• Archives of Plastic Surgery
• /
• v.36 no.4
• /
• pp.512-515
• /
• 2009

Purpose: Neurofibromatosis(NF) is an autosomal - dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop - shaped ligation before removal of the giant NF in both buttocks. And then we could successfully reduce the amount of hemorrhage during the operation. Methods: A 46 - year - old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about $30{\times}20cm$ in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop - shaped suture ligation(weaving the thread up and down in a loop - shaped pattern, leaving a space of 2 cm between each loop) with a straight needle and prolene 2 - 0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged - shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop - shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscense did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow - up, the functional and cosmetic result was excellent. Conclusion: A continuous loop - shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.20 no.3
• /
• pp.527-534
• /
• 2006

This is a pilot study to survey the general demand of senior-assistive necessities before a standardization system for senior-assistive necessities is developed as well as to describe health professionals' opinions about the demand and quality of Oriental medical aids and necessities for daily living for the elderly. This is a descriptive survey in which 29 health professionals are questioned, using structured questionnaires based on ISO 9999. The questionnaires were developed by 7 expert conduction standardization system of senior-assistive products in Korea. The data is analyzed by descriptive statistics. The result is as follows : First, with regard to the demand for all of the items in Oriental medical aids for the elderly, the demand of cupping glasses is the highest, followed by instrument used to apply heat treatment, massage equipment, thermo-therapeutic mattress, and heat or ice packs. With regard to the demand for all of the items for the necessities for daily living for the elderly, chairs are the highest, followed by rolling chairs, beds for health, and heigh adjustable beds. Second, with regard to quality of Oriental medical aids, ${\ulcorner}$aids for hair care${\lrcorner}$ are the best, whereas ${\ulcorner}$aids for boiling Oriental medicine${\lrcorner}$ are the worst. In quality of the necessities for daily living, ${\ulcorner}$chairs${\lrcorner}$ are the best, whereas ${\ulcorner}$beds${\lrcorner}$ are the worst. Above all, this result shows that with ${\ulcorner}$aids for heat or cold treatment${\lrcorner}$, there is relatively high demand and low quaily of Oriental medical aids, and with ${\ulcorner}$Beds${\lrcorner}$, there is relatively high demand and low quality. Therefore, aids for heat or cold treatment and beds in th necessities for daily living are required to be developed for standardization of senior-assistive necessities.

• Journal of Veterinary Clinics
• /
• v.29 no.5
• /
• pp.368-371
• /
• 2012

The present study evaluated the outcome of use of thoracostomy tube tunneling technique under the latissimus dorsi muscle for the evacuation of postoperative pneumothorax induced by thoracotomy in 11 dogs. A stab incision was made through the skin and the latissimus dorsi muscle over the rib in the fifth intercostal space caudal to a surgical window. The thoracostomy tube with a Kelly hemostat was advanced into the thoracic cavity in a cranioventral direction through the sublatissimal tunnel. After tube placement, a # 1 nylon horizontal mattress suture was placed around the skin incision. The thoracostomy tube was removed after creating a negative pressure in the thoracic cavity. Dogs were monitored after surgery for pneumothorax, subcutaneous emphysema, clinical signs including dyspnea, and tube kinking in a muscle tunnel using physical examination and postoperative radiography. There was no tube kinking in the sublatissimal tunnel in 11 dogs on introducing the tubes into the thoracic cavity. The mean (${\pm}SD$) follow-up period was $19{\pm}10$ months. On postoperative radiography, there was no evidence of pneumothorax in 11 dogs. Subcutaneous emphysema was identified around the stab incision in a dog postoperatively. The subcutaneous emphysema disappeared spontaneously within 3 days. On postoperative physical examination, there was no evidence of dyspnea in 11 dogs. Our results suggest that the sublatissimal tunneling technique for thoracostomy tube placement is effective to prevent air leakage around the thoracostomy tube while the tube remains in the thoracic cavity and along the thoracostomy tunnel after tube removal. Tunneling under the latissimus dorsi muscle should be considered the thoracostomy tube placement technique to prevent iatrogenic pneumothorax with first priority.

• Journal of Veterinary Clinics
• /
• v.31 no.6
• /
• pp.515-518
• /
• 2014

A castrated male Yorkshire Terrier dog was presented for urinary incontinence and constipation. On physical examination, the dog showed difficult urination. There were no neurological abnormalities and no bacterial detection on urinalysis. Rectal examination revealed a regular, normal-sized prostate. Urethral catheterization was performed easily. Excretory urography and retrograde positive contrast urethrocystography showed displacement of the urinary bladder to the intrapelvic region. There was no evidence of an ectopic ureter. A tentative diagnosis of urethral sphincter mechanism incompetence accompanied with a pelvic bladder was made. Cystopexy was decided to place the urinary bladder to its normal position. The neck of the urinary bladder was anchored to the body wall and prepubic tendon using mattress sutures. Additional sutures were placed to appose the lateral part of the urinary bladder and abdominal wall. A simple interrupted suture was placed to tack the apex of the urinary bladder on the abdominal incision line. A urinary catheter was placed in the urinary bladder to provide post-operative evacuation. The catheter was removed when the dog was able to urinate with minimal straining at 3 days post-operatively. The owner reported that the dogs showed normal urination without straining at 3 days after the catheter was removed. Excretory urography revealed that the urinary bladder was located on its normal position at 2 months post-operatively. Subsequent communication with the owner by telephone revealed that the dog was in good urination at 3 years 11 months post-operatively.

• Journal of the Korean Society of Radiology
• /
• v.15 no.7
• /
• pp.943-948
• /
• 2021

The purpose of this study was to investigate changes in surface dose due to increased scattering of gamma rays from patients injected with ^99mTc and ¹⁸F, which are radioactive isotopes, in close contact with materials with high atomic number such as the walls of the stable room. Prepare ^99mTc and ¹⁸F by injecting 20 and 10 mCi respectively into the NEMA phantom, and then measuring the surface dose for 60 minutes by positioning the phantom at a height of 1 m above the surface, at a distance of 0, 5 and 10 cm from the wall, and at the same location as the phantom facing the wall. Each experiment was repeated five times for reproducibility of the experiment and one way analysis of variability (ANOVA) was performed for significance testing and Tukey was used as a post-test. The study found that surface doses of 220.268, 287.121, 243.957, and 226.272 mGy were measured at ^99mTc, respectively, in the case of empty space and in the case of 0, 5 and 10 cm, while those of ¹⁸F were measured at 637.111, 724.469, 657.107, and 640.365 mGy, respectively. In order to reduce changes in surface dose depending on the patient's location while waiting, it is necessary to keep the distance from the ground or the wall where the patient is closely adhered to, or install an air mattress, etc., to prevent the scattered lines as much as possible, considering the scattered lines due to the wall etc. in future setup of the patient waiting room and safety room, and in addition to the examination, the external skin width may be reduced.

• 재활복지
• /
• v.18 no.4
• /
• pp.221-235
• /
• 2014

Recently, the frequency of stroke disease is increased due to the rapid aging population, and is contributed to the major occurrence factors of the posteriori acquired disability. This study is about an postural change device for the control of supine posture which is an assisted equipment using in daily rehabilitation process for overcoming the disability by the aftereffects of the stoke disease. In this paper, the existing domestic and Japan postural appliances is examined and its comparison and categorization is performed according to its functions and purposes. Here, in order to control the supine posture state, the design method for advanced multi functional system is proposed, which is devised to have an unified mattress control operations of combining the bedsore prevention tube with the supine posture tilting tube. And also, in addition of an smart function, it is designed to enable to perform an RF functions such as the monitoring of the present device state, the alteration of the basic position and the control of alternative floating and supine posture. This system control hardware consists of three main parts : the sensor detection part, the motor driving /control part, and the system control part for bluetooth communication. In results, we confirmed that the system designed by this research is possible to make it practical as an advanced smart postural change device combined by IoT technology in the application field of the recent IT technology.

• Journal of Korean Society of Disaster and Security
• /
• v.12 no.1
• /
• pp.23-34
• /
• 2019

It is an urgent issue to manage and reduce non-point pollution sources for improving the water quality of stream and lakes in rural areas. In this study, in order to reduce non-point pollution sources in rural area, Gabion mattresses was proposed to provide protection of riverbanks with anaerobic and aerobic area. The utilization of this was assessed by lab scale model test and pilot plant test. After filling the inside of the gabion mattresses with aggregate, the filtration zone under anaerobic and aerobic conditions was formed to treat the contaminants. In addition, vegetation was deposited on the surfae of the gabion to prevent the inflow of soil and to promote purification by the plant. COD and nitrogen content (T-N, $NH_4{^+}$, -N, $NO_3{^-}N$) were monitored in model and field tests. The lab scale model test showed removal efficiency of 17% of TCOD, 35% of SCOD, 14% of TN, 62% of $NH_4{^+}$, -N, and 33% of $NO_3{^-}$ N. Also, pilot plant test showed removal efficiency of 24% of TCOD, 29% of SCOD, 47% of TN, 50% of $NH_4{^+}-N$, 33% of $NO_3{^-}$, N and 29% of TP.

• Journal of Chest Surgery
• /
• v.40 no.11
• /
• pp.727-732
• /
• 2007

Background: The reciptents of aortic valve replacement or a Bentall operation usually display various degrees of mitral regurgitation. When deciding whether or not to correct the mitral regurgitation, one must consider its severity, underlying causes and operative risk. Recently, the operation method for correcting the concomitant mitral regurgitation has been done through aortic root to reduce the operation time and the cardiac trauma. We report our experiences that transaortic mitral valve commissuroplasty done with aortic valve replacement or a Bentall operation has been a simple, less invasive, effective method in the operative management of mitral valve regurgitation without significant organic changes. Material and Method: Between June 2002 and June 2005, twenty patients under-went mitral valve commissuroplasty via the aortic root with aortic valve replacement (n=14) or a Bentall operation (n=7). The mitral valve regurgitation of the patients didn't exceed a moderate (grade 2) degree and there was no significant organic disease. The preoperative diagnosis of MR was established by TTE and intraoperative TEE, and the patients were followed postoperatively by TTE. The operative technique was a simple anterolateral commissuroplasty of the mitral valve with a single mattress suture via the transaortic annular approach after excision of the aortic valve leaflets. Result: The mean patient age was 56.2 years and 65% (n=13) were male. The preoperative MR was mild (grade 1) in 9 (45%), mild to moderate in 8 (40%), and moderate (grade 2) in 3 (15%) patients. There were no operative mortalities. The MR improved in all patients (p=0.002) and the left ventricular ejection fraction (LV EF) improved in 14 (70%) patients (p=0.005). The mean cross-clamp time for the patients who under- went aortic valve replacement with transaortic mitral repair was $62.1{\pm}13.9 min$ and this was $137.5{\pm}7.2 min$ for the patients who underwent a Bentall operation with transaortic mitral repair. Conclusion: For selected patients without significant mitral organic disease, transaortic mitral valve commissuroplasty combined with aortic valve replacement or a Bentall operation may be a feasible, effective method without adding significant aortic cross clamping time and more cardiotomy.

• The Journal of Korean Society for Radiation Therapy
• /
• v.20 no.1
• /
• pp.37-43
• /
• 2008

Purpose: To evaluate dosimetry results of three different techniques for whole breast irradiation after conservative surgery of large pendulous breast patient. Materials and Methods: Planning computed tomography (CT) scans for three techniques were performed on a GE Hi-speed advantage CT scanner in the supine (SP), supine with breast supporting Device (SD) and prone position on a custom prone mattress (PP). Computed tomography images were acquired at 5 mm thickness. The clinical target volumes (CTV), ipsilateral lung and heart were delineated to evaluate the dose statistic, and all techniques were planned with the tangential photon beams (Pinnacle$^3$, Philips Medical System, USA). The prescribed dose was 50 Gy delivered in 25 fractions. To evaluate the dose coverage for CTV, we analysed percent volume of CTV receiving minimum of 95%, 100%, 105%, and 110% of prescription dose ($V_{95}$, $V_{100}$, $V_{105}$, and $V_{110}$) and minimal dose covering 95% ($D_{95}$) of CTV. The dosimetric comparison for heart and ipsilateral lung was analysed using the minimal dose covering 5% of each organs ($D_5$) and the volume that received >18 Gy for the heart and >20 Gy for the ipsilateral lung. Results: Target volume coverage ($V_{95}$ and $V_{100}$) was not significantly different for all technique. The V105 was lower for PP (1.2% vs. 4.4% for SP, 11.1% for SD). Minimal dose covering 95% ($D_{95}$) of target was 47.5 Gy, 47.7 Gy and 48 Gy for SP, SD and PP. The volume of ipsilateral lung received >20 Gy was 21.7%, 11.6% and 4.9% for SP, SD and PP. The volume of heart received >18 Gy was 17.0%, 16.1% and 9.8% for SP, SD and PP. Conclusion: Prone positioning of patient for large pendulous breast irradiation enables improving dose uniformity with minimal heart and lung doses.

• Magazine of the Korean Society of Agricultural Engineers
• /
• v.24 no.2
• /
• pp.49-55
• /
• 1982

The purpose of this study is to classify the factors influenced on the damages of head works suffered from the storm flood occurred on July 22 1980 in both Musim and Bochong rivers and to find out an integral counter measures against the causes influenced on the disaster of head works in the engineering aspect of planning, design, construction and maintenance. In this survey, number of samples was taken 25 head Works, and the counter measures against the causes of their disasters summarized was as follows, 1. In the aspect of planning a. As the flood water level after the establishment of head works is more increased than the level before setting of head works owing to having more gentle slope of river bed between the head works than nature slope of river bed. Number of head works should be reduced for the appropriate annexation of them b. In the place where head works is established on the curved point of levee, the destruction of levee becomes severe by the strong deflective current. Therefore the setting of head works on the curved point should be kept off as long as possible and in case of unavoidable circumstances the construction method such as reinforced concrete wall or stone wall filed with concrete and anchored bank revetments should be considered. 2. In the aspect of design a. As scoring phenomena at up stream is serious around the weir Where the concentration of strong current is present in such a place, up stream apron having impermeability should be designed to resist and prevent scoring. b. As the length of apron and protected bed is too short to prevent scoring as down stream bed, the design length should be taken somewhat more than the calculated value, but in the case the calculated length becomes too long to be profitable, a device of water cushion should be considered. c. The structure of protected river bed should be improved to make stone mesh bags fixed to apron and to have vinyl mattress laid on river bed together with the improvement for increasing the stability of stone mesh bags and preventing the sucked sand from the river bed. d. As the shortage of cut-off length, especialy in case of the cutoffs conneting both shore sides of river makes the cause of destruction of embankment and weir body, the culculation of cut-off length should be taken enough length based on seepage length. 3. In the aspect of design and constructions a. The overturing destruction of weir by piping action was based on the jet water through cracks at the construction and expansion joints. therefore the expansion joint should be designed and constructed with the insertion of water proof plate and asphalt filling, and the construction joint, with concaved shape structure and steel reinforcement. b. As the wrong design and construction of the weep holes on apron will cause water piping and weir destruction, the design and construction of filter based on the rule of filter should be kept for weep holes. c. The wrong design and construction of bank revetment caused the severe destruction of levee and weir body resulting from scoring and impulse by strong current and formation of water route behind the revetment. Therefore bank revetment should be designod and constructed with stone wall filled with concrete and anchored, or reinforced concrete wall to prevent the formation of water flow route behind the wall and to resist against the scoring and impulse of strong stream. 4. In the aspect of maintenance When the damaged parts occurred at head works the authorities and farmers concerned should find and mend them as soon as possible with mutual cooperation, and on the other hand public citizen should be guided for good use of public property.