• Title/Summary/Keyword: External drainage

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Catastrophic complications from filler injection on external genitalia

  • Kwon, Byeong Soo;Kim, Jin Woo
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.10-14
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    • 2021
  • Soft tissue filler injections are widely used due to their immediate effects, predictable results, and high stability. However, as the use of soft tissue filler injections has increased, various complications have been reported. We report a life-threatening complication in a patient who developed sepsis and necrotizing fasciitis. A 45-year-old woman presented with right leg pain and discharge from the labia majora. The patient had received a soft tissue filler injection of unknown composition 1 year earlier and had recently undergone incision and drainage for an inflammatory cystic nodule. Antibiotic treatment was administered for cellulitis, but the infection progressed to necrotizing fasciitis and sepsis. Fasciotomy and intensive care unit treatment improved the systemic infection, but the soft tissue filler injection site did not respond to treatment for 1 month. Thus, the injection site was covered with a pedicled vertical rectus abdominis musculocutaneous flap after wide excision. The area of skin necrosis on the leg was covered with split-thickness skin grafts. Infections occurring after soft tissue filler injections are related to biofilms, and treatment is sometimes difficult. Therefore, although soft tissue filler injections have a favorable safety profile, it is important to be aware of the risk of life-threatening complications.

High-Dose-Rate Intraluminal Brachytherapy for Biliary Obstruction by Secondary Malignant Biliary Tumors (속발성 담도부 종양에 의한 담도 폐쇄에서 고선량률 관내 근접치료)

  • Yoon Won-Sup;Kim Tae-Hyun;Yang Dae-Sik;Choi Myung-Sun;Kim Chul-Yong
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.35-43
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    • 2003
  • Purpose :To analyze the survival period, prognostic factors and complications of patients having undergone high-dose-rate intraluminal brachytherapy (HDR-ILB) as a salvage radiation therapy, while having a catheter, for percutaneous transhepatic billary drainage (PTBD), inserted due to biliary obstruction caused by a secondary malignant biliary tumor Methods and Materials : A retrospective study was performed on 24 patients having undergone HDR-ILB, with PTBD catheter Insertion, be)ween December 1992 and August 2001. Their median age was 58.5, ranging from 35 to 82 years. The primary cancer site were the stomach, gallbladder, liver, pancreas and the colon, with 12, 6, 3, 2 and 1 cases, respectively. Eighteen patients were treated with external beam radiation therapy and HDR-lLB, while slx were treated with HDR-lLB only. The 4otal external beam, and brachytherapy radiations dose were 30$\~$61.2 and 9$\~$30 Gy, with median doses of 50 and 15 Gy, respectively. Results : Of the 24 patients analyzed, 22 died during the follow-up period, with a median survival of 7.3 months. The 6 and 12 months survival rates were 54.2 (13 patients) and 20.8$\%$ (5 patients), respectively. The median survivals for stomach and gailbladder cancers were 7.8 and 10.2 months, respectively, According to the unlvariate analysis, a significant factor affecting survival of over one year was the total radiation dose (over 50 Gy) (o=0.0200), with all )he patients surviving more than one year had been Irradiated with more than 50 Gy. The acute side effects during the radiation therapy were managed with conservative treatment. During the follow-up period, 5 patients showed symptoms of cholangltis due to the radiation therapy Conclusion :An extension to the survival of those patients treated with HDR-ILB is suggested compared to the median historical survival of 4hose patients treated with external biliary drainage. A boost radiation dose could be effectively given, by performing HDR-lLB, which is a prognostic factor In addition, the acute complications of radiation therapy were effectively controlled by conservative management, and It could be regarded as a safe treatment.

The Behavior Characteristics of Segmental Crib Retaining Wall by Model Test (모형실험에 의한 조립식 격자 옹벽의 거동 특성)

  • 김상수;신방웅;김용언;이재영;변동건
    • Proceedings of the Korean Geotechical Society Conference
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    • 1999.10a
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    • pp.449-456
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    • 1999
  • The concrete wall is the most useful of retaining structure which can obtain the engineering stability, but has problems that is not friendly with nature environment in a fine view, such as poor rear drainage, and shrinkage crack by temperature difference, etc. Because of this problems, the research for a segmental crib retaining wall has been performed. A segmental crib retaining wall is quickly and easily erected because is possible to be erected as the individual members, and is not sensitive to differential settlement and earthquakes. Also, it shows effective drainage and has a friendly advantage with nature environment because of being able to be planted with vines and shrubs in retaining walls The design of crib retaining walls has traditionally been based on classical soil mechanics theories. These theories, originally derived by Rankine(1857) and Coulomb(1776), assume that the wall acts as a rigid body. This assumption results in failure being predicted by either monolithic overturning or base sliding mechanisms. However, the wall consists of individual members which have been created a three dimensional grid. This grid confines an fill mass which becomes part of the wall. The filled wall resists the earth pressure with the same mechanism of classical gravity walls. Because of the flexibility of the individual segment, it allows relative movement between the individual members within the wall. The three dimensional flexible grid leads to stress redistribution when the wall is subjected to external or fill loads. Due to the flexibility and the stress redistribution, the failure of segmental crib wall consists of not only overturing and base sliding but the local deformation and the failure between the segmental members. It has been researched in the field that due to this flexibility and load redistribution, serviceability failure of segmental crib walls is unlikely to be due to overturning or base sliding. Therefore, in this study, the relative displacement appearance of retaining wall due to variation of inclination is measured to examine this behavior characteristics. Also, the behavior characteristics of retaining walls by surcharge load, and location of acting point of retaining wall rear, and the displacement characteristics and deflections are estimated about the existence and nonexistence of Rear Stretcher performing an role in transmitting earth pressure of Header and Stretcher organizing retaining walls. This research focuses on the characteristics due to the behavior of retaining walls. This research focuses on the characteristics due to the behavior of retaining walls.

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Analysis of Flood Inundation using WMS and RADARSAT SAR Image (WMS와 RADARSAT SAR 영상을 이용한 유역 침수구역 분석)

  • Kim, Kyung-Tak;Kim, Joo-Hun;Park, Jung-Sool;Byun, In-Kyung
    • Journal of the Korean Association of Geographic Information Studies
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    • v.10 no.3
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    • pp.1-12
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    • 2007
  • This study was conducted in order to analyze a flooded area by the overflow of a stream using hydrological and hydraulic models and to estimate the utility of the SAR satellite image by comparing a protected lowland inundation area with a past inundation area map. The research area selected for this study is Sapkyocheon, which was flooded in August 1999. The flood stage was analyzed to select an inundation area by applying flood events in August 1999. By importing analyzed flood stage data into TIN data of WMS, the inundation area of a protected lowland was selected and then compared with an flood hazard map of WAMIS. An inundation area is selected by the SAR satellite image in comparing the image of August 4, 1999 (inundation time) with the image of September 8, 2002 (after inundation). The method of selecting an inundation area with the hydraulic model of HEC-RAS can be used to select an inundation area of external overflow, but it has the limit of selecting an inundation area concerning the internal drainage. The method of using the SAR satellite image can complement the limit of an inundation area of an internal drainage but accuracy of inundation area depends on using SAR satellite image acquired at time of maximum depth.

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A Clinical Study of Branchial Apparatus Anomalies (새성기형 50예의 임상적 고찰)

  • Gam Bong-Soo;Joo Jong-Soo;Kim Sang-Hyo;Paik Nak-Whan
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.1
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    • pp.6-13
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    • 1992
  • Branchial apparatus anomaly is rarely encountered congenital neck disease, it presents a palpable non-tender mass or fistulous opening existed at any site from external auditory canal or mandible angle to lower part of neck We have reviewed the records of 50 patients operated upon for branchial cleft anomaly, at Department of Surgery, Inje University Hospital, between 1981 and 1990, and the following results were obtained. I) In the classificiation of branchial cleft anomaly, first branchial fistula was 1 case, second branchial cyst 32 cases, second branchial sinus 11 cases, second branchial fistula 5 cases and third branchial fistula 1 case. 2) There were 20 men and 30 women in this series and male to female ratio was 2:3. 3) The age at first clinical presentation was 1st decade 15 cases, 2nd decade 10 cases, 3rd decade 17 cases, 4th decade 5 cases and 5th decade 3 cases. The peak age incidence was 3rd decade in overall, but the cyst was most common in 2nd decade, and majority of sinus or fistula was seen below 10 years old age. 4) The prevalent side of this anomaly was right side in 19 cases, left side in 29 cases and bilateral 2 cases, and so left side was more common than right. 5) The clinical presentation was characterized by the lesion along anterior border of sternocleido muscle, non-tender palpable mass were 28 cases, drainage sinus 18 cases, recurrent abscess and drainage 5 cases and intermittent ear discharge 1 case. 6) The mean size of cyst was about 4cm that containing turbid white-yellowish fluid but discharge from sinus or fistula was clear mucoid. 7) The culture of cyst fluid was no bacteria, but 2 cases showed staphyloccoci suggesting secondary infection. 8) The surgical procedure were complete excision of cyst 32 cases, sinus excision 11 cases, fistula excision 6 cases and I&D 1 case. And the recurrent 1 case was that fistula tract could not be identified due to severe scar from previous several operations.

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Physico-chemical Properties of Disturbed Plastic Film House Soils under Cucumber and Grape Cultivation as Affected by Artificial Accumulation History

  • Han, Kyung-Hwa;Ibrahim, Muhammad;Zhang, Yong-Seon;Jung, Kang-Ho;Cho, Hee-Rae;Hur, Seung-Oh;Sonn, Yeon-Kyu
    • Korean Journal of Soil Science and Fertilizer
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    • v.48 no.2
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    • pp.105-118
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    • 2015
  • This study was carried out to investigate the effects of profile disturbance with different artificial accumulation history on physico-chemical properties of soil under plastic film house. The investigations included soil profile description using soil column cylinder auger F10cm x h110cm, in situ and laboratory measurements of soil properties at five sites each at the cucumber (Site Ic ~ Vc) and grape (Site Ig ~ Vg) plastic film houses with artificial soil accumulation. The sites except sites Ic, IVc, IVg and Vg, belong to ex-paddy area. The types of accumulates around root zone included sandy loam soil for 3 sites, loam soil for 1 site, saprolite for 2 sites, and multi-layer with different accumulates for 3 sites. Especially, Site IIg has mixed plow zone (Ap horizon) with original soil and saprolite, whereas disturbed soil layers of the other sites are composed of only external accumulates. The soil depth disturbed by artificial accumulation ranged from 20 cm, for Site IIg, to whole measured depth of 110 cm, for Site IVc, Vc, and Site IVg. Elapsed time from artificially accumulation to investigation time ranged from 3 months, Site IIc, to more than 20 years, Site Vg, paddy-soil covering over well-drained upland soil during land leveling in 1980s. Disturbed top layer in all sites except Site Vg had no structure, indicating low structural stability. In situ infiltration rate had no correlation with texture or organic matter content, but highest value with highest variability in Site IIIc, the shortest elapsed time since sandy loam soil accumulation. Relatively low infiltration rate was observed in sites accumulated by saprolite with coarse texture, presumably because its low structural stability in the way of weathering process could result in relatively high compaction in agro-machine work or irrigation. In all cucumber sites, there were water-transport limited zone with very low permeable or impermeability within 50 cm under soil surface, but Site IIg, IIIg, and Vg, with relatively weak disturbance or structured soil, were the reverse. We observed the big change in texture and re-increase of organic matter content, available phosphate, and exchangeable cations between disturbed layer and original soil layer. This study, therefore, suggest that the accumulation of coarse material such as saprolite for cultivating cash crop under plastic film house might not improve soil drainage and structural stability, inversely showing weaker disturbance of original soil profile with higher drainage.

Correlation Between the Number of Anastomosed Vessels and Survival Rate in Digit Replantation (수지접합술의 생존율과 문합혈관수의 상관관계)

  • Lee, Byung-Il;Kim, Woo-Kyung
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.44-49
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    • 1999
  • From January 1990 to December 1998, 449 consecutive single-digital replantations were reviewed retrospectively in order to determine the essential number of vascular anastomoses for successful finger replantation. The correlations between the number of anastomosed vessels and survival rate were examined according to the amputated digital levels and all of the correlated results were compared with each other statistically. In zone I, The survival rate of the digits with a repaired vein was higher than that of digits treated with external bleeding method. In zone II, the equal number(s) between the arterial and venous repair was an important factor in successful replantation. And the repaired arteries more than repaired veins in number led to venous congestion and resulted in a failure of replantation, which was maybe due to the large amount of arterial input relative to small volume of amputated stump with small sized vein. In zone III, the equal number(s) between the arterial and venous repair was also an important factor in successful replantation. But unlike in zone II, venous congestion was scarcely happened if the venous drainage was sufficient with a repaired large vein alone. In zone IV, two or more arteries and veins were required for successful replantation. In conclusion, it is desirable that the repair of vessels as many as possible to increase the possibility of a good result. But digital amputations and their condition for replantation were variable, therefore, the numbers in vascular repair should to be modified and straightforward as the case may be.

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A Study on the Cartographic Generalization of Stream Networks by Rule-based Modelling (규칙기반 모델링에 의한 하계망 일반화에 관한 연구)

  • Kim Nam-Shin
    • Journal of the Korean Geographical Society
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    • v.39 no.4
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    • pp.633-642
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    • 2004
  • This study tries to generalize the stream network by constructing rule-based modelling. A study on the map generalization tends to be concentrated on development of algorithms for modification of linear features and evaluations to the limited cartographic elements. Rule-based modelling can help to improve previous algorithms by application of generalization process with the results that analyzing mapping principles and spatial distribution patterns of geographical phenomena. Rule-based modelling can be applied to generalize various cartographic elements, and make an effective on multi-scaling mapping in the digital environments. In this research, nile-based modelling for stream network is composed of generalization rule, algorithm for centerline extraction and linear features. Before generalization, drainage pattern was analyzed by the connectivity with lake to minimize logical errors. As a result, 17 streams with centerline are extracted from 108 double-lined streams. Total length of stream networks is reduced as 17% in 1:25,000 scale, and as 29% in 1:50,000. Simoo algorithm, which is developed to generalize linear features, is compared to Douglas-Peucker(D-P) algorithm. D-P made linear features rough due to the increase of data point distance and widening of external angle. But in Simoo, linear features are smoothed with the decrease of scale.

Pressure Sore and Necrosis over the lateral malleolus of the Ankle (족근 관절 외과 부위의 압박궤양과 괴사)

  • Park, In-Heon;Song, Gyung-Won;Shin, Sung-Il;Lee, Jin-Young;Suh, Dong-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.21-27
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    • 2002
  • Pressure sores are an ulceration and necrosis of the skin and underlying tissue usually occur after prolonged or repeated pressure by interruption of blood flow from the small. vessels to the skin and deep tissue. The management of pressure sores is mostly difficult and requires prolonged hospitalization or repeated surgical interventions with a high recurrence rate. In this article we reviewed 14 cases of National Pressure Ulcer Advisory Pannel staging III, IV over the lateral malleolar area of the ankle in 2 years period from January 1999 to October 2001. The pressure over lateral malleolar area was mainly due to unique Korean sitting position with cross legs at flexed hips and knees or supine position of patient with external rotation of low extremity. Male to female ratio was 11: 3 and ages were between 36 and 83 (mean age: 67.1 years). Associated diseases were DM(7 cases), Hemiparesis caused by CVA(2 cases), Liver cirrhosis(2 cases), disarticulation of opposite hip due to squamous cell ca.(1 case), Intertrochanteric Fx.(1 case). Wound cultures reported Staphylococus, Pseudomonas and others. Abnormally elevated ESR and CRP were seen in 6 cases. Operative treatments were irrigation and debridement, direct closure with gravity drainage and skin grafting. The most important aspect of pressure sore treatment is pressure relief of the lateral malleolar area. Pressure-relieving Cast or Brace was helpful for local management and preventing recurrence.

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Sternoclavicular Joint Infection: Classification of Resection Defects and Reconstructive Algorithm

  • Joethy, Janna;Lim, Chong Hee;Koong, Heng Nung;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • v.39 no.6
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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.