• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.56-60
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• 2010

Purpose: Breast reconstruction with abdominal flap has many advantages. However, it might cause abdominal complications such as bulging or hernia. SIEA (Superficial inferior epigastric artery) flap is the most advanced form of abdominal flap which has no adverse effect on abdominal fascia. We report 2 cases of breast reconstruction with SIEA flap with reference review. Methods: From Jun 2006 to Jan 2009, 110 patients underwent breast reconstruction with free abdominal flap. We tried to find the SIEA in every cases and adopted SIEP flap if the diameter was larger than 1mm and it had visible pulsation. 2 patients underwent breast reconstruction with SIEA flap. After design of abdominal flap SIEA was investigated with portable Doppler. SIEA was usually found 4-5 cm lateral to the midline. Flap was elevated with SIEA and SIEV to their maximal length at hiatus. Results: There were no complications, such as infection, hematoma, and necrosis of flap. In both cases, flaps survived completely with excellent vascularity and breast reconstruction was successful. In one case, there was skin necrosis of mastectomy flap, and it was healed by conservative management. Conclusion: With the SIEA flap, donor site morbidity can be minimized along with reduction of operation time. If there is reliable SIEA, SIEA flap would be the preferred skills. However, the limitation of the SIEA flap is difficulty in identifying the SIEA. The reason for less availability of the flap in Korea might include high prevalence of the Caesarian section scar and relatively higher level of the lower margin of the flap.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권1호
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• pp.89-92
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• 2000

위 염전증은 소아에서 드믈지만 응급을 요하는 질환으로 최근 비사출성, 비담즙성 구토를 주소로 내원한 3세 환아에서 치험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대기
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• 제20권3호
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• pp.261-271
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• 2010

Carbon isotopic compositions of the YC-2 stalagmite in Yongcheon Cave were analyzed to delineate paleoclimatic variations near Korean peninsula for the past historical period. The YC-2 stalagmite is about 68 mm long and annual growth laminae are distinctively identified. Because the number of growth laminae is at least 242, the stalagmite can be estimated to be at least 241 years old. At about 15 mm from the bottom, one thick brown growth lamina is observed, and this lamina was likely to have been formed when the stalagmite ceased to grow, making the hiatus. High resolution, carbon isotope data indicate past fluctuations of East Asia monsoonal intensity (intimately related to the amount of precipitation). Based on the carbon isotope trend, the stalagmite can be divided into three stages (Stages I, II and III). The highest carbon isotopic compositions of Stage I (${\delta}^{13}C$=-3.3~0.4‰, PDB) indicate that the stalagmite grew during the Little Ice Age when cold and dry climate prevailed with less vegetation. Stage II is characterized by a transitional period from cold and dry to warm and wet climate with a increasing trend of carbon isotopic compositions (${\delta}^{13}C$=-9.6~-0.6‰) and this period indicates the weakening of the Little Ice Age climate. This decreasing trend also suggests that Little Ice Age was terminated near middle 1870's around Korean peninsula. Relatively low carbon isotopic compositions during Stage III (${\delta}^{13}C$=-11.0~-8.0‰) indicates that the climate was changed to warm and wet conditions which are similar to the present.

• The Korean Journal of Pain
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• 제10권2호
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• pp.214-219
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• 1997

Background: Epidural neural blockade with local anesthetics combined with steroids has been in clinical trials for patients with low back pain. But pain treatment of low back pain remains somewhat problematic. Many patients with low back pain have epidural fibrosis and adhesions proved with magnetic resonance imaging(MRI) examination. These findings might play an important role in the origin of back pain. Present study was aims to investigate the effect of epidural adhesiolysis in patients with low back pain. Methods: We investigated 76 patients suspected with epidural fibrosis and adhesion was suspected. Nerve pathology was demonstrated and epidural fibrosis suspected or proved with MRI examination. 17G needle specially designed by Racz was inserted at sacral hiatus and catheter was inserted untill its tip was located at lesion site under fluoroscopic guidance. Injection of contrast dye was achieved and prospected spread of agents. Injection of 0.25% bupivacaine, triamcinolone, and 10% hypertonic saline via catheter were carried out daily for 3 days. Evaluation included assessment of pain relief (Numerical Rating Scale; NRS) post-epidural adhesiolysis 3 days, 1 week, and 3 months. We also looked for complication of epidural adhesiolysis. Results: Statistical analysis(Friedman nonparametric repeated measures test and Dune's multiple comparison test) demonstrated NRS was significantly less during 3 months after epidural adhesiolysis(P<0.05). Especially, there is a extremely significance in post-epidural adhesiolysis 3 days (P<0.001). Only four patients reported any complications the most common symptom among three persistent headache but disappeared after a few months without residual sequelae. Conclusion: We conclude epidural adhesiolysis is a safe and effective method of pain therapy for low back pain with proven lumbo-sacral fibrosis and adhesion. A direct visualization by epiduroscopy may be more useful to the resulting functional changes after epidural adhesiolysis.

• 자원환경지질
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• 제37권2호
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• pp.255-267
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• 2004

북동태평양 클라리온-클리퍼톤 균열대(Clarion-Clipperton Fracture Zone) 사이에 위치한 연구지역 퇴적물의 전단강도 특성과 퇴적학적 변화요인을 파악하기위하여 연구지역 각 지점에서 다중주상시료채취기로 채취된 69개 표층퇴적물을 분석하였다. 북부지역 원양성 적점토의 평균 전단강도는 4.4kPa로 낮은 반면, 중부지역 규질 퇴적물의 평균전단강도는 6.3kPa로 가장 높다. 남부지역 탄산질 퇴적물은 3.4kPa로 가장 낮으며, 남부지역과 중부지역사이의 전이퇴적물은 3.8kPa로 탄산질 퇴적물과 규질퇴적물의 중간 값을 보인다. 원양성 적점토가 완만한 전단강도 증가를 보이는 이유는 일반적인 고화 과정에 의한 함수율 감소에 의한 결과이다. 반면에 규질퇴적물에서 나타나는 퇴적깊이에 따른 전단강도의 급격한 증가는 퇴적결층과 연관되어 있다. 탄산질 퇴적물이 가장 낮은 전단강도를 보이는 이유는 남부지역이 타 지역에 비해 퇴적율이 월등히 높기 때문이다.

• 한국임상수의학회지
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• 제18권3호
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• pp.269-272
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• 2001

Fourteen dogs referred to veterinary Medical Teaching Hospital, Seoul National University were diagnosed as esophageal foreign body (9 cases), megaesophagus (4 cases) and esophageal stricture (1 case). Patients showed a variety of clinical signs including regurgitation, vomiting, anorexia, hypersalivation, and retching. Survey radiographic examination included the entire esophagus, including the caudal pharynx and cranial abdomen. contrast radiographs were done to identify lesions or to characterize abnormal radiographic findings on survey films. In case static contrast studies were not sufficient were not sufficient to differentiate the diseases, dynamic fluoroscopic studies were performed. In thoracic megaesophagus, when gas filled, it provided several hallmark findings such as visualization of paired longus colli muscle and tracheal stripe sign. When gas-distended, the caudal thoracic esophagus was seen as a pair of thin, soft-tissue stripes that converged into a point overlying the diaphragm and cranial abdomen. All cases of megaesophagus could be solely identified by survey radiographs. In esophageal foreign body, 6 cases out of 9 patients had the history of having foreign body and others not. Most of esophageal foreign body could be diagnosed on survey radiographs and one case with radiolucent foreign body was confirmed by esophagram. It appeared as radiopaque material along the path of esophagus and the radiopacity was determined by its nature. Obstruction caused by foreign body eventually led to dilation of the esophageal lumen cranial to the site in 3 cases. In esophageal stricture, there was no remarkable findings on survey radiograph of the thorax. However, esophagography with barium sulfate showed the narrowing of the esophagus near hiatus. On fluoroscopy, swallowed barium was stagnated cranial to the site despite the esophageal peristalsis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권2호
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• pp.211-216
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• 1999

식도열공 탈장은 그 형태에 따라 진단 및 치료가 지연될 경우 반복되는 구토, 빈혈, 영양실조, 출혈, 감돈, 위궤양, 급성 위팽만 등의 합병증이 발생하여 치명적일 수 있다. 저자들은 심한 탈수와 영양 실조를 주소로 내원한 10개월 남아에서 단순 흉부촬영에서 우측 흉부 종괴로 오인되었으나 선천성 식도열공 탈장과 위의 회전에 의해 상부 위장관 바륨조영술에서 우측 흉강내에 위가 위치한 것처럼 보였던 경우로 탈장 정복술과 위식도 역류방지술을 시행한 후 상기 증상이 호전된 제 3형의 선천성 식도열공 탈장 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대기
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• 제28권4호
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• pp.415-425
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• 2018

The roles of atmospheric heating formation and distribution on the global circulation are of utmost importance, and those are directly related to not only spatial but also temporal characteristics of monsoon system. In this study, before we clarify the characteristics of apparent heat source <$Q_1$> and moisture sink <$Q_2$>, comparisons of three reanalysis datasets (NCEP2, ERA-Interim, and JRA-55) in its global or regional patterns are performed to clearly evaluate differences among datasets. Considering inter-hemispheric difference of global monsoon regions, seasonal means of June-July-August and December-January-February, which is summer (winter) and winter (summer) in the Northern (Southern) Hemisphere are employed respectively. Here we show the characteristics of eight different regional monsoon regions and find contributions of <$Q_2$> to <$Q_1$> for the regional monsoon regions. Each term in apparent heat source and moisture sink is shown to come from the ERA-Interim dataset, since the ERA-Interim could be representative of three datasets. The NCEP2 data has a different characteristic in the ratio of <$Q_2$> and <$Q_1$> because it overestimates <$Q_1$> compared to the other two different datasets. The Australia monsoon has been performing better over time, while some regional monsoons (South America, North America, and North Africa) have been showing increasing data inconsistency. In addition, the three reanalysis datasets are getting different marching with time, in particular since the early 2000s over South America, North America, and North Africa monsoon regions. The recent inconsistency among the three datasets that may be associated with the global warming hiatus remains unexplored.

• 대한소아치과학회지
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• 제36권2호
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• pp.253-261
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• 2009

치아 맹출은 나이, 성별, 인종, 시대에 따라 시기 및 순서의 차이가 있으나, 교과서에 인용되어 임상에서 사용되는 영구치 맹출 및 치근 형성에 대한 자료는 1933년 Logan과 Kronfeld가 발표한 것이므로 현재 한국 어린이의 영구치 맹출 경향과 차이가 있을 수 있다. 따라서 이번 연구의 목적은 한국 어린이의 영구치 맹출연령을 구하고, 이를 근거로 맹출순서를 알아보며, 이전 국내외 연구 자료와 비교하여 차이를 알아보는 것이다. 이에 1998년부터 2005년까지 연세대학교 치과대학병원 소아치과에 내원하여 구강검진을 시행한 E-초등학교의 어린이 중만 6세에서 만 12세의 2,619명 (남자 1,307명 여자 1,312명)의 자료를 수집하여 영구치의 맹출시기 및 순서에 대해 연구한 바 다음과 같은 결론을 얻었다. 1. 상악의 영구치 맹출시기는 중절치는 남자 만 6.81세, 여자 만 6.73세, 측절치는 남자 만7.78세, 여자 만7.65세, 견치는 남자 만10.48세, 여자 만9.92세, 제 1소구치는 남자 만9.76세, 여자 만9.63세, 제2소구치는 남자 만10.65세, 여자 만10.49세 제 1대구치는 남자 만6.39세, 여자 만6.26세, 제2대구치는 남자 만12.13세, 여자 만 12.03세로 나타났다. 2. 하악의 영구치 맹출시기는 중절치는 남녀 모두 정확한 시기의 측정은 불가능하였지만, 만 6.08세 이전에 맹출한다는 것을 추정할 수 있었고, 측절치는 남자 만6.78세 여자 만6.65세, 견치는 남자 만9.76세, 여자 만9.05세, 제1소구치는 남자 만9.82세, 여자 만9.59세, 제2소구치는 남자 만10.67세, 여자 만10.52세, 제1대구치는 남자 만6.22세, 여자 만 6.12세, 제2대구치는 남자 만11.58세, 여자 만 11.14세로 나타났다. 3. 맹출순서는 상악은 제1대구치, 중절치, 측절치, 제1소구치, 견치, 제2소구치, 제2대구치 순이었고, 하악은 중절치, 제1대구치 측절치, 견치, 제1소구치, 제2소구치 제2대구치 순이었다. 4. 모든 영구치에서 남자보다 여자가 빨리 맹출하였으며, 상악은 약 0.19세, 하악은 약 0.29세 먼저 맹출하였다. 5. 남녀 모두 상악은 측절치와 제1소구치 사이, 하악은 측절치와 견치 사이에 휴지기가 있었고. 남자의 휴지기는 상악 1.98년, 하악 2.98년, 여자는 상악 1.98년, 하악 2.40년이었다.

• Advances in pediatric surgery
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• 제17권2호
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• pp.170-178
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• 2011

Hiatal hernia is a very rare disease in the pediatric population. However information from our esophageal atresia postoperative follow-up program has hypotheses; "Hiatal hernia may more frequently occur in postoperative esophageal atresia patients (EA group) than in the general pediatric population (GP group)" and "The tension on the esophagus after esophageal anastomosis may be an important etiologic factor of hiatal hernia in EA group". To prove the first hypotheses, we compared the incidence of hiatal hernia in the GP group with the incidence in the EA group. The Incidence in the GP group was obtained from national statistic data from Statistics Korea and Health Insurance Review and Assessment Service of Korea. The incidence in the EA group was obtained from the medical record and the imaging studies of our esophageal atresia postoperative follow-up program. To prove the second hypothesis, the presumptive risk factors for the development of hiatal hernia in EA group, such as the type of esophageal atresia, degree of esophageal gap, the stage operation and the redo-operation with resection and re-anastomosis of esophagus were analyzed statistically. The total number of patients in the EA group was ninety-nine and there were 5 hiatus hernias. The incidence of EA group (5 %) is significantly higher than incidence of GP group (0.024 %). (p=0.0001) The statistical analysis of the presumptive risk factors for hiatal hernia development in EA group failed to show any evidence of correlation between postoperative esophageal tension and the hiatal hernia. This study shows that the postoperative patients with esophageal atresia have high occurrence of hiatal hernia and should be followed up carefully to detect hiatal hernia.