• Advances in pediatric surgery
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• 제12권2호
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• pp.167-174
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• 2006

Central venous catheter (CVC) for long-term venous access is indispensable for various reasons including hyperalimentation, frequent blood sampling, frequent IV drug use in pediatric patients. We report clinical experience of surgical neonates in whom CVC was inserted primarily via great saphenous vein into suprarenal inferior vena cava. From March 2004 to March 2006, we performed CVC insertion via saphenous vein - contralateral side to main wound - into suprarenal inferior vena cava in surgeries of neonates. 2.7Fr or 4.2Fr, single lumen, tunneled Broviac catheters (Bard Access system, Inc, Salt Lake City, Utah) were used. Skin exit site of tunneled catheter was located in ipsilateral flank area just below edge lower rib. At the end of the procedure, location of the catheter tip was confirmed by plain radiography of abdomen. We retrospectively reviewed the admission records of the patients including nursing staff charts. Nine (50.0 %) patients were male and nine (50.0%) were female. Median gestational age was 38 weeks (range, 29-42 weeks) and median birth weight was 3,105 gm (range, 1,040-3,720 gm). Median age at catheter insertion was 38.5 days (range, 1-236 days). The purpose of CVC insertion was short-and long-term hyperalimentation in nine (50.0 %) patients. CVC insertion was performed in operation room under general anesthesia in sixteen (88.9 %) patients (in these cases, CVC insertion was performed just prior to concurrent operation) and neonatal intensive care unit (NICU) under local anesthesia with adequate sedation in two (11.2%). During the admission period (total catheter-indwelling time: 553 days), CVC functioned well without any significant side effects. Transient swelling of the ipsilateral leg (n=1, 5.6 %) and transient migration of catheter tip (n=1, 5.6 %) were noted, which did not affect function of the indwelled CVC. Mean catheter-indwelling time was 30.7days (range, 3-72 days). All catheters were removed electively except two mortality case. Complications, such as thrombosis, infection, kinking or extravasation of drugs, were not observed in our study period. Tunneled trans-great saphenous vein inferior vena cava catheters are not only comparable to cervical CVCs in terms of function and complication rates, but also very beneficial in selected patients, especially those in whom cervical approach is technically impossible or contraindicated.

• 대한한의학회지
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• 제17권2호
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• pp.100-116
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• 1996

Gastric cancer shows the most high friquency in cancers that occurs in Korea. The western medicine treatment for gastric cancer has radiation and surgery, chemical treatment. While, oriental medicine cures the gastric cancer by herb-drugs, acupunture , moxa and srigma. With just one way of treating gastric cancer can't be effective remedy. Because each medicine has a strength and weakness. Thus, it is effective treatment when two medicine combins and supplement each other. We got the following result about a trend of oriental and westernal combination treatment for gastric cancer through studing records. 1. The western medicine treats gastric cancer patient with surgery first and right after surgery. They need on assembly treatent such as chemical and immune treatment. In oriental medicine, they treats gastric cancer patients with differentiation of symptone and signs and treatment(辨證施治)[for example:incoordination between liver and stomach(肝胃不和), insufficiency of spleen and stomach(脾胃虛弱), stagnation of blood stasis and toxic agent(瘀毒內阻), deficiency of yin by stomach heat(胃熱傷陰), reinforcing both qi and blood(氣血雙虧), stagnation of damp-phlegm(痰濕凝結)] and cure for them by acupuncture and stigma, too. 2. In combination with oriental and western medical treatment principle of gastric cancer by each stage is as follows. First stage and second stage gastric cancer is cured with radical surgery mainly. After operation, the herb of invigoration of the spleen(健脾), coordination of the stomach(和胃), and smoothing the liver and regurating the circulation of qi(疏肝理氣), is used for good gastroenteric condition. The second stage patients can be concidered using in combination with chimical treatment. The third stage gastric cancer is treated with radical surgery or with temporizing surgery. After those surgery, herb-drugs treatment is used jointly. The fourth stage patients who have no extensively metastasis or local contraindication can undergo temporizing and curcuit surgical operation. Herb-drugs and chemical treatments are used together for patients after operating. If he has operating contraindication, he would be treated with herb-drugs and chemical treatment. 3. In case of using in combination with oriental and western medical treatment as follows. As for herb-drugs with chemical treatment, reinforcing both qi and blood(補益氣血), invigorate the spleen and the stomach(健脾和胃), reinforcing liver and kidney(滋補脾腎), clear out the heat and relieve the toxic agent(淸熱解毒), can be used and with radiation treatment, clear out the heat and relieve the toxic agent(淸熱解毒), promoting the production body fluid and moisturizing the vicera(生津潤燥), reinforcing both qi and blood(補益氣血), invigorate the spleen and the stomach (健脾和胃), reinforcing liver and kidney(滋補肝腎) etc, can be used. 4. According to the research of oriental and western medical combination treatment are the 5-year-survival degree with oriental and western medicine combination treatment was for better than that just with oriental or western medical treatment. Especially, it has good effect on the third, fourth stage gastric cancer. That is, the middle and the end of stage gastric cancer. 5. The merits of oriental and western medicine combination treatment are lengthers one's life and diminish the bad effect of chemical treatment and radiation treatment be near completion, prevent from relapsing, maintain the balance in their eveirenment of body and improve immunity.

• 대기
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• 제24권4호
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• pp.481-489
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• 2014

The Chugugi and Wootaek data of Gyeongsang-do (Dagu, Jinju, Goseong) were restored from "Gaksadeungnok", the governmental documents reported by the local government to the central during the Joseon Dynasty, and analyzed. The duration of the restored data represents 6 years for Daegu (1863, 1872, 1890, 1897, 1898, and 1902), 3 years for Jinju (1897, 1898, and 1900), and 2 years for Goseong (1871 and 1873). Total number of the restored data was 134, including 83 in Daegu, 25 in Jinju, and 26 in Goseong with the period ranging from March to September. The summer data from June to August accounts for approximately 50% (73 data), while the April data also shows relatively high number of 22, followed by September and March. Most data was collected from March to October, while this time winter data was not found even in October. The rainfall patterns using Chugugi data were investigated. First, the number of days with rainfall by annual mean showed 41 days in Daegu, 39 in Jinju, 33 in Goseong, respectively. In terms of the time series distribution of daily rainfall, the ratio between the number of occurrences with over 40 mm of heavy rainfall and the number of rainy days showed 14 times (8%) in Daegu, 24 (39%) in Jinju, and 4 (6%) in Goseong, respectively. The maximum daily rainfall during the period was recorded with 80mm in Jinju on August 24, 1900. The result of analyzing monthly amount of rainfall clearly indicated more precipitation in summer (June, July and August) with the relatively high records of 284 mm and 422 mm in April, 1872 and July, 1902, respectively, in Daegu, while Jinju recorded the highest value of 506 mm in June, 1898. When comparing the data with those observed by Chugugi in Seoul during the same period from "Seungjeongwonilgi", the monthly rainfall patterns in Daegu and Seoul were quite similar except for the year of 1890 and 1897 in which many data were missing. In particular, in June 1898 the rainfall amount of Jinju recorded as much as 506 mm, almost 4 times of that of Seoul (134 mm). Based on this, it is possible to presume that there was a large amount of the precipitation in the southern region during 1898. According to the calculated result of Wootaek data based on Chugugi observations, the unit of 1 'Ri' and 1 'Seo' in Daegu can be interpreted into 18.6 mm and 7.8 mm. When taking into consideration with the previous result found in Gyeonggi-do (Cho et al., 2013), 1 'Ri' and 1 'Seo' may be close to 20.5 mm and 8.1 mm, however, more future investigations and studies will be essential to verify the exact values.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권5호
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• pp.355-364
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• 2011

Introduction: This study evaluated nerve recovery through retrospective study of patients with lingual nerve damage. Patients and Methods: The patients who visited Seoul National University Dental Hospital for an injury to the lingual nerve from April 1988 to August 2009 were enrolled in this study (n=41). The relevance of various factors including the causes of damage, age, etc. was analyzed by the subjective improvement based upon questionnaires and the clinical records. The evaluation variants were a subjective assessment and neurosensory examination composed of the direction, contact threshold, two-point discrimination, pin prick, thermal discrimination and current perception threshold. Results: The causes of lingual nerve damage were an extraction of the lower third molar (75.6%), local anesthesia (9.7%), incision and drainage (4.88%), trauma (2.44%). The evaluation of subjective prognosis exhibited no difference in sensory improvement depending on the cause, age and gender. Based upon the subjective evaluation, 44.7% of patients showed sensory improvement. The first hospital visit from injury was shorter in the group showing subjective improvement (3.41 months) than those showing no improvement (5.24 months) (P=0.301). Thirty six out of 41 patients were treated with only conservative therapy and 5 patients were treated by surgical intervention. Neurosensory examinations revealed improvement, although not statistically significant, and the degree was higher in the subjectively improved group. The contact threshold discrimination showed the highest correlation with subjective improvement (P=0.069). Most of the sensory recovery was gained within 12 months and the degree of improvement at the tip of the tongue was higher than that of the dorsum (P<0.001). Conclusion: The damaged lingual nerve improved at a rate of 44.7% and mostly within 12 months after the incident. There was no difference between the subjective prognosis and neurosensory examination depending on the cause of damage, age and gender, whereas the contact threshold discrimination was the best variant that reflected the subjective prognosis statistically.

• 한국복식학회:학술대회논문집
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• 한국복식학회 2001년도 19th International Costume Association Congress
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• pp.11-13
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• 2001

For those unfamiliar with the shoe world, Pinet (1817-1897) was a contemporary of Worth, the great Parisian couturier. So I look at the glamour shoes and the world of haute couture, and indeed the development of the named designer. That is a concept we are all familiar with now. So it is not easy to comprehend the lack of names for the exquisite work before 1850. Straightway I have to say that the number of noted shoe designers is far fewer than famous dress designers, but I will introduce you to some of them, against the background of contemporary shoe fashions. Franc;ois Pinet was born in the provinces (probably Touraine) in 1817, two years after the end of the Napoleonic Wars. His father, an ex-soldier, settled to shoemaking, a comparatively clean and quiet trade. It had a tradition of literacy, interest in politics, and was known as the gentle craft, which attracted intelligent people. We should presume father would be helped by the family. It was usual for a child to begin by the age of 5-6, tying knots, sweeping up, running errands and gradually learning the job. His mother died 1827, and father 1830 when he was 13, and at the time when exports of French shoes were flooding world markets. He went to live with a master shoemaker, was not well treated, and three years later set out on the tour-de- France. He worked with masters in Tours and Nantes, where he was received as Compagnon Cordonnier Bottier du Devoir as Tourangeau-Ia rose dAmour (a name to prove most appropriate). He went on to Bordeaux, where at 19 he became president of the local branch. In 1841 he went to Paris, and in 1848, revolution year, as delegate for his corporation, he managed to persuade them not to go on strike. By now the shoemakers either ran or worked for huge warehouses, and boots had replaced shoes as the main fashion. In 1855 Pinet at the age of 38 set up his own factory, as the first machines (for sewing just the uppers) were appearing. In 1863 he moved to new ateliers and shop at Rue ParadisPoissoniere 44, employing 120 people on the premises and 700 outworkers. The English Womans Domestic Magazine in 1867 records changes in the boots: the soles are now wider, so that it is no longer necessary to walk on the uppers. There is interest in eastern Europe, the Polonaise boots with rosette of cord and tassels and Bottines Hongroises withtwo rows of buttons, much ornamented. It comments on short dresses, and recommends that the chaussure should correspond to the rest of the toilet. This could already be seen in Pinets boots: tassels and superb flower embroidery on the higher bootleg, which he showed in the Paris Exposition that year. I think his more slender and elegant Pinet heel was also patented then or 1868. I found little evidence for colour-matching: an English fashion plate of 1860 shows emerald green boots with a violetcoloured dress.

• 한국수자원학회:학술대회논문집
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• 한국수자원학회 2011년도 학술발표회
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• pp.18-18
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• 2011

Climate change is impacting and will increasingly impact both the quantity and quality of the world's water resources in a variety of ways. In some areas warming climate results in increased rainfall, surface runoff, and groundwater recharge while in others there may be declines in all of these. Water quality is described by a number of variables. Some are directly impacted by climate change. Temperature is an obvious example. Notably, increased atmospheric concentrations of $CO_2$ triggering climate change increase the $CO_2$ dissolving into water. This has manifold consequences including decreased pH and increased alkalinity, with resultant increases in dissolved concentrations of the minerals in geologic materials contacted by such water. Climate change is also expected to increase the number and intensity of extreme climate events, with related hydrologic changes. A simple framework has been developed in New Zealand for assessing and predicting climate change impacts on water resources. Assessment is largely based on trend analysis of historic data using the non-parametric Mann-Kendall method. Trend analysis requires long-term, regular monitoring data for both climate and hydrologic variables. Data quality is of primary importance and data gaps must be avoided. Quantitative prediction of climate change impacts on the quantity of water resources can be accomplished by computer modelling. This requires the serial coupling of various models. For example, regional downscaling of results from a world-wide general circulation model (GCM) can be used to forecast temperatures and precipitation for various emissions scenarios in specific catchments. Mechanistic or artificial intelligence modelling can then be used with these inputs to simulate climate change impacts over time, such as changes in streamflow, groundwater-surface water interactions, and changes in groundwater levels. The Waimea Plains catchment in New Zealand was selected for a test application of these assessment and prediction methods. This catchment is predicted to undergo relatively minor impacts due to climate change. All available climate and hydrologic databases were obtained and analyzed. These included climate (temperature, precipitation, solar radiation and sunshine hours, evapotranspiration, humidity, and cloud cover) and hydrologic (streamflow and quality and groundwater levels and quality) records. Results varied but there were indications of atmospheric temperature increasing, rainfall decreasing, streamflow decreasing, and groundwater level decreasing trends. Artificial intelligence modelling was applied to predict water usage, rainfall recharge of groundwater, and upstream flow for two regionally downscaled climate change scenarios (A1B and A2). The AI methods used were multi-layer perceptron (MLP) with extended Kalman filtering (EKF), genetic programming (GP), and a dynamic neuro-fuzzy local modelling system (DNFLMS), respectively. These were then used as inputs to a mechanistic groundwater flow-surface water interaction model (MODFLOW). A DNFLMS was also used to simulate downstream flow and groundwater levels for comparison with MODFLOW outputs. MODFLOW and DNFLMS outputs were consistent. They indicated declines in streamflow on the order of 21 to 23% for MODFLOW and DNFLMS (A1B scenario), respectively, and 27% in both cases for the A2 scenario under severe drought conditions by 2058-2059, with little if any change in groundwater levels.

• 한국전통조경학회지
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• 제32권3호
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• pp.139-153
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• 2014

본 연구는 지리산 유람록 23편을 대상으로 하여 문인들이 인식한 이상향의 경관을 고찰하였다. 그 결과 문장 속에 묘사된 '무릉도원(武陵桃源)', '별천지(別天地)', '동천(洞天)', '청학동', 그리고 '은거지'라는 다섯 가지 키워드를 지리산 이상향의 유형으로 이해하고, 이들의 경관 특성을 다음과 같이 정리하였다. 문인들이 꿈꾼 지리산의 '무릉도원'은 신비감을 주는 깊은 산속, 협곡 안에 마련된 넓고 평평한 터, 감나무와 밤나무 등 향토식생, 닭과 소 등 생리(生利)를 만족시키는 토속경관이 반영된 이상향이다. '별유천지(別有天地)'의 '별천지'는 선경(仙境)과 승경 개념이 결합된 이상향이다. 또한 문인들은 은일에 적합한 위요된 지형 구조를 가진 곳에 이름을 붙이거나 일정한 영역의 승경지를 한정하는 개념으로 '동천'을 사용하였다. 지리산에 설정된 '청학동'은 불일암 일대 협곡과 불일폭포로 이루어진 수석(水石)경관, 소나무와 대나무 등 식생경관을 토대로 하여 최치원의 설화와 바위글씨로 전승되었다. 문인들은 지리산에서 배산임수형 지세, 교역 가능한 하천, 대숲으로 위요된 평평한 토지, 유실수 위주의 식생, 아름다운 산수를 갖춘 마을을 지상에 실현된 이상향으로 인지하였다. 이것은 대자연 안에서 적당하게 노동하며 사는 인간 세상의 모습과 같다. 살펴본 바와 같이 본 연구는 조선시대 문인들의 유산(遊山) 문화와 이상향의 관련성, 그리고 선계(仙界)로 인식한 지리산의 여건을 파악하고, 중국에서 전래된 개념부터 토착화된 현실적 이상향까지 다양한 전통적 이상향을 설명하였다는 점에서 의의를 가진다.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.365-370
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• 2007

Purpose: There are many reports about facial bone fractures, but limited to retrospective data of a single hospital. Etiology and severity of the facial bone fracture have been changed and treatment method and materials have been advanced. In order to reflect those changes and provide up-to-date data of the facial bone fractures in Daegu, we gathered the data and analyzed the epidemiologic study. Methods: The medical records of 1058 fractures in 895 patients were gathered from 5 general hospitals in Daegu during last year and these data were analyzed by following parameters: age, sex, place of residence, occupation, cause of injury, time of injury, location of fracture, length of in-hospital stay, time of operation, treatment method, associated injury, complication. Statistical analysis was performed using the Chi-square test. Results: Most commonly involved age group was 20s(26%) and the sex ratio was 3.4:1(male predominance). Fractures were occurred more in unban and white-color workers. Among variable etiology of injury, traffic accident was the most common cause. Time of injury was heighest at 6 to 7 P.M., on Sunday, in July. Locations of fractures were following sequence: nasal, zygoma, mandible, orbit, maxilla. Mean length of in-hospital stay and time of operation after injury were 6.3 and 3.2 days, respectively. In treatment methods, operative methods were dominant than conservative management and general anesthesia were favored than local anesthesia. Associated injuries were noticed in 188 cases(21.2%) and complications were in 94 cases(8.9%) and among them, ocular problem were common. Conclusion: Compared to previous studies, mean age of occurrence was lowered and the etiologies showed age-specific pattern and reflected the change of lifestyle. In young age groups, sports injury, violence were more dominant and the other hand, traffic accident and fall were dominant in older groups.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.411-416
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• 2009

Purpose: Malignant melanoma is recognized as the most serious skin cancer. We examined anatomical distribution and 5 - year survival rate of each stage of malignant melanoma on lower leg. Methods: We retrospectively analyzed the medical records of 91 patients(46 males and 45 females) with malignant melanoma on lower leg from 1985 to 2008. Age, sex, anatomical distribution and 5 - year survival rates of each stage of malignant melanoma on lower leg were investigated. Also, 5 - year survival rates of each stage and invasion depth of malignant melanoma on heel pad were investigated. Results: On lower leg, most frequently 32 cases(35.1%) occurred on heel pad, 27 cases(29.7%) occurred on dorsum of foot, 18 cases(19.8%) in toe and 14 cases(15.4%) on others in lower leg. We used the excision margin as 3 ~ 5 cm. After wide excision, in stage III, IV, the patients underwent the immunologic / chemo - therapy. The incidences of each stage were 22 cases(24.2%) in stage I, 47(51.6%) in II, 17(18.7%) in III and 5(5.5%) in IV. The 5 - year survival rates of each stage were 85%, 53.2%, 47.1% and 40%. On heel pad, the incidences of each stage were 5 cases(15.6%) in stage I, 19 cases(59.4%) in II, 7 cases(21.9%) in III and 1 case(3.1%) in IV. The 5 - year survival rates of each stage were 80%, 63.2%, 42.9% and 100%. On heel pad, incidence of local recurrence was 2 and 5 - year survival rate of this case was 100%. And systemic recurrence was 9 and 5 - year survival rate of this case was 55.6%. Conclusion: The 5 - year survival rate of malignant melanoma on heel pad was higher than previous study. To maintain the weight - bearing function of foot, we recommend the active reconstructive surgery for heel pad reconstruction after wide excision of heel pad malignant melanoma.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.145-150
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• 2014

Purpose: To assess the accuracy and role of single-contrast computed tomography (CT) in the management of anterior abdominal stab wound (AASW). Methods: During 8-years period, single-contrast CT was performed in 21 hemodynamically stable AASW patients (age range, 22-64 years; median age, 45 years), including 19 men and 2 women. CT scans were evaluated by one trauma surgeon and one senior resident to determine the depth of injury(peritoneal violation or not), and abnormal findings of intraperitoneal cavity associated with stab injury. We retrospectively reviewed medical records regarding operative findings. Results: Nine patients underwent abdominal surgery and 12 patients nonoperative management. In the abdominal surgery group, abnormal CT findings included peritoneal violation in 14 patients and abnormal intraperitoneal cavity findings in 5 patients. There was no statistical significant difference regarding abnormal CT findings between abdominal surgery group and nonoperative management group. Among the nine abdominal surgery patients, therapeutic laparotomy was performed on 4 patients. The positive predictive value (PPV) and negative predictive value (NPV) of peritoneal violation to predictive therapeutic laparotomy were 28.6% and 100%, respectively. In addition, the PPV and NPV of abnormal intraperitoneal cavity CT findings to predict therapeutic laparotomy were 40.0% and 87.5%, respectively. There was no statistical significant difference regarding the abnormal CT findings between therapeutic laparotomy group and non therapeutic laparotomy group. Conclusion: CT is a good adjunctive method to evaluate hemodynamicaly stable AASW patients. If peritoneal violation is not seen on CT scan, conservative treatment on local wound may be safely performed without additional abdominal surgery. However, further study is warranted to evaluate the exact role of CT in the diagnostic workup of AASW patients.