysis of nitrogen pollution from an ILFA during rainfall events.

Nutritional Status of Intensive Care Unit Patients According to the Referral to the Nutrition Support Team and Compliance with the Recommendations (영양집중지원팀 자문 의뢰 및 순응 여부에 따른 중환자실 환자의 영양상태 비교)

  • Sohn, Yunjin;Hyun, Taisun
    • Korean Journal of Community Nutrition
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    • v.27 no.2
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    • pp.121-131
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    • 2022
  • Objectives: This study aimed to examine the effectiveness of the intervention of the nutrition support team (NST) on the nutritional status of critically ill patients. Methods: The medical records of 176 adult patients who were admitted to the intensive care unit and received enteral or parenteral nutrition for more than 7 days were retrospectively analyzed. The patients were classified into the NST and non-NST groups according to whether they were referred to the NST or not. The NST group was further classified into the compliance and non-compliance groups depending on their compliance with the NST recommendations. Results: The NST referral rate was 56.8%, and the rate of compliance with the NST recommendations was 47.0%. Significantly higher energy and protein were provided to the NST and the compliance groups than to the non-NST and the non-compliance groups. The proportion of patients who reached the target calories after the initiation of enteral nutrition was significantly higher in the NST and the compliance groups than in the non-NST and the non-compliance groups. The serum albumin and hemoglobin levels significantly decreased in every group, but the changes were significantly lower in the compliance group. The nutritional status at discharge from the intensive care unit compared to the status at admission was significantly worse in the NST, non-NST, and non-compliance groups. However, the status was maintained in the compliance group. The length of stay in the intensive care unit was significantly shorter in the compliance group. Conclusions: Compliance with the NST recommendations was found to provide more calories and protein and prevent the deterioration of the nutritional status of critically ill patients. Therefore, effective communication between medical staff and the NST from the early stages of admission to the intensive care unit is needed to improve referrals to the NST and compliance with the recommendations.

Treatment of Pyogenic Arthritis of the Knee Using Drainage Tube Insertion in the Posterior Compartment through the Posterior Transeptal Portal after an Arthroscopic Synovectomy (관절경적 활액막 절제술 후 후격막 삽입구를 통한 배액관의 후방 거치를 이용한 무릎의 화농성 관절염 치료)

  • Kim, Tae Ho;Yu, Chang Eon;Shin, Chung Shik
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.269-275
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    • 2019
  • Purpose: This study analyzed the treatment effects of drain insertion in the posteromedial portal after an arthroscopic synovectomy and posterior septum resection for pyogenic arthritis. Materials and Methods: From June 2005 to December 2016, 56 cases (55 patients, 1 case of bilateral knee) were diagnosed with pyogenic arthritis and arthroscopic treatment was performed. Fourteen patients (25.0%) were identified with causative organisms. The average follow-up period was 12.3 months, and the mean age was 67.8 years old. Twenty-four cases were males and 31 cases were females. Kellgrene-Lawrence grade (K-L grade) I was 6 patients, II was 20 patients, III was 11 patients, and IV was 18 patients. Surgery was performed through six portal. The posterior septum was removed and a drainage tube was inserted from the posterior medial side to the posterior side of the joint. The Lysholm score was used after surgery for a functional evaluation. The K-L grade at the time of admission and at the last follow-up were compared for a radiological evaluation. Results: The mean normalization period of the C-reactive protein was 59.8 days (6-164 days). Intravenous antibiotics were used for an average of 37.1 days. The results of the functional evaluation revealed a mean Lysholm score of 64.5 (30-98) in a total of 56 cases. Two reoperations was performed, but the treatment was completed with same method in all patients. The K-L grade was similar at the time of surgery and at the last follow-up (p>0.05). Conclusion: The method of drain insertion in the posteromedial portal after arthroscopic synovectomy and posterior septum resection for pyogenic arthritis is an effective technique that can obtain satisfactory results by inducing proper exudate discharge.

Analysis on the Effects of Flood Damage Mitigation according to Installation of Underground Storage Facility (지하저류조 설치에 따른 침수피해 저감효과 분석)

  • Kim, Young Joo;Han, Kun Yeun;Cho, Wan Hee
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.30 no.1B
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    • pp.41-51
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    • 2010
  • In this study, runoff simulation was carried out in the area of Bisan 7-dong, Seo-gu, Daegu as drainage basin and the effects of the installation of underground storage facilities were analyzed during heavy rainfall. SWMM model was used for the runoff and pipe network analysis on Typhoon Maemi, 2003. 2-D inundation analysis model based on diffusion wave was employed for inundation analysis and to verify computed inundation areas with observed inundation trace map. The simulation results agree with observed in terms of inundation area and depth. Also, the effects of flood damage mitigation were analyzed through the overflow discharge and 2-D inundation analysis, depending upon whether the underground storage facility is installed or not. When the underground storage facility ($W:120m{\times}L:180m{\times}H:1.7m$) is installed, volume of overflow could be reduced by 72% and flooding area could be reduced by 40.1%. When the underground storage facility ($W:120m{\times}L:180 m{\times}H:2.0m$) is installed, volume of overflow could be reduced by 84.8% and flooding area could be reduced by 50.6%. When the underground storage facility ($W:120m{\times}L:180m{\times}H:2.2m$) is installed, volume of overflow could be reduced by 94% and flooding area could be reduced by 91.2%. There is no overflow of manhole, when the height of storage facility is 2.5 m. It is expected that the study results presented through quantitative analysis on the effects of underground facilities can be used as base data for socially and economically effective installation of underground facilities to prevent flood damage.

Assessment of stream water quality and pollutant discharge loads affected by recycled irrigation in an agricultural watershed using HSPF and a multi-reservoir model (HSPF와 다중 저류지 모형을 이용한 농업지역 순환관개에 의한 하천 수질 및 배출부하 영향 분석)

  • Kyoung-Seok Lee;Dong Hoon Lee;Youngmi Ahn;Joo-Hyon Kang
    • Journal of Wetlands Research
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    • v.25 no.4
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    • pp.297-305
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    • 2023
  • The recycled irrigation is a type of irrigation that uses downstream water to fulfill irrigation demand in the upstream agricultural areas; the used irrigation water returns back to the downstream. The recycled irrigation is advantageous for securing irrigation water for plant growth, but the returned water typically contains high levels of nutrients due to excess nutrients inputs during the agricultural activities, potentially deteriorating stream water quality. Therefore, quantitative assessment on the effect of the recycled irrigation on the stream water quality is required to establish strategies for effective irrigation water supply and water quality management. For this purpose, a watershed model is generally used; however no functions to simulate the effects of the recycled irrigation are provided in the existing watershed models. In this study, we used multi-reservoir model coupled with the Hydrological Simulation Program-Fortran (HSPF) to estimate the effect of the recycled irrigation on the stream water quality. The study area was the Gwangok stream watershed, a subwatershed of Gyeseong stream watershed in Changnyeong county, Gyeongsangnam-do. The HSPF model was built, calibrated, and used to produce time series data of flow and water quality, which were used as hypothetical observation data to calibrate the multi-reservoir model. The calibrated multi-reservoir model was used for simulating the recycled irrigation. In the multi-reservoir model, the Gwangok watershed consisted of two subsystems, irrigation and the Gwangok stream, and the reactions (plant uptake, adsorption, desorption, and decay) within each subsystem, and fluxes of water and materials between the subsystems, were modeled. Using the developed model, three scenarios with different combinations of the operating conditions of the recycled irrigation were evaluated for their effects on the stream water quality.

Study of Patient Teaching in The Clinical Area (간호원의 환자교육 활동에 관한 연구)

  • 강규숙
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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A Clinical Evaluation of Splanchnic Nerve Block (내장신경차단에 관한 임상적 연구)

  • Kim, Soo-Yeoun;Oh, Hung-Kun;Yoon, Duek-Mi;Shin, Yang-Sik;Lee, Youn-Woo;Kim, Jong-Rae
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.34-46
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    • 1988
  • Intractable pain from advanced carcinoma of the upper abdomen is difficult to manage. One method used to control pain associated with these malignancies is to block off the splanchnic nerve. In 1919 Kappis described a technique by which the splanchnic nerve of the upper abdomen could be anesthetized, using a percutaneous injection. This method has been used for the relief of upper abdominal pain due to hematoma and cancer of the pancreas, stomach, gall bladder, bile duct, and colon. During the Period from November 1968 to January 1986, this method was used in 208 cases of malignancy at Severance Hospital and clinically evaluated. Patients were retroactively grouped according to the stage of development of technique used. Twelve patients who received the treatment in the period from November 1968 to March 1977 were designate4i as group 1, 26 patients from April 1977 to April 1979 as group 2, and 170 from May 1979 to January 1986 as group 3. The results are as follows: 1) The number of patients receiving splanchnic nerve block has been increasing since 1977. 2) A total of 208 patients, including 133 males and 75 females, ranging in age from 18 to 84 and averaging 51. 3) The causes of pain were stomach cancer 90, pancreatic cancer 69, and miscellaneous cancer 49 cases respectively. 4) There were 57.7% who had surgery. and 3.7% of whom had chemotherapy before the splanchnic nerve block was done. 5) These blocks were carried out with the patient in the prone position as described by Dr. Moore. For group 2 and 3, C-arm image intensifier was used. In group 1, a 22 gauze loom long needle was inserted at the lower border of the 12th rib on each aide about 7\;cm from the midline. The average distance from the midline was $6.60{\pm}0.61\;cm$ on the left side and $6.60{\pm}0.83\;cm$ on the right side in group 2, and $5.46{\pm}0.76\;cm$ on the left side and $5.49{\pm}0.69\;cm$ on the right side in group 3. The average depth to which the needle was inserted was $8.60{\pm}0.52\;cm$ on the left side and $8.74{\pm}0.60\;cm$ on the right side in group 2, and $8.96{\pm}0.63\;cm$ on the left side and $9.18{\pm}0.57\;cm$ on the right side in group 3. 6) The points of the inserted needles were positioned in the upper quarter anteriorly, 51.8% on the left side and 54.4% n the right side of the L1 vertebra by lateral roentgenogram in group 3. The inserted needle points were located in the upper and anterolateral part, of the L1 vertebra 68.5% on the left side and 60.6won the right side, on the anteroposterior rentgenogram in group 3. The needle tip was not advanced beyond the anterior margin of the vertebral body. 7) In some case of group 3, contrast media was injected before the block was done. It shows, the spread upward along the anterior mal gin of the vertebral body. 8) The concentration and the average amount of drug used in each group was as follows: In group 1, $39.17{\pm}6.69\;ml$ of 0.5% -l% lidocaine or 0.25% bupivacaine were injected for the test block and one to three days after the test block $40.00{\pm}4.26\;ml$ of 50% alcohol was injected for the semipermanent block. In group 2, $13.75{\pm}4.88\;ml$ of 1% lidocaine were used as the test block and followed by $46.17{\pm}4.37\;ml$ of 50% alcohol was injected as the semipermanent block. In group 3, $15.63{\pm}1.19\;ml$ of 1% lidocaine for test block followed by $15.62{\pm}1.20\;ml$ of pure alcohol and $16.05{\pm}2.58\;ml$ of 50% alcohol for semipermanent block were injected. 9) The result of the test block was satisfactory in all cases. However the semipermanent block was 83.3 percent of the patients in group 1 who received relief from pain for at least 2 weeks after the block, 73.1% in group 2, and 91.8% in group 3. In these unsuccessful cases, 2 cases in group 1 were controlled by narcotics but 7 cases in group 2 and 14 cases in group 3 received the same splanchnic nerve block 1 or 2 times again within 2 weeks. But, in some cases it was 3 to i months before the 2nd block and in 1 cases even 7 years. 10) The most common complications of splanchnic nerve block were hypotensino(25.5%) occasional flushing of the face, nausea, vomiting, and chest discomfort. 11) For the patients in group 3, the supplemental block most commonly used was a continuous epidural block; it was used as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 12) The interval between the receiving of the alcohol block and discharge was from 5 to 8 days in 61 cases(31.1%) and from 1 to 2 days in 48 cases(24.5%). From the above results, it can be concluded that the splanchnic nerve block done in the prone position with pure and 50% alcohol immediately after an effective test block with 1% lidocaine under C-arm fluoroscopic control is satisfactory and reliable. How to minimize the repeat block is still a problem to be solved.

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Clinical Study of Corrosive Esophagitis (부식성 식도염에 관한 임상적 고찰)

  • 이원상;정승규;최홍식;김상기;김광문;홍원표
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.6-7
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    • 1981
  • With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

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