• 제목/요약/키워드: drainage ratio

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Effect of a Needle Aspiration in Patients with Lymphedema (암 수술 후 발생한 림프부종 환자의 바늘 흡인술 효과)

  • Yang, Gu-Hwan;Kwak, Sung-Wook;Kim, Sun-Hyn;Shin, Young-Tae;Hwang, Hee-Jin;Park, No-Hyeok;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.27-31
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    • 2009
  • Purpose: Lymphedemas are tissue fluid swellings, usually on the arms or legs, and occur as a result of impaired lymphatic drainage. Presently, the most effective treatment available is complete decongestive physiotherapy (CDP). However, this therapy is ineffective in some patients and surgery may be indicated. Herein, we examined the efficacy of minimally invasive needle aspiration of the most enlarged areas in hypodermic adipose tissues, of patients who had failed CDP. Methods: We included 21 patients who were diagnosed with lymphedema stage II-III in the upper or lower extremities and visited the lymphedema clinic at a university hospital from September 1, 2003 to February 28, 2004. All patients had been treated with CDP at least once, but had failed to respond to the therapy for more than one year. Nine patients had breast cancer and 12 had cervical cancer. We identified the area with the most severe edema by using MRI and performed a 16-gauge angio-needle aspiration on the area. The patients were followed up for 3 months. Effectiveness of the treatment was evaluated by comparing the volume of edema before and after the treatment using Wilcoxon signed rank-test. Results: The mean reduction ratio of the volume of edema comparison normal volume was 41.1${\pm}$35.3% (P=0.001). There were no major or minor operative complications except localized hemorrhage. Conclusion: We conclude that a needle aspiration prior to other surgical treatments is relatively safe and effective for those patients who are unresponsive to CDP.

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Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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Clinical Experiences of Cardiac Surgery Using Minimal Incision (소절개선을 이용한 심장수술의 임상고찰)

  • Kim, Kwang-Ho;Kim, Joung-Taek;Lee, Seo-Won;Kim, Hae-Sook;Lim, Hyun-Kung;Lee, Choon-Soo;Sun, Kyung
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.373-378
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    • 1999
  • Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

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A review of factors that regulate extracellular enzyme activity in wetland soils (습지 토양 내 체외효소 활성도를 조절하는 인자에 대한 고찰)

  • Kim, Haryun
    • Korean Journal of Microbiology
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    • v.51 no.2
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    • pp.97-107
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    • 2015
  • Wetlands constitute a transitional zone between terrestrial and aquatic ecosystems and have unique characteristics such as frequent inundation, inflow of nutrients from terrestrial ecosystems, presence of plants adapted to grow in water, and soil that is occasionally oxygen deficient due to saturation. These characteristics and the presence of vegetation determine physical and chemical properties that affect decomposition rates of organic matter (OM). Decomposition of OM is associated with activities of various extracellular enzymes (EE) produced by bacteria and fungi. Extracellular enzymes convert macromolecules to simple compounds such as labile organic carbon (C), nitrogen (N), phosphorus (P), and sulfur (S) that can be easily taken up by microbes and plants. Therefore, the enzymatic approach is helpful to understand the decomposition rates of OM and nutrient cycling in wetland soils. This paper reviews the physical and biogeochemical factors that regulate extracellular enzyme activities (EEa) in wetland soils, including those of ${\beta}$-glucosidase, ${\beta}$-N-acetylglucosaminidase, phosphatase, arylsulfatase, and phenol oxidase that decompose organic matter and release C, N, P, and S nutrients for microbial and plant growths. Effects of pH, water table, and particle size of OM on EEa were not significantly different among sites, whereas the influence of temperature on EEa varied depending on microbial acclimation to extreme temperatures. Addition of C, N, or P affected EEa differently depending on the nutrient state, C:N ratio, limiting factors, and types of enzymes of wetland soils. Substrate quality influenced EEa more significantly than did other factors. Also, drainage of wetland and increased temperature due to global climate change can stimulate phenol oxidase activity, and anthropogenic N deposition can enhance the hydrolytic EEa; these effects increase OM decomposition rates and emissions of $CO_2$ and $CH_4$ from wetland systems. The researches on the relationship between microbial structures and EE functions, and environmental factors controlling EEa can be helpful to manipulate wetland ecosystems for treating pollutants and to monitor wetland ecosystem services.

A Study on the Methodology of Land-Consolidation Sloping Paddies in land Vallry for the Farm-Mechanization (II) (기계화를 전제로 한 산간경사지답경지정리방안에 관한 연구(II))

  • Hwang, Eun
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.24 no.4
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    • pp.57-68
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    • 1982
  • The paddy fiels slope located in Kangweon province Hwyongsung gun Gonggeun myon Shinchonri was considerably steep and so it was impossible to economically consolidate the field up to date. But for the porpose of farm mechanization, the field (32. 27ha) was consolidated by the auther under the assitance of the Ministry of Agriculture and Fishery and,;the Administration of Kangweon province. This paddy field consolidation was caused by the treatise on "Land-consolidation methods for farm mechanization in the steep-sloped paddy field", of which the auther is the same. The constrution was carried out from September, 1981 to April, 1982. During the 4esign and construction, some Peculiarities were found and discussed. That is, in design, besides the common condititions for a design, some special conditions were considered and written below; (1) The ranges of field slope in this design were 1/100-1/30. (2) Long sides of the land readjustment blocks must be arranged abreast contour line, and so they make the amount of cutting and banking decreased so as to take the maximum advantage of the configuration of the field. (3) In design, the main principles of dividing blocks were written below; i) First of all, long side of a block should be drawn straight abreast a contour line. ii) Long side of a block should arrange abreast contour line and make its length 100-150m, if not, l)reak the side in order to make a bended rectangle. iii) Length of a short side should be determinded within differences of elevation (0.6 -1. 2m) between the two adjacent blocks toward the normal to a contour line. iv) Length of a short side should be above 15m and the ratio of long and short side should be slso kept 1: (4-6). v) A new field surface leveling was determinded from the elevation which produce the least amount of cuttingand banking within the range of 0.6-1. 2m diffe rences of elevation between the two adjacent blocks. vi) In the course of dividing blocks with the same width along the line which was normal to a contour line, all blocks connot keep their shape in a retangle because of steep slope of the field and so on, and so it was also necessory to make some non-retanglar and small blocks such as a trianglar or trapezoidal shape, which was impossible to use some of farm machinery. But because this non-rectanglar and small blocks were divided, larger and many rectanglar blocks can be divided and construction cost can also be lowered. According to the conditions discussed above, the paddy field consolidation project designed and constructed. And the results of this study were obtained as below; (1) Three-forth of total cost of this paddy field consolidation was not construction cost, and these cost consist of land grading (1/4), road and canal construction cost (1/4) and the other cost (1/4) such as surveying or materials and 56 on. (2) The steeper the land slope, the greater cost was assigned for road and canal construction, and than land grading. (3) Curtailment of the road and canal construction cost depended on simplificating their strutures. (4) In the case of the land slopes were low, the land grading cost was high by 1: 1.4 in comparison with the road and canal construction cost, and conversely when the slops were steep, the road and canal construction cost was high by 1 : 5 in compa- rison with the land grading cost. (5) The densities of irrigation canal, drainage canal and trunk and branch road were 150. Sm/ha, 60. im/ha and 17. 4m/ha respectively. The density of irrigation canal of the area was high by 2 times in comparison with the average one of Kangweon Province, and the others were nearly the same. (6) Most farmers (above 85%) knew the effects of paddy field consolidation. The effects are; 1) Improvement of irrigation 2) Improvement of farm management 3) Improvement of transportarion 4) farm mechanization and 5) grouping of the scattered land. And the more farm modernization was accomplished by these projects, the more farmers wanted to live in their land. (7) In spite of the very steep sloped paddy field, the diminution rate of the net farm land caused by consolidation was 7.7% which was nearly the same as the one of Chulweon plain of Kangweon province. Land grading cost was 971, OOOwon/ha which was rather cheap by 13.2% than the one of Ghulweon plain, and unit construction cost was 5, 341, OOOwon/ha (included soil addition) which was also nearly the same as the one of Chulweon plain and FNFIA (The federation of national farmland improvement association).

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Interpretation of Soil Catena for Agricultural Soils derived from Sedimentary Rocks (퇴적암 유래 농경지 토양에 대한 카테나 해석)

  • SONN, Yeon-Kyu;LEE, Dong-Sung;KIM, Keun-Tae;HYUN, Byung-Keun;JUN, Hye-Weon;JEON, Sang-Ho
    • Journal of the Korean Association of Geographic Information Studies
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    • v.20 no.4
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    • pp.1-14
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    • 2017
  • In Korea, the soil series derived from sedimentary rocks are classified into seven soil series of coarse loamy soil such as Dain, Danbug, Dongam, Imdong, Jeomgog, Maryeong, and Yonggog; seventeen soil series of fine loamy soil such as Angye, Anmi, Banho, Bigog, Deoggog, Dogye, Dojeon, Gamgog, Gugog, Jincheon, Maji, Mungyeong, Oggye, Samam, Yanggog, Yeongwol, and Yulgog; six soil series of fine silty soil such as Goryeong, Bonggog, Juggog, Gyeongsan, Yuga, and Yugog; and four soil series of clayey soil such as Mitan, Pyeongan, Pyeongjeon, and Uji. All thirty-four soil series have different drainage rates and topography. However, the soil texture depends on the parent rock. The buffer functions in GIS (Geographic Information System) techniques were used to calculate adjacent soil series from a soil series. The length of the adjacent soil series was adjusted because a side of the buffer area was one meter long. The cluster analysis was conducted using the CCC (Cubic Clustering Criterion) method, in which the number of clusters is calculated based on the individual soil series ratio. Soil survey has been carried out since 1964 as "The reconnaissance soil survey", and 1:5,000 detailed soil survey was completed in 1999 with a five-years plan in Korea. Today, all the soil survey information has been computerized. GIS techniques were used to establish a digital soil map; however, there have not been any studies to interpret pedogenesis using the GIS technique. In this study, the area of the adjacent soil series were obtained using the GIS technique. The area of the adjacent soil series can be calculated based on the information area. The similarities of soil originated from sedimentary rocks were estimated using the length. As a result, the distribution of grain size was different based on the types of sedimentary rocks and the location. The clusters were distinguished into limestone, sandstone, and shale. In addition, the soil derived from shale was divided into red shale and gray shale. This means that quantitative interpretation of the catena and this established method can be used to interpret the relationship between soil series.

A Experimental Study on Exclusion Ability of Riprap into Bypass Pipe (저층수 배사관 내 유입된 사석 배출능력에 대한 연구)

  • Jeong, Seok Il;Lee, Seung Oh
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.37 no.1
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    • pp.239-246
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    • 2017
  • There are various transversal structures (small dams or drop structures) in median and small streams in Korea. Most of them are concrete structures and it is so hard to exclude low-level water. Unless drainage valves and/or gates would not be installed near bottom of bed, sediment from upstream should be deposited and also contaminants attached to the sediments would devastatingly threaten the water quality and ecosystem. One of countermeasures for such problem is the bypass pipe installed underneath the transversal structure. However, there is still issued whether it would be workable if the gravels and/or stones would roll into and be not excluded. Therefore, in this study, the conditions to exclude the rip stone which enter into the bypass pipe was reviewed. Based on sediment transport phenomenon, the behavior of stones was investigated with the concepts from the critical shear stress of sediment and d'Alembert principle. As final results, the basis condition (${\tau}_c{^*}$) was derived using the Lagrangian description since the stones are in the moving state, not in the stationary state. From hydraulic experiments the relative velocity could be obtained. In order to minimize the scale effect, the extra wide channel of 5.0 m wide and 1.0 m high was constructed and the experimental stones were fully spherical ones. Experimental results showed that the ratio of flow velocity to spherical particle velocity was measured between 0.5 and 0.7, and this result was substituted into the suggested equation to identify the critical condition wether the stones were excluded. Regimes about the exclusion of stone in bypass pipe were divided into three types according to particle Reynolds number ($Re_p$) and dimensionless critical shear force (${\tau}_c{^*}$) - exclusion section, probabilistic exclusion section, no exclusion section. Results from this study would be useful and essential information for bypass pipe design in transveral structures.

Patient's Selection for Extracorporeal Shock Wave Lithotripsy for Treatment of Common Bile Duct Stones Resistant to Endoscopic Extraction (체외충격파쇄석술 적용을 위한 총담관결석의 선택)

  • Lee, Won-Hong;Son, Soon-Yong;Kim, Chang-Bok;Park, Cheon-Kyoo;Kang, Seong-Ho;Ryu, Meung-Sun;Lee, Yong-Moon
    • Journal of radiological science and technology
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    • v.28 no.2
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    • pp.105-110
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    • 2005
  • Background/Aim : Common bile duct (CBD) stones may cause jaundice, cholangitis, or pancreatitis. Extracorporeal shock wave lithotripsy (ESWL) may be needed whenever endoscopic procedure are failed to extract common bile duct stones. The aim of this study is to provide the standard for patient's best choice on ESWL for treatment of CBD stones resistant to endoscopic extraction. Materials and Methods : Fourty-six patients failed in endoscopic stone extraction including mechanical lithotripsy were treated by ESWL. In all patients, endoscopic sphincterotomy and nasobiliary drainage tube was done before ESWL using the ultrasonography for stone localization with a spark-gap type lithotriptor. Patients were sedated with an intravenous injection of 50 mg of Demerol. None were treated under general anesthesia. Results : Overall complete clearance rate of CBD stone was 89.1% (41/46). In 82.6% of the patients, the stones were extracted endoscopically after ESWL, and spontaneous passage was observed in 6.5%. In the clearance rate after ESWL, there were no noticeable differences with regard to number (single: 82.8%, two or three: 100%, more than three: 100%) and size of the stone (less than 33mm: 92.9%, 33 mm or larger: 83.3%), whereas there were significant differences with regard to the ratio of sum of long-axis length of the all stones to sum of long-axis length of the CBD excluding stone (1:2.4, 1:2.1) and diameter of the largest stone to diameter of CBD excluding stone (1:0.9, 1:0.4) for patients with complete clearance compared with those without. Conclusion : We propose that stones without the fragments are travelable sufficient space in CBD or extractable sufficient diameter of CBD regardless of stone size and number should be treated by other technique to prevent time and cost consuming, such as percutaneous transhepatic cholangioscopylithotomy.

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A Study on the Valley Shapes with Different Parent Rocks in Yeongnam Area (영남지역(嶺南地域) 주요(主要) 모암별(母岩別) 곡간(谷間)의 특성(特性)에 관한 연구(硏究))

  • Yun, Eul-Soo;Jung, Yeun-Tae;Kim, Min-Tae;Jung, Ki-Yuol
    • Korean Journal of Soil Science and Fertilizer
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    • v.33 no.3
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    • pp.139-144
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    • 2000
  • This study was conducted to obtain the basic information to increase the practical use of soil survey data through the subdividing of valley shapes with soil sequences due to different parent rocks, and to study the relationship between the valley shapes and parent rock. The various rocks such as sedimentary(gray shale and sand stone) and igneous rocks(granite, granite gneiss and andesite porphyry) which are the major parent rocks in Yeongnam area were investigated. The characteristics of valleys formed and the kinds of soils derived from different rocks were analysed by using aerial photographs and topographical maps scaled 1:5,000. The rill density in igneous rock area was as high as 40. But the rill bifurcation ratio of first order stream was higher in the sedimentary than the igneous rocks except granite area. The mean slope of valleys in igneous areas was about 8%, which was higher than that of the sedimentary areas. The variability of valley width in the complexly metamorphosed rock, such as granite gneiss, and andesite porphyry, was greater than in sedimentary and in granite rocks. Based on the variability of valley widths and valley slopes, it was possible to classify the valleys into two types. The "Uterus-shaped valleys" had wide variability of valley width and were located in the areas of granite gneiss and andesite porphry rocks. while the "Roots-shaped valleys" had narrow variability of valley width and were located in the sedimentary areas. "Uterus-shaped valleys" were typified by having land forms of mountain foot slopes and alluvial fans, and the soil drainage sequences also had complexities. So that, we concluded that the variability of valley width and valley slopes was associated with kinds of parent rocks and metamorphism which influences soil sequence and characteristics.

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Fish Community Characteristics and Habitat Aspects of Endangered Species, Rhodeus pseudosericeus in Heuk Stream, a Tributary of the Han River Drainage System (한강지류 흑천의 어류군집 특성 및 멸종위기종 한강납줄개의 서식양상)

  • Ko, Myeong-Hun;Myung, Ra-Yeon;Kim, Hyeong-Su
    • Korean Journal of Environment and Ecology
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    • v.33 no.3
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    • pp.266-279
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    • 2019
  • We investigated the characteristics of fish communities and habitat status of endangered species Rhodeus pseudosericeus in Heuk Stream, a tributary of the Han River, from April to October 2018. During this period, we collected 47 species of 14 families from 10 survey stations using kick nets, cast nets, and long bag set nets. The dominant and subdominant species were Zacco platypus (37.6%) and Z. koreanus (13.8%), respectively. The next most abundant species were Squalidus gracilis majimae (11.1%), Pungtungia herzi (7.7%), Rhodeus pseudosericeus (5.0%), Microphysogobio yaluensis (4.3%), and Hemibarbus longirostris (3.0%). Among the fish collected, 19 species (40.4%) were Korean endemic species. Endangered species were R. pseudosericeus and Acheilognathus signifer while exotic species were Micropterus salmoides and Oncorhynchus mykiss, and land-locked species were Plecoglossus altivelis and Rhinogobius brunneus. The community analysis showed that the dominance and evenness indexes were mostly low and that the diversity and richness indexes were high. Moreover, the river health (index of biological integrity) was mostly excllent (1 site is good, 9 sites are very good). R. pseudosericeus inhabited widely from St. 3 to St. 9 in Heuk Stream, and its population size was large. Age groups for R. pseudosericeus estimated by the frequency distribution of total length in spawning season (April) indicated the 32~45 mm group as 1-year old, the 46~59 mm group as 2-years old, 60~69 mm group as 3-years old, and the 70~89 mm group as 4-years or older. Total length range of male and female was similar, and the sex ratio of female (426) to male (394) was 1 : 0.95. A. signifer, which had been released in Heuk Stream, inhabited from St. 4 to St. 5, but its population size was small. Lastly, this paper discusses a conservation plan for fish in Heuk Stream.