• Archives of Reconstructive Microsurgery
• /
• v.17 no.1
• /
• pp.19-27
• /
• 2008

Purpose: Microvascular reconstructive surgery has become an integral part of the treatment of head and neck cancer patients. This review of 121 free flaps for head and neck cancer patients performed over the last 11 years was done to evaluate circulatory crisis, salvage, and secondary reconstruction and to investigate which factors may contribute to these rates. Method: Nine emergent explorations among 121 head and neck reconstruction with free flaps were reviewed to analyze detection of vascular crisis, the time interval from detection of circulatory crisis to exploration, operation procedures and results, and secondary reconstructions. Emergent exploration was done with our protocol. Result: Nine free flaps exhibited signs of vascular problems between 1 day and 6 days postoperatively. The emergent exploration rate of this series was 7.4% (9/121). The salvage rate was 55.6% (5/9), giving an overall flap viability of 96.7% (117/121). In our study, preoperative radiation therapy, positive smoking history, alcohol consumption history, combined disease such as diabetes mellitus and hypertension, recipient vessels and types of vascular anastomosis were not related to the causes of circulatory crisis. The mean time interval between the onset of clinical recognition of impaired flap perfusion and re-exploration of the salvaged 5 flaps was 3.2 hours, that of failed 4 flaps was 11.25 hours. Conclusion: Despite high overall success rate, relatively low salvage rate may be attributed to late detection of circulatory crisis and in long time interval between detection and exploration. We conclude that early detection of circulatory crisis and expeditious re-exploration are a matter of great importance for the success of salvage operation.

• Journal of Chest Surgery
• /
• v.5 no.1
• /
• pp.19-24
• /
• 1972

The recent development of cardiovascular surgery as well as aortoarteriogaphy has been established excellent operative result with great aid of limb-salvage. However, less consideration or less experience still exists on the regard of vascular accident and vascular disease, as well as vascular surgery in Korea. During the last 13 years, we experienced only two cases of aorto-iliac occlusion,acute and chronic, regardless of having had more than 300 cases of mitral valvotomy and gradual increasing tendency of arteriosclerosis and hypertension in Korea. Therefore it is noteworthy to report the cases in order to promote the consideration for vascular surgery. Case 1; 52 year old female who had 20 years history of mitral stenosis with uricular fibrillation and received medical treatment for recent 1 year in the medical department. 10 days before admission, acute saddle emboli developed and 15 days after the onset, embolectomy through both common femoral arteries on the groin and abdominal approach was made. The progression of emboll to the right popliteal bifurcation was found by arteriography on operating table and retrograde flushing with heparin solution by the polyethylene catheter inserted through posterior tibial artery. The operation was successful, but 9 hours after operation sudden death occurred. Considering this case, first, mitral valvotomy already before might prevent peripheral embolizatlon, secondarily, the more early detection and surgery might also prevent the progression of emboli. Thirdly, although preoperative or postoperatlve heparinization is controversial for mitraI stenosis, heparinization might prevent additional emboli to vital organs in this case Cases 2; 66 year old female who had 4 years history of left hip and calf intermittent claudication and has had rest pain, inability to walk and ischemic necrosis on the the left leg since last 3 months prior to admission to the orthopedic department under the suspicion of herniated disc. Absence of pulsation on the groin and aortography evidenced aortoillac occlusion predominantly on the left side. Thromboendarterectomy was made and the operative result was successful with absence of claudication, healing of ulcer and aortographic patency of occlusive site. This chronic occlusion is considered to result from arteriosclerosis in origin with the evidence of moderate hypertension, x-ray evidence of calcified plaque on the aortic knob and operative finding of palpable plaques.

• Archives of Plastic Surgery
• /
• v.38 no.4
• /
• pp.531-534
• /
• 2011

Purpose: The rectus abdominis myocutaneous flap is currently the most commonly used donor site of immediate and delayed breast reconstruction surgery, for its versatility and ease of handling, as well as sufficient blood supply. Despite many advantages of rectus abdominis flap, morbidity of donor site is considered as inevitable shortcoming. The authors recently faced a devastating complication, small bowel obstruction that led to strangulation, after delayed breast reconstruction with free transverses rectus abdominis myocutaneous (TRAM) flap. And we would like to report it, because abdominal pain after TRAM flap is a common symptom and can be overlooked easily. Methods: A 56-year-old female patient who had history of receiving total abdominal hysterectomy 20 years ago underwent delayed breast reconstruction with TRAM flap transfer. She complained abdominal discomfort and pain from third postoperative day, postoperative small bowel obstruction that arose from strangulated bowel and prompt emergency operation was done. Results: After resection of the strangulated bowel and reanastomosis, quickly her symptoms were relieved, and there were no further problems during her hospital stay. 7 days after her emergency operation she was discharged. Conclusion: In patients with previous abdominal surgical history, prolonged ileus can lead to bowel strangulation, so surgeons should always consider the possibility, and must be aware of abdominal symptoms in patients who receive free TRAM flap operations.

• Journal of the Korean Institute of Traditional Landscape Architecture
• /
• v.30 no.1
• /
• pp.103-112
• /
• 2012

This study aims at assessment of local festivals focused on analysis of operation program for local festivals held in Jeonbuk province. The subjects were 65 local festivals held in Jeonbuk in 2010 excluding festivals held in province, county, and town level, and those held with single purpose. Type of festivals were classified to type for residents' unity, tourism, industry, and special purpose type. The portion was industry type 36.9%, type for residents' unity 23.1% in the order. By theme, animal, plant, nature phenomenon, history, culture and tradition, special product, regional industry were classified - the portion was special product 36.9%, culture and tradition 24.6%, history 13.8%. Assessment of operation program was conducted with assessment indexes such as compliance with theme, uniqueness, diversity, effect of experience, size, educational effect, and entertainment. As a result, it appeared that because local festivals of Jeonbuk had high uniqueness, duplication of program between local festivals was very low and educational effect was comparatively high. On the other hand, because entertainment and effect of experience was very low, considerations of entertainment and effect of experience are necessary in planning of program.

• Archives of Craniofacial Surgery
• /
• v.11 no.1
• /
• pp.7-12
• /
• 2010

Purpose: 'White-eye blowout' fracture is often occur in young patients and defined as blow out fracture with little or no clinical sign of soft tissue trauma such as edema, ecchymosis, but with marked motility restrictions in vertical gaze. In this conditions, immediate operation is essential. We reported the clinical investigation study of these cases about clinical symptoms and radiologic findings and introduce our experiences about immediate operations in 'white-eye blowout' fractures. Methods: From January 2008 to December 2009, nine pediatric patients who were diagnosed as pure white-eye blowout fractures were involved this study. Patients with other facial bone fractures or with poor general medical condition were excluded. In all cases, we performed immediate operation within 48 hours. Results: All patients had diplopia, vertical gaze restriction or systemic symptoms. Six patients had nausea, vomiting and syncope caused by oculocardiac reflex. In all patients, preoperative symptoms were improved after immediate operation. There were no postoperative complications such as infection, hematoma or wound dehiscence. Conclusion: When we meet the young patients with history of periocular trauma, with little or no soft tissue trauma signs, but with marked vertical gaze restriction or general symptoms caused by oculocardiac reflex, we should immediately examine by facial bone computed tomography and refer the patient to ophthalmologist for ophthalmic evaluations. If patient is diagnosed as orbital floor fracture with entrapped muscle or soft tissue, the earlier surgical reduction get better clinical outcomes.

• The Journal of The Korea Institute of Intelligent Transport Systems
• /
• v.16 no.6
• /
• pp.112-123
• /
• 2017

The accurate forecasting of the public transportation's transit and arrival time has become increasingly important as more people use buses and subways instead of personal vehicles under the government's public transportation promotion policy. Using bus management system (BMS) data, which provide information on the real-time bus location, operation interval, and operation history, it is now possible to analyze the bus schedule reliability. However, the punctuality should always be considered together with the operation safety. Therefore, this study suggests a new methodology to secure both reliability and safety using the BMS data. Unlike other studies, we calculated the bus travel time between two bus stops by dividing the total travel length into 6 sections using 5 different measuring points. In addition, the optimal travel time for each bus route was proposed by analyzing the mean, standard deviation and coefficient of variation of the each section's measurement. This will ensure the reliability, safety and mobility of the bus operation.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.11 no.7
• /
• pp.2491-2496
• /
• 2010

The DFA(detrended fluctuation analysis) which is included the correlation property of the EEG is used to analysis the depth of anesthesia. We studied ASA I or II adult patients supported by the society of anesthesiologists. Patients with history of dementia and neurological disorder are excluded. Average age is $48.9{\pm}10.9$ old, average weight is $57.1{\pm}8.2$ kg and average hight is $158{\pm}6.6$cm of the patients under the operation. Anesthesia medicine is Sevoflurane and the stages of anesthesia are 6 stages, that is pre-operation, induction, right after induction, stop the medicine and post-operation. Among the scaling exponent ${\alpha}1$, ${\alpha}2$, ${\alpha}3$ we know that ${\alpha}1$, ${\alpha}3$, were well appeared to discriminate pre-operation, induction, right after induction, stop the medicine and post-operation. So we confirmed that the parameters is useful to the depth of anesthesia.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.2
• /
• pp.321-328
• /
• 1997

Background : we have evaluated the association of age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases with postoperative pulmonary complications and identified which parameter of preoperative spirometry was a predictor of postoperative pulmonary complications. Method : In 270 patients older than 60 years, the postoperative pulmonary complications were evaluated according to age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases and the parameters of preoperative spirometry were analyzed. Results : The postoperative pulmonary complications rates were significant higher among patients older than 70 years, and among those with previous chronic pulmonary diseases or their smoking history. The pulmonary complications were increased among patients with general anesthesia or duration of surgery more than 2 hours. The pulmonary complications rates did not differ according to sex, type of operation. The patients with hypercarbia($PaCO_2$ > 45mmHg) have more increased postoperative complications. The preoperative FEV1 less than $1\;{\ell}$, FVC, MMEFR & MVV less than 50% of predicted respectively were predictive of complications. Conclusion : Age $\geq$ 70, history of smoking,duration of operation more than 2 hours, general anesthesia, previous chronic pulmonary disease and hypercarbia ($\geq$45mmHg) on preoperative arterial blood gas analysis were predictive of pulmonary complications. Among the parameters of spirometry, FEV1, FVC, MMEFR and MVV were indicator of predicting postoperative pulmonary complications.

• Journal of architectural history
• /
• v.12 no.3
• /
• pp.87-100
• /
• 2003

This study is on the construction of government office of Dongnaebu through researching the construction reports and historical documents in 19century. Especially it focuses on the local construction system and operation for the government office. Main contents of the study are 1) Scope and process of construction, 2) Architectural administration and official notes, 3) Organization of participants and the feature, 4) Felling trees and transport, 5) Monetary of construction The results are summarized as follows. 1) Repair office customary were the courtesy new provincial man. Government building were inspected and repaired periodically. 2) Administrative system of construction have been operated. There are official notes which are about application, permition and order, concerned works such as logging at the bongsan, means of transport, paying wages and progressing works. 3) Organization of construction was made up of an officer and sangnee to supervise and supply. 4) Due to financial difficulty, local government reserved and appropriated funds with moneylending for building office.

• Journal of Environmental Science International
• /
• v.17 no.1
• /
• pp.119-128
• /
• 2008

Laboratory analytical results of 22 sets of hydrophobic adsorbent coils containing surface soil-vapor and two soil samples collected by conventional intrusive method from each boring location at two active dry cleaning facilities in the State of Illinois, U.S.A, were presented to evaluate the performance of soil-vapor survey. The most critical factor to determine the effectiveness of soil-vapor survey is the distance from the soil-vapor sampling device to the actual contamination, which is a function of soil porosity, permeability, primary lithology, and other geological and hydrogeological site-specific parameters. Also this factor can be affected by the history of contaminant-generating operations. The laboratory analytical results in this study showed longer dry cleaning operation history (i.e., 50 years) and presence of fine sand at the beneath Site B allow the contaminants to migrate farther and deeper over a fixed time compared to Site A(i.e., 35 years and silty clay) so that the soil-vapor survey is not likely the most effective environmental site investigation method alone for Site B. However, for Site A, the soil-vapor survey successfully screened the site to identify the location reporting the highest soil concentration of chlorinated solvents.