• Title/Summary/Keyword: Valid Reconstruction

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Is a Fast-track Critical Pathway Possible in Gastric Cancer Surgery? (위암 수술 후 조기회복을 위한 임상진료 지침서의 활용이 가능한가?)

  • Yi, Jeong-Min;Hur, Hoon;Kim, Sung-Keun;Song, Kyo-Young;Chin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.18-25
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    • 2009
  • Purpose: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. Materials and Methods: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. Results: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. Conclusion: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.

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A Study of the Impractical Area and Boundary of an Outer Royal Garden "Hamchunwon" Attached to Gyeonghuigung Palace (경희궁 별원(別苑) 함춘원의 실지(實地) 경역 고찰)

  • Jung, Woo-Jin;Hong, Hyeon-Do;So, Hyun-Su
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.40 no.1
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    • pp.26-42
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    • 2022
  • The purpose of this study is to examine and understand the area and the original outer boundaries of Hamchunwon(含春苑), which was the outer royal garden of Gyeonghuigung Palace, which existed before the site of the Russian legation. The results of the study are as follows. First, examining the 3 types of drawings prepared for securing the Russian legation's site and constructing a new building, it was confirmed that two low peaks, which appear to be the original terrain of Hamchunwon, existed in the north and south directions inside the site. According to the initial plan of the of the legation's site, it appears that the entrance of the legation building is connected to the Saemunan-ro in the northwest. However, according to the report made at the time when the Russian temporary minister Veber purchased the legation's site, it was recorded that the site already had a narrow entrance and a dirt road in place, and hence, it was connected to Saemunan-ro. This fact makes it possible to learn that the line of movement for officials and the original gate were located to the northwest of the site planned as the entrance of the legation building towards Hamchunwon. Second, the site was created by cutting the top of the high hill at the time of the construction of the legation building, and as a result, a two tiered staircase typed terrace was built. The ground on which the main building and the secretary's building, etc., were erected was made by cutting the highest peak and solidifying it flat, and a large quantity of soil was used for grading. In the case of the northern area of the main building, the traces of leveling the terrain by cutting the mountains are apparent, and an observation typed garden with a walking path and pavilion was formed by utilizing the physical environment equipped with an easy view. This may be considered as a use which is consistent with the topographical conditions of creating an outer royal garden to block the civilian views on a high terrain overlooking the palace. Third, Hamchunwon's fences were partially exposed in the photos from the 1880s through the 1890s, which demonstrate the spatial changes made around the US, UK, and the Russian legations. As a result of the photo analysis performed, Hamchunwon occupies the northern area of the Russian legation's site, and it is estimated that the north, west, and east walls of the legation resembled those of Hamchunwon. The area to the south of the Russian legation was originally a place made available for civilian houses, and it was possible to examine the circumstances of purchasing dozens of civilian houses and farmlands according to various materials. Fourth, Hamchunwon, which was formed as the outer royal garden of Gyeongdeokgung Palace of Lord Gwanghaegun, lost its sense of place as an outer royal garden when the entire building of Gyeonghuigung Palace was torn down and used as a construction members during the reconstruction of Gyeongbokgung Palace, and faded away as the site was sold to Russia around 1885. The area where Hamchunwon used to be located transformed into a core space of the Russian legation where the main building and garden were located after the construction of the new building. Hence, Hamchunwon, which was limited to the northern area of the Russian legation, does not carry the temporal and spatial context with Gyeongungung Palace and Seonwonjeon which were constructed after 1897, and it is determined that the view of Seonwonjeon as Baehoorim or Baegyeongrim is not valid.